HomeMy WebLinkAboutSupplemental Communication - City Council Study Session #1 - (9)City of Huntington Beach —Standards of Cover Study and Evaluation of Fire, Rescue, and EMS Delivery
Volume 1—Executive Summary
1.5 DEPLOYMENT OPTIONS — CHANGE THE EXISTING LEVEL OF :EFFORT
Public safety agencies post -recession have to continue being concerned about their ability to
balance expenses to revenues. Citygate was asked to examine alternative deployment strategies
and discuss the cost and benefit of alternative provision of fire and/or ambulance services. The
current provision of both firefighting unit and ambulance staffing, while up to local elected
officials to decide, is highly regulated by safety laws. Other levels of government also regulate
EMS care. Finally, the City has a negotiated agreement with its firefighters that likely cannot be
changed during the current contract term.
As stated throughout this report, the City operates both firefighting crews and transport
ambulances. The State of California has regulated the provision of EMS services to the counties
in California. They set patient care standards, and oversee paramedic and Emergency Medical
Technician (EMT) training, quality of care, and recertification. All of this occurs under the
direction of an appointed physician medical director.
In Orange County, the Local EMS Agency of the County (LEMSA) has required for decades
that a paramedic "unit" be staffed by two paramedics, operating as a team and arriving together.
The paramedic team can be either on a fire apparatus or on an ambulance. While other California
counties have allowed so called "one and one" paramedic deployment with one paramedic on the
fire crew and one paramedic on the ambulance, to date, Orange County has not.
Almost since the inception of paramedics in the County, Huntington Beach Fire Department has
provided paramedics. In early years, ambulance transportation was provided by private
ambulance companies. To provide the highest quality and integration of the ambulance and fire
paramedic teams, Huntington Beach in 1993 began operating the ambulance service itself. The
staffing model chosen was (and still is) innovative and effective; the ambulances were staffed by
lesser -trained EMTs who are allowed to care for and treat non -paramedic level patients. These
EMTs were also not sworn firefighters, nor were they long-term employees with benefits. The
City chose to use the program as an apprenticeship for those wishing to eventually join
permanent fire or ambulance service employment. Thus, the two paramedics were maintained on
the fire engine, as was the norm across much of Los Angeles and Orange Counties.
In this Fire Department ambulance program, the City also chose to staff its fire engines with four
personnel for several reasons:
♦ A four -person fire crew is more effective when needed to control serious, still
growing fires. Thus, upon arrival of one unit, under Occupational Safety and
Health Administration (OSHA) regulations, two firefighters could enter the
burning building, while two remained outside providing command as a safety
team.
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City of Huntington Beach —Standards of Cover Study and Evaluation of Fire, Rescue, and EMS Delivery
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♦ The four -person fire engine or ladder crew included the required two paramedics.
♦ Approximately 50% of the time, the patient needing ambulance transport was a
moderately serious level situation requiring at least one paramedic to accompany
the patient to the hospital.
♦ When one paramedic had to go to the hospital with the ambulance, the fire engine
was still staffed with three firefighters, one of whom was a paramedic and could
still respond to emerging fires, specialty rescue incidents as a one -person
paramedic unit. While this unit still needed a second paramedic unit to be
dispatched with it, at least the one paramedic was closest being still in the
neighborhood.
♦ When the patient situation was critical and required that both paramedics had to
go in the ambulance to the hospital (which occurred 16% or less of the time), the
two -person engine typically was considered out of service and went to the
hospital to retrieve its personnel.
In summary, the Department chose to staff the transport service with two lower cost EMTs and
knew that some of the time all of the firefighters could remain in the City for other emergency
responses when a less serious patient was transported. The Department also knew that 50% of
the time when a paramedic engine "lost" the fourth crew member to a transport, it still had a
somewhat effective three -person team still in the neighborhood.
In 2015, even after 22 years and an ever-increasing population and demand for emergency
services, the occurrences of a paramedic being required for transport were:
♦ Of 11,943 transports, 5,771 (or 48%) required at least one paramedic on the
transport.
♦ Of the 5,771 paramedic level transports, 115 (or 2%) required two paramedics.
The City has four theoretical re -structuring choices:
1. Reduce the fire crew to three personnel and place one paramedic on the
ambulance, which, as of this writing, the LEMSA will not allow.
2. Reduce five fire crews to three personnel, keeping two of the three as paramedics,
and placing a sworn firefighter on the ambulance. This would allow laying off 15
non -sworn ambulance operators. The savings would not equal 100% of the cost of
the 15 positions since the firefighter is more expensive, including overtime for
earned leave absence replacement.
3. Reduce the staffing of five fire companies by placing both paramedics on
ambulances, which would allow laying off 30 ambulance operators. However,
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nine firefighters would need to be hired (including overtime for earned leave
absences) to staff the five reduced crews back to three personnel.
4. Given that aerial ladder companies are very dangerous to operate, Citygate
suggests that the City maintain staffing these apparatus at four personnel each.
However, the City could consider not maintaining the four firefighter staffing
positions on the engines 12 hours per day at during night hours. Thus, during
earned leave absences, overtime would only be used to backfill the fourth positon
during the busiest daylight hours.
Option 2 has another significant operational consideration. With an engine crew of three (two of
whom are paramedics during the peak daylight hours), at least four of the five ambulances are
very busy with transports. The Department has a simultaneous incident rate of having at least
two incidents open 28% of the time. It is therefore completely conceivable that during daylight
hours, two to three engines, now staffed with only three, will send a paramedic to the hospital.
When this happens, those engines fall to 2-person staffing and are ineffective as a firefighting
force. They must either go to the hospital to retrieve their paramedic, or stay in their assigned
District but then must have a full second engine dispatched with them. Thus, out of eight
available engines, three are short staffed and for even another EMS incident have to rely on a
partner engine to be dispatched. Thus, during peak daylight demand hours, three to six engines
(out of eight) are affected. This substantially reduces the City's stand-by firefighting force and
makes it more dependent on mutual aid from a distance should a fire or other serious emergency
also break out.
The following table shows the net savings or increase of each option, inclusive of total
compensation costs, and overtime increases or decreases as needed for each staffing model:
Table 3—Net Savings or Increase of Restructuring Options
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While the City has three staffing restructuring choices, none can be quickly implemented. There
needs to be extensive, nuanced negotiations with both the Firefighters Bargaining Unit and the
Orange County EMS Agency. Without knowing the result of those negotiations, it is not possible
at this point for Citygate to recommend one, best -fit option, as savings and operational
challenges must be balanced.
1.6 OVERALL HEADQUARTERS SERVICES EVALUATION
Citygate's review of headquarters programs revealed very few issues requiring attention. We
found an appropriately staffed headquarters team adhering to many best practices. Our findings
and recommendations in this area should be considered as a best practices tune-up, not a
criticism. While any organization would like more personnel to expand the "should -do"
programs versus the "must -do" programs, few, if any, cities can afford the "should -do"
programs, even this far after the great recession.
As workload demands increase, the headquarters team must continually compare emergency
incident types and other customer services requests to incident severity outcomes along with
changing training or personnel practices. This information can be used to maintain accountability
and to inform the City leadership and community that the revenues received are being used
effectively. In a sense, this is no different than medical triage, in that staff have to meet mandated
regulatory and safety standards first. If the Department is unable to expand some of the "should -
do" programs at desired frequencies, improvements can be spaced out over a longer time period.
The Department's fire apparatus, training, and small tools and equipment are all in adequate
condition, are well maintained and are replaced at best practice intervals. There are some
logistics issues to be addressed but they are not burdensome.
We found the City's and the Department's personnel practices to be well designed and built
around best practices. There are multiple systems in place to track the use of employee earned
leave, injury prevention, injury rehabilitation, and overtime. Citygate did not see a pattern of
problems or an issue the City was not addressing with the appropriate technique. The use of
overtime is appropriate given the City's negotiated leave policies with its employees and the
need to maintain minimum staffing on all units 24/7/365.
1.7 DEPLOYMENT FINDINGS AND RECOMMENDATIONS
Citygate's deployment findings and recommendations are listed below. For reference purposes,
the findings and recommendation numbers refer to the sequential numbers as these are presented
in the technical report volume.
Finding #1: The City Council has not adopted a complete and best practices -based
deployment measure or set of specialty response measures for all-risk emergency
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responses that includes the beginning time measure from the point of the Metro
Net Communications Center receiving the 9-1-1 phone call, nor a goal statement
tied to risks and outcome expectations. The deployment measure should have a
second measurement statement to define multiple -unit response coverage for
serious emergencies.
Finding #2: The current number of eight fire stations does not reach the northern sections of
the City within 4 minutes travel.
Finding #3: Traffic congestion impacts constrain 4-minute travel time coverage. While such
gaps do not last long enough (in hours) to warrant an additional fire station, the
gaps do mean that the City needs at least all eight of its fire station locations, or
the coverage would be much worse during traffic congestion hours.
Finding 44: The relocation north of Station 8 has a significant, positive impact on the northern
City coverage that automatic or mutual aid from other agencies cannot provide.
Finding 95: Given the eight fire station locations, the City has effective multiple -unit coverage
within a desirable 8-minute travel time. If Station 8 is relocated, the ladder truck
from Station 2 should be moved to Station 8 to improve northern City ladder truck
coverage.
Finding 46: The City's time -of -day, day -of -week, and month -of -year calls for service
demands are very consistent. This means the City needs to operate a fairly
consistent 24/7/365 response system.
Finding #7: The performance of the Metro Net Communications Center at 1:24
minutes/seconds to 90% of the EMS and fire emergencies is slightly better than
published best practices.
Finding #8: The City's turnout times are close to, or just under, Citygate's recommendation of
2 minutes.
Finding 99: The first -due unit travel times in the City are longer than a best practice goal of 4
minutes, which is reflective of the non -grid street design in some areas, and traffic
congestion. The times are reflective of the reality in congested urban areas that
even with a good pattern of eight fire stations, achieving 4-minute travel is very
difficult.
Finding #10: Three of the ambulances are approaching saturation at peak hours in the day. At
some point in the future, if the Unit Hour Utilization percentages stay at 50% for
several hours in a row, an additional daytime ambulance may be necessary.
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Finding #11: The fifth ambulance is not highly utilized at night and may be more efficiently
used during just daylight hours.
Finding #12: While the City has four staffing restructuring choices, none can be quickly
implemented. There needs to be extensive, nuanced negotiations with both the
Firefighters Bargaining Unit and the Orange County EMS Agency. Without
knowing the result of those negotiations, it is not possible at this point for
Citygate to recommend one, best -fit option, as savings and operational challenges
must be balanced.
Recommendation #1: The City should strongly consider relocating Fire Station 8 and
moving the ladder truck from Station 2 to new Station 8.
Recommendation #2: Adopt City Council Deployment Measures Policies: The City
elected officials should adopt updated, complete performance
measures to direct fire crew planning and to monitor the operation of
the Department. The measures of time should be designed to save
patients where medically possible and to keep small but serious fires
from becoming greater alarm fires. With this is mind, Citygate
recommends the following measures:
2.1 Distribution of Fire Stations: To treat medical patients and
control small fires, the first -due unit should arrive within 7:30
minutes/seconds, 90% of the time, from the receipt of the 9-1-1
call in the Metro Net Communications Center. This equates to a
1:30-minute dispatch time, a 2-minute company turnout time,
and a 4-minute drive time in the most populated areas.
2.2 Multiple -Unit Effective Response Force for Serious
Emer eng ties: To confine fires near the room of origin, and to
treat up to five medical patients at once, a multiple -unit
response of a minimum of three engines, one quint/ladder truck,
and one Battalion Chief totaling 17 personnel should arrive
within 11:30 minutes from the time of 9-1-1 call receipt in fire
dispatch, 90% of the time. This equates to 1:30-minute/second
dispatch time, 2 minutes company turnout time, and 8 minutes
drive time spacing for multiple units in the most populated
areas.
2.3 Hazardous Materials Response: Provide hazardous materials
response designed to protect the community from the hazards
associated with uncontrolled release of hazardous and toxic
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materials. The fundamental mission of the City response is to
minimize or halt the release of a hazardous substance so it has
minimal impact on the community. It can achieve this with a
travel time for the first company capable of investigating a
HazMat release at the operations level within 7:30
minutes/seconds total response time or less than 90% of the
time. After size -up and scene evaluation is completed, a
determination will be made whether to request additional
resources from the City's multi -agency hazardous materials
response partnership.
2.4 Technical Rescue: Respond to technical rescue emergencies as
efficiently and effectively as possible with enough trained
personnel to facilitate a successful rescue. Achieve a travel time
for the first -due company for size -up of the rescue within 7:30
minutes/seconds total response time or less, 90% of the time.
Assemble additional resources for technical rescue capable of
initiating a rescue within a total response time of 11:30
minutes/seconds, 90% of the time. Safely complete
rescue/extrication to ensure delivery of patient to a definitive
care facility.
2.5 Emergency Medical Services: The City should continue to
continue to provide ambulance services in all neighborhoods
within at least 11:30 minutes/seconds total response time.
Recommendation #3: Given the fifth ambulance is not highly utilized at night, the City
should conduct a trial period of splitting the expense of that unit into
two 12-hour-per-day units and deploying them during the peak
workload daylight hours to keep all ambulance utilizations below
50%. Doing so could also allow staggered 12-hour shift start times.
1.8 HEADQUARTERS AND SUPPORT SERVICES FINDINGS AND RECOMMENDATIONS
Citygate's headquarters services findings and recommendations are listed below.
Finding #13: The Department does not have an adequate number of spare Personal Protective
Equipment for all employees should they be required to remove and clean their
gear after fire combat or if the gear is unavailable due to annual inspections.
Finding #14: The number of spare sets of turnout gear will continue to diminish over the next
few years as the life expectancy of 10 years is reached.
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Finding #15: The Department has transitioned to a new occupancy inspection frequency of 1 to
4 years based on occupancy type.
Finding #16: The Division has an adequate number of full-time and contract employees to
perform the current fire inspection workload.
Finding #17: The Division does not rotate inspection areas between the five inspectors allowing
for growth and redundancy.
Finding #18: The Division does not switch plan check geographical areas between the two
analysts allowing for growth and redundancy.
Finding #19: The Division does not perform any over-the-counter plan check reviews for the
community.
Finding #20: The Division has adequate staffing to assure all Certified Unified Program
Agency inspections and reviews are accomplished according to the codes.
Finding #21: The use of off -duty personnel, in conjunction with the on -duty personnel and
Huntington Beach Police when needed for fire investigations, is adequate.
Finding #22: There is adequate depth in the Department to bring additional trained and certified
personnel to a call -out if needed due to complexity and size of the incident.
Finding #23: The Fire Investigation team members are assigned to the Fire Marshal for
reporting and supervision.
Finding #24: There is no formalized Fire and Life Safety Education program for the community
to help reduce fire loss, life loss, or injuries to the residents.
Finding #25: The Department follows current best practices and the training standards
established by the Office of State Fire Marshal. In addition, it has taken the step
of partially adopting many of the current National Fire Protection Association
standards for employee training.
Finding #26: The Department is not enforcing completion of the training hours by individual.
Finding #27: There is no written career development guide or succession plan for the
Department.
Finding 928: The Department does an excellent job maintaining the props and drill grounds to
keep them in good shape and current to meet the needs of the firefighters.
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Finding #29: The Training Center is a state-of-the-art facility with excellent props and training
areas for new and veteran employees.
Finding #30: The Department's EMS program is appropriately staffed to maintain patient care
quality and employee training.
Finding #31: The City uses all of the available best practices -based Human Resources
programs and measures to monitor the use of earned leave and employee
wellness. Citygate did not find any unusual patterns in the use of leave or injuries
and the time off allowed was typical of California firefighter labor agreements.
Finding #32: The City tracks the use of overtime very closely and, given the City's staffing
plan and labor contract agreements, is appropriately budgeting for overtime given
the constant staffing nature of fire services.
Finding #33: The adoption of National Fire Protection Association 1071 Standard for
Emergency Vehicle Technician Professional Qualifications is critical to a healthy
fire apparatus maintenance program. The City Fire Shop has a master fire
mechanic on staff. He is a member of the statewide fire apparatus committee; he
attends and helps with workshops in Sacramento. In addition, there are three
mechanics in training to be fire mechanics when he retires. This is an unusually
high level of commitment to fire service apparatus maintenance by a shop not
totally devoted to fire apparatus.
Finding 934: The fleet maintenance system and apparatus maintenance system is working well
for the Department.
Finding #35: The average age of both the front-line and reserve engines is not beyond the best
practices normal life expectancy of fire apparatus.
Finding #36: The front-line quint/ladder trucks should have many years of service ahead based
on regular preventative maintenance and care.
Finding #37: The Emergency Transport units are fairly new and not yet in need of replacement.
Finding #38: The logistical support system in Huntington Beach is effective. It is typical of
departments of this size and scope and takes advantage of the time, skill, and
interests of the workforce.
Finding #39: The Emergency Management Program in Huntington Beach is effective. It is
typical of cities of this size.
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Recommendation 44: The Department should develop a replacement program for Personal
Protective Equipment on a staggered basis so the 10-year end -of -life
does not create a huge impact.
Recommendation #5: The Department should acquire a spare set of Personal Protective
Equipment for each employee and assure proper sizing and fit.
Recommendation #6: The Fire Marshal should, at the end of the first and fourth years of the
fire inspection program, perform a quality assurance review of the
program to determine any changes such as number of incidents
responded to, completion of inspection percentages, quality of the
inspections, and findings and recommendations.
Recommendation #7: The Division should rotate fire inspectors on a two-year frequency
between inspection areas to improve cross -training and depth in the
Division.
Recommendation #8: The Division, on an annual basis, should monitor the workload and
work hours of all fire personnel, to assure all inspections are being
accomplished.
Recommendation #9: The Division should rotate the Fire Protection Analysts between areas
every two years to improve cross -training and depth in the Division.
Recommendation #10: The Division, in conjunction with Community Development, should
review and develop a method and means to serve the community with
over-the-counter plan reviews.
Recommendation #11: The Department should evaluate the supervisory chain of the fire
investigators to be in line with a sworn member of the Department.
Recommendation #12: The City should consider adding one Public Educator to the Division
to help reduce injuries to the residents caused by fires or accidents in
the home.
Recommendation #13: The Department should develop a plan to enforce its training
requirements to ensure full compliance by all companies with the
training policies and procedures in the Training Manual.
Recommendation #14: The Department should develop a written career development plan
and ensure the requirements are stipulated in the plan and policies.
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Recommendation #15: The Department should develop a succession plan for its headquarters
staffing.
1.9 NEXT STEPS
The purpose of a Standards of Cover Study and Evaluation of Fire, Rescue, and EMS Delivery is
to compare the City's current performance against the local risks to be protected as well as to
compare against nationally recognized best practices. This analysis of performance forms the
base from which to make recommendations for changes, if any, in fire station locations,
equipment types, staffing, and headquarters programs. Citygate recommends that the City's next
steps be to work through the issues identified in this study in the following sequence:
♦ Absorb the policy recommendations of this fire services study and adopt revised
Fire Department performance measures to drive the deployment of firefighting
and emergency medical resources.
♦ Provide the Capital Improvement Plan (CIP) funding to relocate Fire Station 8.
Then consider relocating the ladder truck from Station 2 to new Station 8 to
improve northern City ladder truck coverage.
♦ Conduct a trial period of cutting the expense of the fifth 24-hour-based ambulance
unit into two 12-hour-per-day units and deploying them during the peak workload
daylight hours to keep all ambulance utilizations below 50%. Doing so could also
allow staggered 12-hour shift start times.
♦ Monitor the performance of the Fire Department's deployment system using the
adopted deployment measures and the methods in this study.
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