Study recommends changes to Las Vegas Fire Department

Las Vegas could slow spending increases and generate new revenue in the Fire Department, according to the results of a city-sponsored study.

The study, conducted by the International City/County Management Association Center for Public Safety and released Tuesday, recommends changes to everything from handling ambulance transports to firefighter shift lengths.

It's the result of a vote by the City Council in June to spend $155,000 studying the efficiency and productivity of the Fire Department, where spending has increased 43 percent since 2004.

"We are asking individuals to come into our shop, turn over the rocks and look for ways we can improve," Fire Chief Mike Myers said. "And we are not afraid of it."

The study, which was denounced as wasteful by the International Association of Firefighters Local 1285, generated 23 recommendations, some more substantive than others.

Among the top recommendations was a suggestion the Fire Department change the way it handles responses to medical emergencies by adopting one of two options.

The department handles 28 percent of emergency medical transports with the remaining 72 percent done by private ambulances.

In option one, the Fire Department would discontinue EMS transport service and allow private ambulance companies to pick up the slack. The study estimates this could save $14 million to $18 million a year.

Option two would be to take over all medical transports from the private ambulances, which the study estimates could generate $12 million to $14 million in revenue from charges to patients.

Myers said the department could handle option two if it changed its business model to be more flexible with the 21 ambulances and staff it already has.

"There is a firm belief we could do that without any increase," Myers said.

Others questioned how easily the Fire Department could take over the entirety of medical transports without increasing costs or undermining service.

Michael Gorman, general manager of AMR/MedicWest, which provides ambulance service in Las Vegas, Clark County and North Las Vegas, said running an ambulance fleet at a profit isn't easy .

Gorman said the company needs to average about $350 per transport to make a profit, which sounds easy given the approximately $1,000 it can charge for an insured patient.

But about 30 percent of the company's trips don't result in a transport, another 30 percent or so don't have insurance, and about 10 percent are paid by Medicaid at a rate of $180.

To maintain coverage the company has about 90 ambulances stationed throughout the valley, plus another 30 percent in reserve for maintenance, Gorman said.

Maintaining and stationing those ambulances in good position to anticipate calls takes money and expertise, he said.

"It is not the cost for just one ambulance, it is the cost of having all those ambulances spread out where the calls might come from," Gorman said.

In addition to the ambulance recommendations, the study looked at other areas of the Fire Department.

Firefighters union President Dean Fletcher said the study is "nothing more than what we already knew."

Fletcher said getting out of medical transports would mean reducing the department by 42 firefighters per day.

"I don't think the citizens would like that option," Fletcher said.

Taking over 100 percent of transports would be doable, Fletcher said, but difficult with current staffing levels.

"I believe, personally, that would be a stretch," he said.

Myers didn't have any timeline on when any of the recommendations might be enacted.

"Sometimes when you get a consultant report it takes several years to implement the recommendations," he said.

Contact reporter Benjamin Spillman at bspillman@reviewjournal.com or 702-383-0285 .