Well it's been about one year since the take over of ambulance service in Kansas City, MO and things are at best, unsettled. For many the feeling is that the service is not as good as it was. Recently, the editorial page at the Kansas City Star took notice--and wrote an excellent piece that asks all the right questions.Here's the link to the editorial, which is bylined "Kansas City Star editorial."
The issue of the response times has been talked about here and in other places. I have heard Chief Dyer's song and dance about how response times are not as important as they are made out to be and how it is important to deliver quality care. The times I have heard him he has been careful to not be overly dismissive. It sounds like he failed this time. In addition, I have heard the chief talk about how he feels that such concerns grow out of, not a public safety concern, but a political concern. However, all that posturing does not solve the problem--it tries to make itSomeone Else's Problem or even worse, says, "What problem? There's not a problem." All I'm hearing is that it is too expensive to solve the problem, or too hard to solve the problem. It's funny, we all know that MAST wasn't perfect, but did we hear about response time problems when MAST was running the ambulances?
The two other important concerns, raised by the editorial writer, are the use/non use of 24 shifts for EMS workers and the pension issue. The problems reflected in the 24 shift issues are those of badly blended work cultures and career goals, with a good dollop of legal labor issue thrown in. It is not an issue for fire departments where the EMS personnel are fully qualified firefighters and were hired with the understanding that they were firefighters as well as EMS providers--see Grandview and Lee's Summit for the easiest examples. Until the day comes that all EMS providers employed by KCMO are fully qualified firefighters also, this is going to be an issue, and a dividing point. Toss in the national discussion on the effects of 24 hour shifts, and this issue is not going away any time soon. As to the pension issue, it again is a function of the different nature of the personnel that the KCFD took in. MAST employees were under an entirely different type of retirement plan, one that cannot legally be rolled into or converted to the type of pension that firefighters are under. If the city had taken MAST in and made it its own department with its own management and command structure, something that would not cost the city as much (if any cost at all) could have been done without breaking promises that were made to the rank and file MAST employee. Now, it looks inevitable that the city will not provide a pension that matches completely the years of service of the former MAST worker. In the current political environment, I do not see that happening.
So there you go. The results of a politically motivated and understudied decision. Every single issue explored by this editorial should have been throughly studied BEFORE any action was taken, not a year AFTER the deed was done. To borrow a phrase, these were "known unknowns"--things we knew that could very well be issues with this merger idea. NONE of them were "unknown unknowns"--things that we didn't know were going to be issues.
It's a mess and now we have to, somehow, clean it up. Cleaning it up is going to cost, and there will be collateral damage of all kinds. Tough assignment for the new mayor and new city council--are they up to doing the best for the people of the city, above city hall and union politics?