Emergency Service: It's Life and Death, but Also a Business

Two tones chimed from a handheld Motorola radio -- bing bung -- and Ken Wheaton and Lt. Ken Chesnut bolted.

They turned their rescue truck toward I-696 east and sped past conifers draped with snow.

Sirens called out, telling other drivers to get out of the way as the two Southfield firefighter/paramedics turned the city's roads into a one-vehicle racetrack.

Cathryn Ramage, 77, had been in a car accident and needed their help.

When Wheaton and Chesnut arrived at the woman's white bungalow, she appeared shaken. Her left hand gripped her kitchen table; the other grasped a neighbor's palm. Her lower back stung. Her breath came out in short gasps.

Her silver Ford Escort, its right side smashed, lay several feet from her house.

Ramage told the firefighters she felt dizzy and light-headed. She looked dazed as they took her pulse and blood pressure. They told her she had better go to the hospital.

But they would not be the ones to take her there.

Instead, that Friday in late January, two paramedics from a private ambulance company carried Ramage away.

Had this incident happened later this month, Wheaton and Chesnut would have carried the woman out on a gurney. They would have been the ones to take her to Beaumont Hospital in Royal Oak.

And Southfield would have made some money.

This month, in a move designed to bring in revenue for the city and prevent cutting vacant firefighter positions, Southfield will begin switching its ambulance services from private to public.

Unknown is how the change will affect ambulance response times for Southfield's and Lathrup Village's roughly 84,000 residents -- and a daytime population of about 250,000 office and commercial workers.

Southfield, like most metro Detroit communities, is looking to save and make money in the midst of cuts in state revenue sharing. It's one of the latest communities to take over the transport of patients to hospitals from private ambulance companies.

Income source

By using its own firefighter/paramedics, Southfield can bill insurance companies for its services, and according to Fire Chief Patrick Healy, bring the city between $1.2 million and $1.5 million a year.

Chesterfield Township, which has about one-fifth the ambulance call volume of Southfield, also is considering the switch from private to public transport. The move, according to the township's Deputy Fire Chief Doug Charbonneau, should generate $300,000 to $700,000 a year.

Livonia Fire Chief Alan Brandemihl said his department made $1.8 million last year transporting patients.

Healy added that transporting patients also means Southfield will not have to cut 13 firefighting positions. This, said Southfield Firefighters Association President Tom Colombo, makes the extra work worthwhile, even if existing firefighter/paramedics will not see pay increases.

"We could not live with a massive reduction," said Colombo, a captain who is also the Fire Department's paramedic coordinator. "Obviously, if a person works more, they expect greater compensation, but the Fire Department is about operating as a team. Staffing is extremely important, as important as benefits and pay."

To equip the department for patient transport, the city will spend about $49,400 retrofitting five ambulances and buying extra equipment, such as stretchers, and another $72,000 to pay 12 firefighters who will be promoted to firefighter/paramedics, according to City Administrator Dale Iman.

That will put the total number of firefighter/paramedics at 51; the number of positions in the Fire Department will remain at 105. Southfield also may put a fifth ambulance in service to cut down on response times.

Still, after the switch, ambulances will be out of service longer because firefighter/paramedics would be at a hospital taking care of patient transfers and paperwork. On the other hand, they may be able to transport patients faster because they do not have to wait for a private ambulance.