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Mission Creep at the L.A. Fire Department 

The LAFD has become a huge mobile health clinic. And that's simply unsustainable

Thursday, Aug 8 2013
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Traffic grinds to a halt as an absurdly long hook-and-ladder truck pulls out of Fire Station 9, on Seventh and San Julian streets in Skid Row, lately rebranded as "Central City East." Shining like a fresh tomato, the truck is the cleanest thing on the block. The driver doesn't bother hitting the siren. They're not going far.

About two blocks, in fact, just past San Pedro Street, where an old Asian man lies on the sidewalk, his pants around his knees.

"What's wrong?" asks one of the five firefighters who gather 'round.

click to flip through (3) PHOTO BY TED SOQUI - Captain Walter Duffy, center, with A shift at Station 9 in Skid Row
  • PHOTO BY TED SOQUI
  • Captain Walter Duffy, center, with A shift at Station 9 in Skid Row
   
 

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"He keeps falling down," a bystander says.

The firefighters ask what seems to be the trouble. Someone hears the man say, "chest."

"Chest? Chest?" They decide to call an LAFD ambulance.

"If someone says 'chest pains,' we're obligated to take them to a hospital," Capt. Walter Duffy explains, " 'cause the city of L.A. is liable."

In a perfect world, an ambulance from Fire Station 9 would be on scene. But life in LAFD is far from perfect. Most stations have one or two ambulances, called "rescues." Fire Station 9 has four — all unavailable just now, because it's L.A.'s busiest station.

"This run is a perfect example of what's going on," says Duffy, slipping on his tortoise-shell Ray-Bans. He's the picture of cool — 60 years old, 33 on the job, two years from retirement. "We got it as 'person down.' It's a guy complaining of chest pains. I say we need a rescue. Now, the next [available ambulance] is at Fire Station 10" — south of Pico Boulevard, a mile and a half away. That means, Duffy says: "There's a delay, maybe a few minutes. If he was having a heart attack, it woulda been bad."

Alarmingly slower response times by LAFD to 911 and emergency calls have generated withering criticism. One-time mayoral candidate Austin Beutner revealed the problem last year, and the L.A. Times confirmed it, showing not only that LAFD crews were slowing down but also that LAFD brass were thoroughly incapable of measuring their own emergency-response times.

Fire Chief Brian Cummings was hauled in front of the angry (and equally statistically challenged) L.A. City Council, which wanted answers but didn't know the questions. Cummings grabbed at an answer — he blamed budget cuts. Council members had no real clue but threw $35.6 million at LAFD, much of it to pay for hiring hundreds of new firefighters.

Since then, the debate has been framed thus: More money means more firemen, which means shorter response times.

That's not the whole truth.

LAFD response times are being inexorably dragged down — not by fire calls, and not by requests for those dramatic life-or-death rescues that make the news. Average response times to those serious events actually decreased by 21 seconds between 2007 and 2012, a City Controller audit found.

No, LAFD slowdowns are being caused by a tsunami of ambulance calls from people with shortness of breath, vague pains, cardiac arrest and all manner of real and imagined maladies.

LAFD gets absurd requests — like help finding the lost remote control. And it gets hundreds of calls, every single day, just for a lift to the hospital.

Almost unnoticed, these often lower-level calls now all but define LAFD's reason for being.

The cost, and the mission drift at LAFD, are vast. A report by Chief Cummings himself concluded that in 2012, LAFD firefighters, who at the basic fireman level earn $187,000 in salary, overtime, health care and pension ($200,000 is the average when all LAFD jobs are included), spent a cumulative 3.2 years simply sitting outside emergency rooms in city ambulances or standing in ER hallways.

The city's well-paid firefighter crews aren't there due to emergencies. They are waiting for people they've transported, with non-emergency complaints, to be booked by busy ER staffs. Some firefighters call it "wall time," as in "holding up a wall" while a patient is admitted for a broken toe or a funny burning feeling in the lower back. The courts say it's medical malpractice to simply leave a patient at the ER.

Darren Evans, a paramedic at Station 9, says wall time is "anywhere from 20, 30 minutes — to four or five hours."

Last year, LAFD ambulances spent a cumulative 28,239 hours parked outside ERs, twiddling their thumbs. It cost L.A. taxpayers $3.4 million in 2012. That's a lot of cheddar.

Wall time also matters because each marooned ambulance, sitting silently outside the ER at Good Samaritan Hospital, USC Medical Center, UCLA or Valley Presbyterian, inevitably causes other LAFD ambulances to be called to incidents outside of their own jurisdictions. That contorted situation means they arrive late, dangerously slowing LAFD's emergency-response times. Sometimes, a "light force" — two large, gas-guzzling, difficult-to-maintain vehicles carrying five or six firefighters — has to respond as well. Or both happen at the same time, stressing the broader system.

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