Aside from swearing in four firefighters hired by the Chehalis Fire Department during the pandemic and honoring retired Captain Steve Emrich at last week’s Chehalis City Council meeting, Chief Adam Fulbright requested the council authorize him to transition the department to offer advanced life support (ALS) emergency medical services by 2024.
Fulbright’s request was approved unanimously by the Chehalis City Council.
The department is currently staffed to support basic life support (BLS) services, which it has been historically, Fulbright said. BLS services include a general array of medical services the department’s staff provides.
“They continue, day-in and day-out, to provide exceptional service … But this level of service does have some limitations,” Fulbright said. “It does not provide the necessary level of protection that the citizens and community could have.”
To transition from BLS to ALS services, the department will need to fill both of its two vacant positions with ALS-qualified paramedics.
ALS services include a wide scope of medical care options to drastically improve survival chances for patients suffering from life-threatening illnesses or injuries, including heart attacks, strokes, respiratory conditions, diabetic emergencies and more than 200 other life-threatening medical emergencies, Fulbright said.
He added to become qualified, paramedics have to complete more than 3,000 hours of training in ALS classes.
“They learn how to read monitors, they defibrillate, they can pace the heart when they have critical cardiac events that are happening,” Fulbright said.
With the current two vacant positions, Fulbright said he believes this is a vital opportunity to both fill those positions and improve emergency response patient care within Chehalis while the city continues to grow.
To attract ALS-qualified paramedics, Fulbright proposed offering them a 10% salary increase above the city’s standard firefighter engineer salary, once those paramedics have also completed firefighter engineer training.
“Historically, the industry standard is 10%,” Fulbright said.
In the city’s current firefighter salary scale, both engineers and paramedics in the department make a monthly salary starting at $5,468 and a maximum monthly salary of $6,588 after five years of service.
After engineer training, a fully qualified ALS paramedic’s salary starts at $6,014.80 a month three to six months after hiring, with a possibility of making a maximum of $7,246.80 after five years of service with the department, Fulbright told the council.
Annually, a fully qualified ALS paramedic engineer will make $6,561.60 more a year initially compared to the standard salary, and up to $7,905.60 more annually after five years of service.
Additionally, paramedics and engineers already with the department will be eligible for the same 10% raise should they become dual-qualified ALS paramedics, City Manager Jill Anderson said.
Aside from the salary increase, Fulbright said the department’s emergency medical services (EMS) supplies and medications would need to be upgraded, costing the city an estimated $30,000 annually.
An additional $10,000 annual budget allotment would also be needed to pay a physician to provide required medication oversight and additional services to achieve ALS services. Currently, it costs the city $5,000 annually to pay for a physician under BLS services.
Finally, EKG heart monitors with at least 12 leads would need to be purchased for the city to meet ALS services, normally costing between $32,000 and $45,000 to operate and maintain annually.
Due to an existing agreement allowing the use of federally provided pass-through grant funds with Colorado-based EMS company American Medical Response — which currently provides ALS services in Lewis County with paramedics and ambulances operating out of Centralia and Chehalis — the department will be able to purchase the required EKGs for $25,000, Fulbright said.
Along with the salary increase, the transition to ALS services will cost an additional estimated $75,000 annually, Fulbright said. Chehalis’ budget committee stated the city has the funds to afford the increase and supported the transition, Fulbright added.
Included with Fulbright’s proposal was a letter from International Association of Fire Fighters Local 2510 Chehalis union chapter President Rob Gebhart supporting the department’s transition to ALS services.
Despite American Medical Response’s presence in the county, Gebhart doesn’t think it would be a good idea to continue to rely on the company.
“American Medical Response is a for-profit company, and if at any time they do not see a profit in Chehalis or Lewis County, they will leave,” Gebhart said in the letter.
The company’s absence could leave some residents in the county without an ALS agency. “Chehalis Fire would be hard pressed to create an ALS program quickly,” Gebhart added.
Additionally, Lewis County Medical Program Director Dr. Peter McCahill supported the department’s transition to ALS services, Fulbright said.
According to Fulbright, there are already times when American Medical Response is swamped with calls and is either delayed or can’t respond to a medical emergency.
Fulbright said the city’s fire department was the first responder to approximately 70% of medical 911 calls in 2022, responding to a total of 1,477 calls. American Medical Response was not available or delayed for 10% of those calls, and approximately 5% of those calls required the Chehalis Fire Department to transport the patient, he added.
“Our primary goal is to enhance the service, optimize our staff and modernize the fire and EMS system that Chehalis Fire provides to the community with the ever increasing demand for services,” Fulbright said.
Due to the possibility of American Medical Response leaving, Fulbright stated other Lewis County fire departments have already transitioned to provide ALS services. Those departments include the Lewis County fire districts in Adna, Napavine, Winlock and Onalaska as well as the Riverside Fire Authority in Centralia.
“They saw the need early on and made the necessary transitions to provide that extra (ALS service) layer,” Fulbright added.
The Chehalis City Council unanimously supported the transition.
“I think it’s wonderful,” Councilor Daryl Lund said. “I thought we should have done this years and years and years and years ago.”
