A consultant's report states that it would be cheaper for Hemet to contract its fire services with the Riverside County department than continue to operate its own. The Hemet City Council will discuss fire service Nov. 12.
A consultant's report states that it would be cheaper for Hemet to contract its fire services with the Riverside County department than continue to operate its own. The Hemet City Council will discuss fire service Nov. 12.
A consultant's report states that it would be cheaper for Hemet to contract its fire services with the Riverside County department than continue to operate its own. The Hemet City Council will discuss fire service Nov. 12.
A consultant's report states that it would be cheaper for Hemet to contract its fire services with the Riverside County department than continue to operate its own. The Hemet City Council will discuss fire service Nov. 12.
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Fire Services Options
and Fiscal Costs Review
for the 2250 East Bidwell St., Ste #100 Folsom, CA 95630 (916) 458-5100 Fax: (916) 983-2090 Management Consultants Folsom (Sacramento), CA City of Hemet, CA October 28, 2013 www.ci.pasadena.ca.us
Table of Contents page i TABLE OF CONTENTS Section Page Executive Summary .......................................................................................................................1 Policy Choices Framework ......................................................................................... 1 Citygates Findings ...................................................................................................... 1 Citygate Services and Economics Perspective ............................................................ 4 Citygates Recommendations ...................................................................................... 8 Section 1Introduction and Background .................................................................................11 1.1 Report Organization ...................................................................................... 11 1.1.1 Goals of Report ................................................................................. 11 1.1.2 Limitations of Report ........................................................................ 11 1.2 General Observations and Project Approach ................................................ 12 1.3 Fire Service Regulatory Framework and Service Design Needs .................. 12 1.4 Fire Service Headquarters Needs .................................................................. 14 1.5 Fire Crew Deployment Measures and Recommended Practices ................... 16 Section 2Review of City-Provided Fire Services Issues ........................................................18 2.1 Overview of City Geography and Incident Statistics .................................... 18 2.2 Hemet Fire Department Current Staffing ...................................................... 19 2.3 Citygates Minimum Fire Headquarters Recommendations ......................... 20 2.4 Stations and Response Times ........................................................................ 21 2.5 Fire Prevention and Other Specialty Services ............................................... 23 2.6 Paramedic Services and Emergency Medical Dispatch (EMD) .................... 24 2.6.1 Emergency Medical Dispatch (EMD) ............................................... 26 2.6.2 Overall Paramedic Program Costs .................................................... 27 2.7 The City Fire Department Proposal for Continued Independent Operation . 30 2.8 Analysis and Comment ................................................................................. 31 Section 3Review of County-Provided Fire Services Issues ..................................................32
Table of Contents page ii 3.1 Services Provided in County Proposal .......................................................... 32 3.2 County Proposal Benefits and Constraints .................................................... 34 3.3 County Proposal Items that Need Clarification ............................................. 34 Section 4Cost of Fire Services Choices and Services ............................................................37 4.1 How the Costs in the Tables Were Developed .............................................. 38 4.2 Cost Comparison Tables with Explanation ................................................... 39 4.3 County Proposal Issues to be Resolved ......................................................... 43 4.4 Cost Analysis Findings .................................................................................. 44 Section 5Advantages and Disadvantages of a County Fire Contract..................................46 Table of Tables Table 1Summation of Major Incident Types in City of Hemet ................................................ 18 Table 2City Paramedic Costs NO EMD Staff, September 2013 ........................................... 28 Table 3Citygate Paramedic Program Costs October 2013 .................................................... 29 Table 4Comparison of City Service Level D to County Option #1 without EMD Costs ......... 40 Table 5Comparison of Service Level and Cost Alternatives without EMD Costs ................... 41 Table 6Comparison of City Service Level D to County Option #1 WITH EMD Costs ........... 42 Table 7Comparison of Service Level and Cost Alternatives WITH EMD Costs ..................... 43
Executive Summary page 1 EXECUTIVE SUMMARY The City of Hemet (the City) retained Citygate Associates, LLC to conduct an operational and cost review of its current choices for providing fire services. The objectives of this analysis are to (1) compare the City fire services and costs over a multiple year period against best practices and the needs of Hemet; and (2) then evaluate, as a policy option, the County Fire Departments proposal to meet those needs. Throughout this comparative analysis, Citygate makes findings, recommendations, and outlines the resultant policy choices and next steps facing the Hemet City Council. This study is presented in several sections including this Executive Summary outlining the findings and recommendations, followed by detailed sections on background facts, City- and County-provided fire services, cost analysis, and then a conclusion outlining the advantages and disadvantages of a contract with the County. Overall, there are 14 key findings and 3 recommendations. As a comparative analysis report of the two fire department proposals, this document does not contain detailed background information regarding how a fire department operates or the multitude of best practice recommendations and federal or state safety laws on fire services. This report is intended to brief a reader familiar with local government and fire services regarding the provision of fire service choices and costs under consideration by the City of Hemet. POLICY CHOICES FRAMEWORK As a starting point, the reader needs to remember that there are no mandatory federal or state regulations directing the level of fire service staffing, response times, and outcomes. Thus, communities have the level of fire services that they can afford, which is not always what they would desire. However, the body of regulations on the fire service provides that if fire services are provided at all, they must be done so with the safety of the firefighters and citizens in mind. CITYGATES FINDINGS Throughout this report Citygate makes key technical findings that are presented below in one list for ease of reading. These findings represent the foundation for our economics model and resultant recommendations. Finding #1: Fire and emergency medical incident outcomes are most effective where response times for 90 percent of incidents consist of either (1) 4 minutes travel time for first-due engines, or (2) 6:20 minutes/seconds total response time for the first-due unit capable of starting effective intervention for the type of emergency.
Executive Summary page 2 Hemet Measure C phrases response time goals as 5 minutes or less, for 80 percent of fire and emergency medical calls, provided on both a citywide and response areas basis. The City does not have current response time data based on best practice response time measurements. As a result, both the City and County proposals could only state that they would comply with Hemet Measure C (Measure EE) and that they would provide the staffing at four stations as requested by the City in its RFP. Without accurate response time data and a revised City policy that both defines and measures response time, the City is unable to determine whether either the City or the County, as the fire service provider, complies with Measure C. Finding #2: Emergency Medical Dispatch (EMD) is not a critical need for the City, since most, if not all, of the medical calls, given their nature, will still have an engine or squad response. EMD, in and of itself, will not allow the closure of one or more of the four firefighting engines needed for citywide adequate response time. Finding #3: While EMD might free up some fire units to be more available to perform simultaneous demand at peak hours of the day, or avoid some wear-and-tear costs on some fire apparatus, the direct cost savings will not be close to the expected City cost of adding 9 dispatchers at a low-side estimate of $739,075. Finding #4: Projected paramedic costs, even as adjusted by Citygate, are on the low side at best. The unknown is the longer-term cost of services to be provided by the contracted clinical oversight and training provider. Finding #5: The current Administrative Captain coverage in lieu of Battalion Chiefs needs to be evaluated to ensure the Administrative Captains are trained to the Battalion Chief duty chief level. Further, the following question needs to be addressed: how long can this model be continued if the compensation and/or skill set is significantly lower than that of Battalion Chief? Finding #6: The City appears to be assigning Fire Marshal and Training responsibilities as extra duties to 2 fire crew Captains, but this is inadequate for a City the size of Hemet. Finding #7: The location of the current County truck company is too far from Hemet to provide initial needed ladder truck coverage. Finding #8: The County proposal that includes a truck company that would be located in Hemet is cost-effective because it serves both Hemet and fills a gap that the County has in timely truck coverage to its own service areas north and east of Hemet. Thus, the Countys proposal only charges Hemet half the cost of a 4- firefighter-staffed ladder truck that will be stationed in Hemet.
Executive Summary page 3 Finding #9: If the City contracts with the County for fire services, CAL FIRE will only absorb firefighters with paramedic certification. After hiring four firefighter-paramedics to fill existing vacancies this fall, the number of firefighter-paramedics will be 13 of the 15 firefighter positions in the budget. Thus, a merger with the County, if it occurred before more firefighters retired or resigned, would result in 2 firefighters being laid off or transferred out of the County due to the lack of paramedic certification. If the City does not start its paramedic program before conversion, then all 15 firefighters will be subject to transfer or layoff. Finding #10: There are significant unknowns that can cause one-time County Fire conversion costs to swing substantially, including liability for employees injured prior to conversion, the vacation leave buyout, and start-up costs. Finding #11: Citygate cautions the City that level of service choices A through C anticipate the continued use of acting chief officers, until, through retirements and/or training and certification, the acting chief officer positions can be transitioned into permanent chief officer positions. If the City seeks to convert the acting positions immediately to permanent appointments, the City is likely to have one or more of the current acting chief officers return to the rank of captain, resulting in there being more captains than the current budget provides for. The continued use of acting chief officers is unsustainable. Finding #12: Given current levels of staffing and funding, it would be surprising if the Hemet Fire Department is able to keep up with mandates for training provision, training verification, fire code inspections, fire code permits, permit fees, and second-tier priorities like public education and disaster preparedness. Based on this, and the unsustainable use of acting chief officers, it is very likely that if the City chooses to even maintain the current Hemet Fire Department crew deployment levels, doing so will require more investment in fire services, starting with headquarters staff and paramedics. Finding #13: The most comparable service configuration between the City and County proposal is for the City to convert the 2-person squad back to a 3-person truck company and add paramedics, a Fire Marshal, a fire prevention clerk, a 40-hour Training Officer and permanent chief officers. This compares most directly to the County proposal that provides a shared 4-person truck company and adequate fire headquarters services in Hemet. Finding #14: If the City contracts with the County, it will be most cost-effective for all City fire apparatus and specialty tools to be given to the County. The County will then be responsible for maintenance and replacement. The County prefers that all front-
Executive Summary page 4 line fire apparatus be in County ownership, due to the liability of County fire personnel driving the equipment. CITYGATE SERVICES AND ECONOMICS PERSPECTIVE In the very near term, if the Council and community can afford firefighter paramedics, EMD, a ladder truck with dedicated staffing, and a restored, permanent chief officer headquarters team, then it is less costly to select the County Fire Department contract. The County contract provides cost savings at that higher level of service, and the County provides greater depth in staffing, training and management. The major issue for the City is loss of cost control over future fire personnel costs if another economic downturn occurs. The City should first make a policy decision to choose the fire services level it can fund for a minimum of the next three years. Citygate has recommended that the following four levels of service are the most cost-effective choices for the City. These levels of service may also be approached as a set of phased steps, so that the City can choose the level that it can fund at this time and then improve the level of service in later years as funding allows. A. Current operation. Includes 4 engines, 1 squad, 1 cross-staffed ladder truck, and 4 acting chief officers. Does not include paramedics or Emergency Medical Dispatch. B. Option A plus the City fire paramedic program. C. Option A+B plus the addition of headquarters personnel for a training chief, fire marshal, and second office assistant. D. Option A+B+C plus the addition of permanent chief officers (4) and a return to a dedicated 3-person ladder truck crew, to replace the 2-person squad. Given Citygates fire services consulting and practitioner experience, we have set forth these policy choices in priority order from service level A being below minimum expectations to service level D completely meeting the current and likely near term needs of Hemet. The City can then choose the level that it can fund at this time and then improve the level of service in later years as reoccurring, not one-time, funding allows. The service levels are more completely described below as to the specific staffing and services improvements as funds allow: Service Level A: Continue As Is Hemet Fire Department Operations 1. Current Hemet fire operations, methods, training, equipment and personnel issues may or may not meet safety regulations or best practice recommendations. The
Executive Summary page 5 City should strive to replace and repair critical safety equipment and train its personnel. 2. Due to economics, the City is forced to continue the use of acting chief officers, until, through retirements and/or training and certification, the acting chief officer positions can be transitioned into permanent chief officer positions. If the City seeks to convert the acting positions immediately to permanent appointments, the City is likely to have one or more of the current acting chief officers return to the rank of captain, resulting in more captains than the current budget provides for. Service Level B: Continue Hemet Fire Department Operations, Add Paramedics 1. Current Hemet fire operations, methods, training, equipment and personnel issues may or may not meet safety regulations or best practice recommendations. The City should strive to replace and repair critical safety equipment and train its personnel. 2. Due to economics, the City is forced to continue the use of acting chief officers until, through retirements and/or training and certification, the acting chief officer positions can be transitioned into permanent chief officer positions. 3. The City negotiates final costs and contracts with the needed outside vendors to implement fire paramedic program. 4. The City finalizes currently estimated start-up and annual operating costs for paramedics using a person experienced in operating a current fire paramedic program of Hemets size. Service Level C: Continue Hemet Fire Department Operations, Add Headquarters Personnel after or with Starting the Paramedic Program 1. Due to economics, the City is forced to continue the use of acting chief officers until, through retirements and/or training and certification, the acting chief officer positions can be transitioned into permanent chief officer positions. 2. The City, in addition to adding the paramedic program, recruits and hires a Battalion Chief level training officer, an experienced, lateral hire fire prevention officer, and a second Office Assistant. 3. Current Hemet fire operations, methods, training, equipment and personnel issues may or may not meet safety regulations or best practice recommendations. The City should strive to replace and repair critical safety equipment and train its personnel.
Executive Summary page 6 Service Level D: Continue Hemet Fire Department Operations, Add Paramedics, Headquarters Staff AND Replace the Acting Chief Officers to Restore Dedicated Ladder Truck Staffing 1. Having added paramedics and critically-needed headquarters positions, it may still be possible that current Hemet fire operations, methods, training, equipment and personnel issues may or may not be adequately funded or meet safety regulations or best practice recommendations. Citygate would recommend a performance audit to determine personnel and equipment compliance. 2. The Citys permanent Fire Chief should have strong skills in fire administration and EMS programs. 3. Due to economics, the City is forced to continue the use of acting chief officers until, through retirements and/or training and certification, the acting chief officer positions can be transitioned into permanent chief officer positions. 4. The City maintains supply and equipment funds to a level that ensures safety regulation compliance. 5. The City restores dedicated 3-personnel-per-shift staffing to the ladder truck. The services-to-cost comparison table shown below (found in Section 4 of this report) provides the three-year cost comparison of City service level D to County Option #1. This represents the closest comparison of service levels that are nearly the same. It is important to recognize in using Citygates cost comparison tables that the County proposal represents the maximum cost the City can expect. Each fiscal year County Fire bills only their actual costs, which, in Citygates experience, will be most likely 2-5 percent less, or roughly a $200,000 to $400,000 savings over the County costs in the table below. These savings occur because the County contract proposal assumes that all personnel assigned to the fire stations are at the top pay step and that maximum overtime costs are incurred for earned leave absences. This is rarely the case, as staff turnover results in some personnel being assigned to the Hemet stations who are at a pay scale below the top step. A review of City staffing and costs demonstrates that, at the Hemet stations, not all personnel are at the top step and this fact is already reflected in the Citys FY 2013-14 budgeted costs. Thus, comparatively, the County cost proposal is somewhat overstated when compared to the Citys, but the exact amount cannot be determined because the real cost will only be reflected with actual costs that are known at the end of the contract year.
Executive Summary page 7 Comparison of City Service Level D to County Option #1 without EMD Costs Service Level Alternatives Service Level Description Adjusted Annual Operate Cost 1st Year Adjusted Annual Operate Cost 2nd Year Adjusted Annual Operate Cost 3rd Year Enhanced Services 3rd Year (Savings) or Expense versus a County Contract City Service Levels City Service Level D Comparable to the County Option #1 City w/staffed Ladder Truck + Medics + HQ staff $12,257,908 $11,718,257 $11,726,657 $306,283 County Service Level County Option #1 County w/staffed Ladder Truck @ 50% cost to City $11,422,146 $10,757,374 $11,420,374 Annual Savings to the City: $835,762 $960,883 $306,283 Below is a second table that compares the cost for each of the four City service levels (A-D) compared to County Option #1, again reflecting that in three years, once all conversion costs are stabilized, County Option #1 is less expensive than the City fully restoring its fire services to City service level D, which is comparable to the County Option #1. At service level D, a County contract becomes less expensive and has significant other advantages for the City.
Executive Summary page 8 Comparison of Service Level and Cost Alternatives without EMD Costs Service Level Alternatives Service Level Description Adjusted Annual Operate Cost 1st Year Adjusted Annual Operate Cost 2nd Year Adjusted Annual Operate Cost 3rd Year Enhanced Services 3rd Year (Savings) or Expense versus a County Contract City Service Levels A Current City Service Level City w/Squad & cross staff Truck, no Medics, NO extra HQ $10,487,600 $10,487,600 $10,487,600 $(932,774) B City w/Squad & cross staff Truck + Medics, NO extra HQ $11,300,318 $10,760,667 $10,769,067 $(651,307) C City w/Squad & cross staff Truck + Medics + HQ staff $11,724,344 $11,184,693 $11,193,093 $(227,281) D City Service Level Comparable to the County Option #1 City w/staffed Ladder Truck + Medics + HQ staff $12,257,908 $11,718,257 $11,726,657 $306,283 County Service Level County Option #1 County w/staffed Ladder Truck @ 50% cost to City $11,422,146 $10,757,374 $11,420,374 CITYGATES RECOMMENDATIONS If the City wants to further consider going with the County, it should add the fire paramedics now, which would make converting employees to CAL FIRE employment easier. Then the City can leave the temporary command staff in place, and negotiate with the City firefighters and the County for the best-fit conversion package of services, costs, timing, and employee retention. A final decision can be made after the City is satisfied with the resolution of open issues. The County contract alternative (County Option #1), even if found to be the most promising policy choice, has substantial cost and policy issues that need to be resolved in negotiations with City employees and the County. This is necessary for the City to have all of the required information to make a fully informed final choice of retaining its own fire department or contracting with the County.
Executive Summary page 9 Based on our understanding of the issues and economics, Citygate makes the following recommendations: 1. If the City determines that it wants and can afford a higher level of service than the level provided by the City Fire Department, and the increased level of service is equivalent to County Fire Department Option #1 to include a staffed ladder truck, then the City should consider contracting with the County for County Option #1. Contracting with the County for this level of service is less costly to the City. The City will need to balance cost savings and the advantages of a larger service provider against the loss of local control over setting fire personnel costs. 2. If the City believes that a County Fire Department contract is the best service-to-cost option, then the City should, prior to entering into a contract with the County, negotiate with the County and, where appropriate, the City Firefighters Union, to resolve the following issues: Start-up the City firefighter paramedic program Identify and accept the level of Priority Cover for Hemet fire stations by the County Fire Department Identify the impact on Hemet fire personnel who do not have paramedic certification and are not active paramedic-level firefighters Submit for transfer verification by CAL FIRE all City fire employee records to determine who can be transferred, at what rank and pay Resolve City firefighter return rights to the City, if the contract is stopped Resolve disposition of earned leave credit Resolve City employee continuity of medical coverage during the transition Resolve post-retirement retiree medical costs Understand the retirement formula applicable to City employees who transfer to CAL FIRE Identify retirement reciprocity Identify the number and cost of City employees on disability (City expense) on the effective date of a contract Finalize ownership and maintenance of front-line and reserve apparatus and equipment. 3. After negotiations with both County and City firefighters to determine the final, hard, one-time conversion and on-going costs for at least three fiscal years, then the City
Executive Summary page 10 Council would be asked to approve final contract documents and a conversion date with both the County and City Firefighters Union in early to mid spring.
Section 1Introduction and Background page 11 SECTION 1INTRODUCTION AND BACKGROUND 1.1 REPORT ORGANIZATION This report is structured into the following sections that group appropriate information together for the reader. Section 1 Introduction and Background: Background facts about the Citys Fire Services and provision choices. Section 2 Review of City-Provided Fire Services Issues: A review of the programs staffing, services and needs. Section 3 Review of County-Provided Fire Services Issues: A review of the Countys proposal to provide fire services. Section 4 Cost of Fire Services Choices and Services: An examination of the costs of continuing Hemet-provided fire services contrasted with contracting with the County. Section 5 Advantages and Disadvantages of a County Fire Service Contract: A discussion of the issues with fire service delivery via a contract with another entity. 1.1.1 Goals of Report This document provides technical information about how fire services are provided, legally regulated, and how the Citys Fire Department currently operates. This information includes findings and recommendations for the City leadership to discuss. As a comparison, the level of services proposed by the County is reviewed along with costs and the issues arising from contracting for fire services. 1.1.2 Limitations of Report This report is designed to be a summary document of key issues, findings, and recommendations, all of which are necessary for Hemets leadership to understand the fire service issues and best- fit next steps. Citygates report does not include either a financial audit or a program compliance audit of every possible fire services legal requirement. Rather, this study is a high-level review of the Fire Department organization and the needs of the community. These are then compared using best practices and our experience against the alternative service level choices and costs. Thus, our work is not a detailed review of the Departments personnel and their performance of every aspect of their job descriptions or to other fire service requirements of the City of Hemet.
Section 1Introduction and Background page 12 While this report can provide a framework for the discussion of fire services for Hemet, neither this report nor the Citygate consulting team can make the final decisions or cost out in detail every possible alternative. Once final strategic policy direction is given by the City Council, City staff can conduct any final implementation work, either for internal changes or a contract for service. 1.2 GENERAL OBSERVATIONS AND PROJ ECT APPROACH Citygate used several tools to gather, understand, and model information about Hemet Fire Services for this study. We started by making a large document request to the City to gain background information on costs, current and prior service levels, the history of service-level decisions, and what other prior studies, if any, had to say. We also received the latest proposal and costs from the County Fire Department. We then conferred multiple times with City staff, the Citys Interim Fire Chief, the Citys firefighters leadership and County Fire Department leadership. Some of these meetings occurred in Hemet. We also reviewed all prior City Council reports on fire services and listened to the early 2013 Council meeting video and audio files to gain a perspective on the communitys view. Included in this report is an abbreviated review of Fire Department headquarters systems, including both emergency and non-response-related services, such as fire prevention, training and administration. Citygate uses the Commission on Fire Accreditation International self- assessment criteria and various National Fire Protection Association Standards as the basis for this review. 1.3 FIRE SERVICE REGULATORY FRAMEWORK AND SERVICE DESIGN NEEDS While in the Executive Summary we stated the policy fact that the level of fire services provided by a local government agency is a local choice issue in the United States, there are operational and safe operating regulations to be complied with. In addition to restrictions on local government finance, there have been a number of newer state and federal laws, regulations, and court cases over the last fourteen years that limit the flexibility of local governments in determining their staffing levels, training, and methods of operation. These are given an abbreviated overview below: 1999 OSHA Staffing Policies Federal Occupational Health and Safety Administration (OSHA) applied the confined space safety regulations for work inside tanks and underground spaces to Americas firefighters. This requires in atmospheres that are IDLH (Immediately Dangerous to Life and Health) that there be teams of two inside and two outside in constant communication, and with the outside pair equipped and ready to rescue the inside pair. This situation occurs in building fires where the fire and smoke conditions are serious enough to
Section 1Introduction and Background page 13 require the wearing of self-contained breathing apparatus (SCBA). This is commonly called the 2-in/2-out policy. This policy requires that firefighters enter serious building fires in teams of two, while two more firefighters are outside and immediately ready to rescue them should trouble arise. While under OSHA policy one of the outside two-out personnel can also be the incident commander (typically a chief officer) or fire apparatus operator, this person must be fully suited-up in protective clothing, have a breathing apparatus donned except for the face piece, meet all physical requirements to enter IDLH atmospheres, and thus be ready to immediately help with the rescue of interior firefighters in trouble. May 2001 National Staffing Guidelines The National Fire Protection Association (NFPA) Standard on Career Fire Service Deployment was issued twelve years ago. While advisory to local governments, it has become locally adopted in places and used by neighboring communities in designing fire services. NFPA 1710 calls for four-person fire crew staffing, arriving on one or two apparatus as a company. The initial attack crew should arrive at the emergency within four minutes travel time, 90 percent of the time, and the total effective response force (first alarm assignment) shall arrive within eight minutes travel time, 90 percent of the time. Incident Commanders at Hazardous Materials Incidents The on-scene Incident Commanders (Battalion Chiefs) at Hazardous Materials Incidents must have certification compliant with NFPA 472, Standard for Emergency Response to Hazardous Materials Incidents. This is also now an OSHA requirement. Cal/OSHA Requirements Among the elements required is a safety orientation for new employees, a hazard communications system for employees to communicate hazards to supervisors, the Cal/OSHA process for post-injury reviews, the required annual report of injuries, and a standard for safety work plans. Employers have many different responsibilities under the Occupational Safety and Health Act of 1970 and the Code of Federal Regulations (CFR). Initially, OSHA focused its efforts on the private sector; more recently, it has turned its attention to the public sector and specifically the fire service. The above sea changes in personal and agency liability mean that not just any firefighter can, or should be, an incident commander on serious, sustained incidents. Along with increasing firefighter deaths nationally and Federal OSHA citations to fire commanders, the trend has started for requiring significant training and certification of incident commanders. Fire captains, as front-line crew supervisors, are not typically trained or experienced enough to be full-time incident commanders. They are front-line supervisors in charge of one crew, and
Section 1Introduction and Background page 14 as such, must stay in close contact with that crew during firefighting activities out of the direct sight of the incident commander. The first or second arriving fire captain is trained to take command, but only temporarily until the arrival of an incident commander (chief officer). Therefore if a local government agency provides fire services at all, they must be provided with the safety of the public and firefighter in mind. Additionally, the chief officers, as scene incident commanders, must be well trained, competent and are liable for mistakes that violate the law. An under-staffed, under-led token force will not only be unable to stop a fire, it opens the agency up for real liability should the fire department fail. 1.4 FIRE SERVICE HEADQUARTERS NEEDS With regard to fire administration services, the federal and state safety regulations and fire personnel best practices result in the need for a management team that is the proper size, and is adequately trained and supported. There are increasing regulations to be dealt with in operating fire services, and the proper hiring, training, and supervision of line employees requires an equally serious commitment to leadership and general management functions. A department of Hemets size needs to be effectively led, trained, and supervised. This need is stated in the National Fire Protection Association (NFPA) Recommended Standard 1201 Standard for Providing Emergency Services to the Public which states in part, the [department] shall have a leader and organizational structure that facilitates efficient and effective management of its resources to carry out its mandate as required [in its mission statement]. Based on the experience of our consultants in managing fire services and in the consultancy design of fire services meeting best practices, these questions must be addressed for headquarters functions: Are there an adequate number of management and support staff members? Is there an effective distribution and assignment of duties to accomplish the management needs of the Department? Are the proper administrative procedures in place to operate the Department? Does the Department have enough managers to maintain an emergency management span of control ratio of one supervisor for every three to seven subordinates as suggested by the National Incident Management System (NIMS) and NFPA 1006 Standard for Rescue Technical Professional Qualifications? Do the managers have rank level consistent with the International Association of Fire Chiefs (IAFC) Officer Development Handbook to carry out their duties? The IAFC recommends four levels of officer development: Supervising Fire Officer (Company Officer, Captain); Managing Fire Officer (Battalion Chief); Administrative Fire Officer (Division or Deputy Chief); and Executive Fire
Section 1Introduction and Background page 15 Officer (Fire Chief). Within each level, the handbook recommends specific training, education, and experience, which, if followed, should develop well- rounded and prepared fire officers. These, of course, are not the only safety and operational standards to be met by a fire department, but represent a basis for recommending an adequate department administration team fitted to the particular characteristics of a community and the size and level of service being provided by its fire department. Adequate, supervised, verified training is needed to prevent firefighter and civilian tragedies, which have enormous long-term emotional and fiscal impacts on not only the firefighters and their families, but the agency and the community as well. Charleston had to completely replace its fire department executive leadership, bring in an outside training and leadership team, and totally revamp its entire training and incident management processes after a tragic multiple firefighter fatality. As Hemet is also painfully aware, tragedies also occur in wildland firefighting. Had Charleston maintained currency with the best practices of the fire service and required standardized, verifiable, ongoing, and realistic training, it is likely the nine firefighters that died would be alive today and firefighting in Charleston would be business as usual. Fire prevention is also an important issue for every community. It only makes common sense to prevent fires where possible to avoid the cost of a large firefighting force to suppress multiple, preventable, fire occurrences. Fire prevention includes any activity that decreases the incidence and severity of uncontrolled fire. Once a building has completed construction and taken occupancy, the responsibility for oversight of its use and maintenance throughout the remainder of its life switches from the Building Official to the Fire Marshal. The fire code is then used as the document that ensures that a proper level of fire and life safety exists in the building throughout the remainder of its use. Usually, the methods used by the fire service focus on inspection, which includes engineering, code enforcement, public information, public education, and fire investigation. Preliminary and subsequent fire investigations of all fires are essential to understand the sources of the communitys fire problems. Accidental fires may reveal weaknesses in the codes, in the building inspection process, or in other aspects of processes. Suspicious fires may reveal an arson problem. The general questions to address for an adequate fire prevention program are: Is there an adopted fire code and staffing plan to meet the needs of new construction, existing commercial occupancy inspection, and public education? Are inspectors trained? Do trained investigators investigate fires? Does the fire investigation system coordinate with law enforcement to bring about the appropriate arrests and convictions in arson cases?
Section 1Introduction and Background page 16 How are ongoing fire code safety inspections managed? How does the Department handle hazardous materials code enforcement? Is there an appropriate fee schedule for fire prevention activities to the business community? 1.5 FIRE CREW DEPLOYMENT MEASURES AND RECOMMENDED PRACTICES Most urban and suburban communities, if asked, would probably expect that fires be confined to the room or nearby area of fire origin, and that medical patients have their injuries stabilized and be transported to the appropriate care location. Thus, the challenge faced by a city is to maintain an equitable level of fire service deployment across all similar population density service areas in a community without adding significantly more resources as demand for services grows and traffic congestion increases, slowing response times. The Insurance Services Office (ISO) Fire Department Grading Schedule in urban/suburban areas would like to see first-due fire engines stations spaced 1.5 miles apart and ladder trucks spaced 2.5 miles apart, which, given travel speeds on surface streets, is a 3- to 4-minute travel time for first-due engines and a 7- to 8-minute travel time for first-due ladder trucks. The newer National Fire Protection Association (NFPA) guideline 1710 on career-staffed fire services deployment in urban/suburban areas suggests a 4-minute travel time for the initial fire apparatus response and 8 minutes travel time maximum for the follow-on units. The ISO grades community fire defenses on a 10-point scale, with Class 1 being the best. Historically, the Hemet has been evaluated as a Class 4/9 department, meaning the fire engine and ladder truck coverage is provided at the suburban service level with the goal being to reduce the risk of serious fire spread, generating conflagrations in the community. For many reasons, it is not necessary for an agency to deploy with the sole objective of meeting the ISO measures. For underwriting purposes, the ISO criteria are actually designed to evaluate a departments ability to stop a building fire conflagration. The ISO system does not address the adequacy of response to small fires, auto fires, outdoor fires and emergency medical incidents. In addition, underwriters today can issue fire premiums in Grading Schedule bands such as 3-5, recognizing the above a factors. Also the ISO can issue a separate rating for individual commercial and industrial buildings that have built-in fire prevention features and, as such, give these safer buildings a single rating of Class 1, for example, even if the city itself has a different overall ISO rating. Thus, if an agency only tries to meet the ISO or NFPA station placement criteria, it does not necessarily deliver better outcomes to the most typical fire department responses.
Section 1Introduction and Background page 17 Emergency medical incidents have situations with the most severe time constraints. In a heart attack that stops the heart, a trauma that causes severe blood loss, or in a respiratory emergency, the brain begins to die in 4 to 6 minutes without oxygen. Not only heart attacks, but also other emergencies, can cause oxygen deprivation to the brain. Heart attacks make up a small percentage; drowning, choking, trauma, constrictions, or other similar events have the same effect on the brain and the same time constraints. In a building fire, a small incipient fire can grow to involve the entire room in a 4- to 5-minute time frame. The point in time where the entire room becomes involved in fire is called flashover, when everything is burning, life is no longer possible, and the fire will shortly spread beyond the room of origin. If fire service response is to achieve positive outcomes in severe EMS situations and incipient fire situations, all the companies must arrive, size up the situation, and deploy effective measures before brain damage or death occurs, or the fire spreads beyond the room of origin. Importantly, positive outcomes are the goal, and therefore key factors are fire crew size and response time, which can be calculated to allow efficient fire station spacing to optimize the outcome of each fire department response.
Section 2Review of City-Provided Fire Services Issues page 18 SECTION 2REVIEW OF CITY-PROVIDED FIRE SERVICES ISSUES 2.1 OVERVIEW OF CITY GEOGRAPHY AND INCIDENT STATISTICS The Citys area includes approximately 27.847 square miles and has a population of approximately 78,657. The City of San Jacinto is situated on Hemets northern boundary, and the County of Riverside borders Hemet on all other sides. The City contains approximately 40,000 housing units, of which about one-quarter (10,000) are mobile homes. The City is fairly isolated when compared to many other cities in the greater Los Angeles basin. As a result, the City of Hemet does not have the same access to mutual aid emergency services as do many other cities, and it has limited access to nearby automatic aid or contract services. The last assigned ISO rating placed the City in Class 4/9, and the call volume was 11,226 1
incidents for the 2012 calendar year. The National Fire Incident Reporting System (NFIRS) requires fire departments to report incidents broken into dozens of sub-types. From the Fire Department response report attached to its January fire services proposal, a summation of major incident types shows this distribution of emergencies: Table 1Summation of Major Incident Types in City of Hemet Category Count Percent Comment Building Fires 55 .49% Fires in major buildings and mobile homes, not out buildings such as sheds. Grass/Wildland Fires 23 .20% Major categories, not those in containers such as fire pits and barbeques. Emergency Medical 9,752 87% All types of medical events and accidents. Other 1,396 12.4% Small outdoor, trash and auto fires, false alarms, citizen assists, technical rescues. Total 11,226 100% For a population and square mileage of Hemets size, the quantity of building fires at a rate of about 4.5 per month is very typical. So are the wildland fire and other types of response counts. What is very atypical is the 87 percent rate of medical emergencies and the total quantity of emergencies per year in Hemet. At a rate of 11,200-13,000 incidents per year in the past and near term, this rate is about double that of other communities of Hemets size. The causes for this are
1 City Fire Proposal, page 11 dated 2-5-2013
Section 2Review of City-Provided Fire Services Issues page 19 varied, but are typically driven by a population that is under covered by medical and preventive health care coverage and age demographics. This increases the use of 911 services for medical assistance. It is unknown at the time of this writing how and if Federal Health Care Reform will change this situation in the United States. 2.2 HEMET FIRE DEPARTMENT CURRENT STAFFING The City of Hemet Fire Department currently staffs a minimum of fifteen personnel on-duty 24 hours per day. This includes one Acting Battalion Chief, four Fire Captains, five Fire Engineers and five Firefighters. Four fire stations are staffed with an Engine Company (pumper) consisting of a 3-person crew comprised of a Captain, Engineer, and Firefighter. The fifth fire station/crew was closed due to budget reductions. This station now houses, under a rental agreement, a paramedic ambulance as part of the Countys regional ambulance contract with American Medical Response (AMR). One fire station also houses a 2-person response squad that can assist at mild to moderate status medical emergencies along with an ambulance. Another station also houses the Departments aerial ladder truck, which is cross-staffed by the engine crew. This means that if a building fire or other technical rescue requires the ladder truck, it responds instead of the engine if the engine is not already on another call. Thus, what Hemet can currently field to a building fire is 3 engines and 1 ladder truck (if the co-located engine crew is in the station). Prior to the budget reductions, Hemet had 5 engine companies staffed, a dedicated crew on the ladder truck, and a Battalion Chief. For all three duty shifts this was a staffing of 19, or 57 total personnel. Taking all of the recession-caused reductions into account, the daily staffing has fallen to 15 per shift, or 45 total. But even the loss of a staffed engine and a staffed ladder truck does not tell the entire impact of the recession-driven reductions. The headquarters team was severely reduced; some managers retired or left, and there have been several interim or short duration Fire Chiefs. Why, how, and when all this occurred has been well documented elsewhere. At the high point of Hemet Fire Service staffing in FY 2008-2009, the Department had a total of five other full-time headquarters positions for a total of 62 personnel (57+5). The reality today is the total staffing has dropped to 48, with the remaining headquarters team consisting of four staff in acting positions as interim chief officers (1 Fire Chief and 3 Battalion Chiefs) and one Administrative Assistant. All of the current-acting chiefs are, in reality, Fire Captains; three of whom were the Ladder Truck Captains and one was the fifth engine Captain. All of the permanent chief officers are gone; there is no training officer or fire prevention officer or second office specialist. This Citygate services and cost options review is not a performance audit, and as such, we did not review the personnel records, training records and certifications of the acting chief officers.
Section 2Review of City-Provided Fire Services Issues page 20 Those we met are all very caring, committed individuals doing their best to help the Hemet Fire Department stay in operation. However, it would be surprising to Citygate to find many, if any, small suburban fire departments with five Fire Captains to be fully trained, certified and credentialed to be Battalion Chiefs and Fire Chief all at once. During the recession and during unexpected vacancies, interim appointments are made particularly in smaller departments, but this exposes the City to liability unless a trained and credentialed individual fills the interim position. The current fire engine personnel are trained to the Emergency Medical Technician (EMT) level, which is far less in training and allowed skills of a paramedic. While some of the Hemet staff has received paramedic training elsewhere, the Hemet Fire Department does not currently provide paramedic service. This issue will be discussed in a following sub-section. 2.3 CITYGATES MINIMUM FIRE HEADQUARTERS RECOMMENDATIONS When Citygate does performance audits, master plans and merger studies for suburban fire departments, the common question asked is what does a minimum headquarters team look like for a two- to five-station, career fire department? Hemet needs adequate chief officer coverage to meet all of these needs on a 24/7/365 basis. Citygate typically recommends for a safe and effective headquarters staff: 1 Fire Chief 3 Battalion Chiefs to provide 24/7/365 incident command and station supervision/training 1 Administrative Assistant office support position. This minimum set of positions requires that the shift Battalion Chiefs also handle administrative duties such as training, fleet and facility management, EMS program quality assurance, and community disaster preparedness. To do so, means they have the time, in addition to going to emergency incidents and supervising multiple fire captains and their station crews. The higher the volume of emergency work and training program duties, the less time they have to do anything according to best practices and the greater need there is for additional administrative headquarters staff. Given Hemets population and types and quantities of emergency incidents, it is very likely the Battalion shifts on 24-hour shift duty will not be able to handle the entire administrative workload. As such, the following 40-hour positions also are likely necessary for a minimum, effective headquarters team in Hemet: 1 Fire Marshal or fire inspector, which can be a non-safety position 1 Training Officer
Section 2Review of City-Provided Fire Services Issues page 21 1 Emergency Medical Services oversight position (this can be a part-time contract position) 1 Fire Prevention Clerk for fire prevention needs and back-up when the other position is on earned leave A second office support position for fire prevention needs and back-up when the other position is on earned leave. In Section 2.7.1 and Section 4 of this report on Hemet Fire Services, the future headquarters needs of Hemet will be addressed. 2.4 STATIONS AND RESPONSE TIMES As prior City reports have identified, station locations and response times are, of course, important to every community. In 1998, Hemet passed what is known as Measure C, requiring the City to develop and adopt a Public Services and Facilities Element, for inclusion in the 1992 General Plan, setting minimum standards for several public services in Hemet, including fire protection. In 1992, the City Council approved the Public Services and Facilities Element by Resolution No. 2981 and then approved Resolution No. 2994 authorizing a Public Services and Facilities Element to be submitted to the voters for ratification. The voters approved Ballot Measure EE and the Public Services and Facilities Element was subsequently incorporated into the 1992 General Plan. Technically, the correct reference to the Measure with which the City must comply is Measure EE. However, the community has embraced the reference to Measure C and that is the only term commonly used over the past decade and therefore we continue to use that as the reference for consistency. These actions resulted in a performance standard for fire that is phrased as: A response time of 5 minutes or less, for 80 percent of fire and emergency medical calls, provided on both a citywide and response area basis. Response time is actually comprised of three components: (1) dispatch processing; (2) crew turnout where the crew hears the dispatch, dons protective clothing, and begins travel; (3) then the actual travel time across the streets. The sum of these three measures is also called response time, but more completely, total response time. Best practices national advice on response times suggests either a total or just travel time measure be used. In either case, the agency stating the response measure has to define the start and end times. Thus, a complete statement would say, Response time is defined as Best practice advice for the three components is 60 seconds for dispatch processing, 80 seconds for turnout time, and 4 minutes travel time in urban/suburban areas for a total of 6:20 minutes/seconds. National best practices also recommend that response times be measured as a percent of goal completion, such as 90 percent of incidents by minute X; the fire service has moved away from the use of an average measure.
Section 2Review of City-Provided Fire Services Issues page 22 In the early 2013 City staff reports and fire service proposals, the Hemet Fire Department reported average response times, not percentile time measures either citywide or by defined zone. Average response time measures only state where the middle of the data range lays. This measure does not state how many calls and at what response time they were past the middle. Said this way, an average five-minute measure could have many response times as far out as 10 minutes. It was not in Citygates scope for this fire services options and costs review to determine what the response times actually are, or if they meet the Measure C desired outcome of responding to 80 percent of the calls within a 5 minute response time. The reality is that, at the moment, Hemet has made the choice, based on available revenues, to operate four fire stations. Thus, the City and County Fire Department proposals were based on this baseline staffing/station level and it is these proposals and costs that are being reviewed here. As the City Council makes on-going fire service decisions, the City can develop updated clearly documented response time measures in determining the need for and location of a 5 th or even 6 th fire station based on growth. However, it must be pointed out by Citygate that while the Citys RFP for fire services appropriately requires response time compliance, and defines the start and end time measurement points, the measures below from the Citys RFP do not clarify Measure C permanently as they are only being used for the first time in an RFP. The Citys Fire Service RFP requested: 4.1 Response Time: Assume responsibility for the delivery of fire protection and other emergency services with the boundaries of the City of Hemet. Provider will respond to all calls for service in five minutes or less 80% of the time for first-due fire unit. For reported fire responses, a fire apparatus with a minimum of three fire fighters, hose, water, and the ability to pump water at 1,500 gallons a minute or more shall arrive within six minutes or less 80% of the time. Response time is defined as the time the alarm is received at the initial dispatch agency until the arrival of the responding unit is parked with the responding personnel ready to exit the vehicle. Given the lack of definition of response time in Measure C and given that the City does not have current data based on best response time measurement practices, both the City and the County proposal could only say they would comply with Measure C and they would provide the staffing at four stations as requested by the City in the RFP. Without data and a revised City policy that both defines and measures response time, the City is unable to determine whether either the City or the County as the fire service provider complies with Measure C. What the City can say is that both providers would staff the current number of fire stations.
Section 2Review of City-Provided Fire Services Issues page 23 Citygate believes that to make a fire services provider decision, the City can make its decision based on the number of stations and crews provided and the proposed expense. This provides the closest approximation of cost to service from a physical capacity on duty point. Based on four funded fire stations, at this point, the response times are what they are. The Measure C definitions can be clarified down the road and annual reporting requirements set for either fire department to comply with. Finding #1: Fire and emergency medical incident outcomes are most effective where response times for 90 percent of incidents consist of either (1) 4 minutes travel time for first-due engines, or (2) 6:20 minutes/seconds total response time for the first-due unit capable of starting effective intervention for the type of emergency. Hemet Measure C phrases response time goals as 5 minutes or less, for 80 percent of fire and emergency medical calls, provided on both a citywide and response areas basis. The City does not have current response time data based on best practice response time measurements. As a result, both the City and County proposals could only state that they would comply with Hemet Measure C (Measure EE) and that they would provide the staffing at four stations as requested by the City in its RFP. Without accurate response time data and a revised City policy that both defines and measures response time, the City is unable to determine whether either the City or the County, as the fire service provider, complies with Measure C. 2.5 FIRE PREVENTION AND OTHER SPECIALTY SERVICES Pre-recession, the Hemet Fire Department provided all of the essential services normally expected from a smaller suburban agency. These included, but were not limited to, fire prevention, public education, disaster preparedness, hazardous materials incident response, and a multitude of allied agency cooperative agreements or contracts. They are to be commended for doing so. During the recession, the Department got even more creative with the use of grants and partnerships to keep these programs, with some at a more modest level. The program that appears to have suffered the greatest decline is fire prevention. There is not currently a dedicated fire preventions staff. The last trained fire prevention officer has left the Department. As of this writing, new construction plan reviews and inspections will be handled under contract by the Citys Building Department staff/contractor. This only helps buildings getting built.
Section 2Review of City-Provided Fire Services Issues page 24 The Fire Code is a maintenance code; the Building Code is a construction code. The handoff occurs when the new building or tenant occupancy is given a Certificate of Occupancy at final inspection. Then the Fire Code and fire staff inspect the building over its lifetime for compliance during operation. Currently, the on-going fire prevention duties are assigned as other duties to one acting Battalion Chief who is doing the best he can. At this point, inspections, fire permits, weed abatement, and fee collections are incidental at best. The other acting Battalion Chiefs are coping with disaster preparedness and public education, plus anything else in addition to the primary duties of crew training, personnel and emergency incident management. The office support staff is down to one person who has no relief during days off. This makes it difficult to do more than the most important office functions. Based on Citygates experience with many other fire agencies, it would be surprising if the Hemet Fire Department is able to keep up with mandates for training provision, training verification, fire code inspections, fire code permits, permit fees and second-tier priorities like public education and disaster preparedness. Even if things are being done correctly, they need to be rigorously documented, because if there is an accident or injury to an employee there needs to be proof of compliance when Cal/OSHA or others investigate. Absence of compliance or documentation of compliance worsens the Citys liability exposure. 2.6 PARAMEDIC SERVICES AND EMERGENCY MEDICAL DISPATCH (EMD) Currently many fire departments in the County provide a paramedic-firefighter level of service from career-staffed fire engines on a 24/7/365 basis. This ensures a high level of initial patient care, should the regionally-provided paramedic ambulance not be close by to the incident. The ambulance contractor, AMR, has to space out its ambulances to maintain response time compliance as directed by the County taking into account historical workload patterns. If a fire department is not providing neighborhood-based fire engine paramedics, the City is relying on the spacing, quantity, and availability of ambulances to ensure paramedic coverage. The Hemet Fire Department, for a variety of reasons over the years, has never started a firefighter paramedic program. The most recent recession-driven staffing reductions further delayed the consideration of establishing a fire-engine-based paramedic level of service. The City does not have data readily available to establish how quickly AMR paramedic ambulances arrive on a scene. Nevertheless, to provide a standard of care more consistent with the rest of the urban areas in the County and to provide a comparable level-of-service bid to compare to the County Fire Department proposal that includes providing paramedic engines, the Hemet Fire Department staff included a paramedic program option in its early 2013 services proposal. In order to keep costs low, the Department staff identified several outside parties that could assist with program start-up and mandated quality oversight programs. For equipment and supplies,
Section 2Review of City-Provided Fire Services Issues page 25 Fire Department staff stated they could buy used cardiac monitor/defibrillators. For paramedic training the staff proposed licensing current firefighters that already held paramedic licenses from elsewhere, and then over time as firefighters retired or resigned, the Department would only hire firefighter-paramedics. In the February and March City Council hearings on the fire service proposals, the Fire Chief at the time called this Hemet Fire Department paramedic program essentially free due to the cooperative agreements. However, City management, current Fire management staff, and Citygate have since found the free program statement to be overly optimistic. There are important cost elements that the City will have to pay for if it starts a paramedic program. First, the purchase of used cardiac monitor/defibrillators was found to be based on substandard equipment. City staff feels they have to go with new equipment and maintenance agreements. Second, the program costs have to include the incentive pay to firefighters serving as paramedics. Third, the major outside partnership to provide free clinical oversight by a private company in exchange for paramedic internship slots on Hemet units was flawed and the private company now wants $15,000 annually. Fourth, staff and then Citygate found the supply and small hardware costs to be stated below the more likely annual amounts needed. While the hospital stood by its proposal to provide the medical director oversight at no cost, AMR made the business decision to withdraw their clinical oversight free proposal leaving only the private vendor option at $15,000 annually. Once Citygate was retained, we went over all of the paramedic program work to date and built a more realistic implementation and cost model to be used by the City going forward. As of October 2013, there is still not a final set of deal points with the private clinical oversight vendor, or the hospital for medical direction. Based on the private clinical oversight vendors opinion, staff wants to phase-in fire paramedics over a three-year period. Based on this and dispatch costs to be addressed in the next section, an updated set of costs for the paramedic program was presented to Citygate in September 2013. However, as will be shown in the costs section of this report (Section 4), the staff costs were still flawed and understated for equipment costs. While all this seems strange, it is actually understandable and somewhat common when a command staff tries to develop and cost something they have never done before and have no experience in. The same is true of the City Hall staff, as they used the Fire Chiefs proposal and follow-up costs. The Fire Departments passion for paramedics and enthusiasm for a low-cost approach is commendable. However, the fact at this point is that this study has to provide updated, realistic paramedic program costs and phasing if the City is to implement a paramedic program. A revised cost estimate for a paramedic program is provided in Section 2.6.2 of this report.
Section 2Review of City-Provided Fire Services Issues page 26 2.6.1 Emergency Medical Dispatch (EMD) There was considerable emphasis placed on the need for Hemet to upgrade to Emergency Medical Dispatch (EMD). This program has two key components: Pre-arrival self-help instructions the dispatcher tells the caller how to provide basic first aid, CPR, etc. Differential dispatch based on the call severity, not all units, fire or ambulance, are sent to every request for help. Many 911 centers today provide the first step of pre-arrival self-help. Doing this requires dispatcher training, dispatch computer software, and on-going continuing education. The time impact per call can be significant, so dispatch centers typically increase their staffing so 911 calls can still be answered and field units coordinated while another dispatcher provides the caller assistance. Differential dispatch is very different from self-help EMD. It trains the dispatcher to use very sophisticated software decision trees to ask the caller what is wrong and then send only the most appropriate resource. In some cases, that could be dispatching only a basic life support ambulance (BLS) or a paramedic (ALS) ambulance. In more severe cases, the fire unit is also sent. Large agencies use these systems to not send scarce resources on less severe incidents. However, the dispatcher training, certification, software, clinical oversight and audits are all very expensive. As with self-help, there are more dispatchers on-duty to handle the increased time on the phone with the callers. Finally, there is a significant liability with this program due to the small chance of not dispatching the correct resources, quickly enough. But this is mitigated in large systems such as San Diego City or Oakland where at peak hours of the day, they often run low on available fire units in some areas and so the liability risk is acceptable to these agencies as they allocate their scarce fire resources at peak times. As the Hemet Fire Department researched EMD costs, it tried to get assistance from the State. The Department was successful in getting verbal commitments for grants to provide dispatch consoles, software, and training. However, the State will not assist with the annual cost of added dispatchers. This is a cost Hemet will entirely have to bear. In the Fire Chiefs presentation early in 2013, it sounded like the justification for implementing EMD via the Hemet police/fire dispatch center was to relieve pressure on Hemet fire units when multiple calls for service occurred and to provide callers a higher level of service with self-help and for the City program to be comparable to the County level of service. However, as for differential dispatch, there are two problems. First, currently even Riverside County does not use differential dispatch. The County continues to always send the neighborhood fire engine in order to err on the side of the best possible customer service. Second, with only four fire stations needed in Hemet 24/7/365 for firefighting and effective
Section 2Review of City-Provided Fire Services Issues page 27 response times to all neighborhoods, if differential dispatch were used, Hemet could not save money by closing or deferring the addition of fire stations. If Hemet did stop sending an available engine to a medical emergency and began telling some of the 911 callers to wait for an ambulance, this would be a different level of service than Hemet now provides. Thus, if Hemet implemented EMD with differential dispatch, it would result in all new costs, with no significant cost off-sets in the fire budget other than small wear-and-tear costs on the fire engines. Citygate found no Hemet studies (only verbal statements) that looked at the types of medical emergencies versus the differential dispatch criteria to determine how and if EMD would even yield operational savings. Nor was there a review by an EMS system Medical Advisor (physician) regarding the level of EMD appropriate for the patient cases seen in Hemet. Therefore, with little or no City off-set budget savings and with the significant added cost of implementing EMD, Citygate believes that a higher priority use of any available City funds is to restore adequate headquarters services to the Hemet Fire Department. Citygate would not place a high priority on securing EMD immediately at the Citys sole expense. If the City, nevertheless, wants to provide an EMD service in the community, the City could as another option, contract fire or all 911 dispatch services to the County, which already has an EMD program. Many suburban agencies contract for this and other reasons with regional fire communication centers, while maintaining their local departments. This option and cost has not been researched for Hemet. Finding #2: Emergency Medical Dispatch (EMD) is not a critical need for the City, since most, if not all, of the medical calls, given their nature, will still have an engine or squad response. EMD, in and of itself, will not allow the closure of one or more of the four firefighting engines needed for citywide adequate response time. Finding #3: While EMD might free up some fire units to be more available to perform simultaneous demand at peak hours of the day, or avoid some wear-and-tear costs on some fire apparatus, the direct cost savings will not be close to the expected City cost of adding 9 dispatchers at a low-side estimate of $739,075. 2.6.2 Overall Paramedic Program Costs The City Fire Department proposal in early 2013 stated there would be zero costs for the paramedic program, as AMR and others would provide all services, supplies and hardware. The outside partner letters attached to the proposal seemed to reflect this, but not with the specificity of contract terms that Citygate would normally see.
Section 2Review of City-Provided Fire Services Issues page 28 In the March 26 th update to the City Council, the City Managers staff report on fire services discussed how City staff had conducted additional due diligence research on the free paramedic program. In that staff report, the following, but still conceptual, costs were identified: 1. No cost was cited for Hemet firefighter wage differential for firefighter- paramedics, but a cost was supposed to have been contained in the Fire Department original proposal in the salaries line item. But without the back-up data, Citygate and City staff cannot determine the exact amount. 2. Start-up costs totaling $87,900 to include 4 refurbished monitor/defibrillators. 3. Overtime for paramedic continuing education as required by the State was not in the Fire Department budget proposal, as the Fire Chief believed all training could occur on-duty. (Citygate finds this impossible to achieve.) 4. To add EMD, a City cost of $673,584 for nine additional dispatchers. By September 2013, the now Acting Fire Chief, other Fire Department staff, and the City Hall team had further clarified the paramedic program costs, phased across three years, summarized here: Table 2City Paramedic Costs NO EMD Staff, September 2013 Item Cost EMS Clinical Training & Oversight $15,000 Paramedic pay stipend for 15 firefighters $144,153 New Cardiac Monitors @ $35,000 each. 3 for 1 st year $105,000 Cardiac Monitor annual service plan @ 975/unit $2,925 Small equipment and supplies $2,431 Cardiac Monitors annual replacement fund @ 5-year life $10,000 Based on 3-year Phasing, 1 st Year estimate $279,884 2 nd Year (could include EMD which needs more lead time) $234,198 3 rd Year $161,528 EMD Program additional dispatchers $673,584 2 nd Year City phased cost + EMD $907,782 The Citygate team spent considerable time, at the City Managers request, to review all of the paramedic program documents and cost estimates. The Citygate consultants have actually started, managed, and audited fire paramedic programs in their careers. Citygate found the late
Section 2Review of City-Provided Fire Services Issues page 29 summer 2013 costing, phasing, and lack of final, executable contracts with outside vendors incomplete and very problematic. The acting chief officers did their best to solidify costing, but they still face the challenge, as does the City Hall staff, of having never operated a fire department paramedic program. Citygate determined that the Fire Department, in the fall of 2013, already had 9 firefighters that held paramedic licenses that just needed activation. Another 4 firefighter-paramedics are to be hired before the end of the year due to attrition, bringing the total to 13. Then there are two Fire Engineers who hold paramedic licenses. If they are activated and given paramedic pay, until more firefighter-paramedics are hired, the Department could field 15 paramedics this fiscal year. At four engines per day, and with three duty platoons, the Department needs a minimum of 12 paramedics, with the additional medic per shift off-setting some need for vacation relief. Therefore, the Department has the personnel to start paramedics on each engine, on each shift, likely by the end of the current fiscal year. As Citygate followed-up on the County Fire Department proposal, we clarified that, in fact, the County, due to State personnel rules, would not be able to transfer in Hemet firefighters that are not already being used and compensated as paramedics (more will be said on this in the County Fire Department Section of this report). Based on this and the number of paramedics being potentially available now for patient care reasons, as well as the possibility of a decision now or later to contract with the County, Citygate believes the Hemet Fire Paramedic program should be implemented fully, this fiscal year. Based on this opinion, the Hemet City Manager asked Citygate to prepare a complete budget for the proposed paramedic program based on a full first year implementation. Using City-provided cost figures as well as our experience elsewhere, Citygates paramedic budget based on information to date is: Table 3Citygate Paramedic Program Costs October 2013 Year 1 Year 2 Year 3 Start-up & Operating Annual Total without EMD $812,718 $273,067 $281,467 EMD Staff* $739,075 $739,075 $739,075 Poss. Max Total $1,551,793 $1,012,142 $1,020,542 *Citygates estimated EMD staff cost includes not only the salary and benefits estimated by the City, but also overtime to cover vacancies due to approved leaves. These updated paramedic costs will be used to compare the costs of a Hemet-provided Fire Department to the County Fire Department proposal in the cost analysis section of this report.
Section 2Review of City-Provided Fire Services Issues page 30 Finding #4: Projected paramedic costs, even as adjusted by Citygate, are on the low side at best. The unknown is the longer-term cost of services to be provided by the contracted clinical oversight and training provider. 2.7 THE CITY FIRE DEPARTMENT PROPOSAL FOR CONTINUED INDEPENDENT OPERATION The City Fire Department proposal, as updated in March 2013 to the City Council, provides for: Four fire stations, each staffed with a crew of three personnel per day, one of whom is a paramedic The continued lease of Station #5 to AMR for an ambulance location A 2-person Squad at Station #1 A cross-staffed ladder truck at Station #4 Three Battalion Chiefs (currently all three are interim acting BCs) One Fire Chief (currently an interim acting Fire Chief) One Administrative Assistant .5 Disaster Coordinator One Fire Prevention officer (now vacant) Emergency Medical Dispatching. Finding #5: The current Administrative Captain coverage in lieu of Battalion Chiefs needs to be evaluated to ensure the Administrative Captains are trained to the Battalion Chief duty chief level. Further, the following question needs to be addressed: how long can this model be continued if the compensation and/or skill set is significantly lower than that of Battalion Chief? Finding #6: The City appears to be assigning Fire Marshal and Training responsibilities as extra duties to 2 fire crew Captains, but this is inadequate for a City the size of Hemet.
Section 2Review of City-Provided Fire Services Issues page 31 2.8 ANALYSIS AND COMMENT The other City Fire Department proposals from last January also include other variations to use less or more headquarters staff to show a range of costs and service-level decisions. Then the Hemet Fire Department proposal lists, at length, the other programs that Hemet Fire provides in disaster preparedness, weed abatement, fire prevention, public education, and community partnerships. All of these are rolled into the lump sum costs and none have specific service measures, so it is impossible to quantify the value, quantity, or quality of many of the other services statements. The City Fire proposal accurately portrays the status of the Citys fire stations and fire apparatus. It also accurately states that continuing with the City Fire Department will not incur County conversion costs. Citygate observes that many suburban fire departments, especially those seriously reduced by the recession, are dealing with: Keeping up with changes and all of the regulatory required tasks Retaining and growing internally qualified chief officers, especially with skills in personnel and fiscal issues Having management staff trained in very complicated programs such as paramedics Providing fire prevention services using sworn personnel that are rotated in and out of the position, thus not gaining the technical skills needed to completely use the fire code. For these and the other reasons stated in this report, it is very likely that if the City chooses to even maintain the current Hemet Fire deployment levels, doing so will require more investment in fire services, starting with headquarters staff and paramedics. If so, and if Hemet can afford more fire services, is there a crossover point where the County becomes a better option at the same or less cost? The cost model in Section 4 of this report will identify where the crossover point is.
Section 3Review of County-Provided Fire Services Issues page 32 SECTION 3REVIEW OF COUNTY-PROVIDED FIRE SERVICES ISSUES The City has received and reviewed the lengthy County Fire Service proposal. Citygate reviewed the proposal and found it typical of what we see from a County (CAL FIRE or other) full-service proposal to a city or fire district. For cost comparison purposes, our cost model uses the County Option #1 that includes a staffed ladder truck. The reasons for this are several: In Citygates opinion, Hemet needs ladder truck services. Hemet Fire Department staff, in prior years, and in their 2013 proposals, believe a ladder truck is necessary in Hemet. The nearest County ladder truck southwest of Hemet is too far for primary (1 st
Alarm) response time use. County Fire Department staff advised Citygate that they believe Hemet needs adequate ladder truck service as do the other County fire service areas north and east of Hemet that do not have a ladder truck. As such, County Option #1 cost- shares the ladder truck 50 percent to the City and 50 percent to the County. The County does provide an option that has no ladder truck, and retains a two- person squad. But, importantly, the County will not cross-staff a ladder truck with an engine crew as Hemet fire currently does and as Citygate will include in two Hemet Fire cost models. These needs and limitations on the County proposal mean that, unless Hemet can afford and chooses County Option #1, the only way for Hemet to continue ladder truck use is to stay independent and cross-staff the unit for part-time availability. Finding #7: The location of the current County truck company is too far from Hemet to provide initial needed ladder truck coverage. Finding #8: The County proposal that includes a truck company that would be located in Hemet is cost-effective because it serves both Hemet and fills a gap that the County has in timely truck coverage to its own service areas north and east of Hemet. Thus, the Countys proposal only charges Hemet half the cost of a 4-firefighter-staffed ladder truck that will be stationed in Hemet. 3.1 SERVICES PROVIDED IN COUNTY PROPOSAL The Countys overall proposal met Hemets RFP requirements for full services with detailed costs. It includes:
Section 3Review of County-Provided Fire Services Issues page 33 Four fire stations, each staffed with a crew of three personnel per day, one of whom is a paramedic The continued lease of Station #5 to AMR for an ambulance location A 4-person-staffed ladder truck Station #1 Three Battalion Chiefs, one per day One Administrative Battalion Chief dedicated to City support A Fire Chief, Division, and Deputy Chief to provide oversight and City staff coordination Disaster Coordinator via Riverside County Office of Emergency Services One Assistant Fire Marshal, dedicated to Hemet Emergency Medical Dispatching Regional hazardous materials and technical rescue teams Complete headquarters services with dedicated personnel for: Training Emergency Medical Services / paramedic oversight Logistics and supplies Apparatus ownership, repair and replacement Facility maintenance Dispatch and technology integration. The County proposal and included programs can provide and continue the City Fire Department current programs in fire inspection, community education and preparedness partnerships, and co- location of AMR ambulances. Citygate did not identify a current City Fire Department program that the County could also not deliver. Several of the Countys fire stations overlap into Hemet at a 4-minute travel time measure. This was shown on the exhibit maps provided as part of the County proposal. While today, either department can request the other to assist, they rarely do if their own units are immediately available. This is for two reasons: first, there is a longer dispatch time as either agency first checks to see if the other agency is available and is closer to the emergency; and second, the two agencies do not have common training/equipment standards. While fire departments work well enough together on large mutual aid events, a common training, dispatch, command chief and
Section 3Review of County-Provided Fire Services Issues page 34 fire crew skill-set makes day-to-day operations faster, smoother, and safer when done by one agency. 3.2 COUNTY PROPOSAL BENEFITS AND CONSTRAINTS The Riverside County Fire Department proposal offers benefits typical of any large fire service contract provider in the State when compared to smaller, suburban stand-alone fire departments: Predictability of service levels and quality A city sets it terms of staffing and response time performance via contract clauses and penalties Stability: a city does not have recruitment and retention challenges Training staff depth and educational program resources Back-up equipment and staff Cities do not have the time and cost expense for workers compensation, general liability, payroll, personnel, legal and labor negotiations Credentialed command staff Relieves cities of the responsibility of meeting Cal/OSHA safety requirements. However, these positives have to be contrasted against possible losses to: Loss of local control over all labor costs and some types of services (such as cross-staffed ladder trucks) An inflexible regional service-to-cost model if one or more cities wants severe cost and service reductions in another recession Turnover in chief officers experienced in Hemets affairs. 3.3 COUNTY PROPOSAL ITEMS THAT NEED CLARIFICATION In regard to the specific Riverside County Fire Department proposal to Hemet, there are some items that need clarification and/or negotiation, and one or more could become serious impediments to reaching an acceptable contract: 1. When major emergencies strike elsewhere in the County or beyond, how many units will the County maintain in Hemet, which has a high call-for-service rate? The County proposal states that Hemet will be a Priority Cover area during regional emergencies. This needs to be clarified, as there are no specific minimum
Section 3Review of County-Provided Fire Services Issues page 35 unit counts or backfill response times in the County proposal. Currently for mutual aid, Hemet will send out one unit, leaving three engines and the squad, while it tries to callback a crew on overtime to staff a reserve apparatus. A regional deployment plan cuts both ways, in that if the region needs help, Hemet could decide to drop to three or fewer units for a period of time. However, if in turn, Hemet needed multiple units quickly, the County will respond in force. This two-way street is similar to mutual aid, except that under a contract, one dispatch center and chief officer, not two, coordinates movements. But in a mutual aid request for more than one unit, today an independent Hemet Fire Department could say no because it felt that the level of emergency calls at the time required all Hemet fire engines to be on duty in the City. This is why the County needs to be specific in describing what it means when it says Hemet will be a Priority Cover area. What level of service will this be? 2. There are impacts to Hemet employees if some are not accepted for transfer to the County Fire Department. This is especially true for everyone in the firefighter rank, not being worked and paid as a paramedic. Riverside County does not employ non-paramedic firefighters, and even the statewide system might not be able to absorb so many non-paramedic firefighters from Hemet. Even if the statewide system could, the Hemet employee would be faced with a move to another part of the State if the employee did not want to be laid off. This issue was not made clear to City staff until Citygate followed up on the County proposal. Unless Hemet begins a paramedic program prior to contracting with the County, all Hemet firefighters (15 currently) face either layoff or possible relocation to another CAL FIRE Unit outside of Riverside County. 3. The actual rank for rank transfer of employees requires a credential review and final pay determination by CAL FIRE. The current County proposal assumes all Hemet employees will be qualified to transfer to CAL FIRE at their present rank.
Section 3Review of County-Provided Fire Services Issues page 36 Finding #9: If the City contracts with the County for fire services, CAL FIRE will only absorb firefighters with paramedic certification. After hiring four firefighter-paramedics to fill existing vacancies this fall, the number of firefighter-paramedics will be 13 of the 15 firefighter positions in the budget. Thus, a merger with the County, if it occurred before more firefighters retired or resigned, would result in 2 firefighters being laid off or transferred out of the County due to the lack of paramedic certification. If the City does not start its paramedic program before conversion, then all 15 firefighters will be subject to transfer or layoff.
Section 4Cost of Fire Services Choices and Services page 37 SECTION 4COST OF FIRE SERVICES CHOICES AND SERVICES As Citygate discussed in Section 1.4 and 2.3 of this report, we believe the practice of using acting chief officers to provide headquarters management services in the Hemet Fire Department is unsustainable and not in Hemets best interests. Citygate identified in Section 2.3 the recommendation that ideally Hemet should have the following fire headquarters staffing: 1 Fire Chief 3 Battalion Chiefs to provide 24/7/365 incident command and station supervision/training 1 Training Officer 1 Fire Marshal or fire inspector (which can be a non-safety position) 1 Emergency Medical Services oversight position (this can be a part-time contract position) 1 Administrative Assistant office support position 1 Fire Prevention Clerk for fire prevention needs and back-up when the other position is on earned leave. We also stated in the Executive Summary of this report that the level of fire services is a local choice that has to match desired services to revenues available. Based on the various Hemet Fire Department staffing proposals and taking in account the cost variables of implementing paramedics and Emergency Medical Dispatch, Citygate developed a cost model using our and City staffs most up-to-date data. The cost model shows four Hemet Fire Department service levels starting with the service level as it is today and increasing to Citygates recommended as should be level of service. We then compared these four City levels of service and costs to County Option #1 that includes the staffed ladder truck. This County option is the most comparable to the Citys as should be service level and cost. The County cannot provide a lesser service level, such as using acting chief officers or cross- staffing a ladder truck, because these are not consistent with CAL FIRE and Riverside County Fire Department best practices that limit the liability exposure to the fire agency. As a result, there is no lesser cost County alternative that provides a direct cost comparison to the City alternatives. If the City can only afford a cost and service level less than that proposed by the County in its Option #1, then continuing a City-operated fire department is the only affordable option available to the City that provides at least minimal ladder truck availability. The tables in this section will then compare the cost of the various alternatives available to the City, as compared to the County proposed Option #1.
Section 4Cost of Fire Services Choices and Services page 38 4.1 HOW THE COSTS IN THE TABLES WERE DEVELOPED City costs began with using the FY 2013-14 budget, less the $900,000 estimate added by the City in that budget for the possibility of starting a paramedic and EMD program. This is the cost of providing the current Hemet Fire Department service level. For progressively higher levels of service, Citygate added the annual cost developed by Citygate of operating a paramedic program, including a one-time $525,000 start-up cost of purchasing equipment in the first year. For alternatives that also add an enhanced headquarters staffing level, we added the cost of that staff as developed with Hemet City Hall staff using current pay and benefit levels. Finally in the City alternative that includes adding a dedicated ladder truck crew, Citygate used Hemet pay and benefit levels. County Option #1 costs began with the cost provided by the County in its latest proposal, which is also reflective of FY 2013-14 CAL FIRE expected costs. To the County proposal we added a number of costs, which have to remain with the City. This was done in order to make the County proposal represent the true complete annual cost of fire service to the Citys General Fund if there is a contract with the County. For example, all of the non-sworn positions are proposed to remain on the City payroll. The City will continue to pay for the utilities and major maintenance on fire stations and accrued annual retiree medical costs for prior City retirees and current employees who qualified for that benefit. In addition, there are general overhead expenses and allocated City internal service costs, such as a portion of the general liability insurance and citywide legal expenses, that the City allocated to the Fire Department budget and which will not be reduced even if the City contracts with the County for fire services. Citygate carefully reviewed these have to be kept expenses with the City to ensure that it was appropriate to add them onto the County base proposal cost in order to bring the County proposal up to a true cost comparison to the City alternatives. County Option #1 also included a one-time start-up cost of $262,595, which occurs only in the first year of a contract. Citygate also acknowledged that under CalPERS retirement system actuarial practices, even though sworn firefighters would be transferred to CAL FIRE employment, the City will retain responsibility for approximately $663,000 in unfunded firefighter retirement liability for these personnel that has already been accrued but not yet fully paid. This is a cost that will be added to the Citys CalPERS expense beginning in the third year. The City, of course, will have experienced no fire-employee-related CalPERS expenses in the first two years and so the City may consider setting aside this $663,000 annual savings in those first two years in order to buy down a portion of the long-term unfunded liability and slightly reduce the annual $663,000 cost that the City will incur beginning in the third year. It is important to recognize in using Citygates cost comparison tables that the County proposal represents the maximum cost the City can expect. Each fiscal year County Fire bills only their actual costs, which in Citygates experience will be most likely 2-5 percent less or roughly a
Section 4Cost of Fire Services Choices and Services page 39 $200,000 to $400,000 savings over the County costs in the table below. These savings occur because the County contract proposal assumes that all personnel assigned to the fire stations are at the top pay step and that maximum overtime costs are incurred for earned leave absences. This is rarely the case, as staff turnover results in some personnel being assigned to the Hemet stations who are at a pay scale below the top step. A review of City staffing and costs demonstrates that at the Hemet stations not all personnel are at the top step and this fact is already reflected in the Citys FY 2013-14 budgeted costs. Thus, comparatively, the County cost proposal is somewhat overstated when compared to the Citys, but the exact amount cannot be determined because the real cost will only be reflected with actual costs that are known at the end of the contract year. 4.2 COST COMPARISON TABLES WITH EXPLANATION The far left-hand columns list four levels of service if the City retains the Hemet Fire Department and compares each of these service/cost levels to the County Option #1 which is the last row in the table. The four service level choices that Citygate recommends as the best service-to-cost-range choices are: A. Current operation. Includes 4 engines, 1 squad, 1 cross-staffed ladder truck, and 4 acting chief officers. Does not include paramedics or Emergency Medical Dispatch. B. Option A plus the City fire paramedic program. C. Option A+B plus the addition of headquarters personnel for a training chief, fire marshal, and second office assistant. D. Option A+B+C plus the addition of permanent chief officers (4) and a return to a dedicated 3-person ladder truck crew, to replace the 2-person squad. The remaining columns in the table first list the cost, without inflation adjustments, that can be expected based on the City and County proposals in each of the first three years. The column to most appropriately use in comparing costs is the third-year column (second to last column). The first- and second-year cost columns include one-time costs discussed above. In Year 3 the one- time costs are completed, but the payment of the CalPERS unfunded retirement liability begins, so the third-year column represents the most accurate long-term cost to the City under the various alternatives. Of course, even in Year 3 the probable cost reduction in the County contract for the true up at year-end for actual versus budgeted costs cannot be calculated, so the table cost is the budgeted or worst-case contract cap cost the City should expect.
Section 4Cost of Fire Services Choices and Services page 40 The next two tables assume that the City decides not to implement EMD, as Citygate has recommended. The first table provides the three-year cost comparison of City service level D to County Option #1. This represents the closest comparison of service levels that are nearly the same. Table 4Comparison of City Service Level D to County Option #1 without EMD Costs Service Level Alternatives Service Level Description Adjusted Annual Operate Cost 1st Year Adjusted Annual Operate Cost 2nd Year Adjusted Annual Operate Cost 3rd Year Enhanced Services 3rd Year (Savings) or Expense versus a County Contract City Service Level City Service Level D Comparable to the County Option #1 City w/staffed Ladder Truck + Medics + HQ staff $12,257,908 $11,718,257 $11,726,657 $306,283 County Service Level County Option #1 County w/staffed Ladder Truck @ 50% cost to City $11,422,146 $10,757,374 $11,420,374 Annual Savings to the City: $835,762 $960,883 $306,283 The second table compares all four City service level alternatives that Citygate recommends as the best service-to-cost-range choices:
Section 4Cost of Fire Services Choices and Services page 41 Table 5Comparison of Service Level and Cost Alternatives without EMD Costs Service Level Alternatives Service Level Description Adjusted Annual Operate Cost 1st Year Adjusted Annual Operate Cost 2nd Year Adjusted Annual Operate Cost 3rd Year Enhanced Services 3rd Year (Savings) or Expense versus a County Contract City Service Levels A Current City Service Level City w/Squad & cross staff Truck, no Medics, NO extra HQ $10,487,600 $10,487,600 $10,487,600 $(932,774) B City w/Squad & cross staff Truck + Medics, NO extra HQ $11,300,318 $10,760,667 $10,769,067 $(651,307) C City w/Squad & cross staff Truck + Medics + HQ staff $11,724,344 $11,184,693 $11,193,093 $(227,281) D City Service Level Comparable to the County Option #1 City w/staffed Ladder Truck + Medics + HQ staff $12,257,908 $11,718,257 $11,726,657 $306,283 County Service Level County Option #1 County w/staffed Ladder Truck @ 50% cost to City $11,422,146 $10,757,374 $11,420,374 The next set of tables differ from the two above only in adding in the estimated annual cost of implementing Emergency Medical Dispatch (EMD) to the Citys dispatch center beginning in the second year. While Citygate believes the City can begin a full paramedic program in the first year, the lead-time for acquiring equipment, recruiting and training dispatchers make a second year implementation more realistic.
Section 4Cost of Fire Services Choices and Services page 42 Table 6Comparison of City Service Level D to County Option #1 WITH EMD Costs Service Level Alternatives Service Level Description Adjusted Annual Operate Cost 1st Year Adjusted Annual Operate Cost 2nd Year Adjusted Annual Operate Cost 3rd Year Enhanced Services 3rd Year (Savings) or Expense versus a County Contract City Service Level City Service Level D Comparable to the County Option #1 City w/staffed Ladder Truck + Medics + HQ staff $12,257,908 $12,457,332 $12,465,732 $1,045,358 County Service Level County Option #1 County w/staffed Ladder Truck @ 50% cost to City $11,422,146 $10,757,374 $11,420,374 Annual Savings to the City: $835,762 $1,699,958 $1,045,358
Section 4Cost of Fire Services Choices and Services page 43 Table 7Comparison of Service Level and Cost Alternatives WI TH EMD Costs Service Level Alternatives Service Level Description Adjusted Annual Operate Cost 1st Year Adjusted Annual Operate Cost 2nd Year Adjusted Annual Operate Cost 3rd Year Enhanced Services 3rd Year (Savings) or Expense versus a County Contract City Service Levels A Current City Service Level City w/Squad & cross staff Truck, no Medics, NO extra HQ $10,487,600 $10,487,600 $10,487,600 $(932,774) B City w/Squad & cross staff Truck + Medics, NO extra HQ $11,300,318 $11,499,742 $11,508,142 $87,768 C City w/Squad & cross staff Truck + Medics + HQ staff $11,724,344 $11,923,768 $11,932,168 $511,794 D City Service Level Comparable to the County Option #1 City w/staffed Ladder Truck + Medics + HQ staff $12,257,908 $12,457,332 $12,465,732 $1,045,358 County Service Level County Option #1 County w/staffed Ladder Truck @ 50% cost to City $11,422,146 $10,757,374 $11,420,374 4.3 COUNTY PROPOSAL ISSUES TO BE RESOLVED The County proposal indicates a number of issues that would need to be resolved as part of a final contract. Some of these can affect the short- and long-term costs of a County contract, although at this stage none of the issues appear in the long-term to significantly narrow the cost/savings difference between the City and County Option #1 alternatives. Citygate cautions, however, that if the City finds the County proposal worth pursuing, that prior to making a final decision at a future public meeting, the following issues will need to be resolved to the satisfaction of the City: Start-up the City firefighter paramedic program
Section 4Cost of Fire Services Choices and Services page 44 Identify and accept the level of Priority Cover for Hemet fire stations by the County Fire Department Identify the impact on Hemet fire personnel who do not have paramedic certification and are not active paramedic-level firefighters Submit for transfer verification by CAL FIRE all City fire employee records to determine who can be transferred, at what rank and pay Resolve City firefighter return rights to the City, if the contract is stopped Resolve disposition of earned leave credit Resolve City employee continuity of medical coverage during the transition Resolve post-retirement retiree medical costs Understand the retirement formula applicable to City employees who transfer to CAL FIRE Identify retirement reciprocity Identify the number and cost of City employees on disability (City expense) on the effective date of a contract Finalize ownership and maintenance of front-line and reserve apparatus and equipment. As discussed in other sections of this report, cost is only one factor to consider in determining whether to contract for fire service with the County. Nevertheless, cost is critical, because if the City cannot or chooses not to spend more on fire services comparable to the level of services proposed by the County, all other issues are rendered moot. 4.4 COST ANALYSIS FINDINGS Finding #10: There are significant unknowns that can cause one-time County Fire conversion costs to swing substantially, including liability for employees injured prior to conversion, the vacation leave buyout, and start-up costs.
Section 4Cost of Fire Services Choices and Services page 45 Finding #11: Citygate cautions the City that level of service choices A through C anticipate the continued use of acting chief officers, until, through retirements and/or training and certification, the acting chief officer positions can be transitioned into permanent chief officer positions. If the City seeks to convert the acting positions immediately to permanent appointments, the City is likely to have one or more of the current acting chief officers return to the rank of captain, resulting in there being more captains than the current budget provides for. The continued use of acting chief officers is unsustainable. Finding #12: Given current levels of staffing and funding, it would be surprising if the Hemet Fire Department is able to keep up with mandates for training provision, training verification, fire code inspections, fire code permits, permit fees, and second-tier priorities like public education and disaster preparedness. Based on this, and the unsustainable use of acting chief officers, it is very likely that if the City chooses to even maintain the current Hemet Fire Department crew deployment levels, doing so will require more investment in fire services, starting with headquarters staff and paramedics. Finding #13: The most comparable service configuration between the City and County proposal is for the City to convert the 2-person squad back to a 3-person truck company and add paramedics, a Fire Marshal, a fire prevention clerk, a 40-hour Training Officer and permanent chief officers. This compares most directly to the County proposal that provides a shared 4-person truck company and adequate fire headquarters services in Hemet. Finding #14: If the City contracts with the County, it will be most cost-effective for all City fire apparatus and specialty tools to be given to the County. The County will then be responsible for maintenance and replacement. The County prefers that all front-line fire apparatus be in County ownership, due to the liability of County fire personnel driving the equipment.
Section 5Advantages and Disadvantages of a County Fire Contract page 46 SECTION 5ADVANTAGES AND DISADVANTAGES OF A COUNTY FIRE CONTRACT As this report has identified in several sections, a suburban fire department, unless located in a high-revenue city, frequently struggles to recruit and retain enough qualified headquarters staff, or provide enough supplies and updated firefighting apparatus and equipment. Larger and regional contract-for-service fire departments can spread overhead costs across many firefighters and thus have quality dedicated staffed headquarters support programs. They can train future command staff leaders more easily because they can rotate candidates through different bureau assignments to round out a resume. They do not have to worry as much about an injury leave or disability retirement crippling a critical command staff position. But the larger and regional contract-for-service fire departments are inflexible when it comes to costs. They use the common tools to set labor costs, but once done, they have to be passed onto the contracting cities and counties. However, Citygate takes note that after this recession, government employers of all sizes are re-setting their pension, medical, and salary costs to the new economic reality. This should moderate contract cost increases, at least in the near term. There are other benefits to smaller cities like Hemet in the areas of not having the time and cost expenses for workers compensation, general liability, payroll, personnel, legal, and labor negotiations. The City Hall overhead is a real issue for fire and police services. Even if a fire contract did not mean Hemet could reduce, over a period of time, its already smaller City Hall staffing, the staff would gain more time for other under-met Hemet needs. If Hemet can afford the level of fire services that includes a full headquarters team as identified in the Citygate cost model, along with a staffed ladder truck, then even if there were zero direct fire cost savings, Citygate would recommend Hemet carefully consider all of the obligations of running a fire department internally versus contracting with the County and simplifying its internal operations. The County also can easily do all of the non emergency response programs such as the disaster preparedness partnerships identified in the City Fire Department proposal, as the County proposal states.
All chapter download Test Bank for Paramedic Care: Principles and Practice, Vols. 1-5, 5th Edition, Bryan E. Bledsoe, Robert S. Porter, Richard A. Cherry