University Heights fire chief warns uncoordinated volunteer EMS response risks lives, urges council action

Chief Perko, Fire Chief of the University Heights Fire Department, told the City Council on June 16 that uncoordinated volunteer emergency medical services operating outside the 911 system have caused operational delays, communication gaps and unclear medical oversight that pose risks to patient care.

"Public safety must remain above politics," Chief Perko said. "For any emergency, fire, medical, police, always call 911." He said volunteer responders can be valuable complements to professional crews but only when integrated with unified dispatch, shared protocols and joint training.

Perko described multiple incidents since January when Hatzalah Cleveland began operating in the city, saying the volunteer group maintains a separate hotline and parallel dispatch process that can delay activation of advanced life‑support crews. He cited one April 28 case in which volunteers were on scene and 911 was not contacted until about two hours later; Perko said paramedics arrived substantially later than they would have if 911 had been called first. "We cannot say for certain that a faster 911 call would have changed the outcome," he told council, "but the delay in activating 911 meant advanced life support was initiated far later than it could have been." He said the patient later died.

Perko detailed operational concerns: time lost when calls go first to a volunteer hotline and then are relayed to regional dispatch; incomplete handoffs when professional crews arrive; responders operating on different radio systems; and uncertainty about volunteer medical oversight after Hatzalah's regional medical director resigned. He said University Heights firefighter‑paramedics operate under a physician medical director and regional protocols and that paramedics' training (typically more than 1,000 hours) allows advanced interventions volunteers are not authorized to perform.

Council members asked questions and urged more documentation. Councilwoman Weiser pressed Perko about whether the April 28 delay was causally linked to the death; Perko replied that he could not say for certain but that the delayed activation of advanced life support was a documented fact in the patient care record. Councilman Cooney proposed convening the safety committee to review Perko’s full report; several members said a committee meeting or executive session would be appropriate to examine operational and legal details. Perko said he will circulate a comprehensive report to council members this week.

Perko asked the council to support a formal agreement to integrate volunteer responders into the 911 system and to consider legislation to license or regulate non‑911 EMS services operating in the city. He said the department and neighboring cities have already begun reaching out to Hatzalah to seek dispatch and protocol agreements. "The solution to these concerns is mutual understanding and a formal agreement that integrates volunteer responders into our system without compromising safety," Perko said.

No ordinance or formal council vote addressing Hatzalah was taken at the meeting. Several council members signaled interest in scheduling a safety‑committee meeting to review Perko’s full report, and Perko said he would make a comprehensive statement available to council and the public in writing this week.

Background: Perko emphasized the value of calling 911 because it immediately alerts and coordinates fire, police and EMS and provides automatic location services and dispatcher instructions. He said the department’s average response time is about four minutes and that the perception of longer response times can arise when volunteers have been on scene but 911 was not activated promptly.

The council did not adopt any new rules or binding agreements at the June 16 meeting; Perko requested council support for drafting regulations and protocols that would ensure volunteers operate under shared medical oversight and dispatch procedures.