By Doug Partello
Oxnard Fire Dept. Interim Chief Alexander Hamilton presented a recommendation, at the 11/17/20 City Council Meeting, to continue a feasibility study, and provide consultation by AP Triton on ambulance services and billing, through 1/31/2022.
The motivations stated by Chief Hamilton for changing the delivery of EMS services for Oxnard were poor response times, high costs, and a desire to assert local control. He claims that millions of dollars can be saved and service improved dramatically by bringing it in house, staffed with firefighters. This passed 7-0 by City Council. It was initially presented at the Public Safety Committee Meeting 11/18/2020, which passed 3-0. Hamilton also made a presentation at the previous city council meeting.
At the Safety Meeting Hamilton included the recommendation of increasing OFD staffing by 24 FTEs (Full Time Equivalent employees) to provide EMS services through the City. An Oxnard firefighter costs approximately The median salary for Oxnard firefighter is $53K, plus generous benefits and pension. The average salary for a paramedic ambulance driver working for a private company is $15/hour, without the pension. In other words about half the salary, no pension. Training academy and overhead costs are additional.
At the latest council meeting, on Dec. 1st, the notice to end the Joint Powers Agreement with Ventura County for EMS ambulance services, and move forward with other options was recommended by Alexander Hamilton, OFD. This passed 7-0.
The Ventura County EMS System had an Assessment Report done, contracted with Page, Wolfberg, & Wirth, LLC on January 18, 2019. In March & April of that year the assessment was done, and the analysis was shared at meetings with the stakeholders. There were recommendations made, but the overall report was that the system is functioning well. There are seven Exclusive Operating Areas (EOA) for the County. Oxnard is No. 6, with Gold Coast Ambulance (GCA) designated for this area. Lifeline, and AMR are the others. In 2010, AMR took over GCA.
Oxnard now has a much different perspective on the quality of service for its residents and visitors. Interim Chief Hamilton in his presentation to City Council stated that the 90% compliance threshold was met by GCA, (92%), but with exemptions, . Without exemptions, such as distance,rural areas, gated communities delays, red lights, traffic, it was 78%. The goal set by VCEMS is 90%. The response times vary based upon many factors, but essentially 8 minutes within the City. This is a critical factor in patient survivability, length of hospital stays, and outcomes.
He further claimed a $2.7 million savings to the City, which would be reinvested in OFD EMS services. The total revenue from the AP Triton assessment of current service was presented as $7.7 million, with a comparison cost of $5 million for OFD providing services. These figures were promoted even with the public pension liability, and higher salaries, and benefits of OFD paramedics, versus the GCA staff. Training academy and overhead add additional costs. The average firefighter makes $200K, including benefits and pension. There are additional costs in certifications, ongoing educational hours, seminars, overtime, and community outreach programs suggested. Paramedics get additional pay for added responsibilities.
Many questions were raised at the Dec. 1st City Council Meeting, which would vote to end the JPA, and change the delivery of this vital public service. Jeremy Shumaker, Regional Director of Operations for GCA, disputed facts given by Chief Hamilton. In 2019 there were over 15,000 ambulance responses with on scene compliance of 92.34%, without exemptions, and 96% with exemptions. The 78% given by Hamilton false. He stated that average response times within 5 minutes, which is below industry standards. The AP Triton cost per hour given at $274 also stated as false, and the OFD being a cheaper option, also false, per Mr. Schumaker. He stated to me the actual per hour cost is $121/hour. He mentioned that Oxnard Fire providing a cheaper service, with the same quality is an impossibility with the public pension liability the City would shoulder, which a private company does not. VCEMS supported the figures he shared. AP Triton cited dispatcher data as the source of response times.
The issue of bias was raised by both sides on this issue. Members of the City Council, and Mr. Hamilton expressed bias by VCEMS toward Oxnard in lack of priority in ambulance allocation unit hours,particularity to South Oxnard, and a say in how that works within the County system, and expressed concerns of bias in the Assessment Report data. Concerns were raised by citizens, and questions by Council member Bert Perillo, about whether this was an attempt by OFD to increase staffing, and that the AP Triton report is a “quid pro quo” relationship, as they would gain $72K/year for three years as a vendor to OFD, should OFD get the EMS contract.
There were concerns expressed about the process, and lack of communication to stakeholders, specifically, VCEMS, and GCA, in being blind sided by this move. The City Manager,Chief Hamilton, and some Council members countered that argument, stating that “hints were given” at prior meetings, calls and emails were made voicing some concerns about service.
Two former paramedics for GCA had differing views on the quality of service related to response time, ambulance availability, and community commitment. Tony Norton, thirty-nine year paramedic, who worked for GCA, stated that when AMR took over in 2010 things changed. He was sent to other areas where outside the area ambulances were needed to come in to respond to calls. He felt that the local community spirit in dealing with clients with difficulties was not the same. Another paramedic for GCA felt the false data, and perception of poor service was completely false. ER physician Daniel Shepard took great exception to the statement from Mr. Hamilton and a Council member that there is a price on mortality. In other words money over saving lives. He felt the process was not inclusive, as he was not communicated to by the City before such a drastic step was taken. Mr. Hamilton conceded that Dr. Shepard was not notified.
Steve Carroll, VCEMS Administrator, stated that a bias against Oxnard was completely not accurate. He worked closely with the former Oxnard Fire Chief, in 2018, to develop the paramedic program for the City, when concerns were raised about ALS services to Oxnard. He backed the data from the VCEMS Assessment, and compliance and performance measures met by GCA. He stated that the agreed upon coverage by OFD paramedics was not consistently delivered. He stated that concerns were not brought to VCEMS attention prior to seeing the recording of the last City Council Meeting, only after the fact.
Both sides seem dug in, and this may be another case where Oxnard finds itself in litigation again. The City Council is going with their staff, and VCEMS and GCA will stand by their data, and reputations for delivery of quality service to the public. We just hope in the end that when we dial 911 in an emergency, as an Oxnard resident, or visitor, that the better choice was made by the powers that be, and we live to see another day.
Douglas Partello is a homeless advocate, community activist, retired neonatal respiratory therapist, Executive Director, Nicaraguan Children’s Fund.