ACTION:
____________________________
Clerk/Secretary
Department: Fire Item No: D3
Prepared by:
Craig Usher, Deputy Chief
Maia Hodge, Management Analyst Meeting Date: April 25, 2023 Approved by:
Roy O. Palmer, Interim Fire Chief
John Conley, City Manager Agenda Location: Discussion
SUBJECT: FIRE DEPARTMENT – MODIFICATON OF AMBULANCE STAFFING RECOMMENDATION: Discuss the addition of two Basic Life Support (BLS) ambulances in the city and provide direction to staff regarding the costs to maintain the BLS emergency services delivery model.
CORRELATION TO CITY COUNCIL GOALS: 1) Public Safety; and 2) Fiscal Responsibility PRIOR ACTION: On May 9, 2017, authorized the restoration of a fourth Advanced Life Support (ALS) ambulance and directed staff to bring the options identified to fund the service back to the City Council for discussion. (Vote: 4-0; Green absent).
On November 9, 2010, approved reducing the current four Advance Life Safety (ALS) ambulances to three with the following conditions: 1) Receipt of formal confirmation that there are no impacts to the City’s SAFER grant if a staffing reduction is made; 2) Confirmation that reductions will not affect the Border Drop Program; and 3) Maintain commitments made to the Vista Fire Protection District (Vote: 3-2; Ritter and Lopez opposed).
On January 9, 1996, adopted City Council Resolution No. 96-4, amending the City-Wide Classification and Compensation Index and Repealing all Resolutions in Conflict Herewith, to reflect Fire Department staffing changes to transition all Firefighter positions to Firefighter/Paramedic positions as vacancies occur in the future (Vote: 5-0).
PRIOR COMMUNITY SAFETY COMMISSION ACTION: On April 13, 2023, voted to recommend to the City Council the addition of two BLS ambulances and staffing over the next year (Vote: 5-0, De La Fuente and McKean absent).
STATEMENT ON THE SUBJECT: The Vista Fire Department has been experiencing a steady increase in emergency calls for service. In 2022, the Department recorded 16,400 responses, which is an increase of approximately 5 percent per year. Administrative staff monitor how busy ambulance units are based on Unit Hour Utilization (UHU). The UHU is a measurement of how often a unit is assigned to a response and is unavailable. The Commission on Fire Accreditation International (CFAI) standards has identified 25 percent as the recommended maximum UHU for an Advanced Life Support (ALS) unit staffed with Firefighter/Paramedics due to the dual role demands of this emergency services delivery model.
AGENDA
REPORT
CITY COUNCIL
COMMUNITY DEVELOPMENT COMMISSION
SUCCESSOR AGENCY
BUENA SANITATION DISTRICT
JOINT POWERS FINANCING AUTHORITY
04/25/2023 D3 Page 1 of 3
Discussed and approved the addition of two Basic Life Support (BLS) ambulances in the city and provided direction to staff regarding the costs to maintain the BLS emergency services delivery model. Vote: 4-0 (O'Donnell absent)
MEETING DATE: April 25, 2023 PAGE 2
SUBJECT: FIRE DEPARTMENT– MODIFICATON OF AMBULANCE STAFFING Exceeding the standard would restrict staff’s ability to train as firefighters and paramedics, perform daily equipment checks and maintenance, paperwork, station duties, physical training, meal breaks, and public education. When a unit is in the 25-30 percent range, it is recommended to find ways to reduce the utilization, or to consider adding resources. Utilization greater than 35 percent is at a critical level.
Below is the unit hour utilization data for the city’s four ALS ambulances in the past two years.
Basic Life Support Emergency Services Delivery Model. Administrative staff and Vista Fire Fighters Association (VFFA) members have worked together and propose a long-term solution to add resources over time to allow adequate staffing for service demands now, as well as in the future, as outlined in the established Vista Fire Department 2020-2025 Strategic Plan and adopted 2020 Standards of Cover (SOC).
In July 2021, all fire agencies in North County started to triage emergency medical calls to send an appropriate level of response. It was determined that approximately 70 percent of medical calls are at the basic life support (BLS) level with emergency medical technicians (EMT) staffing ambulance units.
Currently, our ALS services delivery model exceeds the appropriate level of life support services. Vista Fire provides an ALS paramedic evaluation of each patient; each of our fire units is staffed with one firefighter/paramedic and our ambulances are staffed with two firefighter/paramedics.
Many agencies in North County have adopted an emergency services response model that includes BLS ambulances with EMT staffing in some fashion. In April 2022, North County Fire staffed a 12-hour BLS ambulance in Vista to support the excess workload in the area. In October 2022, this ambulance had staffing increase to 24 hours and averaged a UHU of 28.6 percent.
Staff is recommending the addition of one Basic Life Support (BLS) ambulance staffed with two full-time equivalent Emergency Medical Technicians (EMTs) for a total of six new EMT positions in July 2023, and an additional BLS ambulance staffed with two full-time equivalent EMTs for a total of six additional new EMT positions in January 2024. The fully loaded cost of the twelve new positions would be $1,063,373.
The two additional BLS ambulance units would reduce the demand for our ALS units without any reduction in the patient care provided to the community. In addition, the reduced demand on firefighter personnel will provide increased reliability to respond to fire-related incidents.
Support Staff for BLS Model. The BLS emergency services model will create new EMT positions with additional administrative staffing requirements. The program is projected to generate 12 new positions impacting procedures in four administrative programs as well as training and reporting guidelines for the new classifications. Staff is recommending the addition of one full-time equivalent Administrative Captain to provide implementation and supervision of the BLS ambulance program. The fully loaded cost of the new position would be $213,287.
Staff is also recommending the addition of one full-time equivalent Division Chief to provide oversight and management of the new BLS ambulance program. The position would assist the Administrative Captain, ALS 1 ALS 2 ALS 3 ALS 4
2021 34.5% 28.6% 28.4% 22.4%
2022 36.0% 29.8% 28.9% 25.0%
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MEETING DATE: April 25, 2023 PAGE 3
SUBJECT: FIRE DEPARTMENT– MODIFICATON OF AMBULANCE STAFFING Training Battalion Chief, and Emergency Services Officer with hiring, training, program oversight, quality assurance, and reporting requirements. The fully loaded cost of the new position would be $361,091.
Due to the increase in the number of staff to be hired, the proposal includes the addition of one full-time equivalent Human Resources (HR) Coordinator to help the Human Resources Department contend with the impacts of the additional positions on its recruitment and payroll processes. The HR Coordinator position would assist the Human Resources recruitment team, while also supporting the Human Resources payroll team in its day-to-day operations. The fully loaded cost of the new position would be $133,129.
FISCAL IMPACT: Personnel costs for one Administrative Captain, one Division Chief, one HR Coordinator, and 12 Emergency Medical Technicians are $1,770,880. Equipment costs for one ambulance, increase in supplies and fuel, uniforms, personal protective equipment, and training are $696,303. Additional revenue from two BLS transport units is estimated at $1,200,000 per year.
EXHIBITS: None.
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