The idea of combination, career and volunteer systems isn鈥檛 new. Fire and EMS agencies have used this staffing model across the country for years to save money either through salaries, equipment purchases, crew quarters and the like.
Changing the mindset
In the past, employers would allow fire/EMS volunteers to leave work when an emergency would arise, and volunteers lived, worked and volunteered all within their own communities, allowing their departments adequate staffing. These times have changed.
Volunteer shortages and recruiting challenges are exacerbated as the workforce faces long commutes, multiple jobs and long hours, which also inhibits their ability to put in training time and obtain certifications.
At times, volunteer departments become overwhelmed with call volume, resulting in increased delayed or failed responses. These challenges mean sometimes, volunteer departments require career support to keep the continuity of care, and governing bodies assume providing fire and/or EMS services to the communities.
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Combination systems
Combination fire/EMS systems can work and, in some areas, work seamlessly with paid systems. Ambulance and fire crews arrive to emergency scenes and the patient can tell no difference. But what happens when this model of service delivery grows static or worse, leads to conflicts and competing interests?
In a 2009 paper titled, written by James Cullinan III, of Spotsylvania County (Virginia) Fire, Rescue and Emergency Management, he identified challenges including:
- Agencies operating independently, in regards to rank structure, operation and administrative policies
- A lack of clarity as it related to authority and responsibility
- Competing interests when it comes to budgeting appropriately to provide the desired level of services
Maintaining integrity
Seamless continuity of care is the goal. The patient shouldn鈥檛 be able to tell whether the clinicians responding are career or volunteer. Both groups should be held to the same:
- Standards of care
- Educational requirements
- Quality assurance review
- Response times
- Minimum staffing levels
- Uniformed appearance
These six key goals must remain at the forefront through change 鈥� changes in leadership, changes in time, changes in best practices, changes in equipment and changes in population.
The bottom line, if a combination system isn鈥檛 able to handle call volume, continuing educational needs and 鈥� more importantly 鈥� supporting your community in their time of crisis, than a career system should be fully funded. This becomes the responsibility of your local government to make it happen. The citizens of your city, county or jurisdiction deserve that.
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Matt Zavadsky on performance measure recommendations that prioritize quality over response times.
