Charlottesville City & Fire vs. CARS

Jason See writes:

The members of the Charlottesville-Albemarle Rescue Squad are up in arms over a recent line item budget addition proposed by the City of Charlottesville. Both the City and the Charlottesville Fire Department feel that the response times by the busiest all-volunteer rescue squad in the country are “unacceptable.” Their solution is simply to drop a million dollars of the taxpayers money to allow the Charlottesville Fire Department to transport their own patients.

Officials with the City and Fire Department were hoping to avoid any public debate so that it “would be all under the radar,” however public outcry has forced the City to create a task force to try to make amends with the volunteers.

Thoughts to chew on include:

  • If the City was so concerned with response times, why didn’t they try to work it out with CARS instead of becoming sneaky with the Fire Department?
  • Coincidence that the former chief of the department is now City Councilor?
    (wink, wink.nudge, nudge)
  • Just think what kind of recruitment and retention program CARS could create to fill the volunteer-void if the City even donated half of that chuck to them, noting that the city never pays a dime for CARS services.
  • What would the public think once the Fire Department starts running calls and charging patients for the 6 minute trip to the hospital, when CARS can do the same thing for free?

Rob Seal wrote in the Progress yesterday that an August study shows that unifying city and county fire and rescue services wouldn’t result in any savings, though neither the city nor the county would give a copy of the document to the Progress. (Which I’m not sure they’re legally allowed to withhold.) In his most recent column, Bob Gibson argued that it just doesn’t make sense to keep the services separated. Lone City Council candidate (at this point) Jennifer McKeever isn’t buying the city’s criticism of CARS. And in today’s Progress, Rob Seal and Jeremy Borden describe the area’s planned move to more and more paid rescue employees, moving from our current 91% volunteer rate to something much lower in the next few years.

CARS, to their enormous credit, publishes all of their response times to the web in real time, using Ty Hoeffer’s excellent Rescue Incident Display System. All of those calls are archived, making it trivial to look at their response times. The Albemarle County Fire Department participates in the system, too. But the Charlottesville Fire Department does not, making it impossible to provide a comparative analysis. Jason See was kind enough to go through and weed out all response to calls in the county (which skew response times upwards considerably, of course), providing me with a spreadsheet of 1,338 response times from January 1 through Tuesday. (You can download that spreadsheet, if you like.)

Here’s a histogram of how much time elapses between the call and CARS’ arrival at the scene. It’s a long-tailed normal distribution with a median of 7:29.


And here’s a stacked, filled line graph of the time that it takes to arrive at the scene (the same data as in the histogram) and the time that it takes to get the patient to the hospital, with the total indicating the entire time spent in transit. The median time to the hospital is 6:58 (just 0:31 less than the time to arrive at the scene), and the median total travel time is 13:27.

Stacked Line Graph

Also, I looked at the time elapsed from when the call is dispatched and when they’re enroute, and found that the median time elapsed is 1:56, with the great majority between one and three minutes.

Given that the standard response time for life-threatening incidents is eight minutes, it’s noteworthy that the average response time is 7% lower…and that’s including responses to a great many situations that quite likely aren’t life-threating (“sick person,” “back pain,” “childbirth,” etc.) I also have to wonder to what extent any response time problems come from traffic, which the rescue squad can’t control. I have zero experience in rescue, but I have to suspect that the only thing that’s really within their control is how long it takes them to suit up and hit the road.

12 thoughts on “Charlottesville City & Fire vs. CARS”

  1. Excellent analysis, Waldo. I strongly suspect that putting that $1 million into a congestion taxing system and using the proceeds to provide free transit and street improvements would make a much bigger difference in response time than a parallel emergency response.

  2. What would the public think once the Fire Department starts running calls and charging patients for the 6 minute trip to the hospital, when CARS can do the same thing for free?

    Is it really for free?

    I know someone who recently had to use the R.S. and they got a bill for something like 1,400.00 a large chunk of which might wind up being covered by insurance- but then there’s still the deductible.

  3. It depends where your friend lives. CARS has never charged a fee for their service. The Official EMS Proposal by the City Fire Department cites that:

    Examples of cities that are currently billing for ambulance transport include but not limited to the cities of Alexandria, Chesapeake, Hampton, Lynchburg, Newport News, Norfolk, Petersburg and Portsmouth, and the counties of Arlington, Chesterfield, Fairfax, Hanover, Roanoke, Spotsylvania and Stafford. Locally, the following communities that have implemented EMS revenue recovery through ambulance billing include but are not limited to Nelson, Orange, Louisa, Madison, and Waynesboro. Albemarle County stated its interest of implementing an EMS revenue recovery program in the 07/08 fiscal year at its October 6, 2006 Board of Supervisors meeting. Revenue recovery strategies are not only very prevalent but are becoming the norm.

    Although I know for a fact that Louisa currently does not charge for EMS, they are looking into implementing the policy.

  4. I say give CARS half a million bucks and thank the fire department for pointing out the need for public support to CARS. And leave it at that.

  5. Albemarle County stated its interest of implementing an EMS revenue recovery program in the 07/08 fiscal year at its October 6, 2006 Board of Supervisors meeting.

    Thanks for the info. Based on my experience then, Albemarle County has implemented an EMS revenue recovery program. They aren’t thinking about it anymore. It’s a fact.

  6. Albemarle County has not implemented EMS revenue recovery. They are studying the feasibility of such with a panel comprised of County officials and volunteer rescue squad representatives from CARS, WARS, & Scottsville.

    Further, it amuses me that people continue to cite Bob Gibson’s remarks on fire and EMS in Charlottesville (and Albemarle) as though he is an expert on the matter, when he certainly is not. His only expertise is with a column of logorrhea based on unsubstantiated opinion. But, hey, I guess facts don’t sell newspapers.

  7. The person I mentioned in my first post on this thread is a resident in albemarle co and received a bill. If there is a difference between that and “EMS revenue recovery” then so be it. But I’m not seeing any.

  8. Charlottesville doesn’t even know the deal it gets with CARS … extrememly high quality care and service, fully volunteer (as I understand it), free. If you’ve ever lived anywhere with only private Squad “service” you know exactly what I mean. Competition has its plusses, but CARS just does a great job and pretty much always has.

    I agree … give ’em the buck s and let them continue to kick ass.

  9. I went to the hospital in a CARS ambulance twice in a week in February. They showed up quickly and handled the matter professionally. Plus the price was right.

    Thanks Waldo for the link to RIDS. I looked my ambulance trips up, and the response times seemed very reasonable.

  10. Charlottesville & Albemarle are truly fortunate to have numerous volunteer-based fire & EMS organizations serving the community.

    TrvlnMn – who was the billing agent for the person you are referring to? Albemarle County DOES NOT bill (yet) for emergency services.

    va displaced – a point of clarification: CARS (the 501c3 organization) is all-volunteer; however, the County does staff CARS with two Medic-Firefighters during daylight hours on weekdays. Those career staff work jointly with volunteer staff to provide needed services to the County and City.

  11. Jason – I didn’t know tht, but it makes good sense. Thanks for the clarification.

  12. TrvlnMn –

    The county board of supervisors has not authorized its fire department to charge for services – you can check their minutes where they have authorized discussions to do so. So if your friend indeed has received a bill from an ambulance service, it likey was a private ambulance company

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