Finding a funding source for full-time paramedics and a medical unit in the South San Francisco Fire Department to focus on medical and mental health calls is being considered with the City Council weighing a parcel tax or possibly other measures.
“For many years, it has been placing an ever-increasing burden on the fire service to continue the model that we have had for the last 25 years of firefighters being dual-hatted as paramedics,” City Manager Mike Futrell said.
The combination of increased medical calls, mental health calls, responding to the pandemic, having to send firefighters on mutual aid out of the city for long periods of time, and fighting wildfires are reasons for restructuring the fire service, he said.
The department is recommending dedicated transport paramedics and dedicated firefighter staff; creation of a health and emergency transport division staffed with single role EMTs and paramedics for ambulance transport; have the number of advance life support, or ALS ambulances, increased from two 24-hour ambulances by an additional one 12-hour ALS ambulance that would be in service during peak call times; and the addition of a disaster preparedness coordinator to alleviate the amount of work for the emergency services manager.
The division would have the addition of a community paramedicine behavioral health branch staffed with a part-time medical director, nurse practitioner, mental health clinicians and technicians. The branch would be focused on new ways to improve overall community health, reduce chronic emergency transport use and address behavioral and substance abuse related to emergency calls, South San Francisco Fire Chief Jess Magallanes said.
“The recommended restructuring would maintain response service levels, maintain ambulance response times and provide lower transport fees as compared to the rest of the county,” he said.
These proposed changes would cost about $3.7 million annually with $1.4 million allocated to the behavioral health branch.
“If we do a parcel tax right now, based on what we know, we will be looking at something shy of $95 per residential unit and then about $850 for commercial properties,” Janet Salisbury, the city’s finance director, said. “In order for it to pass, there would be a supermajority vote.”
The city would also conduct a community survey to engage public interest and support.
The department has been providing ambulance transport for more than 45 years as part of its emergency response service and South San Francisco remains the only city in San Mateo County to fully operate its own ambulance service.
“This has allowed us to have ambulance response times that are more than three minutes faster than the county’s goal of 12 minutes and 59 seconds. And our transport fees are less than the county’s private insurance provider. And we get a paramedic on scene of high priority medical calls within six minutes and 55 seconds, 90% of the time,” he said.
The model has worked for the past 25 years when it first added the second ambulance, but now as call volumes continue to increase, the response model is becoming more difficult to sustain, he said.
Over the past 10 years, call volume has increased 37%, medical calls have increased 44%, and transports have increased by 27%. In addition to the over 7,500 calls for service in 2020, the department also responded to 14 different wildfires statewide.
“Since these ambulances are staffed with paramedic firefighters, they’re becoming less and less available for other emergency responses or important activities like firefighter mandated training, pre-fire planning, equipment and facility repair and maintenance,” he said.
Paramedic firefighters were also trained to administer COVID-19 vaccinations and assisted with vaccination clinics.
The current two ALS dual-role paramedic firefighting ambulances services are about just under $3.5 million per year. The tax would fund a new sixth response unit with new single role paramedics and EMT division, he said.
Vice Mayor Mark Nagales asked what it would look like for mental health professionals to work with the department and Magallanes said it would be following the model where the police department liaisons with the behavioral health group and decides which calls they will triage.
“I think it’s about time, right, after 45 years. We’re going to restructure and it’s really a great time to restructure it and having a health and emergency transport division,” Councilmember Buenaflor Nicolas said.
However, she said she doesn’t think a parcel tax will be the answer to this. Mayor Mark Addiego and councilmember Eddie Flores also agreed with the concerns.
Flores suggested looking at other various funding models and options. Nagales agreed to take more time and said he would still be interested in doing the community survey to see the data.
Councilmember James Coleman also agreed.
“Maybe we can go out to the community and ask them different various mechanisms for funding, to see which would be the preferred way of funding this for the community,” he said.
The council will meet again for a study session to continue discussing the future of fire service and find alternatives to a parcel tax.
“I definitely would call out also our county. They should step up more in terms of this funding model. This shouldn’t be South City leading it. It should be San Mateo County leading it and the leadership in the county,” Flores said.
(650) 344-5200, ext. 105