ANNUAL REPORT. Pierce County Fire Protection District No. 6 Central Pierce Fire & Rescue nd Avenue East Tacoma, Washington 98445

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2011 ANNUAL REPORT Pierce County Fire Protection District No. 6 17520 22 nd Avenue East Tacoma, Washington 98445 (253) 538-6400 Fax (253) 537-7294 www.centralpiercefire.org

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Table of Contents Department Overview... 4 Mission Statement... 4 Core Values... 4 Board of Commissioners... 5 A Message from the Fire Chief... 6 Organizational Chart... 7 2011 Statistics... 7 Field Operations... 8 Accomplishments in 2011... 8 Types of Incidents (chart)... 9 Calls in Station Area (chart)... 9 Apparatus Responses (chart)... 10 Emergency Medical Services & Transport... 11 Emergency Medical Services... 11 Transport... 11 Accomplishments in 2011... 11 Transports by Medic Unit (chart)... 12 Transport Destinations (chart)... 12 Top 10 EMS Call Types (chart)... 12 Prevention and Education... 13 Fire Prevention... 13 Fire Investigation... 13 Public Information... 13 Public Education... 13 Public Relations... 13 Accomplishments in 2011... 13 Training Division... 14 Accomplishments in 2011... 14 Annual Training Report (chart)... 15 Logistics... 16 Facilities... 16 Maintenance Shop... 16 Central Stores... 16 Accomplishments in 2011... 16 Compliance Report - RCW 52.33... 17 Emergency Response Goal Statements... 17 Appendices... 19 Premise... 20 Definitions... 20 Sequence of Events... 22 Dynamics Of Fire In Buildings... 22 Fire Growth vs. Reflex Time (chart)... 23 Emergency Medical Event Sequence... 24 Cardiac Arrest Sequence of Events (chart)... 24 Predictable Consequences... 25 Steps to Achieve Compliance... 25 District Map... 27 Station Locations... 28 3

Department Overview Pierce County Fire Protection District No. 6, also known as (CPFR), operates as a legally organized fire protection district under the Revised Code of Washington (RCW) Title 52 and is governed by a five member Board of Fire Commissioners. CPFR was originally formed in 1996 through the merger of several districts and has continued to grow through annexations and mergers. Our service area covers approximately 85 square miles with a population of approximately 200,000 people. The District encompasses the communities of Spanaway, Parkland, Midland, Summit, Summit View, South Hill, Elk Plain, a portion of Frederickson, and the City of Puyallup. Our service area borders the cities of Tacoma, Lakewood, Edgewood, Sumner, Graham, and Joint Base Lewis McChord (which is one of the largest military posts in the United States). We serve our constituent communities from 12 fire stations, all of which are staffed 24 hours a day by professional firefighters and paramedics. Eight of our stations house paramedic units, which provide basic and advanced life support care and patient transport to area hospitals. CPFR is known as a progressive fire and emergency services provider. We have grown considerably with the inclusion of multiple diverse communities, but always with the emphasis on service, stability, and sustainability. Mission Statement The mission of is to quickly, skillfully, and compassionately respond to the needs of our diverse communities by safely providing: Fire Suppression Emergency Medical Services Technical Rescue Hazardous Materials Mitigation Public Information and Education Prevention and Code Compliance Core Values Commitment to Excellence -- The spirit of determination and dedication found in our members. It inspires unrelenting resolve to achieve and sustain a standard of excellence in every endeavor. Honor -- Guides our members to exemplify ethical and moral behavior with uncompromising integrity and respect for human dignity. Courage -- The inner strength that enables us to do what is right and to make tough decisions under stress and pressure. It carries us through challenges and helps to overcome fear. We, the members, proudly serve our community with commitment, honor, and courage. This is the standard by which we live. 4

Board of Commissioners The Board of Fire Commissioners is the oversight body of the fire district. The Board has the responsibility to: manage and conduct the business affairs of the fire district, execute contracts, employ necessary services, and adopt reasonable rules to govern the District. The Board is comprised of five commissioners who are elected to six-year terms and represent the citizens of the District in at-large positions. Currently, one member of the Puyallup City Council serves on the Board in an ex-officio capacity. The Board of Fire Commissioners meetings take place the second and fourth Monday of each month. Larry Nelson Chairperson Current Term: 2006-2011 Bob Willis Commissioner Current Term: 2008 2013 Bill Eckroth Commissioner Current Term: 2010-2015 Rich Coleman Vice Chair Current Term: 2006-2011 Ron Morehouse Commissioner Current Term: 2008-2013 Rick Hansen Ex-Officio Puyallup City Council Member 5

A Message from the Fire Chief Chief Doug Willis This annual report provides an overview of major events and information about the volume of services we provide our citizens. Similar to other government agencies and private business, our revenue continues to fall while expenses continue to rise. This is our third year of declining property values (assessed valuation) and the second year our firefighters and support staff have made concessions in salary and benefits in order to balance the budget and not reduce services. These decreases in revenue are not manageable without making changes in how we use our resources. We are doing more with less to make your tax dollars go farther. Not filling vacant positions, postponing major purchases, seeking grant funds where possible, and other cutbacks will help maintain services to the community. We have lost several positions this year through attrition: the Deputy Chief of Administration, one Support Specialist, and six firefighters from the field. The DC of Administration and the Support Specialist position remain unfilled due to declining revenue and the firefighter positions are currently being replaced by paying overtime to existing personnel. In August, voters re-authorized the EMS levy and Fire Benefit Charge for another six years. Both are critical components in our short and long-term financial stability. However, this reauthorization does not increase revenue; we continue to receive less revenue due to declining assessed property values. In November, Pierce County voters also approved funding for South Sound 911 (SS- 911). SS-911 is a county-wide agency that will build and maintain a state-of-the-art county-wide radio and data communications system for all Pierce County first responders. South Sound 911 will also build and maintain two new dispatch centers; one for Fire & EMS and one for Law Enforcement. Our radio system and dispatch center both must be upgraded and SS-911 will provide these upgrades in an efficient regional approach. While we have had to make many cutbacks, I m proud of the fact that our core service of responding to emergencies has not been directly affected. Regardless of economic conditions, the men and women of are committed to excellence and will continue to serve our citizens with honor and courage. 6

Organizational Chart 2011 Statistics Uniformed personnel FTE - 251 Non-uniformed personnel FTE - 26.5 o Full-time - 25 o Part-time - 3 Support service volunteers - 20 Emergency response volunteers - 5 Chaplains - 2 Total number of emergency incidents - 26,377 Total number of emergency medical service calls - 19,322 Total number of patients transported to area hospitals - 11,008 The Deputy Chief of Administration retired in February and, due to budget concerns, the position was left vacant. One Support Specialist retired in September and this position will not be filled until a later date. 7

Field Operations The main work of the Field Operations Division concentrates on responding to 9-1-1 calls. Their mission is to provide resources in the extinguishment of all types of fires, Emergency Medical Services operations, and non-emergent incidents (service calls, alarm activations, gas leaks, electrical malfunctions, etc.), as well as provide the supplemental resources for specialty teams. The District utilizes career personnel and volunteers to perform the duties of suppression, emergency medical services, and patient transportation. The costs of these personnel are shared between the suppression, EMS, and transport budgets. The primary elements in the success of meeting the above mission are preparedness of personnel and maintaining equipment in a high state of readiness. This is accomplished by devoting duty hours to training in the latest technology, mandated requirements, and core techniques to promote safety and efficiency, pre-planning based on our community s risks, and maintenance of equipment and systems that support the Field Operations Division s efforts (hydrant testing, pre-incident and disaster planning, map updates, hose testing, etc.). This division also supports a research and development committee whose responsibility is to research and recommend tools, equipment, and procedures that enhance firefighter safety and job performance. The retention of a highly skilled workforce, which operates under dynamic, hazardous situations, requires a focus on safety, wellness, system efficiency, and professional growth. Accomplishments in 2011 Continued adding to SOP 431 library of operational guidelines. Began work on Standards of Cover to ensure the best use of resources. Added N5Alive, Crystal Reporting, and MyFire Rules software programs to assist with data capture, reporting, and accuracy. Completed drawings and emergency action plans for the new Dally Tower at Good Samaritan Hospital utilizing light-duty personnel and our CAD Zone drawing staff member. Both Special Operations and Haz-Mat included fire suppression personnel in their drills. Lieutenant and Captain promotional tests were completed with positive outcomes. Authorization was granted to reform the Officer Development Committee to emphasize officer training and development. Sick leave usage and its impacts to the District s operating budget was actively monitored. Initiated Special Operations training at the shift level for both Technical Rescue and Haz-Mat. Completed Graham Hill tower project. This completes the District s move from a VHF radio system to 800 MHz system. A channel was added to Puyallup s radio system that will add valuable resources to the 800 MHz system. Created framework for department s Continuity of Operations Plan (COOP) which included activities and actions from all divisions. 8

Field Operations Types of Incidents Fire 725 EMS/Rescue 19,322 Hazardous Conditions 285 Good Intent 2,129 Services Calls 2,272 Others 1,644 Fire 725 Service Calls 2,272 Good Intent 2,129 Other 1,644 Hazardous Conditions 285 26,377 EMS/Rescue 19,322 Calls in Station Area 4,000 3,500 3,399 3,000 2,676 2,808 2,702 2,500 2,000 2,251 2,004 2,141 1,500 1,426 1,480 1,189 1,461 1,182 1478 1,000 500 0 143 37 * Station 70 is located at the Western Washington Fairgrounds in Puyallup and is staffed during the Spring Fair, Fall Fair, and Interim Events. 9

Field Operations Apparatus Responses * Total Responses 45,866 3500 3000 2500 2000 1500 Medic Engine Ladder 1000 500 0 60 61 63 64 65 66 67 68 69 70 71 72 73 Station 60 61 63 64 65 66 67 68 69 70 71 72 73 Medic 2425 2533 1761 2363 2673 1857 101 234 2431 2174 86 Engine 2294 3031 1746 1481 2597 2661 1364 1563 1285 40 77 2252 2649 Ladder 2025 2081 82 M68 is operational when staffing allows. Station 70 is located at the Western Washington Fairgrounds in Puyallup and is staffed during the Spring Fair, Fall Fair, and Interim Events. Effective mid-january, Engine 71 moved to Station 73 (becoming Engine 73), and Medic 73 and Ladder 73 were moved to Station 71 (becoming Medic 71 and Ladder 71). * Responses showing when enroute date and time is not blank. 10

Emergency Medical Services & Transport Emergency Medical Services The Emergency Medical Services (EMS) Division is responsible for providing emergency medical care to the citizens of the District, as well as to others in need through mutual aid agreements. The District provides both advanced life support and basic life support. Emergency medical technicians (EMTs) and paramedics provide immediate medical assessment, evaluation, and treatment. Transport The Transport Division s function is to ensure efficient and effective delivery of emergency medical transport services based on the community s needs and expectations. Patients are transported to area receiving facilities as their condition warrants. The Transport Division has a split workforce of paramedics and EMTs to meet a diversity of needs. In order to accomplish these functions, the District must provide highly trained, skilled personnel and adequate vehicles and equipment to do the job. In order to keep their certifications, paramedics and EMTs must continually train to maintain their skills and knowledge in any type of medical emergency. Additionally, through our EMS and Transport Divisions, Central Pierce has an EMS Transport Levy Program, by which residents of the fire district are not billed for emergency department transports beyond what their insurance will pay. The balance of transport costs not paid by insurance comes from the EMS Levy and is transferred as needed into the Transport Budget. Accomplishments in 2011 Ensured the successful implementation of a computer based patient care reporting system. Began researching alternative staffing and vehicle placement options to better manage periods of high call volume. Continued to work on the Continuity of Operations Plan which outlines internal plans to manage catastrophic events. Represented Pierce County Fire Chief s Association on the county-wide Hospital Divert Committee. The Divert Committee has seen significant success in 2011 with less than 1% divert for medical and 5% for trauma patients. Developed a reciprocal relationship for the EMS Levy program with East Pierce Fire & Rescue. Worked with law enforcement partners, including Puyallup Police Department, Metro and Pierce County SWAT, to develop and deliver three curricula regarding active shooter scenarios. These curricula included fire service recovery teams, advanced first aid for law enforcement, and incident management. Represented the fire service in the development of a county-wide all hazards medical disaster planning with the Tacoma Pierce County Health Department. Led EMS Committee of Pierce County Fire Chief s Association in the development and implementation of a county-wide Firefighter Rehabilitation policy. 11

Emergency Medical Services & Transport Transports by Medic Unit 1,800 1,600 1,400 1,200 1,000 800 600 400 200 0 1573 1566 1490 1425 1438 1346 1112 952 47 17 42 M60 M61 M63 M65 M66 M67 M68 M70 M71 M72 M73 M68 is operational when staffing allows. Medic 70 is located at the Western Washington Fairgrounds in Puyallup and is staffed during the Spring Fair, Fall Fair and Interim Events. M73 was in service until mid-january, when it was moved to Station 71 and began working as Medic 71. Transport Destinations Good Sam 6,098 St Clare 2,164 St Joseph 1,208 Tacoma General 666 Madigan 367 Mary Bridge 367 Allenmore 45 Crisis Triage 38 Harborview 11 Other 44 11,008 Madigan Tacoma General Mary Bridge St Joseph Allenmore St Clare Crisis Triage Good Sam Harborview Other Top 10 EMS Call Types * Trauma 3,355 Abdominal Pain 942 Chest Pain 2,058 Seizure 712 Generalized Illness 1,721 Diabetic Emergencies 649 Respiratory Distress 1,074 Mental Health 637 Altered Level of Consciousness (LOC) 1,051 Stroke 517 * The Electronic Reporting System implemented in January 2011 assisted with more specific data reporting. 12

Prevention and Education Fire Prevention Within the city limits of Puyallup, Prevention personnel inspect occupancies and property to ensure compliance with codes and ordinances as adopted by the City of Puyallup. Fire Prevention issues and administers operational permits, plan reviews and inspections, Spring and Fall Fair permits, and receives and receipts fees associated with the permitting process. The division provides Knox box service, recreational fire permits and compliance, and other prevention functions. In the unincorporated area of the District, they work closely with the Pierce County Fire Marshal s office to coordinate similar services. Fire Investigation Within the city limits of Puyallup, Deputy Fire Marshals respond to emergencies examining fire scenes and determining the cause and origin of fires. This involves collecting and preserving evidence, interviewing witnesses, conducting background investigations, and testifying in court proceedings. Public Information The division is the primary conduit for information to the public about the fire district. Public information releases, The Responder newsletter, CPFR website and other media channels are utilized. The Public Information Officer (PIO) provides timely release of information regarding incidents to the public. Public Education Fire and life safety awareness programs are provided to the public. These include school programs for first and fifth graders, Safe Sitter classes, fire extinguisher training, CPR/First Aid classes, and presentations to high school students addressing driving while impaired. They provide a number of activities making our communities safer, such as smoke alarm installation and battery replacement (including hearing impaired alarms), blood pressure checks, sport helmet fittings, and child car seat checks. They schedule station tours, engine and medic unit visits, participate in community events, and health and safety fairs. Public Relations The Public Relations section develops and seeks to enhance the relationships with the citizens of our District and remain actively involved within the community. Accomplishments in 2011 Effective January 2, 2011, Station 71 began the issuance of operational permits and inspections to include, but not limited to: temporary stands, open flame, public assembly, special and interim events in Puyallup, hazardous material inspections, permits, inventory, and administered collection of fees for all operational permitting applications. Fire Inspector I training was completed by the Division s Public Education Specialist, allowing for additional inspections, fire alarm follow-ups, and routine inspections in the Puyallup city limits. Beginning in June 2011, the migration of the City of Puyallup s FireRMS database was facilitated, allowing CPFR to host the occupancy data and historical inspection data from Puyallup which was then imported into CPFR s database. The FireRMS database and attachment folder are the source of record for any data entered or documents created after the migration. Presented two resolutions providing a cost neutral CPR/First Aid class program. 13

Training Division The Training Division is responsible for coordinating and scheduling the majority of department training. All suppression personnel must receive initial training, and skills must be continually maintained. Initial firefighter training is accomplished through our Recruit Academy. The Recruit Academy is approximately 16 weeks and operates Monday through Friday during the day. The maintenance of firefighter skills is done through in-service training. In-service training is accomplished in a variety of ways, including: outside instructors, company level training, battalion level training, monthly reading assignments, online web-based computer training, monthly written tests, and in-house academies. Personnel are also sent to conferences and classes outside the department for specialized training. Training operates in compliance with requirements established by Washington Administrative Code (WAC), Revised Code of Washington (RCW), and the standards of the National Fire Protection Association (NFPA). As standards change, training programs, records, and District policy must be continually evaluated and updated to remain in compliance. Technology is an integral part of training division operations. Use of the computer network and an intranet web page have optimized training by keeping emergency crews and administrative personnel up-to-date on training information, opportunities, and schedules. Accomplishments in 2011 Updated and enhanced the training data collection process within existing software programs to provide for accurate reporting and training program management. Updated firefighter text books, curriculum, and lesson plans to comply with the latest version of the NFPA standard. Applied for and received Pro Board accreditation extension for NFPA 1021 Fire Officer I and Fire Officer II. Utilized Training Division staff to instruct the majority of in-service training and drills. Enhanced requirements and retention for course development worksheets, lesson plans, and Power Point visuals. Purchased 1.37 acres south of the current Training Center property. This property will be developed at a later date. PCDEM replaced the existing storage containers at Station 60. Four new connex containers were purchased with grant funds to improve existing storage for rescue systems and training props. Completed Firefighter 2 certification testing for approximately 100 District personnel. Training Center tower roof prop was redesigned and rebuilt. Training Division staff delivered six EMT OTEP classes in 2011. Successfully applied for and received grant to purchase live car fire training prop. 14

Annual Training Report 40,000 35,000 30,000 25,000 20,000 15,000 10,000 5,000 Total Amount of Training Hours for 2011 11,477 11,668 11,425 34,570 0 A Shift B Shift C Shift Total 20,000 17,500 15,000 14,752 Comparison of Training Hours from 2010-2011 15,824 17,608 12,500 11,477 11,668 11,425 10,000 7,500 5,000 2,500 0 A Shift 2010 A Shift 2011 B Shift 2010 B Shift 2011 C Shift 2010 C Shift 2011 Training hours were down in 2011 from 2010 due to some the following: Academy in 2010 approx Target Safety OTEP Total 6,600 hours 1,582 hours 8,182 hours 15

Logistics The Logistics division is comprised of an Assistant Chief who provides management services of planning, supervising, and evaluating facility needs, vehicle maintenance and replacement, and the District s centralized purchasing operation, which includes runner service. This division also coordinates the installation and maintenance of all emergency communications equipment in facilitices and vehicles, as well as those used by front-line personnel. Facilities This division is responsible for the acquisition and maintenance of various facilities owned by CPFR; specifically nine fire stations owned by the District, three stations leased from the City of Puyallup, one technology office, two training towers, one training center, and one vehicle maintenance shop. Maintenance Shop The District owns and operates a maintenance shop for the repair and maintenance of vehicles and small equipment it owns, including emergency apparatus, automobiles, and suppression and communication equipment. Central Stores The responsibility of the Central Stores division is to, within the parameters of the District s purchasing policy, purchase, inventory, and deliver supplies to all Central Pierce stations and administrative offices. This division is also responsible to ensure appropriate stock levels are available for emergency responders to respond quickly and efficiently to citizens. This division also maintains an inspection and maintenance program for personal protective equipment as well as fitting personnel with bunker gear, uniforms, and equipment as required. Accomplishments in 2011 Completed a review of the Equipment Replacement Fund (ERF) and concluded that due to the current financial situation, the fund shall be reviewed annually and vehicle replacements will be considered on a case-by-case basis. Reviewed contracts with outside vendors to ensure the District is receiving the appropriate levels of service for the best possible price. Worked with local utility companies to swap out lighting fixtures at stations to reduce electrical costs while taking advantage of rebates offered. Hired an additional full-time mechanic at the Maintenance Shop. Enhanced the efficiency of the Maintenance Shop by using more automation when possible. Requested bids for fuel which resulted in the reduction of fuel costs. Enchanced the operation of Central Stores by creating a more efficient on-line ordering system. Streamlined the inventory process of Central Stores to provide greater accuracy in inventory counts and value. 16

Compliance Report - RCW 52.33 Revised Code of Washington (RCW) 52.33 requires substantially career fire protection districts to set performance standards and issue an annual report based on data relating to level of service, deployment, and the achievement of each objective. (CPFR) has developed our annual report around the following response types: Fire Suppression Emergency Medical Services both ALS and BLS Special Operations (Hazmat and Special Ops) The District has adopted Resolution No. 06-21 for the purpose of complying with this law. The resolution declares the fire department as established and identifies the services, organizational structure, and number of employees of the department. Resolution No. 06-22 was established to evaluate performance elements and objectives and to establish written turnout and time goals for service. The district is required to report to our Governing Body, as well as have the report available to the citizens, on how well the fire department is doing in meeting its established emergency response standards. CPFR is part of a consortium of Pierce County departments working to standardize reporting information. The format is new and the report matrices have been altered from past reports. Times are accurate with previous reports but information has not been validated to the new format. Updated information will be reported to the Board of Commissioners and posted to the website once the information is validated. Every effort has been made to accurately present this information based on the data available. Emergency Response Goal Statements 1. Turnout Time 1 a) The National Fire Protection Association 2 defines 80 seconds as the Turnout Time 1 performance standard for a Fire Suppression 15 and Special Operation response 5. Our agency meets this objective 39.37 percent of the time. b) Due to circumstances outlined in Appendix 1, our agency has defined 120 seconds as the Turnout Time 1 performance standard for a Fire Suppression 15 and Special Operation response 5. Our agency meets this objective 88.54 percent of the time. c) 90% of our Fire 15 and Special Operation 5 responses have a Turnout Time 1 of 125 seconds or less. d) The National Fire Protection Association 2 defines 60 seconds as the Turnout Time 1 performance standard for an Emergency Medical Services response 9. Our agency meets this objective 49.08 percent of the time. 17

e) Due to circumstances outlined in Appendix 1, our agency has defined 120 seconds as the Turnout Time 1 performance standard for an Emergency Medical Services response 9. Our agency meets this objective 97.23 percent of the time. f) 90% of our Emergency Medical Services responses 9 have a Turnout Time 1 of 104 seconds or less. 2. Response time 10 for the arrival of the first arriving engine company 12 at a fire suppression incident 15 (Building or Dwelling Only NFIRS 111 & 121) a) The National Fire Protection Association 2 defines 4 minutes as the performance standard. Our agency meets this objective 45.24 percent of the time. b) Due to circumstances outlined in Appendix 2, our agency has defined 1 geographic area within our jurisdiction: o For the 1 st geographic area, our agency has defined 6:35 minutes as the performance standard. Our agency meets this objective 86.9 percent of the time. 90% of our response times 10 for this objective are 6:46 minutes or less. 3. Response time 10 for the arrival of the first arriving engine company 12 to all other fires 16 a) The National Fire Protection Association 2 defines 4 minutes as the performance standard. Our agency meets this objective 33:58 percent of the time. b) Due to circumstances outlined in Appendix 3, our agency has defined 1 geographic area within our jurisdiction. o For the 1 st geographic area, our agency has defined 6:35 minutes as the performance standard. Our agency meets this objective 64:56 percent of the time. 90% of our response times for this objective are 8:05 minutes or less. 4. Response time 10 for the arrival of the 4 th firefighter at a fire suppression incident 15 (Building or Dwelling Only NFIRS 111 & 121) a) The National Fire Protection Association 2 defines 4 minutes as the performance standard. b) Due to circumstances outlined in Appendix 4, our agency has defined 1 geographic area within our jurisdiction. THIS IS A NEW MATRIX FOR CPFR. INFORMATION HAS NOT BEEN PERFORMANCE TESTED AND VALIDATED. 5. Response time 10 for the deployment of a full first alarm assignment 17 at a fire suppression incident 15 (Building or Dwelling Only NFIRS 111 & 121) a) The National Fire Protection Association 2 defines 8 minutes as the performance standard. Our agency meets this objective 0 percent of the time. b) Due to circumstances outlined in Appendix 5, our agency has defined 1 geographic area within our jurisdiction. o For the 1 st geographic area, our agency has defined 16 minutes as the performance standard. Our agency meets this objective 66.67 percent of the time. 18

90% of our response times 10 for this objective are 25:08 minutes or less. 6. Response time 10 for the arrival of a unit with first responder 18 or higher level capability at an emergency medical incident 9 a) The National Fire Protection Association 2 defines 4 minutes as the performance standard. Our agency meets this objective 47.68 percent of the time. b) Due to circumstances outlined in Appendix 6, our agency has defined 1 geographic area within our jurisdiction. o For the 1 st geographic area, our agency has defined 7:15 minutes as the performance standard. Our agency meets this objective 92.33 percent of the time. 90% of our response times 10 for this objective are 6:52 minutes or less. 7. Response time 10 for the arrival of an advanced life support unit 19 at an emergency medical incident 9, where this service is provided by the fire department 20. a) The National Fire Protection Association 2 defines 8 minutes as the performance standard. Our agency meets this objective 95.1 percent of the time. b) Due to circumstances outlined in Appendix 7, our agency has defined 1 geographic area within our jurisdiction. o For the 1 st geographic area, our agency has defined 6 minutes as the performance standard. Our agency meets this objective 82.95 percent of the time. 90% of our response times 10 for this objective are 6:51 minutes or less. Appendices Appendix 1 Our turnout time is extended as the receipt of our dispatch information is included in this time. In addition, our two story fire stations typically have longer travel distances to apparatus than our single story fire stations. Appendix 2 Our department uses an Urban classification only. Our district has a wide variety of land use zones with several that may qualify for a Rural distinction; however our fire stations are in close proximity to these areas, negating a differentiation. Appendix 3 Our department uses an Urban classification only. Our district has a wide variety of land use zones with several that may qualify for a Rural distinction; however our fire stations are in close proximity to these areas, negating a differentiation. We expected this number to be similar to structure fire response data. We expect closer times for 2012 with the implementation of a validation tool for our incident reports. Appendix 4 The 4 th firefighter time measurement is now being used because of the 2in/2out firefighting rule. According to RCW 296.305, except as provided in WAC 296-305-05001(11), firefighters must not engage in interior structural firefighting in the absence of at least two standby firefighters. Also, NFPA 19

1500 has similar language. Using the 4 th firefighter arrival time stamp will, under normal circumstances, indicate when interior firefighting operations may begin. Appendix 5 For a full first alarm assignment, CPFR uses 4 Engines, 1 Ladder, 2 Battalion Chiefs, and one medic unit. This response is for residential structure fires, and for reporting purposes. These resources perform the functions as defined in Definition 17. Typically the total number of personnel responding on these apparatus is 19. Appendix 6 All of CPFR s uniformed personnel are either Washington state certified EMTs or Paramedics. These certifications are higher than the First Responder certification. Appendix 7 All of CPFR s uniformed personnel are either Washington state certified EMTs or Paramedics. All of our Medic units have at least one Paramedic, and depending upon daily staffing, many of our engine and ladder companies have a paramedic as well. Premise 1) We are only capturing the apparatus times when that unit is responding and arriving priority. 2) We are only reporting on incidents that occur within our own jurisdiction. 3) Apparatus from neighboring agencies that respond into our jurisdiction (mutual aid or automatic aid received) will be measured. Definitions 1) Turnout Time The time interval that begins when the notification process begins by either an audible alarm or visual annunciation, or both, and ends at the beginning point of travel. Reference NFPA 1710 3.3.53.8. 2) National Fire Protection Association (NFPA 1710 Standard - 2010 Edition) The standard for the organization and deployment of Fire Suppression Operations, Emergency Medical Operations, and Special Operations to the Public by Career Fire Departments. 3) NFIRS National Fire Incident Reporting System. 4) Fire Incident All NFIRS 100 incident types. 5) Special Operation Incident Those emergency incidents to which the fire department responds that require specific and advanced training and specialized tools and equipment. Reference NFPA 1710 3.3.41.2. 6) CPR Cardiopulmonary resuscitation. 7) BLS A specific level of pre-hospital medical care provided by trained responders, focused on rapidly evaluating a patient s condition; maintaining a patient s airway, breathing, and 20

circulation; controlling external bleeding; preventing shock; and preventing further injury or disability by immobilizing potential spinal or other bone fractures. Reference NFPA 1710 3.3.36.2. 8) ALS Emergency medical treatment beyond basic life support that provides for advanced airway management including intubation, advanced cardiac monitoring, defibrillation, establishment and maintenance of intravenous access, and drug therapy. Reference NFPA 1710 3.3.36.1. 9) Emergency Medical Incident The treatment of patients using basic first aid, CPR, BLS, ALS, and other medical procedures prior to the arrival at a hospital or other health care facility. Reference NFPA 1710 3.3.17. Note: Only NFIRS 321, 322, and 323 incident types. 10) Response Time (aka Travel Time) Means the time immediately following the turnout time that begins when units are en route to the emergency incident and ends when the first arriving unit arrives at the scene. Reference NFPA 1710 3.3.53.7. 11) NFPA 1710 The standard for the organization and deployment of fire suppression, emergency medical operations, and special operations to the public by career fire departments. 12) Engine Company Apparatus whose primary functions are to pump and deliver water and perform basic firefighting at fires; including search and rescue. Reference NFPA 1710 5.2.3.1. 13) NFIRS 111 Building fire. 14) NFIRS 121 Fire in mobile home used as fixed residence. 15) Fire Suppression Incident - Only NFIRS 111 and 121 incident types. 16) All Other Fires All NFIRS 100 level incident types except 111 and 121. 17) Full First Alarm Assignment - Means the appropriate number and type of both apparatus and fire suppression personnel, as defined by each jurisdiction, sufficient to perform the eight NFPA defined fire-fighting tasks at a working structure fire incident. Reference NFPA 1710 5.2.4.2.2. 18) First Responder A trained individual providing initial assessment and basic first-aid intervention, including cardiac pulmonary resuscitation and automatic external defibrillator capability. Reference NFPA 1710 3.3.24. 19) Advanced Life Support Unit Personnel and equipment capable of providing ALS care. 20) Fire Department A fire protection district or a regional fire protection service authority responsible for firefighting actions, emergency medical services, and other special operations in a specified geographical area. Reference Revised Code of Washington 52.33.020 (4). 21

Sequence of Events It is important to understand the characteristics of the community s two major priorities within the District: fire suppression and emergency medical services. This section provides a description of the sequence of events involved with a structural fire and cardiac arrest or similar significant medical emergency. These explain the importance of response times in creating a positive outcome to an emergency and the results if the response is delayed. The ultimate goal of any emergency service delivery system is to provide sufficient resources (personnel, apparatus, and equipment) to the scene of an emergency in time to take effective action to minimize the impacts of the emergency. Dynamics Of Fire In Buildings Most fires within buildings develop in a predictable fashion unless influenced by highly flammable material or liquids, ignition, or the beginning of a fire. It may take some minutes or even hours from the time of ignition until flame is visible. This smoldering stage is very dangerous, especially during times when people are sleeping, since large amounts of highly toxic smoke may be generated during early phases. Once flames do appear, the sequence develops rapidly. Combustible material adjacent to the flame heats and ignites, which in turn heats and ignites other adjacent materials if sufficient oxygen is present. As the objects burn, heated gases accumulate at the ceiling. Some of the gases are flammable and highly toxic. The spread of the fire continues quickly. Soon the flammable gases at the ceiling reach ignition temperature. At that point, an event termed flashover takes place; the gases ignite, which in turn ignites everything in the room. Once flashover occurs, damage caused by the fire is significant and the environment within the room can no longer support human life. Typically, in furnished and ventilated buildings, flashover usually happens about five to eight minutes from the appearance of flame. Since it has such a dramatic influence on the outcome of a fire event, the goal of any fire agency is to apply water to a fire before flashover takes place. Perhaps as important as preventing flashover is the need to control a fire before it does damage to the structural framing of a building. Materials used to construct buildings today are often less fire resistive than the heavy structural skeletons of older frame buildings. Roof trusses and floor joists are commonly made with lighter materials more easily weakened by the effects of fire. Light weight roof trusses can fail after five to seven minutes of direct flame impingement. Plywood I-beam joists can fail after as little as three minutes from flame contact. This creates a very dangerous environment for firefighters. In addition, the contents of buildings today have a much greater potential for heat and smoke production than in the past. The widespread use of plastics in furnishings and other building contents rapidly accelerates fire spread and increases the amount of water needed to effectively control a fire. All of these factors make the need for early application of water essential to a successful fire outcome. A number of things must happen quickly to make it possible to achieve fire suppression prior to flashover. The following figure illustrates the sequence of events. 22

Fire Growth vs. Reflex Time The reflex time continuum consists of six steps, beginning with ignition and concluding with the application of (usually) water. The time required for each of the six components varies. The policies and practices of the fire department directly influence four of the steps, but two are only indirectly manageable. The six parts of the continuum are: 1. Detection: The detection of a fire may occur immediately if someone happens to be present or if an automatic fire detection or fire suppression system is functioning. Otherwise, detection may be delayed, sometimes for a considerable period. 2. Report: Today most fires are reported by telephone to the 9-1-1 dispatch center. Call takers must quickly elicit accurate information about the nature and location of the fire from persons who are apt to be excited. A citizen well trained in how to report emergencies can reduce the time required for this phase. 3. Dispatch: The dispatcher must identify the correct fire units, subsequently dispatch them to the emergency, and continue to update information about the emergency while the units respond. This step offers a number of technological opportunities to speed the process, including computer aided dispatch and global positioning systems. 4. Turnout: Firefighters must don firefighting protective clothing, assemble on the response vehicle, and begin travel to the fire. Good training and proper fire station design can minimize the time required for this step 5. Travel: This is potentially the longest phase of the continuum. The distance between the fire station and the location of the emergency influences reflex time the most. The quality and connectivity of streets, traffic, driver training, geography, and environmental conditions are also factors. 23

6. Set up: Once firefighters arrive on the scene of a fire emergency, fire apparatus are positioned, breathing apparatus donned, hose lines stretched out, additional equipment assembled, and certain preliminary tasks are performed (such as ventilation) before entry is made into the structure and water is applied to the fire. As is apparent by this description of the sequence of events, application of water in time to prevent flashover is a serious challenge for any fire department. It is reasonable, though, to use the continuum as a tool in designing the emergency response system. Emergency Medical Event Sequence Cardiac arrest is generally used as a prototypical life-threatening medical event. A victim of cardiac arrest has mere minutes in which to receive definitive lifesaving care if there is to be any hope for resuscitation. Cardiac arrest survival chances fall by 7 to 10 percent for every minute that passes without cardio pulmonary resuscitation (CPR) and defibrillation. Consequently, American Heart Association guidelines now recommend the administration of cardiac defibrillation accompanied by effective CPR as quickly as possible following cardiac arrest. As with fires, the sequence of events that leads to emergency cardiac care can be visualized in the following figure. Cardiac Arrest Sequence of Events The probability of recovery from cardiac arrest drops quickly as time progresses. Research stresses the importance of rapid cardiac defibrillation and demonstration of certain drugs as a means of improving the opportunity for successful resuscitation and survival. 24

Predictable Consequences As an agency, we continually strive to look at policies and practices that provide the best possible service to the community. As the preceding pages show, we currently do not meet all of the response objectives we have established. We are unable to meet the Turnout Time objectives in all instances. We are also unable to assemble adequate personnel on most of the significant fire events within our established time frame. These deficiencies can lead to several undesirable consequences. Some of those consequences include: Increased frequency of brain death or severe mental deficiency in patients who require defibrillation to treat sudden cardiac arrest that presents with ventricular fibrillation. A reduced probability of surviving a hostile fire event in which rescue is necessary. Increased property loss in structural fires that have reached the flashover phase of the fire growth. Increased risk of firefighter injury or death trying to save persons and property in structural fires where either flashover has occurred or the framing elements are exposed to direct flame impingement. Steps to Achieve Compliance IMPROVE DATA COLLECTION: Significant improvements were made last year in our data collection efforts. We updated existing software and added third-party companion software that automates the QA process. This has decreased the entry error rate significantly and increased the reliability of the output. Detailed analysis can now be undertaken more quickly and with greater confidence. To continue to improve upon this initial success, a data administrator could be hired whose only function is to ensure the integrity of the data and provide detailed information to the policy makers. EVALUATE RESOURCE DISTRIBUTION: The largest single factor in the previous section is response time. Driving distance between the fire station and emergency location is fixed and is further limited by safe driving speeds, traffic devices, topography, and traffic volume. Current station locations must be evaluated on current and future predicted call volumes. How a station is configured also plays a significant role in turnout time. An evaluation of response times against stations should be conducted to identify problem facilities. A plan could then be developed to address design deficiencies that hamper the crew s ability to reduce turnout times. A continuing evaluation is necessary to ensure the best resource distribution and the improved data collection should assist in that endeavor. EVALUATE RESOURCE CONCENTRATION: The amount of resources stationed at a fixed site could be altered. Not only should station locations be analyzed, but the personnel and apparatus could be revised or reconfigured to provide better coverage. These items should be evaluated in light of current budgetary constraints. Decreasing personnel will result in us getting further from the goal of meeting our 25

response objectives. Also, reducing crew size has a significant impact on the time required to mitigate fire emergencies effectively while increasing firefighter risk of injury. The improvements in data collection will help identify the impacts of reduced personnel. EVALUATE RESOURCE AVAILABILITY: Having units available to respond to emergencies in their first due area significantly minimizes travel time for calls currently requiring the use of another station. Data should be analyzed to ascertain the frequency and duration of multiple calls. Analysis should be performed to identify and evaluate the causes that contribute to resources being away from their stations on nonemergency functions such as public education events and training. ONGOING TRAINING: It is imperative that crews be given feedback to understand the impact of delayed response. They also need to continuously drill on efficient donning of personal protective equipment and district familiarization to reduce turnout times. Training would also help in the area of improved data collection. INCREASE STAFFING: One of the ways to reduce risk, reduce injury, reduce response times and increase the likelihood of a positive outcome for all significant emergencies is to increase the amount of personnel available at any given time. We meet our minimum daily staffing levels by using overtime on a regular basis. This is due to not replacing personnel who have left the department. Staffing is directly impacted by the balance of desired staffing levels versus publicly approved funding. 26

District Map N W E S 27

Station Locations Station 60 (and Headquarters) 17520 22 nd Avenue East, Tacoma WA 98445 (253) 538-6400 Business Office Station 61 100 114 th Street South, Tacoma WA 98444 Station 62 (Information Technology Division) Station is not staffed with emergency response personnel or apparatus. 1410 Brookdale Road East, Tacoma WA 98445 Station 63 9512 17 th Avenue East, Tacoma WA 98445 Station 64 3421 224 th Street East, Spanaway WA 98387 Station 65 301 146 th Street South, Tacoma WA 98444 Station 66 9813 128 th Street East, Puyallup WA 98373 Station 67 (and Training Center) 8005 Canyon Road East, Puyallup WA 98371 Station 68 5401 136 th Street East, Puyallup WA 98373 Station 69 (and Maintenance Shop) 17210 110 th Avenue East, Puyallup WA 98374 Station 70 (staffed only during fairground events) Western Washington Fairgrounds, Puyallup WA 98371 Station 71 (and Prevention & Education Division offices) 902 7 th Street NW, Puyallup WA 98371 Station 72 3509 27 th Street SE, Puyallup WA 98374 Station 73 311 West Pioneer, Puyallup WA 98371 28