San Francisco to relax ambulance restrictions
By: Brent Begin
Examiner Staff Writer
November 23, 2009
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| Strict rules: City paramedics are required to log hundreds of hours before they can run a rig and train EMTs, a policy that has kept most private companies off of city streets. (Examiner file photo) |
San Francisco’s standards for staffing an ambulance have been so strict that private companies are locked out from coming into The City. New requirements proposed last week, however, could break into the long-standing monopoly.
The changes are part of an agreement with the state, which told local officials in 2008 that San Francisco could no longer operate an “exclusive ambulance zone” because it violated federal antitrust laws.
In order to comply, the city division that handles emergency medical services, which was absorbed by the San Francisco Department of Emergency Management in May, is changing its regulations, according to the department Deputy Director Rob Dudgeon.
For years, San Francisco has been using paramedics to staff ambulances — the Fire Department often uses two of the highly trained professionals per ambulance. City regulations only require that an experienced paramedic and a basic emergency medical technician, or EMT, are on an ambulance.
San Francisco requests its paramedics to log hundreds of hours in San Francisco before they can qualify to run a rig in The City and eventually train EMTs; this has kept new, private companies from offering their services in San Francisco.
If changes are approved on Nov. 30, the Department of Emergency Management will regulate out-of-town paramedics, taking care of what Dudgeon calls a chicken-and-egg problem. If they’re veterans with the knowledge and training to do the job, the department be able to take other EMTs under its tutelage while working in San Francisco.
Currently, there are only two private ambulance companies that have been able to meet the requirements to provide backup for The City’s Fire Department. American Medical Response and King-American Ambulance provide less than 5 percent of transports in The City. Dudgeon said having more companies would improve service.
“My vision for the San Francisco EMS system has always been that we create an efficient system,” Dudgeon said. “While we want more ambulances, what we’re really after is making sure we have a mechanism that allows new companies in while making sure our quality level remains very high.”
Mike Williams, whose Abaris Group consults with municipalities on ambulance efficiency, said San Francisco has to do something to comply with state regulators, such as putting out competitive bids to other companies so they can work in San Francisco.
“The City and county need to go back to the state with a new plan saying how they’re going to deal with antitrust concerns,” Williams said. “This is how they’re addressing the issue and then the state will weigh in.”
Making the grade
Duties included within the three levels of emergency responders:
I EMT: A certified and locally accredited EMT performs basic life support duties on ambulance with a Level II Paramedic.
II Paramedic: A licensed and locally Accredited EMT-P performs advanced life support duties on ambulance with Level I EMT or Level II Paramedic.
III Firefighter/ Paramedic: A licensed and locally accredited EMT-P and fully trained firefighter work on fire apparatus as a fully qualified firefighter and paramedic assigned to a SFFD unit, or on an ambulance with Level I EMT or Level II Paramedic.
Source: Sfgov.org
