Listening Sessions on Ambulance Services for San Marcos Area
EMS SERVICE AREA BACKGROUND
The San Marcos EMS Service Area is currently an exclusive operating area (EOA) pursuant to California Health and Safety Code Section 201.224. From 1988 until 2001, the services in the EOA were delivered through a joint contract consisting of private enterprise Advanced Life Support (ALS) transport units and ALS fire department first responder engine companies. In 2001, the San Marcos Fire Department (SMFD) began providing ALS transport services in San Marcos as a sub-contractor. In 2009, the SMFD was awarded the contract to provide ALS transport services to San Marcos residents.
The City of San Marcos is a Charter City operating under a Council/Manager form of government. The City encompasses an area of approximately 24 square miles and the Fire Protection District adds approximately nine (9) square miles for a total service area of 33 square miles. The San Marcos Fire Protection District became a subsidiary district to the City of San Marcos in 1987. In 1988, the City added paramedic services to the community.
EMS SERVICE AREA COMMUNITY PROFILE
The residential population of the City is nearing 100,000 with a steady estimated 11 percent population growth since 2010. In addition to the City population, approximately 20,000 residents are located within the Fire Protection District, for a total of nearly 120,000 residents being served by the SMFD. The service area’s daytime population increases to approximately 160,000. The San Marcos population is growing four (4) percent faster than the other neighboring cities and almost two (2) percent faster than the San Diego region with a projected growth of 6.1 percent by 2020. It is projected that by the year 2030, the City of San Marcos population is expected to grow by more than 15 percent.
EMS SERVICE AREA SERVICES
San Marcos EOA calls for service are dispatched through the North County Dispatch Joint Power Authority (NCDJPA). Participation in this regionally-based JPA supports and enables the shared use of other area agencies ALS assets through an automatic aid “boundary drop” agreement that utilizes the closest transport resource concept.
The EOA ALS Transport Services contract requires that ALS ambulance response times not exceed nine (9) minutes, 90 percent of the time. ALS Engine and Truck company response times also adhere to strict response time expectations, with an eight (8) minute response time required 90 percent of the time. The SMFD consistently meets or exceeds these response time standards. The Department has steadily experienced significant call volume increases since 2014. Throughout 2017, the Department responded to 11,490 calls which represent an increase of 4 percent from 2016. During 2014 and 2015, the Department experienced a 22 percent and 11 percent increase in calls from the previous year, respectively.
SMFD currently provides ALS transport service to the City of San Marcos and San Marcos Fire Protection District residents. The ALS transport service is a no-subsidy service in San Marcos, meaning the City does not provide monetary support to the provider. Rather, all revenues needed for program operations are derived from billing for services provided. In order to provide the highest level of service to the residents of San Marcos, the Department staffs four (4) ALS Engine companies, one (1) ALS Truck company and five (5) ALS Ambulances 24-hours a day, 365 days a year. In addition to five (5) ALS ambulances staffed with a minimum of one (1) Firefighter-Paramedic and one (1) Emergency Medical
Technician, every Engine and Truck company is staffed with a minimum of one (1) Firefighter-Paramedic and/or Fire Engineer-Paramedic. SMFD employs 105 personnel including those assigned to Emergency Services, Fire Prevention and Administrative Services. Fifty-six (56) of the seventy-five (75) field personnel are licensed, Paramedics.
EMS SERVICE AREA PROGRAM MANAGEMENT
To provide continuous EMS program oversight, the EMS program is managed within the Department’s Emergency Services Division. Under the direction of the Fire Chief, EMS Program leadership and management is provided by a Fire Division Chief, an EMS Program Coordinator (R.N./P.M.) and a Emergency Services Support Specialist. The Department staffs a 24-hour on-duty Battalion Chief to provide field level supervision over all personnel and incident activity.
California’s EMS authority has recognized SMFD as a Continuing Education (CE) Provider for both Paramedics and Emergency Medical Technicians. The Department maintains trained and certified instructors to deliver these CE classes. In addition, SMFD also maintains a comprehensive ALS Quality Assurance and Quality Improvement Program (QA/QI), designed to identify and address potential or existing clinical, operational or equipment concerns. To learn from experiences and improve upon overall EMS service delivery, QA/QI process outcomes are routinely incorporated into CE case review training sessions.
In addition to providing multiple opportunities and platforms for community public education, the Department also maintains innovative program partnerships and customer feedback outreach efforts. Community outreach events provide education related to health, safety and various life-saving techniques. The Department promotes programs that provide specialized medical referrals and associated services in order to integrate a whole health service approach. By adhering to a whole health service approach, the entire patient is evaluated, not just their immediate concern, thereby promoting an advanced level of care for San Marcos residents.
Through dedicated leadership, integrity, safety, competency, and customer service the San Marcos Fire Department has provided emergency medical services since 2001. SMFD encourages and maintains continual education and training, keeping personnel current on all certifications, licenses, protocols, and best practices. Two-thirds of SMFD workforce are licensed Paramedics, creating a highly trained medical team on scene. Incorporating education and training, SMFD manages a quality assurance program overseeing emergency medical services while maintaining excellent customer service. SMFD provides community outreach education and professional emergency medical services connecting, empowering, educating, and acting as advocates for members of the community and offering resources to improve overall health.
SMFD is prepared to grow with the population and continue to provide innovative, cost-effective and consistent service to all members of the San Marcos community. The Department looks forward to continuing to improve and is always seeking avenues to increase our level of service to the community.