Several years ago the Tulare Board of Supervisors were faced with a dilemma. A major ambulance provider had decided to close their doors. How were they going to ensure that the people of the county had adequate emergency services?
They did something that I believe is too rare in politics today…they got out of the way.
The choice they had to make at that time was simple. Do they take the county to a single provider (essentially killing the other smaller units in the county) or turn it over to the remaining providers to see if they could come up with a solution.
The issues identified were as follows:
* No performance standards for ambulance responders
* You could not assure the closest ambulance responded to a request for help
* Rotation of ambulance providers on ambulance requests in the cities of Visalia and Porterville (This led to scheduling confusion and lower response times)
* Ambulance provider agreements were weak and unenforceable
The Tulare County Board of Supervisors directed staff and county EMS to work with the ambulance providers to achieve an ambulance response system that provided all the following:
* A system that was seamless
* A system that assured that the closest ambulance was always sent to an ambulance request
* A system that included strict performance standards
* A system where ambulance costs were consistent throughout the county
At the February 1st board meeting county EMS staff gave statistics showing ambulance response times and how this public team of people had addressed each of the items the Supervisor’s had requested. The one example that stood out for me was when they talked about the closure of one of the providers. On August 17, 2010 the Three Rivers Ambulance Service closed its doors. Three Rivers is a remote community located in the foothills of the Sierras.
In the absence of this service, four of the surrounding ambulance companies stepped in providing personnel and equipment. The area now has a full time paramedic and much improved response times.
The Tulare County EMS system has evolved into a modern emergency response system, consisting of highly trained paramedics, a centralized ambulance dispatch, simultaneous helicopter response, advanced first responders, a trauma center, a cardiac center, and an aggressive ambulance response system. It has been growing and improving over the past 2 years because the Board was wise enough to set the goal, and get out of the way.
You can find the detailed agenda here:
http://bosagendas.co.tulare.ca.us/MG313646/AgendaFrame.htm (Agenda Item 2)
Sunday, February 20, 2011
Information in a Post Wikileaks World
I’ve been reading some very interesting things about a writer named Brad Meltzer. He writes thrillers and you can only imagine the feeling he had when one day he got a call from the Department of Homeland Security (DHS).
I learned about Brad (I’ll take the liberty to call him Brad since we are now fellow authors) through this New York Daily News article:
He was asked to join the government’s Red Cell Program. A “Red Cell” (also known by other names) is a group of hand selected people gathered together to look at problems in their own way and come up with alternative solutions. The awesome thing about this is the people they select are citizens, chosen for their out-of-the-box thinking. Brad says CIA and FBI were present but… “there were far more professors and transportation employees, musicians and software programmers - regular people whose names will never be known and whom you'll never hear about.”
This group of about 20 people would be presented with a scenario such as…how would a terrorist attack some publicly held meeting. (Think U.N. or G8 Summit) They would be provided details of location and attendees and then see what they came up with.
I think this whole thing is a great idea.
So what’s my worry? So far they have completed ten reports and another six are in work. I hope they take great care to secure the information contained in those reports. Terrorists aren’t smart but they are like the Borg on Star Trek. They adapt quickly. They don’t need us to do their thinking for them. So – into my story idea file goes the question of how potentially valuable and dangerous are these reports? What if terrorists hacked the system they were stored in and stole them? What if they were leaked or sold to the highest bidder? It will make an interesting story…I just hope it stays in the realm of fiction.
I learned about Brad (I’ll take the liberty to call him Brad since we are now fellow authors) through this New York Daily News article:
He was asked to join the government’s Red Cell Program. A “Red Cell” (also known by other names) is a group of hand selected people gathered together to look at problems in their own way and come up with alternative solutions. The awesome thing about this is the people they select are citizens, chosen for their out-of-the-box thinking. Brad says CIA and FBI were present but… “there were far more professors and transportation employees, musicians and software programmers - regular people whose names will never be known and whom you'll never hear about.”
This group of about 20 people would be presented with a scenario such as…how would a terrorist attack some publicly held meeting. (Think U.N. or G8 Summit) They would be provided details of location and attendees and then see what they came up with.
I think this whole thing is a great idea.
So what’s my worry? So far they have completed ten reports and another six are in work. I hope they take great care to secure the information contained in those reports. Terrorists aren’t smart but they are like the Borg on Star Trek. They adapt quickly. They don’t need us to do their thinking for them. So – into my story idea file goes the question of how potentially valuable and dangerous are these reports? What if terrorists hacked the system they were stored in and stole them? What if they were leaked or sold to the highest bidder? It will make an interesting story…I just hope it stays in the realm of fiction.
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