Friday, August 21, 2009

Report from the MAST meeting

Hey, just got back from the MAST meeting... Close to 50 people were there at the meeting at 4201 E 63rd St. Most were from the immediate neighborhood. I wish I had asked the folks how it was they came to hear about the meeting. They could have heard about it on TV, and I am still on my TV fast, so I wouldn't have heard that way. They did not exactly fit the demographic of your average blogger! There were a few people with current or past affiliation with MAST there, three local 42 union reps, and a couple of community organizers. When I entered the room, there were 3 video cameras set up, including a guy in a KCFD tee shirt. Check it out. (It turned out camera dude was from KSHB)

The first bit of news was that the current head of MAST, Gil Glass, resigned in the afternoon. From the reaction of people, I don't think it was an expected move. The main presenters were Susan, Lisa, and Yancy Davis. Ms. Davis is a community organizer who worked with the Obama campaign, and Susan and Lisa have MAST connections. There was also a gentleman whose name I didn't catch who spoke, who had been doing EMS in Kansas City so long he worked for Community Ambulance (Sidetrack: He named all the ambulance companies doing business in KC before MAST came into being. One was called Acme Ambulance. Honest. The Wiley E. Coyote ambulance company...sorry, ADD moment.) Information was presented on MAST; call volume of about 87K per year, one of the best response times and code blue save (cardiac arrest-- sneaky medical lingo!!) rates in the country, trained dispatchers, community service in the schools, car seat checks, etc. Letters from two doctors, Dr. Gary Gaddis, from UMKC School of Medicine and St. Luke's Hospital and Dr. Richard Rosenthal, chair of the ED at Research Medical Center, were summarized and copies made available to the audience. To make a long story short, both docs had multiple concerns about the changeover. Dr. Rosenthal was at Providence Medical Center when KCK changed over from MAST to a Fire Department model, and he reported a decline in the level of care and unexpected expense during the transition. Dr. Gaddis was concerned about management issues, and medical control. His letter is three pages long and quite technical.

(above left, participant with question [middle], camera dude, union guy. Right, below, the crowd there)

I think the plan was more of an informational meeting, and not a real open question-answer meeting. Ms. Davis had the best line during the presentations: "This is backdoor political dealing at its finest." However, you know how it is about best laid plans: sometimes, you have to blow them up. So the floor was opened to questions and statements from the audience. And as the questions were asked, the immediate tone of total distrust of the city's management became apparent. The Gloria settlement was mentioned. Bulky item pick-up was mentioned. Mayor Funkhouser was mentioned. It also became immediately clear that the structure of the merged organization was a complete unknown. One of the three union 42 guys described possible "back room service" savings such as merged building maintainace contracts, and saving on the separate broad band/phone service for dispatch. He also related savings from having just one command structure for both the fire service and EMS service. But I am not sure the audience was buying: why mess with what is not broken? A few other items show up on the notepad on my Black Berry: "Pension issue. Distrust city running service. What does the city gain from this? Louie Wright to support Funky?...Goal to take jobs to FD." Both the power playing and the consequences to MAST employees were also discussed. Many people felt that it was a power grab and not done for any particularly good reason. I got my two cents worth, first talking about the mobile post system, where MAST parks ambulances in strategic parts of the city to make getting good response times easy, second talking about firefighters, third why change, city management is bad and finally told the story of the church lady I took care of at the VA. The system worked from beginning to end for her, let's not mess it up! (She had cardiac arrest at her church; we were the nearest hospital, fire and MAST were perfect! She was stabilized and transferred to RMC, where she did really well. High fives all around.)

(right, two other guys from local 42. The guy in the dark shirt did a lot of talking. The guy in the light shirt had a video camera; at one point, he had to be told several times to stop taping when a participant--a MAST employee--was speaking and requested that he not be taped.) I just don't think the crowd was completely buying what the union and others in favor of merging were selling. Savings were too vague--they might have convinced a few with a well done handout of all the savings and a diagram of the new command structure. But they had no such information. So the question of "why?" lingered in the air, and the stench of the playing of power from local 42, and the upcoming mayor's race just would not go away. Many just could not see a really good reason to make this change.
There are basically two models of control for EMS. One is for EMS to be under the control of the local fire department and they have the ambulances and medics under their control. The second is for EMS to be a separate entity, with its own command structure. They may have a tie in with the local hospitals and doctors. MAST is separate. Raytown EMS is not part of the fire department in that city. Lee's Summit and Grandview Fire Departments do the EMS for their respective cities. Each has its pluses and minuses, but all things being equal, I would rather keep the entities separate. Fire's primary responsibility is to put out fires. EMS becomes a step child, especially in areas where historically EMS and fire have been separate. I would vote for MAST staying separate. The only exception would be if it could be thoroughly documented that service would not suffer and there was really economic savings. Even then, I might say MAST should stay separate. Because the smell of power lust and manipulation is just too strong.

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