Last year, the consultant group Emergency Services Consulting International (ESCI) presented its report on the feasibility of a merger between the Honolulu Fire Department and the Honolulu Emergency Services Department, which consists of paramedics and lifeguards.
While the report was 211 pages, some readers keyed in on the four-page executive summary, particularly the sentence: "ESCI estimates that a merger of the organizations has the ability to generate savings in excess of $10,000,000 within the next five years."
However, the analysis is flawed and to suggest a merger of the two departments will save the taxpayer any money at all may be completely false.
At all times, but particularly when funding is tight, we have a responsibility in government to achieve savings for the taxpayer. At the same time, as the director of the Honolulu Emergency Services Department, I have an obligation to make sure pre-hospital patient care remains a priority. If we can improve patient care and save money with a merger — that is a win-win for everyone.
Both the Honolulu Emergency Services Department and Honolulu Fire Department are first-class organizations. That is why Mayor Peter Carlisle and the City Council are putting together a working group to carefully determine the best way to move forward from the merger report in a way that respects all stakeholders and is good for Honolulu.
For example, the two departments could start a cost-effective pilot program to co-locate dispatch centers as well as vehicle maintenance and supply operations. If we do this, we need to do it right — and because the people here believe in it, not just the hired consultants.
That said, I did look closely at all 211 pages of the report and discovered miscalculations and omissions that did not support the claim of $10 million in savings. In fact, the report arguably predicts at least a $10 million cost to the city if we merged the two agencies.
On page 107 of the report, the ESCI lists a training cost for 30 Honolulu EMS personnel to become firefighters at $120,975. However, the math was wrong, and the consultant forgot to multiply by a factor of eight (eight hours per shift) so that actual cost would be $975,800. If you extrapolated this cost to all 180 EMS personnel, the cost of cross-training would be nearly $6 million ($5,854,800). Training fire department personnel to become state-certified EMTs, and later state-certified paramedics, would be an additional cost that could easily be over $100,000 per person. There are more than 1,100 firefighters currently.
After the training is completed, ESCI predicts a cost savings using dual-trained employees (personnel trained as both a firefighter and a paramedic); but in truth the cost is actually increased because of the pay differential for the dual-trained employee’s position. This salary difference would result in more than $2 million in additional costs per year, or $10 million over five years if dual-trained personnel were used.
Looking at other cities across the nation, fire-EMS mergers have been both successful and unsuccessful.
The bottom line is we currently have two very professional and capable agencies serving the residents and visitors of the City and County of Honolulu and we don’t want to sacrifice service by rushing into a merger before we have all the costs and facts.
My department is committed to working closely with the fire department and other stakeholders to find ways to better provide patient care and efficiencies where possible and practical. But we must do it responsibly.