Recommendation to receive and file a report on the status of Basic Life Support (BLS) ambulance vacancies in the City of Long Beach; and Request City Manager to explore and implement solutions to restore BLS 12 and 13 to daily service as soon as possible and prepare a long-term plan that addresses staffing shortages for Emergency Medical Technicians (EMT).
Thank you. That concludes public comment. Thank you. Now we move to item. 21. Communication from Councilmember Richardson, Councilmember Urunga recommendation to receive and file a report on the status of basic life support ambulance vacancies in the city of Long Beach. And request the city manager to explore and implement solutions to restore bills 12 and 13 to daily service as soon as possible. And prepare a long term plan that addresses staffing shortages for emergency medical technicians. Councilman Richardson was speaking. Thank you, vice mayor. Sure. So most recently, I was I and the city council was notified of some recent actions that need to take place in our fire department that impact our ability to deploy our basic life support units 12 and 13 based in north and west Long Beach. This has a small but an important impact on our ability to respond and transport patients to the emergency room. The purpose of the motion tonight is to discuss and receive a briefing on that situation, discuss what actions have already been taken and what can be taken to immediately restore vehicles 12 and 13 as soon as possible. And then to begin the conversation on long term solutions to address the staffing issues associated with the EMT positions of ambulance operator positions here in the city of Long Beach. So that this problem which occurred last year, occurred this year, during the last two months of the holidays, won't occur next year. And so at this point, I'd I'd like to hear your staff report. Thank you. Thank you, Mr. Vice Mayor. Members of the Council. So Javier Espinal, our fire chief, will be able to provide kind of an update of where we are with our blaze ambulances. We provided a 2.4 report on Friday, which is provides a lot of data and we can kind of get into that a little bit and answer your questions. So with that, I will turn it over to our fire chief. Thank you, Mr. Vice Mayor. Members of the Council, thank you for the opportunity to provide this update on our basic life support ambulance staffing. Recent staffing shortages and Long Beach Fire Department's ambulance operator position have caused a change in the staffing model for basic life support ambulance deployment. On October 18, 2019, after having met and conferred with both the International Association of Machinists and the Long Beach Firefighters Association, Long Beach Fire Department elected to stop using mandatory overtime for ambulance operators to staff one of the city's two time to daytime peak bliss units. If full time employees are available or part time employees have signed up to work. This unit will be staffed. This action was taken to provide temporary relief to the remaining full time ambulance operators who were being required to work an excessive number of additional hours to fill the vacancies. The FDA provides two transport methods for patients who have called 911 for a medical emergency. Critical patients like those who are suffering a heart attack or a stroke and need immediate medical intervention are transported to a local emergency room by firefighter paramedics in one of the fire departments. Nine ALS paramedic rescues patients who do not require immediate, immediate medical intervention by paramedics, but who require or request transport to a local emergency room are transported by one of the BFD bellows ambulances, the BLR ambulances or staff with non sworn ambulance operators who hold an emergency medical technician license and are either full time or part time employees at staff. One of the five bellows ambulances, three of the bellows ambulances are staff for 24 hours a day and are currently housed at fire stations two, four and 19. Two of the bellows ambulances are peak load units and are staff during periods in which transports occur more frequently. Currently, a unit is housed at Fire Station 13 and a staff from 8 a.m. to 8 p.m. and one is housed at Fire Station 12 and is staffed from 10 a.m. to 10 p.m.. VLS Ambulances are a citywide resource. Therefore, even though each BLS unit is assigned to a specific fire station, the Bliss units are out in the community more often than they are in their designated fire stations. Long Beach Fire Department typically hires one class of ambulance operators per year. And in past years, this class would graduate approximately 20 ambulance operators. This is typically enough to support the natural attrition that occurs in that classification. Ambulance operators are hired through civil service and applications are screened for qualifications and sent over to the BFD for review. Candidate candidate candidates are selected from that list and 60 or more slated for BFD interviews with firefighters of various ranks. The top candidates are sent to live, scan a thorough background process and a medical exam with occupational health before being offered a position. Once offered the position, ambulance operators complete a three week course that covers internal BFD policies and procedures, an EMT refresher and emergency vehicle operations. The ambulance operators also complete field orientation observation rotations with current ambulance operators. Part time employees are offered full time positions in order of seniority or an order of their performance in the ambulance operator class. Currently they all. BFD is experiencing a shortage of BLS personnel, as many fire departments are hiring for fire positions in addition to ambulance operator companies. The shortage is limited to FDA ability to cover all shifts on the 12 hour bill as ambulances. BFD Ambulance Operator Staffing filled a critical levels in September 2018. We conducted a hiring process and 24 candidates began the background and medical exam process. Of the 24 candidates. Only 13 completed the three week orientation class. The others withdrew from the process or were disqualified during the background. Medical or EMT refresher course. A second process was initiated in May 2019, and in this process, 36 candidates began and a total of 20 candidates completed the process. The civil service list for this position expired, and a new bulletin was published in June 2019. In August 20, 1960, candidates were interviewed. 36 moved to backgrounds, and as of today, 28 candidates remain in the process and those that complete backgrounds are being scheduled for medical exams. The background and medical exam portions of the process are typically slated for ten weeks based on part on prior experience. We're hopeful that we may be able to conduct a smaller class prior to the end of the year if we're able to move through the process quickly. If this is not the case, a class would take place in early January 2020. As previously mentioned, bliss, ambulances, transport patients who do not require immediate medical intervention by a paramedic when there are no bills, ambulances available and a patient meeting. These criteria requires transportation. An analyst unit is dispatched to provide transport. This typically places an A+ unit out of service during a period of typically 20 or 30 to 40 minutes. Other A+ units provide coverage in that unit's area while it's out of service. To reduce the number of mandatory shifts. The ambulance operators recovering the department stopped filling mandatory overtime spots on VLS 12. This unit was selected because of the five B-list ambulances. It has the lowest average call volume at seven calls per shift. Additionally, it has two paramedic rescues nearby that provide overlapping coverage in the event one is out of service. Further, the OB FDA proposes to rotate this reduction between Bliss 12 and Bliss 13 beginning in mid-November. It is anticipated that most of these calls will be absorbed by the other Bliss units. If no Bliss units are available. An elite unit would have to fill in further. The recent restoration of Engine 17 provides an additional citywide resource to provide emergency medical services prior to the arrival of an A+ or a B+ transport unit. These reductions in daily staffing are temporary and will be in place until the BFD is able to hire sufficient number of ambulance operators, which is expected to occur in January 2020. During this period, BFD will strive to maintain response times while continuing to meet the expectations of the community with regard to emergency medical services. This concludes our report and we stand ready to answer any questions. Thank you. Yes. Thank you. Just a thank you for that report, Chief. And you expanded on what was initially submitted in the two from four to the council. So thank you for giving us the most recent update and just have a few questions about the situation. So we had a call with our North local leaders last night and there was a lot of discussion about the difference between Alice and the Beatles. Would you just give a high level explanation of what Alice Rescue does and what a Bliss does? So Alice is advanced life support and those are are paramedic firefighter paramedics that respond to typically heart attacks, strokes, things of that nature that need immediate intervention by a paramedic by higher level of emergency technician. The Bliss ambulances are more slated for transport of patients to hospitals that don't need immediate intervention by a paramedic. Okay. So advanced life support, heart attack, basically it's a life or death situation. Basic life support will be an example of a basic life support call. It could be a minor laceration, a fall with bruising pain of some type that doesn't require immediate intervention. Understood. Okay. And you touched on this. It's the proximity to the ALS units and the three full time, because VLS units will limit the response time. But can you say that there will be no impact to response times, or will there be an impacted response times while we're in this situation? I can't say that there will be no impact. I do anticipate some impact to the system. But as previously stated, especially with the VLS units, once they arrive and change shift in the morning, more generally than not they are out of the station and whether they get back into that particular area within a given number of hours is subject to run count. Okay. And you mentioned in your presentation that you expect that this issue will be resolved and the unit will be placed, the units will be placed back in service January 2020. I do. Are there any factors that could affect the timeline on that, either pushing it beyond January 2020 or sooner than January 2020? So it is we stated we currently are pushing as hard as we can through the background and medical process. There is a potential that we could do a class potentially earlier as far as going past 2020. I don't anticipate that being a problem. We have everybody in the queue as far as the medicals and the backgrounds and I think we're going to be set. Sure. Thank you. Now I want to talk about the future. So based on our conversation, I know that this has happened at least once in the past last year, and then it happened this year. Mr. Modica, can can you would you talk about what your approach would be in responding to this, this motion to think about what we can do to either make the hiring system better or faster, or to build a bench or a pool, or to enhance or improve the problems that lead to the ALS being difficult, a difficult position to maintain. I know that there are concerns about the level, the rate of pay that these folks receive or whether it's a pipeline to a fire position or whatever it is. But how would you respond to this motion? Sure. So we have been putting a lot of thought into this, and this motion helps us really hone in on it. We do. You know, one of the aspects here is it's a smaller group of employees than we do have. For example, firefighter. We have, you know, 100 firefighter positions and just dozens of these positions. Part of the reason that this program was created in the first place place was to be a feeder group into our firefighter ranks. So we know that this happens. We know that we we often have transitioned these people into other employment in long beach. We're going to be looking at working with civil service and with h.r. About planning out those academies. We're also, you know, knowing that there's going to be peaks and valleys sometimes where something like this unexpected will happen and see what are our options to either bring in additional support or having people on a bench or others that we can bring in to do that. And if there's any other solutions out there, we're going to be looking at those in the next month or two. So we we don't like to be in this situation. We always want to have full staffing whenever possible. It does happen in an organization our size and in this case is just a small, limited pool that can do that job. So we were we will be taking this seriously and trying to plan those academies so that this doesn't happen in the future. Thank you. So that's the last thing I'll say is, is number one, I want to thank the residents who submitted comments on each comment and those of you who joined us. I see my neighbors, my Rohnert neighbors sitting here front center paying attention. It's incredibly important. So so Mr. Modica, I was going to say, Mr. West, Mr. Modica and Chief Espino, the more we can, you know, submit to form fours and keep the council updated, keep the public updated on this immediate restoration. But also the conversation about what we're going to do in the future, I think would be welcome. Folks want to want to know that we're on top of this and this won't be the situation next year. Is that okay? Yes. So part of our response will be to come back and look at all those different ideas. We we've had some ourselves. We are hearing from others about what could we be doing. We're going to run those down. We'll make sure we give a report back. And as the chief mentioned, we're going to try a number of things to accelerate that date from January into December so that the it's narrowed as much as possible. To make sure this is. Due in writing. Thank you. This is an issue not just for North Long Beach, right. All of the you know, the system is the sum of its parts. It affects response times across the city. We restored Engine 17 and they responded to a fire in North Long Beach on the 91 freeway last week. So it's all a part of the same system. I know the impact, the Westside North and citywide. Thank you. Thank you. Fine. We're going to public comment. We're going to go to right now. That's he said he wanted to wait. Yes. We're going to go to Japan and come up. Mr.. Good to you first. And then we have, uh, Anita, in a way, Mrs. Harding. You would. Your next question. Thank you. I fully support this motion. And I will use this opportunity as I tried to the last time we were at the council meeting. But the council, our mayor three times said, I already spoke on it when the public record revealed I did not speak on it. The thing to keep in mind and this is something I didn't know and a lot of people didn't know until about two or three years ago. Are they in heresy, dangers in fighting fires to the people that fire that fight those fires? These are the the long term effects on lungs excuse me and hearts from a lifetime of inhaling that smoke. It's debilitating. It cuts life short to short. And anything we can do. To address that we should keep in mind. And ironically, after last week's council meeting, of course, the issue became not just a Long Beach area issue or California issue or law in L.A. County, but it's a nationwide issue. These are the all the fires that nobody expected and so forth. So the that's front and center and should always remain front and center relative to those inherent issues that are extraordinarily difficult to deal with and cut the life short of our firemen. Thank you. Thank you, Mrs. Bonita. Yes. Good evening. Thank you. Vice Mayor De Andrews and our city councilman. My name is. We need a doctor Moore. I'm a resident in the ninth District representing the Collins Neighborhood Association. And the ninth District recently lost and just lost the services to Station 12, I believe it was seven years ago. And just recently those services were restored. Having these basic life support services reduced. To like part time services or loss of them. They put. Our. Most vulnerable residents at great risk. We have several residents that are elderly, they're homebound, and we have several members in our community that depend on public transportation. So having these services taken away from them and if they have an incident for call, for service, where they have to depend on this ambulance service to take them to a nearby hospital, that's not necessarily maybe in that neighborhood, but is across town. These life saving services sometimes can be life threatening and critical to our most vulnerable residents. So I ask that you please consider something that is more of a permanent and long term solution. So our residents in District nine, as well as the other residents in the city of Long Beach, can have a better quality of life. Thank you very much for your time and I appreciate it. Thank you very much. Thank you, sir. Yes, Mrs. Harry. She? Now I will go to the diocese council in anger. Thank you, Mayor. And I want to echo the last person who made a comment there. Although our report says to explore alternative solutions to the temporary to a temporary reduction in bills. I think we should look at more permanent solution to that. I totally agree with that. I would ask the maker of the motion if he would be amenable to. Redirect a step to make a permanent solution to this. That's the intention with a long term plan like fix it permanent. We don't want to deal with this one. On the record that we're. Looking on the record. Absolutely. We understand that's the that's the goal. We want to get there as well. All right. I have a few questions that regarding the the current status of where we're at and what brought us here. So Bill's services are sometimes provided by EMT. Emergency medical technicians are the ones or twos. One. One is that basically entry level emergency medical technician. If you're interested in getting to the fire service below a paramedic. Correct. Okay. The positions that we have here, are they part time positions or full time or a mix of both? They're mix of both. And when we come about to this situation where we're at now. How many hours? A full time EMT one would put in would be would it be a regular eight hour shift an hour firefighters put in 24 hours when they perform as often for as three, 4 hours. So. Valencia if we go in a shift, we shift and see shift. So red, blue and green, I think it is. How do they work? The full time blazer operators work on the same schedule as our firefighters, but they are the only bliss the ambulance operators that are able to be mandatory back in the temporary positions or into the part time positions, I should say. So if you look at their calendars, they're working. 20 days or more, 20 days or more a month, and they're being forced back to work. It's not voluntary. So is the coverage that the EMT, the bells serious ambulance, ambulance service providers? Are they mostly daytime then? You mentioned 8 to 8 or. Correct. So the two units that we would look at closing any event we had, two mandatory people would be the part time. One of them runs from eight in the morning till 8 p.m. and the other runs from ten in the morning until 10 p.m.. So you basically have air services at through the early morning hours or radio shifts. You would have A.L.S. services throughout the day, 24. Hours a day. But I'm saying that the majority of the you wouldn't have that many bells. Ambulance operators in the graveyard shift, we have mostly full time paramedic services. Decorate the three at night. You know? Correct. Also in also looking at this. Acting City Manager mauka. I'd also like to see we could get together with h.R. And Civil Service to look at not only the duties of the emt and what they do, but also look at some of the wage discrepancies that might exist. If we're losing ambulance operators to other jurisdictions. We're probably losing for a number of reasons. Obviously, 1/1 and foremost is pain. And I think that perhaps we should look at what's out there in the market. What can the market bear as far as paying these ambulance operators a little more than they've currently receiving? Now, I know it'll be an effect on our budget. However, if we're losing people and we're getting through the state of emergency, that's something that we need to address and we should address it as quickly as we possibly can. So I would also want to include a classification review, if you will, with including salaries so that we can look at a better long term solution to this issue here. But yes, we do expect this to come up during negotiations. Now's the time to address these types of issues as we're going into negotiations with. And so we we are aware that these of the pay of these employees and recognize the duties that they do for that pay. So we will be looking at that. And one more thing. I if I recall correctly, we used to have somewhat contract ambulance services, provide supplemental services to the city with that American medical services, I think was one at one time. You're in Long Beach, are they? We have no more contract ambulance services out there anymore that we contract with. So we used to contract the service out completely and not have our own ambulance operators of several years ago we went to an in-house model rather than the contract model. That is something we're going to be looking at as well as for those supplemental times. If you, you know, can we do it with in-house staff? Do we have a pool of staff that can do it? But is contracting an option as well? So we'll be looking at that as part of the review. Would contracting out the summit rephrase it? It's a terrible way of saying it. Would contracting with a million services be possible in the in the short term right now to address this current need? We don't believe it to be possible in the short term. By the time we would have that and go through all of the meet and confer and everything required. We're going to be fully staffed already. So this would be more of a long term solution and would not be contracting out. It would be more supplemental services where we. That's what I meant after. That's what I meant. Well, also, in perhaps in this evaluation, we can look at supplemental services, contract services as well for those times when there is a run of emergencies that would require getting a supplemental ambulance service to assist the city in that in that respect as well. What I want to revisit that in the short term. That's all I have. Thank you. Brian. Thank you very much. We have no more comments on that. Can we please no more from you comes by and please cast a vote. Excuse me, Councilwoman Pierce. Okay, fine. Okay, good. Cast your votes, please. Motion carries.