WATERTOWN — Mayor Jeffrey M. Smith doesn’t see any reason for the city’s fire department to respond to an EMS call when a person falls or suffers from a diabetic episode.
Guilfoyle Ambulance Services should respond to those kind of calls, he said, adding that the fire department should drastically cut down on the medical calls they go on.
The City Council and city officials will sit down on Monday night to discuss just that. They’ve scheduled a work session for 7 p.m. to discuss whether to change a policy that would result in the fire department responding to fewer calls.
“There’s a lot of calls they don’t need to go to,” the mayor said.
Much of the discussion is expected to center around Jefferson County dispatchers following Emergency Management Dispatch protocol to ask a caller a series of questions before determining the level of response. The mayor believes the change of Jefferson County 911 dispatch handling emergency medical calls would result in the city’s fire department going on fewer calls. In 2020, the fire department’s rescue truck responded to more than 2,600 medical calls.
Currently, a fire engine is automatically dispatched on EMS calls as soon as it gets a call from county dispatch to go to a call.
Mayor Smith, a physician assistant, believes the city should put in place the same EMD procedures that’s used by county dispatch for EMS calls in other parts of the county, he said.
The EMD system triages 911 calls to determine the seriousness of the call and what kind of response should be sent.
The complicated number-letter system consists a list of 37 EMD protocols, or codes, that describe the medical reason for the call, City Manager Kenneth A. Mix said, who completed research about how the system works to prepare for Monday night’s council meeting.
The list includes such things as abdominal pains or problems, flu symptoms, traumatic injuries, knife or gunshot wounds, traffic accidents, strokes, overdoses, pregnancy and psychiatric emergencies.
Using six determinant categories from Alpha to Epsilon and Omega, the letters indicate the potential severity of injury or illness, based on information provided by the caller and the recommended type of response.
Dispatchers then decide whether it should be “a hot or cold call,” whether an emergency vehicle should have its lights and sirens on when responding to the call, Mr. Mix explained. There is a higher risk for the vehicle to be involved in a traffic accident on its way to the call if they are on, he said.
Mayor Smith has questioned the need for its vehicles to always go to a scene with “lights and sirens blaring.”
It takes about two minutes for dispatchers to go through the EMD call, according to Fire Chief Matthew Timerman.
Guifoyle Ambulance uses the EMD system when calls come into their dispatchers, as do county 911 dispatchers for the towns in the county.
“They decide what calls to go to in the rest of the county,” said Mayor Smith, who noted that he knows how the system works because he was a paramedic who went on calls with Chief Timerman when he worked on the fire department’s rescue truck.
It works well in the county because dispatchers can finish going through the series of questions before volunteer firefighters can get to their respective fire stations and head to the scene, said Daniel Daugherty, president of the city firefighters’ union.
“By the time they get through EMD, we’d be there in the two minutes,” Chief Timerman said.
Those two minutes can be the difference in saving a person’s life, he said.
Only Guilfoyle can transport a patient to the hospital, while the fire department can only treat patients at the scene, according to its certificate from the state’s Bureau of Emergency Management System.
The private company charges for its services. Guilfoyle bills anyone who is taken the hospital in its ambulances, while people treated at the scene by firefighters are not charged for the service.
Lower income residents may struggle to afford health care coverage, so his department’s EMS service might be “their only access to health care,” Chief Timerman said. That’s why they go in an ambulance to get care in emergency rooms, he said.
At a council meeting three weeks ago, the City Council decided to take the rescue truck off the road for good. Without the rescue truck, a fire engine from each of the fire stations now respond to calls.
The mayor and the majority of the council saw the move as a compromise as they agreed to hold off ending EMS calls. They also agreed to hold Monday night’s work session to talk about the issue and find a way for EMD to work for the department.
Like they have for years, the fire department and its union have debated the city for the need for the rescue truck.
Chief Timerman has expressed concern that the state EMS bureau will pull the department’s certification if the city stops going on EMS calls.
Bruce G. Wright, president and chief executive officer of Guilfoyle Ambulance, said his company will be impacted by the city’s decision to end EMS calls. He wanted a chance to talk to the city about the ramifications of making the change.
“I plan on attending the meeting and I am hopeful that we will have a good dialogue about how we can work on a public safety model that is appropriate, safe and efficient,” he said in an email.
But the meeting itself has become a controversy.
Jefferson County officials won’t be attending the meeting, expressing concern that the meeting will be used to criticize the way the county handles EMS calls.
Scott A. Gray, the county Board of Legislators chairman, said he did not want county EMS officials “to be grilled” by elected officials at the meeting.
But Mayor Smith said he didn’t understand why the county would not send EMS officials to the meeting.
“You would think that they’d want to be part of the solution,” he said.
But Mr. Gray said county staff would be more than willing to meet with the city administration — without elected officials present — to educate them about how the county handles EMS calls and help them to come up with a policy for the city.
“We’re prepared to help the city come up with a policy,” he said.
When the mayor brought up EMD issue last year, the county scoffed at the idea because it would mean additional costs of increasing staff at county dispatch.
Mr. Daugherty, president of the Watertown Professional Firefighters’ Association, Local 191, criticized the city for not inviting a representative from the union to attend the meeting.
In response, Mayor Smith said the union is a part of the fire department and that Chief Timerman will be attending, so the union doesn’t need an invitation. After being pressed about not inviting a union official, Mayor Smith said he doesn’t have a problem with the union being there, as long as “they’re constructive and they’re not negotiating.”
Mr. Daugherty insisted the union should be at the table as a participant during Monday’s meeting.
Council members won’t be making a decision about the fate of the EMS calls at the work session.
Mayor Smith said Friday he doesn’t know when a decision will be made.