NORTHBOROUGH FIRE DEPARTMENT STAFFING STUDY

Transcription

1 NORTHBOROUGH FIRE DEPARTMENT STAFFING STUDY EXECUTIVE DEVELOPMENT BY: David M. Durgin Northborough Fire Northborough, Massachusetts An applied research project submitted to the National Fire Academy as part of the Executive Fire Officer Program July 2002

2 2 ABSTRACT The Town of Northborough has experienced a 29% growth in population and a 42% increase in property value since The number of commercial structures has increased by 368%, and residential structures have increased on average by 56%. Along with this growth, the department has encountered a 479% increase in incident volume. The department has expanded its role by assuming responsibility for emergency medical services and upgrading that service to transport paramedic advanced life support. The current average on-duty staff is three personnel. With the increase in population and new structures, it was not known whether the current on-duty staffing of the Northborough Fire is adequate to provide fire and emergency medical services to the community. The purpose of this study was to establish the proper on-duty staffing level for the Northborough Fire to provide fire and emergency medical services to the community. Descriptive and evaluative research methods were used. The research questions were: 1. What, if any, are the national, state, and Northborough Fire guidelines or recommendations for on-duty staffing? 2. Compared to Northborough, what are the pertinent fire department statistics for comparably populated communities? 3. What effects have residential and commercial development had on incident response and staffing demand?

3 3 A literature review of national, state, and Northborough staffing guidelines was conducted to establish adequate on-duty staffing. Comparative performance measures were performed utilizing surveys of 30 similar-sized communities including trends in property values, and dollar loss, population, and incident volume were compared to the level of staffing and departmental funding. The only national standard was found to be that of the National Fire Protection Association which recommends a minimum on-duty responding company strength of four persons. This staffing configuration was validated by the research of others and the fact that surveyed communities staffed, on average, with five and one half firefighters on-duty. Survey data indicated that Northborough operates at below average cost and responds to more incidents from one central fire station with an eight percent lower budget and 36% less career staff. Of the communities surveyed, 33% did not provide emergency medical ambulance transport, and only 42% provided paramedic advanced life support. The conclusion reached was that the department is not adequately staffed. Based on the National Fire Protection Association Standards, benchmarking of similar communities, and other related studies, it was determined that in order to adequately staff one engine company and one paramedic transport ambulance, the minimum on-duty shift strength should be six firefighteremergency medical technicians for fire suppression and emergency medical responses.

4 4 TABLE OF CONTENTS Abstract..2 Table of Contents...4 Introduction 5 Background and Significance 6 Literature Review.11 Procedures 20 Limitations...23 Results..24 Discussion 33 Recommendations 38 References 42 Appendix A Town/ Analysis Appendix B 2001 Call Back Coverage...47 Appendix C Survey Comparative Analysis 48 Appendix D Northborough Fire Benchmarking Data Survey 49 Appendix E Town of Northborough Valuation Request...50 Appendix F Survey Recipients 51

5 5 INTRODUCTION Since the early 1980 s, the role of the Northborough Fire has changed significantly due to population increases, commercial, industrial, and residential development. The fire service has also gone from a provider of fire prevention and suppression services to providing emergency medical service ambulance transport at the emergency medical technician paramedic level. The additional burden of comprehensive emergency management planning for hazardous materials and manmade and natural disasters has become the fire services responsibility as well. It is also expected that the fire service will be the mitigator of these incidents or play a lead role in their resolution. Demand for service in all areas has increased with the common stacking of two to three emergency incidents on a regular basis. The department has experienced a substantial loss of call firefighters over the last 20 years due to a number of factors including affordable housing. Today, the department finds itself faced with increased demand for fire prevention and suppression services. Additionally, the department provides paramedic level ambulance transport with a core on-duty staff of three personnel. The increased fire and emergency medical service demand results in the need to continually recall personnel for station coverage and incidents. The need to provide fire and emergency medical services simultaneously and to respond to multiple calls, as well as to adequately perform search and rescue and to provide for the safety of firefighters working in oxygen-depleted atmospheres bring the current staffing level into

6 6 question. It is not known whether the current on-duty staffing level for the Northborough Fire is adequate to provide fire and emergency medical services to the community. The purpose of this applied research project is to establish the proper on-duty staffing level for the Northborough Fire to provide fire and emergency medical services to the community. The researcher used descriptive and evaluative research methods in order to answer the following questions: 1. What, if any, are the national, state, and Northborough Fire guidelines or recommendations for on-duty staffing? 2. Compared to Northborough, what are the pertinent fire department statistics for comparably populated communities? 3. What effects have residential and commercial development had on incident response and staffing demand? As a result of descriptive and evaluative research, if the present on-duty staffing levels are not adequate for providing the appropriate level of fire and emergency medical services, a minimum recommended on-duty staffing level for the Northborough Fire will be formulated. BACKGROUND AND SIGNIFICANCE Located in the hills of central Massachusetts, the Town of Northborough encompasses approximately nineteen square miles and was primarily a farming community with factories and mills dotting the Assabet River. Agriculture and manufacturing made up the majority of the community s job opportunities, with the cities of Marlborough and Worcester nearby offering additional employment possibilities. Today, Northborough is served by three state highways and

7 7 one interstate road. It is located ten miles east of Worcester and 30 miles west of Boston. This geographical position makes Northborough highly desirable for new residential and business development, as it is adjacent to the Route 495 Technology Corridor and less than one hour from the borders of Connecticut, New Hampshire, and Rhode Island. In addition, Northborough maintains its rural character of open space through town and state-owned forested open spaces, working farmlands, and orchards. It boasts an exceptional elementary and regional school system, making Northborough extremely desirable as a bedroom community, with residential property commanding top real estate prices. In 1982, the fire department assumed daytime responsibility, Monday through Friday, for providing basic life support ambulance transport, while the volunteer ambulance squad members were at their full-time jobs. For the first time since its inception in 1845, two career firefighteremergency medical technicians were hired, forever changing the dynamic and culture from a call fire department and volunteer ambulance squad to a combination department assuming emergency medical service responsibilities. The current combination fire department maintains a strong call firefighter contingent of 18 members which includes a call deputy fire chief. In addition, another eight members assume a non-suppression support role volunteers, call firefighter trainees, and advanced explorers. The Emergency Medical Services Division has one part-time billing clerk and the Hazardous Material Division supports a 19-hour per week position for comprehensive emergency management planning and for the Local Emergency Planning Committee.

8 8 The career staff consists of fourteen members made up of a fire chief, four captainemergency medical technicians, and nine firefighter-emergency medical technicians, ranging from basic to paramedic. The fire chief is supported in the management of the department by a full-time non-uniformed administrative assistant. In addition, the department is financed through a combination of a tax-based budget and town meeting-authorized revolving accounts which allow ambulance transport receipts, hazardous materials fees, and cost recovery funds to be retained by the department. In 1992, the organization expanded its pre-hospital care to the intermediate care level which allowed emergency medical technicians to perform advanced assessment skills as well as endotracheal intubation, intravenous therapy, and medical anti-shock garment. In 1999, the town was served notice by a private regional provider of paramedic advanced life support that service might be terminated in the next year; therefore, in anticipation of the possible loss of paramedic service to the residents, the author presented to the town an Enhanced Staffing Plan in October of 1999 to increase career staffing by the addition of six firefighter-paramedics over a five-year period. To date, three additional firefighter-paramedics have been hired and have completed the Massachusetts Fire Academy s Recruit Training Program. In March, 2001, the Massachusetts of Public Health Office of Emergency Medical Services authorized the department to operate at the paramedic level, essentially allowing us to bring the emergency room to the patient by providing procedures which include twelve lead electrocardiogram and fifty plus medications.

9 9 The department operates from one central station built in 1978 with Enhanced 911, dispatching, and fire alarm service provided from the police station by civilian dispatchers. The fire department operates three engine companies, one medium duty rescue/engine, one aerial ladder, two forest fire vehicles, one pickup truck, one command vehicle, two Class One paramedic, advanced life support ambulances, a dive/rescue boat, an air supply trailer, and one hazardous materials trailer. Career shift staffing is configured into three groups of three and one group of four, all working an average workweek of 42 hours. The group staffing consists of a captain, a firefighter-intermediate, and a firefighter-paramedic. The group of four has an additional firefighter-emergency medical technician. With the exception of the group of four, every emergency medical call which is responded to requires a recall of personnel to insure sufficient staffing for coverage. The recall procedure divides the department into an equal number of career and call personnel with roughly 15 personnel representing all disciplines within the department. Normal alarm investigations are handled with the on-duty staff and recalled personnel manning one engine and one ladder company. First alarms for high life hazard and reported building fires receive a response of two engines, one ladder company, mutual aid rapid intervention crew, and the chief of the department. For the one-third of the town not protected by the municipal water system, automatic mutual aid is requested from an adjacent town with a large capacity tanker.

10 10 Since 1982, the department career staff has only increased by nine persons or 180%, and the call department ranks have shrunk by 51%. From 1982 to 2002, the call volume has grown 479% from 335 to 1,941 emergency responses. The town s total property value increased from $256,467,195 to $1,353,523,390, or 427%. The population grew from 11,000 to 14,185, or 29%. The most telling and startling impact for the Northborough Fire Service is the growth of the number of structures that are protected. From 1982 to 2002, residential structures increased from 2,855 to 3,721, or 56%, while commercial structures increased from 77 to 360, or 368%. (Appendix A) During 2001, the department experienced increased simultaneous incident responses and poor recall response, which required the use of mutual aid fire and ambulance resources for routine incidents. Of the 984 incidents which required recall, 25% of the time the department lacked the ability to respond to another incident. (Appendix B) Another 36% of the time, staffing could not be achieved for either fire apparatus or the ambulance due to driver or staffing unavailability. This resulted in the ability to adequately cover for a second incident only 64% of the time by recalled off-duty career or call firefighters. (Appendix B) Since 1982, the town has seen drastic increases in commercial and residential growth. Additionally, this growth has also resulted in a 29% increase in the population. As a direct result of this growth, the department s call volume has increased by 479% over the last 20 years. This service demand has resulted in a 36% inability to provide adequate recall staffing for incidents. This population, structural growth, and call volume increase, coupled with inadequate recall

11 11 coverage, bring into questions the Northborough Fire s ability to adequately provide fire and emergency medical services. With the recent adoption by the Occupational Safety and Health Organization of Two- In/Two-Out and the National Fire Protection Association s 1710 Standard for the Organization and Deployment of Fire Service Operations, Emergency Medical Operations, and Special Operations to the Public by Career s, the need for adequate staffing levels are emphasized further. To that end and in conjunction with operational objectives of the United States Fire Administration, this research is being conducted to evaluate whether the Northborough Fire, with its current on-duty staffing, is able to adequately protect/reduce the loss of life in the age groups under 14 years old and over 65 years old and reduce the loss of life from fire of firefighters when faced with a fire situation. The research is being conducted in conjunction with the National Fire Academy s Executive Development class and relates to Unit Three of the Executive Development Course Student Manual Research. LITERATURE REVIEW The Literature Review was compiled from a number of sources which included an online search of related Applied Research Projects from the Learning Resource Center at the National Fire Academy in Emmitsburg, Maryland, with an inter-library loan of Applied Research Papers through the Northborough Free Library in Northborough, Massachusetts. Further research was conducted through the on-line sites of Fire Engineering, Fire House, and Fire

12 12 Chief magazines, state laws, and the Massachusetts of Public Health Office of Emergency Medical Services. Technical research was performed at the Northborough, Massachusetts, Fire library where the National Fire Code Subscription, the Code of Federal Regulations-Title 29, and the Standard Operating Orders of the Northborough Fire were reviewed extensively. In response to Question One, What, if any, are the national, state, and Northborough Fire guidelines or recommendations for on-duty staffing?, it was discovered that there are currently no federal laws or regulations for fire department on-duty staffing. The closest related national regulation is found in the Code of Federal Regulations-Title 29, Labor , Respiratory Protection (1994), In areas where the wearer, with failure of respirator, could be overcome by a toxic oxygen-deficient atmosphere, at least one additional man shall be present. Communications (visual, voice, or signal line) shall be maintained between both individuals present. Planning shall be such that one individual will be unaffected by any likely incident and have the proper rescue equipment to be able to assist the other(s) in case of emergency. (p. 413) Dalbey (1999) pointed out, A small part of the whole OSHA is not a fire Service standard; it applies to the industrial community at large and is very broad in scope. Only a small portion of the standard, commonly referred to as the two-in/two-out rules, focuses on the specific tasks associated with interior structural firefighting. (p. 9)

13 13 The National Fire Protection Association, a worldwide respected contributor to fire suppression and prevention technology and research, offers the following standards: National Fire Protection Association 1201, Standard for Developing Fire Protection Services for the Public (2000), 2-3 Fire Suppression 2-3.1, The fire department shall be organized to effectively combat fires that occur within the area it serves. A department s commitment to provide nonemergency service activities shall not interfere with its ability to effectively combat fires when they occur. (see section 2-3.1) National Fire Protection Association 1201, 2-4 Rescue and Emergency Medical Services (2000), Preservation of human life shall be the primary responsibility of the fire department during fires and other emergencies. (see section 2-4) National Fire Protection Association 1500, Standard on Fire Occupational Safety and Health Program (1997) A-6-4.l states, The minimum acceptable fire company staffing level should be four members responding or arriving with each engine and each ladder company responding to any type of fire. These studies indicate significant reductions in performance and safety where crews have fewer members than the above recommendations. Overall, four member crews were found to provide a more coordinated approach for search and rescue and fire suppression tasks. National Fire Protection Association Appendix A Explanatory Material (1997), A notes, The limitation of emergency scene operations to those that can be safely conducted by the number of personnel on the scene is intended to reduce the risk of fire

14 14 fighter death or injury due to understaffing. During emergencies, the effectiveness of companies can become critical to the safety and health of firefighters. Potentially fatal work environments can be created very rapidly in many fire situations. (see section A-6-4.1) National Fire Protection Association 1710, Standard for the Organization and Deployment of Fire Suppression Operations, Emergency Medical Operations, and Special Operations to the Public by Career s (2001), * notes, The purpose of this standard is to specify the minimum criteria addressing the effectiveness and efficiency of the career public fire suppression operations, emergency medical service and special operations delivery in protecting the citizens of the jurisdiction and the occupational safety and health of fire department employees. (see section 1.2.1*) National Fire Protection Association states, Personnel deployed to ALS emergency responses shall include a minimum of two members at the emergency medical technician-paramedic level and two members trained at the emergency medical technician-basic level arriving on scene within the established response time. (see section ) National Fire Protection Association Wildland Fire Suppression Services (2001), , notes, These companies shall be staffed with a minimum of four on-duty personnel. (see section )

15 15 National Fire Protection Association Staffing (2001), states, These companies shall be staffed with a minimum of four on-duty personnel. (see section ) National Fire Protection Association states, The fire department shall have the capacity to deploy an initial full alarm assignment within an 8-minute response time to 90 percent of the incidents as established in Chapter 4. (see section In respect to legal risk, Rukavina (2001) wrote, The general assumption of the law is that everyone owes everyone else a duty to behave in a reasonable way. So a big part of a negligence lawsuit is defining what a reasonable fire officer, fire chief or community would have done. In defining reasonable, lawyers will ultimately look to the fire service at large to see if there s general agreement on relevant standards of behavior. (p. 2) In respect to compliance with the National Association of Fire Protection s 1710 Standard, the International Association of Fire Chief Staff (Fire Chief Magazine, 2001) said, To understand where we are now, you must understand where we ve been. The discussion concerning national benchmarks for staffing, deployment, and response times has been going on for more than 15 years. (p. 1) With respect to state on-duty staffing levels, little guidance is provided. Commonwealth of Massachusetts General Law, Part I, Administration of the Government, Chapter 48, Fires, Fire s and Fire Districts, Chapter 48:Section 51A, Breathing Apparatus, notes,

16 16 Section 51A. Each city, town or district shall equip any fire apparatus operated by it with at least three self-contained breathing apparatus, so called. Could it be argued that the legislature in its enactment of 51A following the National Fire Protection Association guideline for selfcontained breathing apparatus also considered the need for minimum manning of apparatus? (c 48 s51a) The Commonwealth of Massachusetts, of Public Health Emergency Medical Services System Administrative Regulations 105 CMR , Staffing, (2001) provides clear minimum staffing levels for ambulances transporting patients at the basic or advanced life support levels. (A) All ambulance services shall at all times maintain an adequate number of EMT s to staff ambulances to ensure compliance with the requirements of 105 CMR This provision requires two EMT s of the appropriately-trained level on every ambulance transport. (105 CMR-1001) The Town of Northborough Fire, Standard Operating Procedures (1990) state, At no time shall coverage be less than two department members. On-Duty Shift The minimum on-duty shift shall consist of two (2) firefighter/emt s, one of whom is an apparatus driver. (5) Question Two asks, Compared to Northborough, what are the pertinent fire department statistics for comparably-populated communities? Long recognized as the bible of the fire service, Paulsgrove (1997) in the Fire Protection Handbook states, One of the most serious issues faced by public officials and residents is that of adequate fire department staffing.

17 17 Section makes the following recommendation to on-duty staffing strength, A common rule of thumb is that a community using on-duty crews at fire stations should be able to have an initial attack team comprising an entire first alarm response on scene within approximately eight minutes of receipt of the alarm. This equates to about six minutes of running time. (see section 10-30) Carter and Rausch (1989) outlined the role of the fire chief in management of the fire department, Good planning should be based substantially on research that reveals needs for planning or budgeting in particular areas. (p. 143) Varone (1994), after conducting a staffing study, wrote, Thus, the Providence Fire Staffing Study supports the conclusion that staffing engine and ladder companies with four persons will reduce injuries, in terms of frequency and severity, over engine and ladder companies staffed with three persons. The results also support the NFPA recommended minimum staffing of four firefighters per engine and ladder company as a matter of firefighter safety. (p. 226) Following his 1994 report, Varone (1995) further supported his findings of a four-personstaffed engine or ladder, The sustained reductions in injury-related statistics provide clear support for the validity of the conclusion drawn from the staffing study that four-person staffing significantly reduces the number and severity of firefighter injuries compared to companies staffed with three members. (p. 83)

18 18 Question Three asks, What effect has residential and commercial development had on incident response and staffing demands? In an MMA Consulting Group report, the town was informed of potential future staffing crises, The town s difficulty in recruiting and retaining call members has serious implications for the staffing pattern of the department and for town finances. (p. 12) In developing a blueprint analysis, Chubb (1999) made the following observation, Try as we may, asking these questions at a national level, and agreeing, however broadly, on the answers, is no replacement for gaining the consent of the people who pay the price not only for fire losses but for fire service as well. (p. 6) Daugherty (2000), in the nearby and similarly-populated Town of Hopkinton, Massachusetts, studied staffing as well and concluded in his research, There was no complete loss of property when on-duty staffing exceeded three and only one complete loss with three onduty personnel. In contrast, there were four properties lost when on-duty staffing was less than 3. (p. 15) Daugherty further raised an issue not considered by many national standards and officials, When we look at staffing, we need to look at it from every possible angle. The functions and duties performed by many departments have changed over the years particularly in the area of E.M.S. For departments that have not entered into the Emergency Medical arena, staffing levels may be different from those departments that do provide E.M.S. (p. 17)

19 19 The need to provide emergency medical services not only to the public but also to the fire service is profound. Firefighter Fatalities in the United States in 2000 (IOCAD Emergency Services Group, 2001) makes the following Immediate Impact Statement, Emergency medical personnel should standby at all fire fighting and training exercises. Their presence and quick intervention in a medical emergency involving a firefighter could safe a life. (p. 41) Looking at the correlation of matching minimal staffing and apparatus, Blocker and Casey (1997) wrote, Much has been said about the dangers of minimal staffing over the past several years. Few will argue the decreased efficiency and increased danger of two- and threeperson suppression crews. However, the simple fact is that many of us have to prepare to operate until we get four people, and we need to plan our apparatus. (p. 1) Again, Paulsgrove (1997) in the Fire Protection Handbook 10-33, noted that, The broader the services provided by a fire protection agency, the greater the need for resources, (e.g. the fire agency providing emergency medical services will, given the same level of expectations for its mobile suppression forces, require more resources than an agency providing only fire protection services, assuming a significantly increased total work load demand including a significant increase in simultaneous calls.) (see section 10-33) Paulsgrove (1997) in the Fire Protection Handbook, 10-34, critically emphasizes the need for emergency medical operations, The desirable practice of assigning emergency medical

20 20 responsibility to the fire department must be calculated into the staffing formula. (see section 10-34) In the National Fire Data Center s Fire Death Rate Trends An International Perspective (1997) it is stated, Among the strategies that appear to offer the best means of reinventing fire protection in the United States are: better funding and fire department staffing of fire prevention activities; improving awareness of the fire problem; changing attitudes about the acceptability of fire. (p. 17) PROCEDURES The following research procedures were conducted in conjunction with the three research project questions in response to the Problem Statement and to provide information to establish the proper on-duty staffing level for the Northborough Fire to provide fire and emergency medical services to the community. A literature review was initially begun in January of 2002 at the National Fire Academy s Learning Resource and Publication Center at Emmitsburg, Maryland. The search expanded to an on-line search in March of 2002 with a review of Executive Fire Officer Program Applied Research Papers related to the subject matter, staffing. A number of works were identified and requested through an inter-library loan with the Northborough Free Library located in Northborough, Massachusetts.

21 21 One paper identified was from Hopkinton, Massachusetts by Fire Chief Gary T. Daugherty, which was very relevant due to the facts that Hopkinton is used continually as a comparative benchmark community by our department and has been identified as a community of comparable population. On-line research was conducted of related media articles from various fire professional journals including Fire Chief, Fire House, and Fire Engineering magazines. In researching state staffing guidelines, an on-line search, as well as, an in-house department search of the Massachusetts General Laws and of Public Health, Office of Emergency Medical Services Administrative Regulations was conducted. Northborough Fire Standard Operating Procedures and related reports are located at Fire Headquarters at 11 Pierce Street, Northborough, Massachusetts. A review of the following technical publications and nationally-recognized standards was completed through the Northborough Fire Library. This included an extensive review of the Code of Federal Regulations, National Fire Protection Association Fire Code Subscription, and Fire Protection Handbook. These references, along with other applied research projects related to staffing, provided the basis for on-duty staffing comparison, evaluation and subsequent recommendations. To directly provide answers to research Questions Two and Three, descriptive and evaluative research was employed as the methodology for the applied research project.

22 22 Information was collected and used as a comparative performance measure utilizing identical surveys (Appendix D) sent to 40 Massachusetts communities with populations ranging between 12,000 and 19,000, as reported by the Massachusetts Municipal Association web site (Appendix F). Survey information included: cost per capita, firefighting staffing per 1,000, cost per incident, dollar loss, incident volume, fire and EMS incident volume, total services provided, civilian and firefighter injuries and deaths, inspections performed, public education presentations provided, total service/cost per capita analysis per 1,000 population, ISO ratings, square miles protected per station, and incidents per station. This information was utilized to evaluate the effectiveness of the present staffing of the Northborough Fire compared to these similarly-populated communities. In addition, the following research was conducted. The incident volume was evaluated to determine what effect, if any, direct service demands have placed on existing staff. Trends in property loss, property values, population, and incident volume were compared to the level of staffing and department funding. Information was compiled from the following sources for the above research questions in addition to the survey questionnaire: Town of Northborough Fire 2001 Annual Report, monthly reports from January, 2001, through December, 2001, the fiscal year 2003 annual budget, annual reports from 1982 and 1992, and the Town of Northborough Board of Assessors report of valuations and structure types and numbers (Appendices A and E).

23 23 LIMITATIONS While 40 of the 351 cities and towns comprising the Commonwealth of Massachusetts with populations ranges of 12,000 to 19,000 were surveyed, only 30 towns responded to the survey. A number of communities did not match the profile of the Northborough Fire in utilizing career/full-time paid firefighters or on-call firefighters or were inferior or superior in the square miles serviced. Additionally, two-thirds of the departments who responded did not provide advanced life support-paramedic level care. With respect to emergency medical services, a number of departments did not provide basic life support ambulance transport or first responder services. A number of survey responders left some requested information questions blank, and these blank questions were adjusted statistically from that specific set and not recorded as a zero response. In response to survey set validity, the Executive Development Student Manual provides a table to assure a 95% confidence level. The table would require that for Northborough s population of 14,185 persons that 375 surveys would have to be utilized. (p. SM3-40) The author sampled 11% of the total cities and towns of Massachusetts. In previous surveys and benchmarking documents, the Town of Northborough has considered valid and accepted survey sets of 10 to 15 towns for budget and manpower comparisons and justifications.

24 24 RESULTS Question One - What, if any, are the national, state, and Northborough Fire guidelines or recommendations for on-duty staffing? National Fire Protection Association 1500 Standard on Fire Occupational Safety and Health Program , A (1997) makes clear its recommendations for staffing, It is recommended that a minimum acceptable fire company staffing level should be four members responding on or arriving with each engine and each ladder company responding to any type of fire. Additionally, this standard identifies staffing for high-risk and life safety concerns, The minimum acceptable staffing level for companies responding to high-risk areas should be five members responding or arriving on each engine company and six members responding or arriving on each ladder company. (see section 39 A-6-4.1) To further bolster the four-member responding standard, Paulsgrove (1997) in the Fire Protection Handbook verifies this standard with, However, it has been demonstrated that when staffing falls below four fire fighters per company, fire ground effectiveness may be compromised. Tests conducted with the Dallas, Texas, Fire indicated that staffing below a crew size of four can overtax the operating force and lead to higher losses. (see section 10-22)

25 25 On a national standard, the Code of Federal Regulations Labor , Respiratory Protection (1994) requires self-contained breathing apparatus to be worn during interior structural firefighting operations with atmospheres immediately dangerous to life or health and requires standby personnel equipped with proper rescue equipment outside by an incident in the interior and maintain constant visual or verbal contact. Is the assumption made that for each person inside firefighting that one person must be on the outside for rescue? Dalbey (1999) in discussion of compliance with wrote, However, the wearing of scba doesn t automatically constitute compliance with the standard, any more than assigning two firefighters to stand by in case of an emergency automatically equates to increased firefighter safety. (p. 1) Paulsgrove (1997) in The Fire Protection Handbook 10-23, offered the following in response to firefighter staffing and safety, It would seem inappropriate to dispatch an engine company to a fire if the crew could not start fire fighting and rescue operations because of safety concerns. (see section 10-23) According to the Firefighter Fatalities in the United States in 2000, (IOCAD Emergency Services Group, 2001), The third leading cause of fatal firefighter injuries in 2000 was being caught or trapped, which accounted for 16 deaths. (p. 15) In one of the most controversial fire service standards ever enacted, the National Fire Protection Association 1710 Standard for the Organization and Deployment of Fire Suppression

26 26 Operations, Emergency Medical Operations, and Special Operations to the Public by Career (2001), established minimum staffing standards for fire and emergency medical service responses at four personnel, and in the case of advanced life support, required the response of two emergency medical technician-paramedics and two emergency medical technicians at the basic level. Additionally, this standard requires five or six personnel, as does the Fire Protection Handbook for high risk or high life hazard responses. The requirements of Standard 1710 require the department to deploy an initial full alarm assignment in eight minutes 90% of the time. Adding even more justification for adequate on-duty staffing are the findings of Firefighter Fatalities in the United States in 2000 (IOCAD Emergency Services Group, 2001), Fire fighting is extremely strenuous physical work and is likely one of the most physically demanding activities that the human body performs. Most firefighter deaths attributed to stress result from heart attacks. (p. 15) In researching any relevant state standards, the author thoroughly examined the Massachusetts General Laws covering fire department organization, authority, and fire prevention, Chapter 48, 148, and 527 CMR Fire Prevention Regulations. The Commonwealth of Massachusetts General Laws, Part I, Administration of the Government, Title VII Cities, Towns and Districts, Chapter 48: Section 51A, Breathing

27 27 Apparatus states, Section 51A Each city, town or district shall equip any fire apparatus operated by it with at least three self-contained breathing apparatus, so-called. The regulation further states, Any such breathing apparatus shall, in addition to the above, meet the requirements of the standards set up by the National Fire Protection Association for self-contained breathing apparatus. (c 48, s 51A) Did the legislature imply by its requiring three breathing apparatus on each piece of fire apparatus that a minimum of three firefighters was required for interior firefighting operations? And, by citing a National Fire Protection Standard, did the legislature intend for the Massachusetts fire service to recognize and adhere, in general, to the National Fire Protection Association s published standards? The Massachusetts of Public Health, Office of Emergency Medical Services, the licensing authority for all ambulance services, provides standards not unlike the National Fire Protection Association for the minimum number of emergency medical technicians staffing an ambulance. This standard, 105 CMR , Staffing (2001), requires a minimum of two emergency medical technicians on any ambulance transporting a patient. In the case of advanced life support at the paramedic level, two emergency medical technicians at the paramedic level must transport the patient. The CMR has provisions, which allows for ambulance services not meeting the twoparamedic requirement to apply for waivers allowing an emergency medical technicianintermediate and paramedic or an emergency medical technician-basic and a paramedic to work

28 28 at and perform paramedic level skills. The Northborough Fire currently operates its advanced life support paramedic program with the two above waivers. The Northborough Fire currently operates two Class One licensed transport ambulances at the paramedic level. These two ambulances, based on staffing level certification, may operate at the basic, intermediate, or paramedic level. Is it reasonable to assume that if the expectation is to staff two ambulances, a minimum of four personnel is required? Likewise, one ambulance at the paramedic level would require a minimum crew of at least one paramedic and one basic or intermediate. While it is common throughout the fire service to have on-duty firefighter/emergency medical technicians perform dual fire/emergency medical service functions, when personnel are on ambulance responses, suppression strength suffers. Likewise, paramedics on suppression responses are unavailable to staff the ambulance. Daugherty (2000) recommended, In particular, response times for E.M.S. need to be looked at, as time delays could have a direct bearing on the mortality and morbidity rates for people suffering threatening injury and/or illness. (p. 17) The Fire Protection Handbook (Paulsgrove, 1997) reinforces and addresses the need for adequate fire suppression and emergency medical technician personnel to be on staff in communities like Northborough: Section notes, Fire departments operating emergency medical service transports need additional personnel to maintain basic fire company strength. In some smaller communities, the staffing ratio per population

29 29 protected may be relatively high because of the need for sufficient on-duty personnel for effective initial attack and rescue operations. This is especially true in bedroom communities, where call personnel are not readily available during the workday. (see section 10-23) Is it time for the fire service to address staffing levels of fire suppression response and emergency medical services as a separate staffing or, better yet, a customer service issue? Chubb (1999) wrote, The expanding role of the fire service requires that planners and managers consider not only demand for firefighting service but demands on the fire service associated with the delivery of emergency medical services (EMS). (p. 6) From the Town of Northborough Fire Standard Operating Procedures (1990), On-duty shift The minimum on-duty shift shall consist of two (2) firefighter/emt s, one of whom is an apparatus driver. (p. 5) Over the last two years, incident response, increased service demand, and providing paramedic advanced life support, the department has added three additional personnel bringing its standard shift staffing to three personnel. The department operates four platoons working two ten-hour day shifts and two fourteen-hour night shifts. The platoons are configured with three shifts consisting of a captain/emergency medical technician, a firefighter/intermediate, and a firefighter/paramedic. The fourth platoon contains the above configuration and an additional firefighter/emergency medical technician, bringing that on-duty shift strength to four.

30 30 Again, the Fire Protection Handbook (Paulsgrove, 1997) Staffing Practices note, Staffing levels for cities of 250 or more population range from 0.5 to 2.7 fire fighters per thousand population with a median of 1.0 to 1.5 per thousand. Given the town s age, size, and potential hazard and life hazard, the author would use the above staffing median of 1.5 firefighters per one thousand population with a population of 14,000 persons and arrive at a staffing level of 21. This would place four firefighters on each shift/platoon, with the odd shift firefighter being assigned to a Monday through Friday shift, achieving a primary day shift configuration of five. (see section 10-22) Question Two Compared to Northborough, what are the pertinent fire department statistics for comparably-populated communities? Comparative analysis of 30 similar communities reveals that the Northborough Fire operates at 11% below cost per capita with the cost of an average fire or emergency medical services response 8% below average. Dollar loss per 1,000 is 17% below average. Fire incidents per 1,000 are slightly above average by.13%, and emergency medical services provided per 1,000 were 17% below average. Total services per 1,000 were 17% above average when inspection and public education were combined with fire and medical responses. (Appendix C) ISO Commercial Risk Services, Inc., Classification Details (1991), rates Northborough at a town-wide Class 4 (p. 1) making Northborough 20% below the average in and outside the

31 31 municipal water service area. Ratings are from one to ten with one being the best or resulting in the lowest fire insurance premium rate. Northborough covers five square miles less than the average community from one central station, while the average community had two stations. This single station resulted in Northborough s responding to 43 more incidents per station. Of the 30 communities surveyed, none experienced a civilian or firefighter death; however, Northborough experienced 200% less civilian injuries and 600% less firefighter injuries (Appendix C). If the Varone staffing study points to a higher injury rate with less than four firefighters, why does Northborough experience such a significantly low injury rate? The most revealing part of the survey was that Northborough operates with 36% less career firefighters than the average community. This average career staff of 22 firefighters is in agreement with the computation of the Fire Protection Handbook that identifies Northborough as needing 21 firefighters based on a ratio of 1.5 firefighters per one thousand, keeping in mind that 33% of the surveyed communities do not provide transport emergency medical services. (Appendix C) Question Three What effect has residential and commercial development had on incident response and staffing demands? Records were requested through the Town of Northborough Board of Assessors (Appendix E) for years 1982, 1992, and 2002 for residential and commercial development. The

32 32 total valuation of the Town of Northborough increased 427% from 1982 to 2002 or from $256,467,195 to $1,353,523,390. Residential housing units increased from 2,855 to 4,478 or 56%, while commercial structures went from 77 to 360 or a 368% increase. Commercial valuation increased from $53,475,770 to $262,814,600 or 391%. (Appendix A) Firefighter Fatalities in the United States in 2000 (IOCAD Emergency Services Group, 2001) points out two revealing statistics, Residential occupancies usually account for 70 to 80 percent of all structure fires and a similar percentage of civilian fire deaths each year. (p. 21) And, Residential fires accounted for 84% of all fixed property use deaths of firefighters in (p. 21) During this same time period, Northborough s population has increased by 29%, while the total fire and emergency medical responses have increased by 479% from 335 to 1,941. Career staff in 1982 was five including a chief. In 2002, career staff including the chief is 14 or a 180% increase. Call firefighting staff was 37 in 1982 and is now 18, or a 51% decrease. In 1982, the dollar fire loss was $105,025, and in 2002, it was $413,000, or a 294% increase. It should be noted that this figure was not adjusted for inflation. (Appendix A) The budget has grown by 88%, correlating with the increase of residential growth; however, when the Emergency Medical Services Revolving Account Budget is deducted, Northborough s actual tax-generated fire budget is 44% less than the average community. (Appendix A)

33 33 Additionally, commercial and residential structures built outside the municipal water supply present special protection issues related to water supply for firefighting. Many residential structures abut tracts of forested land on long common driveways, increasing the likelihood of wildland/urban interface incidents, as well as restricting apparatus access for firefighting. DISCUSSION When compared to national standards and benchmarked against similar communities, the current on-duty staffing of the Northborough Fire is inadequate to provide simultaneous fire suppression and emergency medical services to the community. The Fire Protection Handbook (1997) states, During recent years, an increasing number of fire departments have established minimum staffing levels for each fire company on-duty. However, it has been demonstrated that when staffing falls below four fire fighters per company, fire ground effectiveness may be compromised. (see section 10-22) In addition, Section notes, The desirable practice of assigning emergency medical responsibility to the fire department must be calculated into the staffing formula. (see section 10-34) The National Fire Protection Association Standards provide clear and definitive recommendations for firefighter staffing Standard on Fire Occupational Safety and Health Program (1997), A states, It is recommended that a minimum acceptable fire company staffing level should be four members responding on or arriving with each engine and each ladder company responding to any type of fire. The minimum acceptable staffing level for companies responding to high-risk areas should be five members responding or

34 34 arriving with each engine and six members responding or arriving on each ladder company. (see section A-6.4.4) Northborough has numerous structures presenting considerable risk and high life hazard including, but not limited to, schools, nursing homes, four-story rack storage, bulk flammable liquid, gas storage, and radioactive material. New commercial structures commonly exceed 100,000 square feet, with in-rack storage presenting search, rescue, and collapse potential. National Fire Protection Association Standard 1710 (2001) states, The purpose of this standard is to specify the minimum criteria addressing the effectiveness and efficiency of the career public fire suppression operations, emergency medical service, and special operations delivery in protecting the citizens of the jurisdiction and the occupational safety and health of fire department employees. (see section ) Within the Standard 1710, four on-duty personnel are required for emergency medical service, and four are required for firefighting and wildland firefighting responses. Additionally, as in the Fire Protection Handbook, high hazard occupancies call for a minimum response of five or six on-duty members. In respect to staffing standards, Varone (1994) wrote, The recommendations found in NFPA 1500 pertaining to staffing influenced this research by providing the clearest articulation of a nationally recognized staffing standard based squarely upon firefighter safety as the primary consideration. (p. 214)