ELMHURST – An analysis by Elmhurst’s fire chief into options for increasing the level of emergency medical services responses indicates that adding medical capabilities to the city’s fire engines should be far cheaper than two other options.
In a memo dated March 8 and addressed to City Manager James Grabowski, Fire Chief Thomas Freeman laid out the costs, advantages and disadvantages of three methods of potentially improving response times to medical emergencies in the city:
• Contracting for a third ambulance with Metro Paramedic Services, which currently supplies two ambulances each day for the city;
• Adding Advanced Life Support equipment to fire engines so that firefighters with paramedic training can provide a higher level of medical service than they do at the current Basic Life Support level; or
• Adding one two Rapid Response ALS Units – a Ford Explorer or similar type vehicle with ALS equipment and staffing with a paramedic from Metro.
Freeman presented these options Monday night at the City Council’s Public Affairs and Safety Committee meeting in the latest in an ongoing series of discussions looking at whether the city needs to improve its EMS response offerings.
Freeman estimated the cost of a third ambulance at $423,507 for the first year, adding two ALS engines at less than $75,000, one Rapid Response ALS Unit at $165,352 and two such units at $371,289.
“They all have their strengths, they all have their weaknesses,” Freeman said of the three options.
Third ambulance option
In exploring the third ambulance option, Freeman notes that while Elmhurst’s engines typically respond to the scene of an emergency in less than four minutes, compared to the “maximum industry standard” of eight minutes, calls where ambulances from neighboring towns are required have averaged 7.38 minutes. That discrepancy, combined with the significant increase in emergency calls in Elmhurst in the past decade, are at the root of the current exploration of options to boost emergency services.
Freeman cited quotes prices from Metro Paramedic Services of $423,507 in the first year, $427,742 in the second year and $432,019 in the third, an increase of just over $4,000 each year.
Freeman explained at Monday night’s meeting that if the city were to buy and staff its own ambulance without using Metro, the cost would be over $1 million a year, so while it’s the most expensive of the three options, it’s not as pricey as it could be.
“Clearly, if we go [with a] third ambulance, we’re going Metro/Superior,” committee Chairman Chris Healy said, referencing Metro’s parent company, Superior Ambulance Service.
When committee members expressed concern that having a third ambulance might be less effective than desired if it’s called out to respond to neighboring communities, Freeman emphasized that the Elmhurst Fire Department can decline to respond if it would leave the city without proper coverage.
“If it were down to one, and it’s requested, it’s denied,” Freeman said. “We have to protect the city.”
ALS engines option
The most inexpensive option on the table has an advantage in that it addresses two areas of concern: instances where an ambulance is required from a neighboring community, and instances where a fire engine reaches the scene of an emergency well ahead of a city ambulance.
The fire engine wouldn’t be able to transport patients, but Freeman is indicated that the time between a call for help and the application of treatment is of greater concern than the time between the beginning of on-scene treatment and arrival at the hospital – though he did emphasize that getting to the hospital as fast as possible is important, too.
Freeman did say that there are wrinkles to be worked out with the firefighters’ union to make sure that the ALS engines option could proceed smoothly if the city goes in that direction. He characterized the conversations he’d had as a situation where they didn’t quite have an agreement, but both sides understood each other.
With 13 or 14 firefighters currently certified as paramedics, Freeman said that the department already has the resources to run ALS engines 24 hours a day, seven days a week, but that sick days or retirements would be problematic, so the department would have to look at requiring paramedic certification for future hires.
Steve Wroble, a lieutenant with the fire department and the secretary of the Elmhurst Firefighters Local 3541 union, spoke up during the public comment portion of the meeting in support of ALS engines.
“We believe an ALS fire company is the better route,” Wroble said. “We do believe this is an enhancement to service. We’ve had very good conversations, and we’ll do what we need to do to get this done.”
Rapid Response ALS Units
The Rapid Response vehicles would have the advantage of being able to reach the scene of an emergency faster than an ambulance from a neighboring community. In cases where Elmhurst’s two ambulances are tied up or delayed in reaching the scene, the Rapid Response medic would render aid until an ambulance could arrive to take a patient to the hospital.
The Rapid Response vehicle was described as having all the medical gear of ambulance, with the exception of equipment such as stretchers that would be required to transport a patient.
Much like the ALS engine option, the Rapid Response vehicle would not be subject to mutual aid requests from neighboring towns for medical services.
Alderman Dannee Polomsky asked Freeman if having a Rapid Response vehicle would mean that fire engines would no longer respond to EMS calls.
“I still see the fire department still going to assist,” Freeman said. “You need the manpower.”
Mayor Steve Morley, who was sitting in on the committee meeting, praised Freeman for the information he had collected.
“These are all very good options,” Morley said.
Morley talked about conversations he’d had in jest with the police department about doubling the number of police officers in town, saying that while it was the city’s responsibility to do everything reasonable to increase public safety, the expense of the various options had to be a factor, too.
“At some point we have to go back to fiscal responsibility,” Morley said.
Chairman Healy said that he committee would look to come up with a recommendation for the full City Council at its next meeting in two weeks.
“I don’t think that anyone here thinks the EMS calls are going to decrease,” Healy said. “This is as much about five years down the road, seven years down the road.”