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A Partnership of EMS and FD

Many of us can remember watching Johnny and Roy (EMERGENCY) as paramedics in a California based fire station. While it certainly wasn’t an unreal vision, even today, in some areas of our country, the incidence of combined departments is relatively low. In New York State, combined departments are currently in the minority. A few (volunteer) fire services that USED to offer EMS were unable to recoup the costs of running an ambulance and unable to get enough reimbursement through their local municipal taxes; however a new bill, passed just this past year will allow fire departments to engage in cost recovery (billing) for their provided ambulance services.

Citing affordability for all departments, one of the NYS lawmakers who pushed for the EMS Cost Recovery Act, Senator Brooks, said, “Emergency medical services are more important than ever right now, and ensuring that there is widespread access to these services is key in maintaining the public health of New York State." Instead of turning to tax-payer funding to cover costs, volunteer fire services running ambulances will be able to bill insurance companies for medical services; since insurance companies already cover this in their benefits, it’s basically a win-win for all. In stand-alone departments, tax-paid funding traditionally is heavier towards fire than EMS.

Village of Fayetteville Fire Chief Paul Hildreth is proud of his department which offers combined fire and ambulance services. He spoke about the staff and strong volunteer base, “It takes a group to be all in the same mindset, values and create a culture.” His department has a mix of career and volunteer members and officers; each year they start out with an officer’s meeting to help set goals for the coming year. Chief Hildreth said that their model works, “it simply comes down to call volume and your AHJ funding your mission.” He added that they’ve been able to rely heavily on their volunteers to staff their station.

The New York City Fire Department Bureau of Emergency Medical Services was established in 1996 and combined the Fire Department of New York with the Health and Hospitals Corporation's emergency medical services division to cover all five boroughs in the city. Prospective FDNY EMTs and Paramedics are trained at the FDNY EMS Academy in Queens. The academy also hosts certified first responder training for FDNY firefighters as well as other education for EMS members such as continuing medical education; emergency vehicle operations; CFR, EMT and Paramedic recertification classes; and more. From both a career and a logistics viewpoint, the merger has been a success resulting in faster response times and better salaries and benefits for EMS members although several initial kinks were worked out through the years.

Even with the mergers between the two lifesaving services, while there are definitely benefits regarding costs and response, there remains the biggest obstacle – the two jobs are NOT THE SAME. Most firefighters do not want any part of riding an ambulance, and many EMS are not trained to enter active fire scenes. Fire protects property, EMS resuscitates individuals; both services are high-stress, and both can be dangerous. Members of combined agencies must be taught individual and combined policies, rules, and expectations. More importantly, all members of combined departments must be treated and respected equally. Management needs to lead appropriately.

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