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City may reduce fire response to medical calls

It's a familiar sight, and it's sometimes a head scratcher.

A fire truck comes roaring up to a house, nursing home or business. Firefighters pile out and respond to what came in as a 911 emergency medical call. Then an ambulance arrives. If the person is in need of further medical care, the ambulance carries the patient to the hospital.
Such redundant care may be comforting but it's also expensive and, in an era of ever tightening local budgets and hard choices, expensive, Hendersonville leaders say.
Troubled by rising overtime and a rising number of medical calls, the Hendersonville City Council wants to explore a major pullback in emergency medical response.
If it can find a way to do it, the City Council wants to eliminate use of the city Fire Department for medical emergencies. It would still respond to calls for backup from the county Emergency Medical Service, calls to extricate motorists at car crashes and calls at any accident situation that posed a fire risk, council members agreed.
"When there's a call, an EMS trucks rolls and a fire truck rolls. If we do their job for them, they're going to let us," interim City Manager Lee Galloway told the council. "If there's an increased demand for EMS service, then the citizens should say we need more service. ... But right now we're duplicating services. With sprinkler systems, with better building construction, there's a lot less fire calls now than there were 50 years ago. This isn't just this department. It's nationwide. They've got to find something to do."


No transport, no bill
The subject triggered a wide-ranging discussion of the limits on what a city can do.
"I live around some old people," said Councilman Ron Stephens, who lives in the Oaks. "The fire truck will come and the ambulance will come, 99 percent of the time the fire truck comes first." Both crews will enter the home for what turns out to be a fall, when a caregiver can't get a person up.
"Once they get the guy up, he doesn't go to the hospital," Stephens added. "I don't know why it takes four people to do that, and that's what happens."
Councilman Steve Caraker said the solution seemed obvious.
"If the EMS calls for mutual aid, then we send them. But if they don't need it we don't send a fire truck," he said. "We can't bill, because we don't transport."
Galloway said in an interview on Tuesday that Fire Chief Dorian Flowers had submitted a budget request showing a 64 percent increase in calls last year. Some of the increase was attributable to the last of four rural fire district zones the city has absorbed, he said. But more was attributable to the rising number of medical calls.
Chief Flowers and Henderson County EMS director Bobby Barnett did not respond to the Lightning's calls for comment on the proposal. It's possible that some city voters will say pulling back on fire response to medical calls puts health and lives at risk.
"I'm not sure that I buy in on that," Galloway said. "I'm sure that's what you're going to hear. My feeling is that EMS is responding and they're supposed to respond. ...
"I think the city needs to look at it and say, This is the way we've been doing business. Is there a way we can do it better? Is there a way we can do it differently? That's not to say anything bad about Chief Flowers. I've been impressed with his capabilities, knowledge and expertise. But to me you just can't duplicate services."
"You have a philosophic question that needs to be resolved," Galloway told the council. "I don't think you can say you'll never respond. I don't think you want to."

Backup available
Stephens said in an interview on Monday that a squad of firefighters is not usually needed at a medical emergency.
"With the kind of technology we have today, if (EMS crews) are strung out and cannot answer, then the fire department should go," he said. "When the fire department goes and they go and the building's not on fire it's a duplication and it's a waste of money because the fire truck is never going to take somebody to the hospital. They don't have the equipment."
Ambulances, he pointed out, carry personnel with advanced training and advanced equipment.
Council members seemed eager to make a budget cut based on enactment of the proposal. John Connet, the new manager who sat in on the work session, urged a closer study of the consequences.
"You don't want to pull the fire truck out and find out that 75 percent of the time the fire truck is there 15 minutes before the ambulance arrives," he said.