City of OKC, EMSA support bill allowing fire departments limited transport of patients

A bill that would allow fire departments across the state to take patients to the hospital in life-threatening situations has been approved unanimously by the state Senate and soon could be considered by House members.

The bill, SB1515, was initiated by the City of Oklahoma City after an attempt to temporarily authorize its fire department limited transport ability was shot down by the Oklahoma State Department of Health for being against state law.

Under the law change, any certified emergency medical response agency — the majority of which are fire departments — responding to a life-threatening medical call can transport a patient with approval from the appropriate medical control. For Oklahoma City, that would mean a call to the Office of the Medical Director, which oversees EMS services in the OKC and Tulsa metros.

More: Oklahoma City ambulance service looks for help with staffing shortage

At a time where the demand for paramedics is up and the supply is down, Oklahoma City Fire Public Information Officer Benny Fulkerson said the proposed change would mean better service to the most critical patients.

"The whole goal, of course, is to save lives," Fulkerson said. "It's just another way to meet the need, on a little bit higher degree than we've been able to do."

The bill passed 42 to 0 in the Senate, but must be passed by a House committee by the March 24 deadline to be heard in the House.

Dr. Jeffrey Goodloe, chief medical officer of the Medical Control Board, said getting the legislation passed is a priority for the medical director's office.

Bill would let EMS systems choose based on their own needs

Goodloe said each EMS system in Oklahoma would have the freedom to decide if they will allow responding agencies like fire departments to provide transport for their patients.

The conditions also would be decided by each system, Goodloe said.

The initial attempt in August to authorize Oklahoma firefighters to provide limited transport was for a patient with acute coronary syndrome, if an ambulance would not arrive within 20 minutes and the control board had to approve the transport.

If the bill passes, Goodloe said the Office of the Medical Director would determine the specific terms for Oklahoma City and Tulsa's systems.

"This is not going to be a freelance plan where everyone just uses unspecified judgment," Goodloe said. "We will have very clear parameters for patient safety."

More: Oklahoma City Council allows creation of basic life support EMSA units

The bill also would allow EMS systems to decide not to transport patients when their medical condition "does not warrant emergency ambulance transport."

EMSA Public Affairs Officer Adam Paluka said if the Office of the Medical Director chose to adopt a no-transport provision, it would be guarded by strict protocols and physician oversight.

"It is our opinion that stringent oversight would ensure that this provision is highly managed and monitored," Paluka told The Oklahoman via text.

How would this impact the OKC fire department?

While fire departments in Oklahoma have never been transport agencies, Fulkerson said medical response is at the heart of what OKC Fire does.

The fire department responded to 58,375 medical calls from Feb. 1, 2021, to Feb. 1, 2022, an average of 4,865 per month, Fulkerson said. A paramedic is assigned to each of the department's 37 fire stations at all times, he added.

Nearly three-quarters of the department's responses are medical calls, according to the fire department's website.

But Goodloe said even if the bill passes, the fire department may not be transporting many patients.

There were only three cases since August, Goodloe said, that fell under the parameters set up by the attempted temporary authorization, but for each one the Medical Control Board determined the patient would be able to wait for an ambulance.

"It doesn't necessarily mean that will happen on a daily basis, it might not even happen on a weekly basis," Goodloe said. "But I think just having that legal allowance … can be very helpful as we look to innovative ways to best take care of Oklahoma City, Tulsa, and the other communities we're privileged to serve."

OKC city council to vote on renewing EMSA services in April

The Emergency Medical Services Authority has provided ambulance services for the Oklahoma City and Tulsa metro areas since 1977, but the cities have the option to withdraw from the public trust every five years.

EMSA is required to meet certain response times 90% of the time in Tulsa and Oklahoma City, but Oklahoma City numbers have been below the threshold since June of 2020. Compliance the first half of 2021 stayed around 70%, but has dropped since that time.

In January, EMSA ambulances met the required response time of 11 minutes on priority 1 calls only 45% of the time in Oklahoma City and Edmond. Paluka said response times this month are trending upward, but that data won't be available until April.

The Oklahoma City Council voted in October to extend its "window of opportunity" to renew or withdraw its place in the EMSA trust to April 1-31, 2022.

City Manager Craig Freeman said at an Oct. 26 council meeting that he wanted more time to review the situation as ambulance providers nationwide struggle to provide the highest quality service. He added that if Oklahoma City chose to withdraw from EMSA, the city would not only be taking on emergency transport services, but also the struggles the system is dealing with.

Since the pandemic began, EMSA has seen an increase in calls and an increase in emergency room wait times. At the same time, there has been a national shortage of people going into the emergency medical technician field and especially those wanting to become paramedics.

More: EMSA response times below standards due to staffing shortages

EMSA attributes its failure to comply with required response time 90% of the time to these struggles, and the proposed law change is just one avenue to improve service, said Paluka.

In November, the public trust requested Oklahoma City and Tulsa city councils change their ambulance codes, allowing EMSA to set up basic life support units. These units would not have a paramedic on board, and therefore be able to respond only to non-life threatening calls.

The goal is to keep paramedics free to get to the highest priority calls as quickly as possible. EMSA predicted these units would improve response times by 5% to 10%, but Paluka said more time is needed to see the full impact.

This article originally appeared on Oklahoman: OKC ambulances could get help from firefighters in emergency transport