Kansas City EMS Update

Clearly the Kansas City Fire Department's takeover of EMS services is a "work in progress." File photo from the Kansas City Star of the livery change on the city's ambulances.

If you've been keeping up around here, you know that it's been about a year since the actual take over of Kansas City, MO's emergency medical service system. On March 24, Tony's Kansas City posted a bit of insider info on what is going on with the staffing patterns for the EMS Bureau and the comment section just exploded. There is a lot of good stuff there. You can use the link to go there as it has fallen off the first page. Yes, there are 100 plus comments but they are generally from "inside" and will give you a good idea of what everyone is thinking.

I am not surprised at the culture clash between EMS and suppression. I was a member of a volunteer EMS service, and our station was right next door to the community's volunteer fire department. It became readily apparent, even to someone as young as I, that firefighters and EMS peeps were cut from different cloth. It's not just what we know and do--the going into a burning building verses taking care of sick and injured people--that's different, it goes to personality. There are some that can be a part of both groups without conflict or difficulty, but it's hard to swing from group to group. We love each other at the scene, but we can sometimes get crossways outside of our work.

I hope the fire department is carefully considering this 24-hour shift thing. In busy stations, it is going to result in some tired medics, with increased errors and injury rates. In fact, with fire personnel responding to so many EMS calls, it could become an issue for suppression personnel too. They need to watch this. Plus they need to follow the labor laws. Personnel can't work 24 hour shifts and not be paid overtime unless they are firefighters. And if any promises were made during the lead up to the MAST changeover to the fire department, those need to be reviewed. It's possible some may not be able to be kept, but to not be open and forthright about those things just generates resentment and discord.

I wrote most of this on Saturday afternoon, with the mind to post today. Saturday night, I wondered where the Kansas City Star was on this issue. It had been discussed in public council meetings and needed to be reported. Finally late Saturday night (after 10:00 on line and in the Sunday paper) an article appeared in the paper that discussed the 24 hour shift issue and how the entire plan was dumped and no ambulance crew would work a 24 hour shift anymore--everyone would work strictly 8 hours 5 days per week, which was the threat contained in the letter that TKC had earlier. Louie Wright blamed Ed Ford for resisting, for political payback for the Burke defeat and generally sounded in the article like the union thug that he is.

MAST isn't coming back. That's a fact. What we have now is an uncomfortable hybrid of Fire and EMS mixed imperfectly together. Some look at other area fire departments and say their medics work 24 hours without problem or breaking labor laws--but that's the way they were trained and hired. They came to their department knowing that if they wanted to be paramedics, they would also be expected to be certified firefighters. I have heard with my own ears Grandview paramedic unit personnel given fire suppression duties. However, the MAST folks pulled into KCFD signed on with an ambulance company. The majority of them had no ambitions to train and work as firefighters. So we have a mixed bag of folks with different expectations. (Tony's Kansas City linked to the Star article--the 12 comments are good including an excellent discourse on the pertinent labor laws so check out the TKC comments.)

The city did not do its homework with this merger, that is crystal clear at this point. The pension problem, still as far as I know not addressed, is a product of this lack of research. So is this labor mess. Obviously the City Manager and City Attorney did not examine the legal aspect of the labor issue closely enough. Now, the workforce of the KCFD has a lot of conflict, and compromise and something workable will be a lot harder to develop because of that conflict.