People from Kern County's rural areas want better emergency medical care, but County Supervisors want more information on how the system works now -- and what more they could do.

On Tuesday morning, the board was briefed on a 100-page report with four alternatives on how to change the system. But supervisors said while the analysis looked at the number of emergency calls -- it didn't give them information on the quality of care.

Residents from the rural community of Pine Mountain Club want firefighters trained as paramedics, and that's one of four alternatives outlined in the joint report from the Emergency Medical Services Department.

Supervisors heard from the concerned residents and they also heard from others who say the existing emergency medical services system works fine as it is.

"The system here has more than adequate response times," Kern Ambulance Association president Peter Brandon told the board. "Compared to national and state rates, they're smoking."

Spokesmen from various ambulance companies in Kern County told the board they think the current system works.

But, residents in rural communities say it can take a long time for an ambulance with a paramedic to reach them. Fire trucks can be on the scene of an emergency much more quickly -- but firefighters are trained only at the EMT level.

Pine Mountain resident Randy Coleman says that is not OK. ''Kern County residents deserve increased service and have the opportunity to have input -- choice -- in the process," he told the board.

The big report issued from Emergency Medical Services said the current system meets the needs of most of the residents most of the time. It found of about 55-thousand emergency calls in the whole county in 2005, only 408 calls were in rural areas when paramedic skills were needed.

But, Kern County Fire Chief Dennis Thompson told the board he has a different analysis of those numbers. Thompson said in 2005, of all the fire department and 911 calls in the county 15.3% required paramedic care.

Thompson said in that same time, of the rural emergency calls 15.1%
required paramedic care. The difference? Rural areas wait "significantly longer" to get the paramedic care.

"It was a matter of perspective in looking at that data and drawing conclusions from it," Chief Thompson told Eyewitness News.

The president of the Firefighters' Union had tough criticism of the Emergency Medical Services 100-page report. Derek Robinson said it left out other important studies.

He brought in blue binder several inches thick. "Beside me you see the binder with information that will prove that early access to ALS care drastically improves patient survival rates where paramedic intervention is needed."

Chief Thompson said he's ready to do a pilot project putting firefighter paramedics into a rural community for a year. However, there are questions about whether that would then prevent residents from voting later for a special district to pay for such additional service.

Still, the union president said his group is committed to the idea. "Our members certified as paramedics are willing to forego any bouns or stipend to perform this function for the one-year trial period for a pilot program as proposed," he told supervisors.

But, supervisors said they need much more information. Supervisor Jon McQuiston says he needs to know a lot more about patient outcomes.

"Is the system broken? I don't think it is. Can it be done better? Yes, I think it can." McQuiston said a pilot program might give the county more information on outcomes, though any such data might need independent analysis.

The board asked the Emergency Services Department to come back with more data in 30 days. Even with additional information, Supervisor Ray Watson predicts the choices won't be easy.

"I suspect it's going to be a very, very difficult decision for this board to make that we want to make a high jump in changing the way our EMS is funded -- and making a commitment to do that out of the general fund."

One more tough question would by how to pay for any additional services for rural areas. Some Pine Mountain residents say they are willing to tax themselves. But setting up a Community Services Area with a yearly fee requires two-thirds voter approval.

The EMS report that went to the board included the four possible options. One is training firefighters as paramedics. Another is getting ambulance companies stationed in the rural areas with their paramedics.

The third option is something called "contract paramedics." That's where paramedics would be hired by private companies, but they would be stationed in county fire stations.

The fourth alternative is training fire-fighters to the EMS-II level. They have less training than paramedics, but can administer most of the life-saving drugs.

The report summary concludes that "...providing urban level EMS servides to every remote area of the County is infeasible."

Pine Mountain residents said while the board didn't vote to start training firefighters as paramedics, they're not discouraged. Susan Maples says she's satisfied by the board's action for now, "I'm glad they didn't just throw it out."