Glendale is not the only municipality facing financial pressure. One has only to look at Phoenix’s $37 million shortfall. Many municipalities are adopting new strategies to cut their budgets. One area of a municipal budget that merits further scrutiny is the fire department. Let’s look at Glendale.
Public Safety consumes over two thirds (67%) of Glendale’s General Fund. Glendale’s proposed FY 2014-15 budget shows a total police department budget of $77,604,581 and a total fire department budget of $36,744,314 (roughly half that of police). The police department has total personnel of 537 and the fire department has total personnel of 267 (roughly half that of police). Everything tracks. The police department has twice the personnel and twice the total budget as that of the fire department. Except in one, major area – Overtime (OT), Hourly & Specialized Pays. You would expect the fire department expense in this line item to track at about half that of the police department. Not so. The police department line item figure for OT in the FY 2014-15 budget is $1,675,000 covering 537 personnel. Astoundingly, the fire department OT line item figure is slightly higher than that of police’s at $1,681,000 covering 267 people. Clearly, the fire department’s OT, Hourly & Specialized Pays is out of control.
So, we know the police department’s budget and personnel are twice that of the fire department’s with the exception of Overtime Pay in which they spend virtually the same amount. How can that be? The fire department’s practice of Constant Staffing requiring 4 people on each fire truck is creating unsustainable demands for overtime pay.
There is one other piece of information that is important to consider. In FY 2013-14 the Glendale Fire Department answered 30,040 EMS (Emergency Medical Service) calls; 3,570 fire calls; 2,238 miscellaneous calls and 619 special operations calls. Glendale’s medical calls have become the “elephant in the room” for the fire department. Its medical calls are ten times that of fire calls. Obviously the fire department’s mission has evolved over time. Its first priority is now medical response and fire suppression response, while still critical, has become its secondary mission.
Municipalities across the nation are recognizing the tremendous financial burdens placed upon them in covering the costs of fire department overtime as well as the costs associated with sending a large fire truck to a medical emergency. And they are beginning to act.
In Spokane, Washington as of January 2, 2013 the city decided that three fire stations and one ladder station would start using smaller vehicles on medical calls as opposed to the larger ladder trucks, which age quickly and operating and maintaining them was becoming more and more expensive. They decided it was important to spend their limited resources wisely taking into account that 78% of those three stations’ calls were medical.
Here’s another example: The Tualatin Valley Fire and Rescue (TVF&R) near Portland, Ore., was one of the early adopters of a fire/ALS deployment model using smaller vehicles. The department initiated its “Car Program” in 2010 as the way to respond to the increasing demand for EMS in a more efficient and effective manner. With 80% EMS calls, the department searched for a way to effectively respond to lower-priority requests for service and still maintain readiness for major emergency incidents. Instead of deploying a four-person staffed $400,000 full-size apparatus, the department purchased a $31,000 Toyota FJ Cruiser and staffed it with a single fire paramedic to handle calls such as minor traffic accidents, community service requests and lower-priority medical emergencies.
Or… In August 2012, the city of Grand Rapids, Mich., received a report that highlighted the recent trend of fire department rightsizing. The ICMA (International City Managers Association) made 22 recommendations to Grand Rapids municipal leaders that included a variety of changes to the fire department’s EMS response. One of the first recommendations was to eliminate five full-size fire department apparatus and replace them with smaller, more cost effective RRVs. The result was an estimated savings of $2.1 million.
And this… The Los Angeles County Fire Department (LACoFD) began providing rescue services in the late 1950s with the use of panel vans that carried firefighters to the scene of motor vehicle accidents and other requests for non-fire suppression services. This model of prehospital care delivery was retained as the LACoFD became one of the nation’s first fire ALS providers in the early 1970s. Today, the department still delivers ALS care by way of quick-response squad trucks staffed with firefighter paramedic personnel. The primary benefit of this ALS model is that it ensures a better utilization of resources while maintaining a cost-effective response. When an LACoFD squad arrives, the paramedic can determine if ALS care is required and then either accompany a contracted ambulance transport provider or return to service for another response.
San Jose, California as well as other cities across the nation are considering or have already reduced the number of firefighters on each response truck. It has proven to provide fire departments with more flexibility and better coverage. Four people on each engine to answer a medical call, was impracticable. Neighboring agencies, like Santa Clara County Fire, already assigns just three people per engine. The reasoning was that since 94% of all calls are medical, the Santa Clara County Fire Department was over deploying.
The practice of responding to medical calls with full-size apparatus is proving to be an expensive and inappropriate use of equipment. One deployment concept that appears to be gaining as an option for the fire service to meet both a decrease in budget and an increase in the demand for organizational efficiency is the transition from full-size fire apparatus to smaller rapid-response vehicles (RRVs). Some departments have used this concept for years to deploy ALS personnel to the scene of a medical emergency and to work in conjunction with other apparatus on fire suppression incidents. Fire departments must embrace new approaches to the deployment of their EMS resources by using peak demand staffing and changes to apparatus.
The “right resource, right place and right time” model has become the key concept for the deployment of fire EMS first response resources. Adopting a clinical, financial and operational strategy; and changing and rightsizing EMS resources appears to be the answer to many of the challenges faced by fire departments today. The modern fire service is now expected to be innovative and able to change its business practices by recognizing evolutions in the response to the majority of service requests, especially as a majority of calls are now medically related.
As we move toward a change in the nation’s healthcare delivery system based on accountability and clinical outcome, the department that can adapt to new norms will be the most successful.
Models with reduction of personnel on response units and redeployment of those personnel to reduce overtime and the use of small, medical response units staffed with fire paramedics are being used successfully throughout the country.
It’s time to right size the Glendale fire department. Will the Glendale City Council have the strength of will to request that changes be made? Will the Glendale fire department and more importantly, the Glendale fire union, innovate and adapt to the reality of shrinking resources and the increased demand for more effective, reasonably priced medical response? Or will they use the buzz words of “diminished service and response time” to fight it?
© Joyce Clark, 2014
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