Why is the integration of Fire and EMS important to Cleveland?

Over the past week, we’ve talked a lot about the “integration” of Fire and EMS – the effort to join two separate units that each provide emergency response in Cleveland into a single, cohesive unit.  And it struck me – most Clevelanders may not know why it is such an important topic and why it should matter to them. Here’s why Fire and EMS integration is so important to everyone in Cleveland.  —Maureen Harper, Mayor’s Office of Communications

More and more, City of Cleveland emergency responders are called upon to help people in medical emergencies.  And both the Division of Emergency Medical Service and the Cleveland Division of Fire are responding. For these medical calls, the time in which it takes for a trained medical professional to arrive on scene can make all the difference in the outcome for the patient.  The faster the response time, the sooner pre-hospital medical care can begin. The City has 18 EMS ambulances, but with the sheer volume of incoming medical calls, often our Fire first responders get to the scene first. While firefighters are trained EMTs, not all are certified paramedics; and, fire trucks are not designed to transport patients.

So, Mayor Frank G. Jackson directed the Department of Public Safety to work on ways to leverage the expertise and availability of our available resources to provide better, faster response to emergency medical needs while enhancing our ability to deal with any rescue operation or fire suppression. Thus the concept for the Division of Fire, Rescue and Emergency Medical Services was born – a single division, with cross-trained firefighters and paramedics capable of responding to all calls for service, in a time when calls for medical help and technical rescues are rising and calls for fire suppression are declining.

  • In 2013, Cleveland Fire responded to 61,728 incidents. 55.6% of these incidents were medical emergencies while only 4% were fire suppression incidents.
  • The number of calls for fire suppression has declined 33.6%, from 3,734 in 2007 to 2,478 in 2013.
  • Last year, Cleveland Fire responded to 2,621 technical rescue incidents.  In 2007, that number was less than 400.
  • In 2013, EMS received 106,385 incoming calls, an increase of 20.6% since 2007 when they received 88,227 calls.

These figures represent the changing nature of calls for help in Cleveland; and since 2010, the Jackson Administration has been actively working with the Division of Fire and its union, Local 93; the Division of EMS and its union, CARE to create the new, unified division and improve service delivery.  For the past two years, Assistant Director of Public Safety Ed Eckart has led those negotiations and after hundreds of hours of painstaking discussions and significant compromise, a tentative agreement was reached with the leadership of Fire Local 93.

The agreement would have increased the city’s Advanced Life Support (ALS) capabilities, increased the number of trained and certified firefighter-paramedics over time, enhanced the ability for the City to respond to hazard and technical rescue calls and still respond to fires – all of this for the same amount of money that the City spends on Fire and EMS services. However, when put to a ratification vote of the union membership, the Fire union voted it down by a wide margin.

“The agreement that was reached was largely based on the union leadership’s proposal and for it to fail defies explanation. The union’s leadership gave no indication that the agreement was not comprehensive enough for final ratification,” said Eckart. “I was looking forward to announcing that we would be able to fulfill the Mayor’s vision of providing faster, better medical, rescue and fire response in Cleveland.”

A fully integrated Division would allow for existing firefighters and EMS paramedics, if they choose, to cross-train and create a new class of personnel: all-hazards firefighter-paramedics.  New hires into the Division of Fire, Rescue and Emergency Medical Services would graduate from the training program as fully certified firefighters with EMT certification.  Then, once on the job, they would receive additional training and certification as firefighter-paramedics. This approach was designed to respect existing personnel, while moving the City’s emergency response abilities in the right direction.

The result? Better response time and better service. The City will continue to work to bring that high level of service to every neighborhood in Cleveland. According to Mayor Jackson, he and his team are reviewing every option to achieve the goals of integration.