Concerned about their future and tired of what they say are inadequate resources, paramedics at Denver Health and Hospitals have been trying for months to switch city agencies and join the Denver Fire Department, where they would stand to enjoy greater clout and earn more money.

Unfortunately for them, DHH doesn't want to see them go. A task force appointed this past spring by the mayor's office to study the move voted overwhelmingly against it, saying it was too expensive. At the same time, the task force did acknowledge that more resources were needed and recommended the addition of two ambulances to the city's fleet of nine. But a member of the task force says the group was "biased" against the paramedics' request to move.

Last spring about 70 percent of the city's approximately 100-member Paramedic Division joined the International Association of Fire Fighters Local 858 as an independent EMS local. (The paramedics' group has not been recognized by the city as a bargaining unit, however.) "The thing that drove us to unionize is that we wanted to be able to present a strong, unified voice to the hospital and be able to have a little muscle behind it," says Jim Manson, the union's president. "Anybody who isn't a fool knows [the firefighters] have more clout."

The paramedics insist that the move would mean better service--including shorter response times--for Denver residents, but DHH administrators suggest that the paramedics' desire to move is largely motivated by money. "They never brought up pay," says Denver General Hospital administrator Stephanie Thomas, "but I think that was a concern. You know how people won't sometimes get to the real issue."

Until last March, when the paramedics received a 10 percent raise, their salaries had remained stagnant for years. Now DHH paramedics make $38,000 a year, while senior paramedics make $50,000. Their average pay is comparable with that of their counterparts in the suburbs, according to figures obtained from metro-area departments.

The paramedics probably do stand to make more money if they join the fire department, but they would also enjoy collective-bargaining rights and more opportunities for advancement.

"Our primary objective was not money," says senior paramedic Bob Petre, a task force member. "When you look at problems the task force looked at, nowhere in there was a demand for more money by the paramedics."

The paramedics have argued all along that their prime concern is quality of service. They point to the generally accepted benchmark that, in 90 percent of calls, the average response time for paramedic care should be under eight minutes (the point at which cardiac-arrest patients almost always begin to suffer brain damage). Seventy-four percent of DHH paramedic calls in the first eleven months of 1995 were responded to in less than eight minutes; the average response time was 7.2 minutes. Proponents of the merger with the fire department point out that the firefighters' average response time, as calculated last spring, was 2.54 minutes. (The response times in the Aurora, Littleton, Englewood and West Metro fire systems, which all have paramedics, are under 4.5 minutes.)

But response time isn't the only measure of the quality of emergency care. Denver's overall survival rate--the percentage of people who call 911 for transport and leave the hospital alive--is well above 90 percent.

Other issues between the paramedics and their bosses revolve around working conditions. For years, paramedics say, they have had to contend with inadequate decontamination facilities, a shortage of staff and ambulances and unresponsive management. "They've gotten such a bargain out of us over the years," Manson says. "To get paramedic coverage for $5 million a year is unheard of. It's dirt cheap."

But the eleven-member task force, which was dominated by city administrators, didn't agree. Among its members were DHH chief Patty Gabow, DHH boardmember Roger Steinbecker, and Butch Montoya, Mayor Wellington Webb's manager of public safety (which oversees the fire department); also on the panel were city councilwomen Happy Haynes and Joyce Foster. They were joined by two physicians--William Duke from Grand Junction and Alden Harken from the University of Colorado; two paramedics; and two private citizens, Robert Harkin and Mary Sylvester.

"I did not think it was a fair and open process," says Sylvester, noting that Gabow set the tone. "In spite of our best efforts to say what we wanted, it always kept coming out in Patty's words." A fire official who asked not to be identified agrees, and yet another fire department employee says the process was slanted against the paramedics.

"The unfortunate thing about politics," says senior paramedic John Putt, "is that the hospital officials feel like they are losing control of something that is theirs. They don't want us to do it."

Defenders of the task force's decision point to the fact that, according to the city's Office of Budget and Management, the switch would cost $3.4 million just to get off the ground, plus $3.4 million per year in additional appropriations.

But at the task force's final meeting, supporters of the move tried unsuccessfully to present a new cost analysis concluding that having the paramedics merge with the fire department would have cost, at most, only $200,000 per year more than keeping them as a DHH division.

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