EMS Changes In One Month

There is just one month left for the entity called MAST to continue to operate the prehospital emergency medical service in Kansas City, MO. As of May 1, 2010, the Kansas City Fire Department will be responsible for the organization and deployment of ambulances in Kansas City, MO and the contracted cities (mostly north of the river). MAST employees will become city employees, with Fire Chief Smoky Dyer as their boss. The plan, as described at City Hall in September 2009, was to essentially avoid much change for the first year. After that--well, there was no concrete plan, at least at that time.

I've been thinking about it since the blizzard of news regarding the resignation of the current MAST leadership, which included some large amounts of money being paid out as they left. I took a minute to review my own work on this topic, as well as much of the material posted by Tony of Tony's Kansas City. I included a review of the comments to Tony's posts, as the anony remarks, frequently posted by MAST and KCFD people are reflective of the emotions, rumors, and concerns of those most immediately affected by the change.

I can tell you that we may be in for a bit of a rough patch. Many of the issues that I thought would be a problem are indeed problems. Billing--no one is clear who will be doing the billing. The residency requirement has caused some resentment in the ranks. There has been complaints about the pension plans and how they've been handled. It appears that some feel that MAST employees will be retiring with a FF like pension without putting in the years as a city employee. There is much complaining about the contracts mentioned above. Personally, I cannot believe these contracts were not backloaded to make sure the execs stayed as long as they were needed. Other city departments, being cut as we speak, with layoffs, are eyeballing the fire department wondering where their cutbacks are, and why their pensions are intact. The comments I read reflected some pretty poor morale--people seem discouraged in many ways. I haven't even touched on day-to-day operational issues, such as dynamic posting, dispatching, and shift/unit number flexibility.

The above is all about process--the question becomes how is process going to affect what happens in the field. Teamwork between the EMTSs/medics and firefighters--improved, worsened or the same? Coverage--improved, worsened or the same? Response times for a) basic life support b) advanced life support--improved, worsened or the same? Who is going to evaluate all this--will it be someone who can be objective, who can say to the Fire Chief, you know, Chief, this sucks, you need to make it better, and not be blown off?

It may work out fine, it may work out OK after a few months, or years. Hopefully, it will not cost anyone their limb or life along the way, and it will not cost too many fine EMTs, paramedics and firefighters leaving our city's service. And it will really save the city money like they said it would.

On that last item, I have my doubts. On the first, I do think it will take months. And there may be personnel casualties, people getting discouraged or annoyed. Hang on folks, it's going to be an interesting ride for EMS around here for a while.