CONFIRE’s Service Delivery Model Evaluation

I received an 11-page document last night which outlined the position of CONFIRE on their Service Delivery Model Evaluation which should put a rest to the conspiracy theorists out there who say the District is not doing enough to look at all angles to reduce costs.

The document is a nice read and provides a bundle of information within it—I’d encourage multiple reads. What is important to remember is this financial problem is not limited to just CONFIRE or East Contra Costa County Fire Protection District, but it’s a nationwide problem. It’s a revenue problem, not a spending problem!

The document outlines what the District and Local 1230 has done to reduce costs, while providing a nice overview of the problem with Pro and Con statements—I’d urge the City of Brentwood Councilmembers to review the 3 vs. 2 engine staffing models to highlight what a disaster that would have been.

The other section I encourage folks to pay attention to is the EMS System summery and what it would take for fire not to respond to medical and to absorb those costs.  There is also a section on volunteer firefighters.

What would be interesting to know is if Dan Borenstein and his yellow journalist buddies in the Editorial Department had this document in their hands prior to writing their reckless editorial against CONFIRE’s proposed $75 parcel tax.

Here is the document in full with some attachments below that accommodate the document.

Contra Costa County Fire Protection District

Service Delivery Model Evaluation

Since 2007, the nation has been gripped by an unprecedented recession. The Contra Costa County Fire Protection District (District) has not been immune from this challenging economic environment. From 2007 to 2011, the District’s revenue which is primarily based on property tax assessments has decreased by approximately $32M. Additionally, approximately $12M per year of property tax revenue was diverted to various Redevelopment Agencies prior to dissolution by the Legislature. During this period, the District has been utilizing reserve funds in an effort to continue to provide critical emergency services to the community.  Unfortunately, at the current “burn rate” of the reserve fund, the District will deplete the entire reserve fund during the FY-2013-2014 budget period.

The budget process is very dynamic and has many variables. Tax revenue projections continue to decline gradually or remain flat.  Pension costs continue to rise as a result of investment losses and de-pooling. Health care costs increase 5 – 10% annually.

As a result of these tax revenue decreases, the District has enacted efficiencies and reduced expenditures by millions of dollars. To achieve these savings, the District has eliminated 15 positions and laid off non-operational staff, managed vacancies, controlled overtime costs, reduced discretionary spending in all areas, deferred capital purchases and improvements (i.e., replacement apparatus, fire station repairs and remodeling), leveraged federal grants, and eliminated entire programs. As a last resort, a functional unit was de-staffed in January 2011 and a second unit was de-staffed in July 2012. De-staffing the two units has reduced the overall capacity of the response system and reduced the number of firefighters/paramedics that are on-duty to respond to emergency incidents. In June of 2011, the International Association of Firefighters Local 1230 agreed to eliminate two awarded 2.5% raises and accept an additional two 2.5% salary reductions. Two new lower starting salary steps were also implemented for new employees. Local-1230 is currently in negotiations to accept a new pension tier for new employees that will begin to reduce current and further costs. Other labor groups have taken similar concessions that include salary reductions, increased payments for health care, increased pension contributions, etc. Additionally, the County has eliminated the ability to sell terminal leave, reduced the “leave sell back” option and continues to reduce the unfunded liability for other post employment benefits. Admittedly, there is a “structural imbalance” between revenue and expenditures for the District. However, a combination of current cost saving efforts, temporary revenue enhancements, an improvement in the general economy, and longer-term solutions such as benefit cost controls are necessary to ensure the long-term sustainability of the District.

Prior to any discussion regarding service alternatives or cuts, community threat/risk must be addressed. The area served by the District contains a number of high risk occupancies including, refineries and bulk storage facilities, chemical plants, hazardous materials transportation (rail, ship, pipeline, and highway), high rise buildings, large commercial and industrial buildings, multiple family dwellings, health care facilities, and institutional and educational facilities. Additionally, the area presents a significant wildland fire-urban interface threat, as well as potential for natural disasters such as floods and earthquakes. The District also routinely responds to residential structure fires, medical emergencies, vehicle accidents, rescue calls, utility emergencies, etc. To this end, the District is an “all-hazards” organization that provides structural and wildland fire suppression, rescue, emergency medical services, hazardous material response, fire prevention, and dispatch services.

Salaries and benefits account for over 85% of the District budget. The only methodology available to achieve savings and balance the budget without additional revenue is to further reduce personnel costs. Unfortunately, due to previous cuts in every sector, any additional cuts will translate to front-line service delivery reductions. Obviously, the goal during any reductions is to minimize the adverse impact on service delivery and maintain the capacity to respond to significant and multiple emergency incidents. Any reduction in front-line fire companies will have a substantial impact on the District’s ability to protect the community and provide essential services.

It is important to note that while cost-cutting measures have been implemented, the District must still maintain both civilian and uniformed staff in a number of administrative positions in order to protect the public, meet statutory requirements, and support field operations personnel.  This includes positions in the Fire Prevention Bureau, Training Division, Apparatus Shop, Supply, the Communications Center, etc. All of these areas have been targeted for reductions in the past and are at the minimum level necessary to perform critical external and internal services.

Fire and emergency medical service delivery is predicated on community threat/risk, local standards, industry standards, and best practices. Based on the County’s General Plan, the current performance measure for the District is to respond within five minutes 90 percent of the time for urban areas. This measure relates to travel time only. The Contra Costa County EMS Agency requires a 7.5 minute response time for medical emergencies. The National Fire Protection Association (NFPA) recommends a response time of six minutes 90 percent of the time. This includes dispatch, turnout, and travel time. In 2010 with 30 fire companies, our response time 6:16. Currently, with 28 companies, our average response time is 6:36. Although the time has increased by 20-seconds, more significant impacts have not been realized yet due to all 28 fire stations remaining open and staffed. These statistics also indicate that we do not meet the performance standards established by the General Plan or national standards. 

Response times are a critical element for public safety. A standard time-temperature curve model indicates that a fire will double in size every two (2) minutes and flashover (rapid fire growth to full involvement of the structure with no chance of survival) will occur in less than eight (8) minutes. From an emergency medical services perspective, clinical brain damage occurs in four to six (4 – 6) minutes without oxygen and brain death occurs in eight (8) minutes. Certainly,

multiple incidents occurring simultaneously or large scale/long-term (multiple alarm) incidents will quickly deplete available resources and exacerbate the extended response times. Another factor that could adversely affect our response time and overall capacity is neighboring jurisdictions that are also reducing services at the same time. The East Contra Costa County Fire Protection District has recently taken three units out of service and reduced their capacity from a high of eight units to their current level of three. Additionally, both the City of Pinole and the Rodeo-Hercules Fire Protection District have de-staffed one engine company per agency and reduced their capabilities by 50%.

When discussing service delivery options, it is important to review industry standards and best practices and benchmark against other similar jurisdictions when evaluating staffing requirements and models. The International City/County Management Association (ICMA) recommends one firefighter per 1,000 population as a standard for adequate staffing levels The LAFCO Municipal Service Review from August of 2009 indicated that the CCCFPD staffing level was .6 per 1,000 residents. This is below the County average of .7/1000 and the Bay area average of .9/1,000 residents. Due to the de-staffing of two units, the current ratio is .44 firefighters/1,000 residents. This is an extremely low percentage to try and protect 600,000 people especially considering the community risk and urban setting. Any reduction in fire companies and staffing will only exacerbate our current staffing deficiencies. Cities of comparable populations, (i.e., Denver, Portland, and Tucson) all have a ratio of 1.3 uniformed personnel per 1,000 residents. Smaller cities of approximately 500,000 population including Fresno, Oakland, Sacramento, Tulsa, Virginia Beach, Long Beach, Cleveland, and Kansas City all had ratios of 1.4 firefighters per 1,000 residents. This demonstrates the significant staffing shortages and lack of capacity that already exists within the District. A number of other jurisdictions across the nation have been forced to remove fire companies from service due to budget constraints; however, as noted, many of those jurisdictions have much greater depth and capacity as a baseline so the impact is not as severe. Organizationally, the District is flat and lean and does not meet industry standards or best practices. Although we provide excellent service to the community, there are a significant number of capacity and infrastructure needs that are unmet.

Any reduction in service delivery is a serious threat to the community. Every effort should be made to prevent this to the extent possible. If service delivery models change or reductions are unavoidable, it is important to note that a deliberative analytical process was utilized to determine the option that would have the least adverse impact. To this end, the District has explored the following service delivery options:

• Service adjustment based on emergency incidents that occur during different times of day and days of the week.
• Reduction in staffing per unit
• Different configurations to respond to emergency medical incidents
• Use of volunteers or reserve firefighters
• Station closures

It should be noted that every option reduces the protection and service to the community and diminishes an already insufficient response capability.  

Service Adjustment Model (SAM):

The SAM would maintain minimum protection/service to all portions of the community until funding is available to restore full service. The statistics and data for the District indicate that 83% of our incidents were EMS related in 2010. Additionally, the majority of incidents occur from approximately 0800 hrs to 2000 hours on Monday through Friday with some peak periods on Saturday as well. Similar to many businesses, it is possible to align our resources with service delivery demands. However, this is not the ideal model for public safety agencies as the risk of miscalculations, deviations from statistical norms, or outliers will suffer much greater consequences than in the private sector. Additionally, the District must maintain some additional capacity in the event of significant incidents or multiple emergencies occurring simultaneously. Additionally, many residential fires occur during non-peak night time and early morning hours when the residents are most vulnerable. The District has experienced a number of fires where rescues were required during the time periods identified below. However, it is critical to maintain a presence in all areas of our community in order to provide protection and service and maintain acceptable response times. This is not a traditional approach for the fire service in light of our fixed resources and 24-hour shift. However, compared to station closures, it does demonstrate to the public that the District is trying to be responsive to their best interests and needs. It also demonstrates the ability to adapt to changing environments and subscribe to business principles. This model should only be a temporary solution that avoids fully closing fire stations. The five versions of the SAM provide financial savings ranging from $1.5M to almost $1.9M which is the equivalent to the closure of a fire station.

Certainly there are a number of specific challenges and risks related to the SAM. However, the basic concept of the SAM is outlined below:

• The SAM will not affect the number of permanent budgeted positions.
• This is a temporary solution to a severe fiscal challenge. All units will be restored to a 3-person engine based platform as soon as fiscal conditions permit.
• All field operational positions will be filled to the best of our ability, i.e. recruitment, hiring process, etc.
• 28-Functional units will be staffed during peak service demand periods on Monday through Saturday from 0800 hours to 2000 hours.
• At 2000 hours on Monday through Saturday and all day Sunday, five (5) units will transition from engine companies to “squads” and be reduced to 2-person staffing. This service adjustment is based on service demands (call volume and type of incidents) in the affected areas.
• The reduction in staffing will be facilitated by releasing personnel on overtime at 2000 hours.
• All squads will be staffed with a minimum of one paramedic.
• Policies, procedures, training and management controls would be implemented to limit the risk and ensure the safety of the 2-person units.
• Squads will be prohibited from engaging in any interior fire operations (search and rescue and suppression) until the arrival of a fully-staffed engine company.

Pro:

• All stations remain staffed at some level 24/7
• Savings of $1.5 – $1.9M

Con:

• Many residential structure fires occur at night or non-peak hours. Residents are typically sleeping and at their most vulnerable time during this period. Recognition that the fire is occurring and subsequent notification may be delayed due to the public sleeping. This leads to more significant fire growth and need for search and rescue operations.
• 2-person squads are not permitted to conduct interior search and rescue or fire suppression operations.
• It will take a longer time period to assemble an adequate firefighting force and meet NFPA-1719 recommendations.

Reduction in Staffing Levels from 3 to 2 per Unit:

Pro:

• Each of the three positions on the apparatus equates to approximately $500K to staff for a year. Reduction in staffing on all 28 functional units would save a maximum of $14M per year.

Con:

NFPA-1710 recommends a staffing level of four persons per unit in order to provide safe and effective operations and assemble an adequate firefighting capability. Currently, the District staffs all functional units with three firefighters/paramedics.

In 2010, the National Institute of Standards and Technology (NIST) issued a study entitled Report on Residential Fireground Field Experiments. The study addressed 22 operational performance tasks based on staffing levels and response time to structure fires in a “typical” 2,000 square foot single family dwelling. The study concluded the following:

• A 2-person crew took 10% longer than a 3-person crew to apply hose streams to the seat of the fire.
•  A 2-person crew took 25% longer than a 3-person crew to ladder and ventilate the structure.
• A 2-person crew took 25% longer than a 3-person crew to conduct search and rescue operations.
• A 2-person crew took 57-seconds longer than a 3-person crew to advance hose lines to the building.
• Both 3-person and 2-perrson crews failed to meet the NFPA-1710 recommendations of assembling an adequate firefighting force of 15-personnel on-scene within 8-minutes. However, the 2-person crew took a longer time period and required more units to assemble the 15-personnel.The 8-minute time frame is a critical factor in order to intervene before flashover of the structure when rapid fire spread with no chance of victim survival occurs.
• The fire will grow and intensify and the safety of the public and responders will be compromised as additional units and response time is required to attach the fire. Currently, we dedicate five units and a command officer to obtain the required firefighting force. With 2-person staffing, eight units and a command officer would be required to obtain the same staffing. Since these units would be required to respond from further distances so overall fire operations will be delayed.
• The NIST study only addresses residential fires in an average sized single family dwelling. The District serves a highly urban area with significant risk levels including heavy industry, hazardous materials, large commercial and high rise buildings, multiple family dwellings, etc. Currently, the Districts operates with only 44% of the recommended staffing levels and I am unaware of any urban department that protects a population of 600,000 that operates with this staffing level or 2-person fire crews.
• A study conducted by the San Diego State University in 2010 entitled Initial Attack Effectiveness addressed staffing for wildland firefighting. The study evaluated 2, 3, 4, and 5 persons on each hose line. This did not include the pump operator/officer in charge. They did not even attempt to study one person advancing the hose line which is what would occur with a 2-person crew due to safety concerns and failure to execute the task.

Different Configurations to Respond to Emergency Medical Incidents:

The Contra Costa County Emergency Medical Services (EMS) Plan identifies an integrated response with fire based first responders and private transportation providers. The two entities collaborate and complement each other to provide the highest quality and most reliable service to the public with acceptable response times. While this mission for the fire service is clearly articulated in the County EMS plan, it also provides added value by fire resources that are geographically distributed to provide fire protection for the community. All life-threatening medical emergencies such as cardiac arrest, heart attacks, difficulty breathing, allergic reactions, trauma, stroke, etc. require rapid response and medical intervention. Fire based EMS provides highly trained paramedics and EMTs for these patients in a timely manner. Additionally, the fire units stay in the community and are available for subsequent emergencies while the medic unit transports the patient to the hospital. In many cases, it can take an hour for the medic unit to transfer the patient to hospital staff, complete reports, clean and restock the units, etc. The fire based EMS units continues to provide services during this time period.

It is important to note that any transfer of service from the public sector to the private sector will result in additional costs for the consumers. None of the stakeholders have the additional capacity to absorb a loss of resources. Additionally, increases in private EMS units will be single dimensional as they cannot provide fire and rescue services.

The District is often asked why large fire apparatus is dispatched to emergency medical incidents. The justification for the response has articulated in the previous paragraph. However, some residents question the use of a fire engine or ladder truck for this response as opposed to a smaller more fuel efficient model. The large fire apparatus provides a very flexible and versatile platform to conduct our “all-hazards” mission. The entire team can respond to an incident and provide medical care. In many life threatening emergencies (cardiac arrest, trauma, etc.), when carrying heavy patients, or when dealing with limited access all three members of the crew as well as the medic unit personnel are needed to provide care. If another serious emergency occurs, (structure fire, rescue, etc.) while they are on the scene of the initial emergency, the entire crew can respond once the initial patient is stabilized and care is transferred to the medic unit. Again, this highlights the flexibility of the system when limited and inadequate resources are available.

Pro:

• Smaller units are more fuel efficient.
• Less mileage and maintenance on the large apparatus
• 2-person crews can treat many of the non-life threatening patients
• This is an effective model if the 2-person units are in addition to and augment the fire suppression units. These units could handle the majority of the EMS incidents and the suppressions would assist for life-threatening emergencies. During fire and rescue incidents both units may be available to respond to provide adequate staffing for operations.

Con:

• Need to purchase 28 light response vehicles equipped with emergency warning devices, radios, etc.
• Significant increase in fleet size, maintenance, insurance, etc.
• When a subsequent incident occurs, the crew will be fragmented. The smaller EMS vehicle may not be available and the fire apparatus will have to respond with one crew member. It is unsafe for a lone operator to drive under emergency conditions, talk on the radio, look at the map on the CAD display, etc. Additionally, once he/she arrives, operational effectiveness is either non-existent or delayed until the rest of the crew arrives.
• With a very low and lean baseline, the existing units must be flexible and able to respond from incident to incident and perform our all-hazard mission. Other jurisdictions have been able to implement innovative solutions; however, all of them are starting with a greater number of resources so the baseline is not eroded.

Use of Volunteers or Reserve Firefighters:

Volunteers or reserve firefighters could be utilized to staff out of service units, reduce overtime costs, or augment existing staffing levels. The District currently sponsors a reserve program; however, participation has been limited and unreliable.

Pro:

• Volunteers provide their services for free and reserves function at a lower per hour rate for training and emergency response.
• Additional resources or units may be available if the revenue measure fails and 7 – 10 fire stations are closed.
• Residents have an opportunity to contribute to and serve their community.
• Volunteers should be recruited to assist with administrative and other support functions that will reduce costs or free uniformed staff to work in front-line operational positions.

Con:

• Beginning in 2004, Senate Bill (SB) 1207 and Assembly Bill (AB) 2118 required extensive training for volunteers/reserves. SB 1207 mandates that all training required by Cal-OSHA for career personnel also applies to volunteer/reserve firefighters. AB 2118 provides for penalties for non-compliance. This includes initial as well as on-going refresher training which is required on an annual basis.
• Each volunteer/reserve must complete a physical examination prior to participating. The physicals cost $750 each.
• Each volunteer/reserve must be equipped with structural and wildland personal protective clothing, fitted SCBA face piece, etc.  The approximate cost is $5,000 per person.
• Inconsistent attendance to training by our current reserve participants affects our ability to adequately train the personnel and maintain required standards.
• Generally, the number of volunteer and reserve programs have been declining across the nation. Due to training requirements, legal liability, general economic conditions and pressures, societal norms, the volunteer/reserve programs have not been reliable or cost effective in many instances.
• Again, this is an urban area with significant community threats/risks, and significant service delivery demands. Full-time, reliable resources are necessary to ensure a safe and effective public safety system.

Station Closures: 

Due to the community threat/risk, current staffing levels, and system capacity, any station closures or additional service delivery cuts will adversely impact the safety of District residents and firefighters. As noted before, in 2010 with 30 fire companies in service, the average response time was 6 minutes and 16 seconds. However, response time in less than 5-minutes occurred only 25.5% of the time and less than 6-minutes only 47.3% of the time.

Our 90 percentile response time was almost 8.5 minutes. Obviously, any reduction of resources will have an adverse impact on response times which currently do not meet performance standards. Excessive response times and the inability to assemble an effective firefighting force within 8-minutes will allow exponential fire growth, reduce victim survivability, allow the fire to spread to adjoining structures or wildland acreage, and increase the dangers to firefighters. For medical emergencies, increased response time will result in a significant delay in providing medical intervention for life-threatening emergencies. The chart below depicts the impact of station closures and not meeting response goals necessary to protect and serve the community. It is important to note that station closures have an exponential effect on the response system as the remainder of the fire stations tries to absorb the emergency incidents. It is also important to note that the District has experienced numerous instances of simultaneous fires and/or greater alarm fires that require a substantial resource commitment concurrently.

If it is absolutely necessary to close fire stations due to fiscal constraints, a number of factors must be considered. The factors include the impact on response time, call volume, proximity of automatic and mutual aid companies, and special threats or risks to the community.

In summary, the Contra Costa County Fire Protection District is facing a very challenging economic environment. At the same time, community threats/risk and calls for services continue to increase. The District is currently significantly understaffed and does not meet response time goals. Any degradation in resources and capability will endanger the public and the firefighting personnel.

10 Yr Updated Fin P-Tax Proj Aug 2012-1

CCCFPD Position Paper – 2012-2

Polar graphs of All Incidents 07_10

Polar graphs of All Incidents DOW

Polar graphs of EMS incident DOW

Polar graphs of EMS Incidents 07_10

Polar graphs of EMS Incidents 07_10-1

Polar graphs of EMS Incidents 07_10-2

Polar graphs of Fires DOW 07_2010

Polar graphs of Fires Incidents 07_10