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Published May 7th, 2014
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The Tangled Web of Lamorinda Ambulance Service
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| By Nick Marnell |
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Shortly after sunrise on Nov. 12 the Contra Costa County Fire Protection District responded to an emergency medical call in Lafayette. A child was determined to be in serious condition and Captain Gil Caravantes asked for an ambulance to transport the patient to the hospital. ConFire's ambulance provider, American Medical Response, relayed that it was 20 minutes away, said Caravantes, so he asked for mutual aid from the Moraga-Orinda Fire District. MOFD Medic 141 arrived in less than 10 minutes and transported the child to John Muir Hospital, where he was treated and released.
How does something seemingly so obvious become a news story, let alone the lead paragraph of one? Because ConFire has a contract with AMR to provide its ambulance service and Caravantes technically violated that contract by calling for MOFD. The incident illustrates one of the many complexities of the county emergency medical service system.
"By the letter of the law, AMR is the one authorized to ask for mutual aid," said ConFire battalion chief Ben Smith, EMS division. "Technically, we should wait for the AMR ambulance."
"I didn't feel comfortable with that," said Caravantes. "MOFD was right around the corner, so I asked to dispatch the MOFD ambulance. I realize ConFire has a contract with AMR, but, we're all about care and safety first."
Erik Rohde, the AMR general manager for Contra Costa County, did not respond to questions for this article.
As counter intuitive as the contract situation may seem, MOFD chief Stephen Healy explained the rationale. "We have to stay within our operating area," he said. "That's the way the system is designed - to prevent chaos. We don't have a right to go into AMR's exclusive operating area to provide ambulance transport; we went because we were called.
"AMR has provided us with a lot of mutual aid; I don't want them to think we were poaching."
The chief added, "What if one of our district residents called for an ambulance, but we were unavailable because we were occupied where we should not have been?"
Unlike ConFire, MOFD has no contract with AMR. MOFD has the exclusive right to provide ambulance service in its district under the California health and safety code because the district provided its own ambulance service prior to June 1, 1980.
"I called Chief Healy and explained what we did and told him the reasons why," said Caravantes. But the captain said he was questioned by his superiors about his actions.
"'Why would you do that,' they asked," said Caravantes. "'Well, you weren't there,' I said. They thought I might catch some flak for it, but that I should be okay. I should be okay? For going above and beyond? 'Don't worry,' I told them. 'I'm okay.'
"I would do it again in a heartbeat," continued the captain. "Would I get called on the carpet for doing it? Absolutely. Is what I did the right thing to do? Absolutely."
"That's the way the system should run, but that's not the way the system is set up," said Smith. "I support what captain Caravantes did. If I were the captain, I would have done the same thing."
"If the ambulances were operated by the fire districts in the county, this type of situation would not occur," said ConFire chief Jeff Carman. "The fire service is very good at sharing resources and always sends the closest resource regardless of what agency it comes from. This situation is not unique, and in the best interest of our customers I support captain Caravantes' decision to call for the closest resource."
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Lamorinda Weekly, Moraga CA