City of Orange Office of Mayor*

Fire Departments that once primarily responded to calls for fire emergencies now have become emergency medical response departments primarily responding to medical emergencies. This evolution has occurred since the onset of "9-1-1" call where all emergency calls are received at one place. The City of Orange partially disagrees with this finding - The City of Orange does not agree that implementation of our 9-1-1 Public Safety Answering Point (PSAP) in the 1980's is directly correlated to the increase in medical incident responses versus fire incident responses. The Orange City Fire Department placed its first paramedic unit in service in August 1973. Finding #1 ignores the first fifteen years of the evolution of modern EMS. Prior to 1973, Federal and State legislation had authorized paramedic programs, created EMS systems, set standards for firefighter first aid and EMT training.

As the fire departments evolved into emergency medical departments, the model for operating the fire departments has not radically changed. The fire departments have simply absorbed the emergency medical responses into their departments under their old "fire response" model. The City of Orange agrees partially with this finding - While the City of Orange has not radically changed the model for operating the Fire Department, specific adjustments to its response model have been made over the years. Nevertheless, the model is purposefully designed to deliver all-risk emergency services through strategically located deployment which allows for quick response time from multifunctional personnel. The California fire service led the effort in 1970 to implement paramedic programs throughout the state. In 1970, the Wedworth-Townsend Paramedic Act was signed into law, establishing the parameters for implementing paramedic programs. The Orange County Fire Chiefs' Association developed a master plan for paramedic services in Orange County in 1974. This document served as the guide in the development of a planned, strategic and seamless countywide fire service based paramedic delivery system. This document also set-forth responsible entities for critical support of the paramedic system, including the County Health Department, County Communications Department, base hospitals, receiving hospitals and teaching institutions. The Orange City Fire Department was one of the initial participants of this countywide system. The emergency medical services system delivered by the Fire Department and other fire departments in Orange County did not "evolve," it was premeditated and thoughtfully designed to efficiently provide outstanding care to the sick and injured. As late as August 2011, the Orange City Fire Department was still making changes to its delivery system for the benefit of the public. This included redistributing three of the on-duty medics to form paramedic teams (two medics) in the three ambulances. This resulted in better partnership, increased mentoring, and reduced the need to deploy multiple engines to a medical aid call.

Economic recessions have forced local fire department boards of directors and city councils to re-evaluate their models for providing fire and emergency medical responses. While this brings to the fore issues of staffing, response times, public safety, training, consolidations, union rules, and privatization of their various services, it also spotlights the model used for all emergency responses. The City of Orange agrees partially with this finding - During the past several years of economic recession, the City of Orange studied and implemented numerous methods to reduce costs, while striving to maintain quality services for the public. Many of these actions were difficult and the Fire Department has not been immune from organizational changes and reductions designed to reduce costs. Among the changes in the Fire Department included cross-staffing the Urban Search and Rescue ("US&R") squad with an engine. Over the years the City and the Fire Department have engaged in multiple evaluations of fire and emergency medical service delivery models, apparatus configurations, response times, staffing and deployment. As a result, over the years a multitude of changes have been suggested, considered, implemented, and deployed. Fire dispatch and training centers were merged with other jurisdictions decades ago. In 2004, the City of Orange hired Emergency Services Consulting, Inc. to conduct a Fire Station Location and Deployment analysis. The 2008 Lewis Report contained eleven