Feature Story

FIREHOUSE OUTSOURCES AMBULANCE SERVICE

The ambulance operator program at the La Habra, Calif. fire department is saving the department money and providing firehouse experience for young fire academy graduates. Begun in 1995, the program employs six full-time and eight 12 part-time ambulance operators; many of the department's new firefighters began in the ambulance operator program.

As in many cities, the La Habra fire department used private ambulances to transport ill or injured persons to area hospitals. Supplies used in the field by paramedics would be restocked by the hospital, and the patient would be billed.

But recently, insurance companies determined that the practice constituted third-party billing and had to be ended. The department could contract with a private ambulance company that would reimburse the department for supplies used, or it could start its own ambulance program that would allow the department to recoup the cost of supplies from the hospital.

La Habra officials thought the city could provide cost-efficient care with its own transport services and started the ambulance operator program. The department employs the ambulance operators through Employment Systems, Inc., San Diego. The outsourcing company functions "almost like a temp agency," according to La Habra Fire Chief Michael McGroarty. The department also selects the operators and pays the company, which then pays the ambulance operators' salaries and benefits.

However, La Habra's ambulance operators are not professional ambulance drivers, they are fire academy graduates. To be eligible to work for the city's ambulance service, they must have California state Firefighter One qualifications, EMT training and the necessary physical abilities.

Whenever a fire truck goes on a call, an ambulance accompanies it. The ambulance operators keep the same schedule as the firefighters. They go through training exercises; help maintain the vehicles and fire station; stock supplies; check first aid stations around the city; participate in EMS training; and assist at an emergency by helping the injured, managing equipment or refilling oxygen tanks for regular firefighters. They can do everything except enter hazardous areas or actually fight the fire.

The ambulance operator program allows participants to gain experience in a firehouse while they look for full-time firefighting positions. According to McGroarty, California has an overabundance of firefighters, with up to 1,000 qualified candidates for each opening. Most of the department's new firefighters start as ambulance drivers, who are eligible to work for up to three years as drivers while they pursue full-time firefighter positions, he adds.

The ambulance operator program has been successful and cost-effective, McGroarty says. "Delivering emergency medical services and ambulance transportation directly under fire department direction and authority has greatly enhanced our ability to serve our community and provide essential pre-hospital care at a more reasonable and economical cost," he says. "We have created a premium customer service that is flexible, pays for itself entirely, and is not a burden on the general fund budget."

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