DATE: July 18, 2023
TO: Honorable Mayor and City Council
FROM: Chen Suen, Fire Chief
SUBJECT: ESTABLISHMENT OF A NEW AMBULANCE OPERATOR CLASS
SPECIFICATION
CEQA: Not A Project
Recommendation: Approve
SUMMARY
As part of the City’s Fiscal Year 202 3-24 Budget adoption, the City Council allocated funds to staff a peak hours Basic Life Support ambulance with two (2) Ambulance Operators. It is recommended that the City Council approve the establishment of a new Ambulance Operator class specification.
BACKGROUND
The Arcadia Fire Department has been providing paramedic ambulance service to the Arcadia community since the early 1970s, with quality pre- hospital care for medical and trauma-related emergency calls. Over the past three years emerging from the COVID-19 pandemic, the Fire Department observed an upward trend in the total number of emergency incidents in the C ity of Arcadia. With the forth coming commercial and residential development throughout the City, the call volume is expected to increase.
Due to increased call volume and longer hospital bed wait times during peak hours, throughout the year, there are times when neither of the Fire Department’s current rescue ambulances are available to respond to medical incidents in the City. To maintain adequate service levels in response to this challeng ing situation , the City Council approved a Basic Life Support ( “BLS”) Peak Hours Ambulance program during the FY 2023-24 Budget Adoption process . Two BLS A mbulance Operator positions would be staffed each day for 12 hours, from 8:00 a.m. to 8:00 p.m. , five days a week. C ritical to this program is the creation of a new Ambulance Operator position. Attached is the new job specification for the proposed Ambulance Operator position (see Attachment “A”). For further reference, the memo in Attachment “B” fully describes the program’s intent and overall assessment of the need for such a program.
New Ambulance Operator Class Specification
July 18, 2023
DISCUSSION
The BLS Peak Hours Ambulance Program will transport lower -acuity medical patients during peak hours, allowing for the advanced life support paramedic ambulances to respond to more critical calls. Additionally, in the event of a significant, larger scale incident, a BLS ambulance will provide an additional medical resource. For this program, two Ambulance Operators would be staffed each day for 12-hours, from 8:00 a.m. to 8:00 p.m., five days a week.
The primary function of the new Ambulance Operator is to provide basic life support care, within t he scope of an Emergency Medical Technician ( “EMT”), on sick, injured, or convalescent persons at the sites of emergencies or enroute to hospitals or other medical facilities. Some of the key duties associated with this position include hemorrhage control, treatment for shock, cardiopulmonary resuscitation, airway maintenance, and fracture stabilization and control. Other responsibilities of an Ambulance Operator include operating an emergency vehicle to transport and provide care to and from the scene of an emergency. This position also requires specialized certification and licensure within the following areas: American Heart Association and CPR; possession of a DMV ambulance endorsement and a California EMT-B license before hiring; National Incident Management System (“NIMS”) IS 700; Incident Command System ( “ICS”) 100 and 200; and graduation from a 240-hour California Fire Academy or equivalent, is highly desirable.
This is a non-safety/non-firefighter position that will work under the supervision of a Fire Captain and the overall direction of an EMS Coordinator. The work schedule for each Ambulance Operator would fall under a part -time position (see Attachment “C” for the salary schedule) . Finally, t he organizational chart in Attachment “D” illustrates the hierarchical responsibilities of this job classification within the Fire Department.
The new job classification for the Ambulance Operator position has been discussed with the Human Resources D ivision, which found the specifications, licensing and required certifications to be in line with other similar positions in the region, and the compensation in line with market expectations.
ENVIRONMENTAL ANALYSIS
The proposed action does not constitute a project under the California Environmental Quality Act (“CEQA”), as it can be seen with certainty that it will have no impact on the environment. Thus, this matter is exempt under CEQA.
FISCAL IMPACT
The Ambulance Operator position would be placed at part-time salary range number PTP14, with its hourly salary schedule ranging from the base step of $17.43/hour through the highest level at $19.24/hour (see Attachment “C”). In the adopted Fiscal Year 2023- New Ambulance Operator Class Specification
July 18, 2023
24 Fire Operations Budget , a total of $127,508.16 was allocated for the Ambulance Operator positions and is sufficient to cover the proposed salary and benefits.
RECOMMENDATION
It is recommended that the City Council determine that this action does not constitute a project under the California Environmental Quality Act (“CEQA”); and approve t he establishment of a new Ambulance Operator class specification.
Attachments: A) New Class Specification – Ambulance Operator Position B) Memo – Implementation of a BLS Peak Hours Ambulance Program C) Proposed Salary Schedule
D) Fire Department’s Organizational Chart
CITY OF ARCADIA
AMBULANCE OPERATOR
DEFINITION
Under general supervision, to provide basic medical care and transport of the ill and injured as an Emergency Medical Technician (EMT); to respond to emergency medical calls for service including accidents and other emergencies; and, to operate an emergency vehicle to and from the scene of an emergency. The ambulance operator is expected to attend didactic and clinical continued education as required; to respond to emergency calls to render first aid and lifesaving techniques; and to participate in fire department training activities.
SUPERVISION EXERCISED
This is a non- safety/non-firefighter position that works under the supervision of a Fire Captain and the overall direction of an EMS Coordinator to perform emergency medical transport services.
EXAMPLES OF IMPORTANT AND ESSENTIAL DUTIES
AMBULANCE OPERATOR:
Perform necessary basic life support care, within the scope of an EMT, on sick, injured, or convalescent persons at the sites of emergencies or enroute to hospitals or other medical facilities. Basic life support includes, but is not limited to hemorrhage control, treatment for shock, cardiopulmonary resuscitation, airway maintenance, and fracture stabilization and pain control.
Record event information including patient condition, patient history, treatments, vital signs, and scene observations.
Observe established basic life support medical protocols in accordance with Los Angeles Department of Health Services.
Provide patient information to physicians or designee via radio, cell phone transmission or direct contact.
Bandaging and lifting patients into an ambulance and assisting paramedics as directed.
Maintain a daily log of responses.
Maintain and inventory emergency ambulance supplies, equipment, and routine vehicle maintenance.
City of Arcadia
Attachment “A”
Ambulance Operator (Continued) Page 2 of 5
Operate emergency vehicles enroute to emergencies and during patient transport to the hospital.
Ambulance Operator duties:
An Ambulance Operator will be required to perform the following job tasks:
Operate City-owned ambulances and other department vehicles as directed, including driving to and from medical emergencies as part of the emergency transportation team.
Perform appropriate field procedures utilizing EMT-B level skills such as attaining and documenting vital signs, bandaging, splinting, lifting patients into an ambulance and assisting paramedics as directed.
Maintain and inventory emergency ambulance supplies, equipment and routine vehicle parts.
Operate within federal, state, county and city laws, regulations and guidelines including the Health Insurance Portability and Accountability Act Attend and complete department and hospital training sessions and drills.
Participate in station and equipment clean-up and perform other assignments as directed.
Respond to and assist the public in a wide variety of emergency calls involving illness and urgent situations and emergency medical incidents; analyze patient needs and administer first aid until relieved by proper medical personnel.
Participate in drills; attend continuing and advanced training sessions which can include emergency medical care, firefighting techniques, and the proper use of all equipment and related tools.
Respond to complaints and requests for information from the public; engage in public information activities; conduct station tours.
An Ambulance Operator will conduct daily inspections of condition and readiness of equipment; clean, wash, and service equipment; inspect, test, and maintain equipment.
Ambulance Operators are expected to drive and operate equipment safely under limited conditions.
An Ambulance Operator must be able to read electronic and incident maps and follow map directions; recognize street names quickly; locate house numbers and navigate quickly through business districts.
Work effectively in difficult and hazardous emergency situations and environments and carry out work assignments as instructed.
City of Arcadia
Firefighter Paramedic (Continued) Page 3 of 5
Safely and properly transport patients during ambulance transportation.
Follow oral and written instructions; communicate effectively both orally and in writing.
Maintain physical fitness to perform the physical aspects of the position.
Assist in the maintenance of the fire station and grounds.
OTHER JOB RELATED DUTIES
Perform related duties and responsibilities as assigned by their supervisor.
JOB RELATED AND ESSENTIAL QUALIFICATIONS
Knowledge of:
Basic emergency medical procedures including obtaining vital signs.
Locations of area hospitals and proper transport destinations.
Symptoms of medical emergencies and of appropriate responses to such conditions.
Principles of inventory management.
Procedures, methods, and techniques of emergency medical services including basic first aid and CPR.
Pertinent Federal, State, and local laws, codes, and regulations.
Principles and procedures of record keeping.
Safe driving principles and practices.
Skill to:
Operate a motor vehicle safely.
Operate a variety of fire emergency response equipment safely and effectively including communications equipment.
Operate modern office equipment and technology.
Utilize handheld electronic devices for electronic care reporting documentation.
City of Arcadia
Firefighter Paramedic (Continued) Page 4 of 5
Ability to:
Evaluate patients' conditions and properly render emergency medical care including administration of emergency medications.
Perform at required emergency medical services within the Los Angeles County Department of Health Services Basic Life Support scope of practice.
Participate in preliminary fact-finding inspections and investigations including evidence gathering and preservation.
Interpret and apply policies, procedures, laws, codes, and regulations pertaining to assigned programs and functions.
Read, understand, and apply basic life support materials and concepts.
Respond quickly to changing situations under stressful emergency conditions.
Demonstrate physical endurance, agility, strength, and stamina in the performance of hazardous tasks under emergency conditions; think and act quickly in emergencies.
Understand and follow oral and written directions promptly and accurately.
Exercise good judgment, flexibility, creativity, and sensitivity in response to changing situations and needs.
Communicate clearly and concisely, both orally and in writing.
Establish, maintain and foster positive and harmonious working relationships with those contacted in the course of work.
Minimum Qualifications:
Training:
Equivalent to the completion of high school supplemented by college-level coursework and/or specialized training in basic life support.
License or Certificate:
American Heart Association First Aid and CPR
City of Arcadia
Firefighter Paramedic (Continued) Page 5 of 5
Must possess and maintain a valid California Class C driver license and satisfactory driving record. Must possess a DMV ambulance endorsement before the date of hire.
Must possess and maintain a California EMT- B license before the date of hire.
National Incident Management System (NIMS) IS 700.
Incident Command System (ICS) 100 and 200.
Graduate of a 240- hour California Fire Academy or equivalent is highly desired.
Special Requirements:
Essential duties require the following physical skills and work environment:
Ability to sit, stand, walk, run, kneel, crouch, stoop, squat, crawl, twist, climb, and lift 125 lbs.; exposure to cold, fire, heat, smoke, noise, outdoors, vibration, confining work space, chemicals, communicable diseases, biohazard materials, explosive materials, mechanical hazards, and electrical hazards; ability to travel to different sites and locations; availability for shift work, on-call, and stand-by.
Effective Date: July 2023
MEMORANDUM
Fire Department
DATE: May 10, 2023
TO: Honorable Mayor and City Council; and Dominic Lazzaretto, City Manager
FROM: Chen Suen, Fire Chief
SUBJECT: Implementation of a Basic Life Support Peak Hours Ambulance Respectfully, the Fire Department is requesting the implementation of a new program, a basic life support (BLS) peak hours ambulance. A basic life support ambulance is staffed by two personnel who are trained at a basic medical technician level.
Grad
ual Increase in Call Volume
Over the past three years emerging from the COVID-19 pandemic, the Fire Department observed an upward trend of total emergency incidents in the city of Arcadia (City). With the coming months and years of future commercial and residential development, the call volume will inevitably continue to increase. With the total number of commercial and residential units added, the rise in population will contribute to this increase. Table A summarizes the total call volume from 2018 through 2023. It shows a gradual increase in incidents and provides the projected call volume for Calendar Year 2023.
Tabl
e A Total Call Volume
Calendar Year Avg. Daily Calls Total Calls
2018 15.63 5,705
2019 15.60 5,693
2020 13.63 4,974
2021 15.28 5,576
2022 16.79 6,128
2023 16.83* 6,142*
*calculated based on the total call volume as of 3/28/2023 Of t
his total, approximately 70% of the total call volume is dedicated to our response to emergency medical incidents and most of these incidents require medical transport to a hospital. An example of this breakdown is given in Table B, provided by our medical biller, Wittman Billing (Wittman).
Attachment "B"
Table B – Actuals for FY 2021-22 (per Wittman Billing)
Total Medical Runs 2,992
Advanced Life Support Care – 82% of Total
Runs 2,447
Basic Life Support Care – 18% of Total Runs 545
Average Advanced Life Support Transport
Charge $2,682.19
Average Basic Life Support Transport Charge $1,797.09
The Fire Department deploys three fire engines, one truck company, two a dvanced life support (ALS) paramedic ambulances, and one command vehicle across three strategically placed fire stations in the city of Arcadia. An advanced life support ambulance requires two paramedic trained firefighters who can provide advanced life support including but not limited to the administration of intravenous therapy including critical medications, the interpretation of electrocardiogram rhythms, the manual electrical shocking of the heart, the intubation of patients using advanced airways, the performance of a needle thoracostomy to alleviate pressure from a collapsed lung, and much more.
Table C below provides a comparison of local cities and their deployme nt models including the number of ambulances utilized.
Table C – Deployment Comparison Between Local Cities
City Call
Volume
Population
Served
Square
Miles Stations Engine
Companies
Truck
Companies Ambulances
Arcadia 6,100 56,681 11.1 3 3 1 2 (ALS)
Monrovia 4,600 37,931 13.7 2 2 1 Contracted
Alhambra 7,100 82,868 7.6 4 4 1 2 (ALS)
Monterey
Park 5,400 61,096 7.7 3 3 1 2 (ALS)
San
Gabriel 3,200 39,568 4.1 2 2 0 1 (ALS)
Sierra
Madre 1,400 11,268 3.0 1 1 0 1 (ALS)
San
Marino 2,000 12,513 3.8 1 1 0 1 (ALS)
Beverly
Hills 7,000 32,701 5.7 3 4 1 3 (ALS)
Culver
City 6,700 40,779 5.1 3 3 1 3 (ALS)
1 (BLS)
Downey 10,000 114,355 12.4 4 4 1 4 (BLS)
Automatic Aid Received for Medical Transport
Although service coverage provided by our existing rescue ambulances appear s to be mostly sufficient, throughout the year our Fire Department has leaned on our neighboring agencies for assistance. When a neighboring agency responds to Arcadia, they receive the benefit of cost recovery when a patient is billed for services rendered.
More importantly, patient transport is delayed due to the extended response time for an ambulance responding from outside of the City. Time is crucial for positive patient outcome. The Fire Department has utilized ambulances from the Sierra Madre Fire Department, the San Marino Fire Department, and as far as the San Gabriel Fire Department.
For part of Calendar Year 2023, it is important to note that the Fire Department also utilized Care Ambulance as part of Monrovia Fire’s automatic aid contract ual obligations to the region. Automatic aid is assistance dispatched automatically by contractual agreement between two communities . In this case, the 13 agencies dispatched by Verdugo Fire Communications in Glendale are under this agreement. Due to staffing shortages, Care Ambulance was unable and unwilling to continue to provide ambulance transport for agencies outside of Monrovia.
Using the furthest geographical example i n Calendar Year 2023, our City utilized San Gabriel Rescue Ambulance 51, twice. The closest distance between San Gabriel Station 51, where their Rescue Ambulance is stationed, and the most southwestern border of our City is 4.2 miles. Depending on traffic conditions, the potential response time for San Gabriel Rescue Ambulance 51 is 10 to 14 minutes.
A summary of the total automatic aid received for the last six years is detailed in Table D.
Table E details which outside agency provided the automatic aid.
Table D – Automatic Aid Received per Calendar Year (Advanced Life Support Care or Basic Life Support Care)
Calendar
Year
Total RA Auto-Aid
to ARC
Advanced Life
Support Care
(82%)*
Basic Life
Support Care
(18%)*
2018 119 98 21
2019 136 112 24
2020 83 68 15
2021 87 71 16
2022 156 128 28
2023 120** 98** 22*
*% of breakdown obtained from the most recent FY 2021-22 actual “Total Runs” or billable transports by Wittman
**calculated based on the total medical transports by auto-aid agencies as of 3/28/2023
Table E – Summary of Automatic Aid Provided by Outside Agencies Calendar
Year
Monrovia
Fire
San
Marino
Fire
Sierra
Madre
Fire
San
Gabriel
Fire
Alhambra
Fire
Total
Calls
2018 105 13 1 0 0 119
2019 136 0 0 0 0 136
2020 83 0 0 0 0 83
2021 87 0 0 0 0 87
2022 115 6 30 2 3 157
2023* 6 4 17 2 0 29*
*As of 3/28/2023
Rapid response to high priority medical calls is critical because it can impact a patient’s outcome. The basic life support ambulance will transport lower acuity medical patients during peak hours, allowing for either of our advanced life support paramedic ambulances to respond to more critical calls.
Cost Recovery from Medical Transports
Based on historical data and costs recovered from our medical transports, the Fire Department collects on an annual basis approximately 27% on total gross billable transports by Wittman. These figures are based on data collected over several years .
The cost recovery difference between gross and net payments is the total amount collected at a private insurance and self -pay rate compared against monetary amounts collected at the Medicare and Medi-Cal reimbursement rates, respectively. Tables F through J detail the approximate net revenue loss as a result of automatic aid responses into our City. Table K summarizes net payments for Calendar Years 2018 through 2022.
Table F – 2018 Revenue Loss per Advanced Life Support or Basic Life Support Transport
Emergency
Type
Average
Rate
Incident
Count Gross Charges
Revenues or
Net
Payments
(27%)*
Advanced Life
Support $2,682.19 98 $ 262,854.62 $ 70,970.75
Basic Life
Support $1,797.09 21 $ 37,738.89 $ 10,189.50
TOTALS 119 $ 81,160.25
*Average % of Revenue Collected (Gross Charges versus Actual Net Payments of 27%)
Table G – 2019 Revenue Loss per Advanced Life Support or Basic Life Support Transport
Emergency
Type
Average
Rate
Incident
Count Gross Charges
Revenues or
Net
Payments
(27%)*
Advanced Life
Support $2,682.19 112 $ 300,405.28 $ 81,109.43
Basic Life
Support $1,797.09 24 $ 43,130.16 $ 11,645.14
TOTALS 136 $ 92,754.57
*Average % of Revenue Collected (Gross Charges versus Actual Net Payments of 27%)
Table H – 2020 Revenue Loss per Advanced Life Support or Basic Life Support Transport
Emergency
Type
Average
Rate
Incident
Count Gross Charges
Revenues or
Net
Payments
(27%)*
Advanced Life
Support Care $2,682.19 68 $ 182,388.92 $ 49,245.00
Basic Life
Support Care $1,797.09 15 $ 26,956.35 $ 7,278.21
TOTALS 83 $ 56,523.21
*Average % of Revenue Collected (Gross Charges versus Actual Net Payments of 27%)
Table I – 2021 Revenue Loss per Advanced Life Support or Basic Life Support Transport
Emergency
Type
Average
Rate
Incident
Count Gross Charges
Revenues or
Net
Payments
(27%)*
Advanced Life
Support Care $2,682.19 71 $ 190,435.49 $ 51,417.58
Basic Life
Support Care $1,797.09 16 $ 28,753.44 $ 7,763.43
TOTALS 87 $ 59,181.01
*Average % of Revenue Collected (Gross Charges versus Actual Net Payments of 27%)
Table J - 2022 Revenue Loss per Advanced Life Support or Basic Life Support Transport
Emergency
Type
Average
Rate
Incident
Count Gross Charges
Revenues or
Net
Payments
(27%)*
Advanced Life
Support $2,682.19 128 $ 343,320.32 $ 92,696.49
Basic Life
Support $1,797.09 28 $ 50,318.52 $ 13,586.00
TOTALS 156 $ 106,282.49
*Average % of Revenue Collected (Gross Charges versus Actual Net Payments of 27%)
Table K - 5-Year Summary of Net Revenue Loss per Advanced Life Support or Basic Life Support Transport, per Calendar Year
Calendar Year
Advanced Life
Support Net
Revenue Loss
Basic Life
Support Net
Revenue Loss
TOTALS Net
Revenue Loss
2018 $ 70,970.75 $ 10,189.50 $ 81,160.25
2019 $ 81,109.43 $ 11,645.14 $ 92,754.57
2020 $ 49,245.00 $ 7,278.21 $ 56,523.21
2021 $ 51,417.58 $ 7,763.43 $ 59,181.01
2022 $ 92,696.49 $ 13,586.00 $ 106,282.49
TOTALS $ 345,439.25 $ 50,462.28 $ 395,901.53
% of Cost -Share 87% 13%
Based on the figures above, Table L predicts what the potential revenue loss will be for Calendar Year 2023. This includes the projected automatic aid responses the City will receive, broken down by advanced and basic life support transports, potential total gross revenue loss, and the projected net revenue loss calculated at the same 27% reimbursement rate.
Table L - 2023 Projected Revenue Loss Advanced Life Support or Basic Life Support Transport
Emergency
Type
Average
Rate
Incident
Count
Gross
Charges
Revenues or Net
Payments (27%)*
Advanced Life
Support $2,682.19 98 $ 262,854.62 $ 70,970.75
Basic Life
Support $1,797.09 22 $ 39,535.98 $ 10,674.72
TOTALS 120 $ 81,645.47
*Average % of Revenue Collected (Gross Charges versus Actual Net Payments of 27%)
Justification for a Basic Life Support Peak Hours Ambulance Based on the information provided herein, a basic life support peak hours ambulance would improve our services to the community. When requested and available, our basic life support ambulance w ill transport patients requiring only a basic level of care. This reserves our advanced life support ambulances to respond to incidents requiring a higher level of medical care. Additionally, the availability of a third medical transport vehicle will cover incidents that now require an automatic aid response. This will improve response times that previously required an out-of-city resource and maximize our ability to recover costs generated by medical transports. This will undoubtedly improve patient outcomes.
Costs and Deployment Model Associated with a Basic Life Support Peak Ambulance
Personnel
There are three possible deployment models. A total of two (2) basic life support ambulance operators would staff each of these deployment options.
(1) A peak hours ambulance staffed Monday through Friday. (“Weekday Model”) (2) A peak hours ambulance staffed seven days a week. (“7-Day Model”) (3) A basic life support ambulance staffed 24-hour a day. (“24-Hour Model”)
When balancing current projected revenue totals against the cost of all three deployment models, it is likely that there will be a net cost. The unquantifiable benefit for this added resource is the potential time saved when lowering response times, which is crucial for patient outcomes.
The Weekday Model would require at least four basic life support ambulance operators.
Two teams of two would be developed and be assigned to an alternating schedule. Team One would work Monday through Wednesday the fi rst week and then Monday through Tuesday the second week. Team Two would work Thursday through Friday the first week and then Wednesday through Friday the second week.
The 7-Day Model would require at least six basic life support ambulance operators. Three teams of two basic life support ambulance operators would be developed and assigned to each of our three platoons. Additionally, there will be other ancillary costs such as station uniforms and personal protective equipment . Since these individuals would not be placed into the same environments as a firefighter, the costs of their uniforms and personal protective equipment would be significantly less. The projected cost is detailed in Tables M and N for the two deployment models calculated for personnel costs only.
Table M – Projected Annual Personnel Cost for Two (2) BLS Ambulance Operators 0800 to 2000 hours, Five Days a Week – Monday Through Friday Personnel Hourly
Rate
Number
of Hours
Total
Amount
Paid Per
Day
Work
Days
Per
Year
Total Annual
Cost
BLS AMBULANCE
OPERATOR 0800 to
2000
$17.00 12.0 $204.00 260 $ 53,040.00
PERS Rate 20.2%
(miscellaneous) $ 10,714.08
TOTALS $ 63,754.08
ANNUAL TOTAL FOR
TWO BLS
AMBULANCE
OPERATORS
$ 127,508.16
Table N – Projected Annual Personnel Cost for Two (2) BLS Ambulance Operators 0800 to 2000 hours, Seven Days a Week
Personnel Hourly
Rate
Number
of Hours
Total
Amount
Paid Per
Day
Days
Per
Year
Total Annual
Cost
BLS AMBULANCE
OPERATOR 0800 to
2000
$17.00 12.0 $204.00 365 $ 74,460.00
PERS Rate 20.2%
(miscellaneous) $ 15,040.92
TOTALS 12.0 $187.00 365 $ 89,500.92
ANNUAL TOTAL FOR
TWO BLS
AMBULANCE
OPERATORS
$ 179,001.84
Busiest Hours
A report provided by Verdugo Fire Communications indicated that the hours between 1000 to 1900 hours were our City’s busiest times of the day for calls. Table O details the busiest hours for 2022. An earlier start time, 8:00 a.m., provides our basic life support ambulance operators an opportunity to receive a briefing in the morning, and conduct vehicle and equipment check out, maintenance, and inventory. An end time of 8:00 p.m. allows our basic life support ambulance operators an opportunity to debrief with their supervisor and return the vehicle to a ready -state for the next operational period. When examining data for automatic aid received from outside agencies, the incidents trended similarly to Table O in regards to the time of day.
Table O - 2022 Busiest Hours for All Incidents - Arcadia Fire Hours Number of
Incidents
1 1:00pm to 2:00pm 400
2 3:00pm to 4:00pm 388
3 2:00pm to 3:00pm 371
4 11:00am to 12:00pm 357
5 10:00am to 11:00am 353
6 6:00pm to 7:00pm 350
7 5:00pm to 6:00pm 346
8 4:00pm to 5:00pm 334
*Provided by Verdugo Fire Communications Center Annual Report
Busiest Days of the Week
Further, in researching what days of the week would benefit the most from a basic life support ambulance, Table P details the call volume for each of the days of the week over the last five years. If the Weekday deployment option was selected, a Monday through Friday basic life support peak hours ambulance would be recommended. When examining data for automatic aid received from outside agencies, the incidents trended similarly to Table P.
Table P – Busiest Days of the Week for All Incidents
Year Sun Mon Tues Wed Thurs Fri Sat
2018 749 795 759 861 833 895 813
2019 799 852 819 834 814 800 775
2020 682 728 728 747 690 711 688
2021 734 792 770 774 807 874 825
2022 813 926 835 886 854 923 891
TOTAL 3777 4093 3911 4102 3998 4203 3992
AVG OF
5 YRS 755 819 782 820 800 841 799
***Highlighted sections are the five busiest days of the week
Vehicle
For Fiscal Year 2023-24 and as part of the new equipment acquisition plan, an additional Rescue Ambulance will be requested at a cost of $731,600 ($634,800 for vehicle cost and $96,800 for upfitting). With the addition of a basic life support peak hours ambulance, we anticipate the need to retain one of the current rescue ambulances to utilize as a reserve vehicle.
Other Costs
Other costs possibly associated with this new program could be absorbed by our other budget line items. Such areas include office supplies, training, and medical supplies. With an increase of approximately 120 incidents per year and adding only four to six part-time personnel, these costs would not have a significant impact in the areas indicated in this section.
Potential Additional Revenue Sources
The Fire Department is exploring and researching possible additional revenue sources associated with a basic life support ambulance. Two such sources include the ability to provide interfacility transfer services for USC Arcadia Hospital and possibly other local hospitals to local destinations and executing a reciprocal agreement with Care Ambulance for mutual aid assistance.
The Fire Department is exploring the possibility of providing basic life support interfacility transfer service to patients from the hospital to a local facility or their personal residence.
This will help USC Arcadia Hospital and other local hospitals transfer patients who are discharged from the hospital back to their homes . Requests for private ambulance service can sometimes be delayed with long estimated arrival times. By providing our resource, it may help “unclog” the system. The basic life support ambulance would b e made available at the discretion of the on- duty Battalion Chief. The patient would be directly billed for this service.
Similar to the La Verne Fire Department ’s basic life support ambulance model, our Fire Department would proactively approach Care Ambulance to explore a possible reciprocal agreement. Our basic life support ambulance would serve as a secondary transport source for Monrovia and the Los Angeles County Fire Department when a Care Ambulance is not available. Care Ambulance has experienced staffing shortages. This would allow Care Ambulance to resume their responses into Arcadia as part of their regional automatic aid obligations with the Monrovia Fire Department. These transport opportunities would generate additional cost recovery opportunities for the basic life support ambulance program.
La Verne Fire Department started their program in March 2022 and their specific financial numbers will not be available until the end of this Fiscal Year. How ever, based on initial projections, the Fire Chief of the La Verne Fire Department has indicated that their ground ambulance transportation revenues will generate more revenues than originally budgeted for.
Summary
The implementation of this new program will improve services to our community. It will alleviate potential long response times from outside resources and provide our City with additional opportunities for cost recovery. When time matters for patient outcome, every minute saved is crucial. A basic life support ambulance program will also help keep vital paramedic resources available for more critical medical responses.
It is recommended that the basic life support ambulance program be phased in, initially starting with a Monday through Friday peak hours ambulance operating from 0800 to 2000 hours. The total projected costs and revenue are detailed in Table Q . Once established and the actual financial numbers are realized, the Department can continue to explore the other options of either adding two additional days or converting the ambulance to a 24- hour basic life support ambulance, or completely discontinuing the program.
Table Q – Total Annual Costs and Revenue Projection for BLS Peak Hours Ambulance, Monday Through Friday – 0800 to 2000 hours
COSTS START UP ONGOING
ANNUAL COST
(2) BLS Ambulance Operators
0800 to 2000 Monday through
Friday
$ 127,508.16 $ 127,508.16
Uniform and Gear
$ 4,000
($ 1,000 per person)
$ 1,600
($ 400 per person)
Ambulance Costs and
Maintenance $ 731,600 (new) $ 20,000
TOTAL $ 863,108.16 $ 149,108.16
REVENUE $ 81,645.47 $ 93,399.10*
ADDITIONAL REVENUE
SOURCES UNKNOWN UNKNOWN
NET TOTAL (-$ 781,462.69) (-$ 55,709.06)
*average net revenue loss for Calendar Year 2018, 2019, and 2022
Should you have further questions or concerns, I am available for discussion. Thank you for your consideration.
Range Number Title Step A Step B Step C Step D Step E
PTP12
Activity Leader I
Library Aide
Laborer
Police Cadet
$16.59 $17.00 $17.42 $17.86 $18.31
PTP13 Administrative Intern $17.00 $17.42 $17.86 $18.31 $18.77 PTP14 Activity Leader II
Ambulance Operator $17.43 $17.86 $18.31 $18.77 $19.24
PTP15 $17.87 $18.31 $18.77 $19.24 $19.72
PTP16 Fire Prevention Aide $18.32 $18.77 $19.24 $19.72 $20.21 PTP17 $18.78 $19.24 $19.72 $20.21 $20.72
PTP18 Camp Manager
Library Clerk $19.25 $19.72 $20.21 $20.72 $21.23
PTP19 $19.73 $20.21 $20.72 $21.23 $21.76
PTP20 Tram Driver $20.22 $20.72 $21.23 $21.76 $22.31
PTP21 $20.73 $21.23 $21.76 $22.31 $22.87
PTP22 $21.24 $21.76 $22.31 $22.87 $23.43
Communications & Marketing Specialist I $28.49 $29.22 $29.94 $30.70 $31.45 Communications & Marketing Specialist II $33.04 $33.87 $34.72 $35.59 $36.48 Volunteer Services Coordinator: $22.93 per hr
Reserve Police Officer (Level II): $26.24 per hr
Reserve Police Officer (Level I): Step A of Police Officer salary, plus 11% $44.40 per hr (as of 7/ 1/22) Law Enforcement Recruit: Step A of Police Officer salary, plus 7% $42.80 per hr (as of 7/ 1/22) Law Enforcement Recruit/ Pre-Service: Step A of Police Officer salary, plus 7% $42.80 per hr (as of 7/ 1/22) City of Arcadia Part-Time Hourly Wage
Schedule CalPERS Retirement
Effective January 1, 2023
Proposed Salary Schedule
with NEW Ambulance Operator Job Classification
Attachment "C"
FIRE DEPARTMENT
SENIOR MANAGEMENT FIRE MARSHAL
SENIOR
ADMINISTRATIVE
ASSISTANT
FIRE CHIEF
DEPUTY FIRE CHIEF
FIRE BATTALION CHIEF
FIRE STATION 105 (HQ)
FIRE CAPTAIN (6)
FIRE ENGINEER (6)
FIRE PARAMEDIC (6)
FIREFIGHTER (6)
RESERVE FIREFIGHTERS
(VOLUNTEERS) (7)
ANALYST
OFFICE
COORDINATOR
FIRE BATTALION CHIEF
FIRE STATION 106
FIRE CAPTAIN (3)
FIRE ENGINEER (3)
FIRE PARAMEDIC (6)
VOLUNTEERS
INTERN (1)
FIRE BATTALION CHIEF
FIRE STATION 107
FIRE CAPTAIN (3)
FIRE ENGINEER (3)
FIRE PARAMEDIC (3)
FIRE PREVENTION
SPECIALIST
FIRE PREVENTION
SPECIALIST
FIRE PREVENTION
AIDE (P)(2) FIREFIGHTER (3)
AMBULANCE
OPERATORS (P)(2)
Attachment "D"