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SF Fire Department seeking more money for paramedics

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Mike Koozmin/the s.f. examiner
San Francisco emergency responders sometimes arrive at calls without a paramedic due to staffing shortages

In order to bring a paramedic to all of its 911 calls, the Fire Department plans to ask Mayor Ed Lee for an extra $10 million during budget season this year despite a citywide directive to departments to cut spending amid an anticipated $100 million-plus deficit.

Supervisor London Breed, a former Fire Commission member, said she will ask Lee during today’s board meeting if he will allow the extra funding.

“We need more ambulances and we need more staff,” Breed said. “This should have happened already.”

When The City’s first responders answer a call for a medical emergency, they cannot always bring a paramedic because sometimes one is not available.

Steady cutbacks during bad budget years and a host of retiring firefighters — with no new hires coming on to replace them — have put the Fire Department in a tough position regarding ambulance services.

A shortage of ambulances and a lack of paramedics mean the department is not meeting a state-mandated goal of responding to at least 80 percent of medical emergency calls within city limits, according to a recent Budget and Legislative Analyst’s Office report.

That does not mean a paramedic will never show up; often they arrive minutes later or the call is taken by a private ambulance service. But the report found an increasing number of medical calls are classified “medic-to-follow,” when first responders arrive on scene without a paramedic.

About 76.5 percent, or 92,000, of The City’s 911 calls handled by the Fire Department annually are medical emergencies.

The extra cash the department plans to ask for would pay for 10 new ambulances, 43 extra paramedics and 11 extra support personnel, including an emergency medical services chief.

Some of the spending could be cost-neutral, as the Fire Department can charge insurance companies for ambulance rides and may be eligible for extra money from the state, Breed noted.

The mayor and Fire Department brass, including Fire Chief Joanne Hayes-White, have met to discuss the issue, but no decision has been made.

The City has for years lacked a full complement of firefighters.

There are only 323 EMS-only paramedics in San Francisco, and 1,070 firefighters assigned to fighting fires. A fully staffed department has 381 EMS staff and 1,358 firefighters, the report found.

The Fire Department responded to about 97 percent of all medical calls in 2008, before the state revoked its right to be the exclusive ambulance provider for San Francisco, according to Lt. Mindy Talmadge.

The state reversed the decision in January 2012 and restored “exclusive operator” status to the department, with the mandate that it respond to 80 percent of medical emergencies.

To date, that goal has not been achieved. Last year, Fire Department-owned ambulances responded to 72 percent of medical emergencies, records show. Private ambulances answer the rest.

The City is anticipating a budget shortfall in excess of $100 million for the coming fiscal year, which begins July 1. All city agencies have been asked to cut spending.

The Fire Department’s budget for the current fiscal year is $344.2 million, most of which is for salaries and benefits. Next year’s budget is expected to include a request for new spending on equipment and firehouses.

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