Report Seeks Changes in Las Vegas Fire Department Duties

Significant issues seen in deployment of EMS

 

 
 
 

States News Services | | Thursday, December 6, 2012


VIDEOS

Multimedia Thumb

Las Vegas Report: All In or All Out of EMS

Significant issues seen in deployment of EMS.
more >





A comprehensive report reviewing the Las Vegas Fire and Rescue (LVFR) Department is now complete. The review, which began in July 2012, was conducted by the International City/County Management Association (ICMA) Center for Public Safety Management. The purpose is to determine current and prospective efficiencies of fire department operations with the goal of stretching city dollars and finding new ways of delivering the same high-quality public safety services more cost effectively. The city of Las Vegas retained the ICMA Center for Public Safety Management to identify best practices already in place and offer recommendations and alternatives to improve current services both operationally and fiscally.

Final Report, Fire and Emergency Medical Services

Since 2004, the LVFR budget has grown by 43 percent, from $77 million to $111 million. This represents an annual growth rate of six percent over the same number of years, while the city's general fund grew at only three-and-a-half percent per year on average.

"Our goal is to manage the growth and unsustainable increases of the fire department budget," said City Manager Elizabeth N. Fretwell. "We want to proactively manage the city's expenses and growth. Just as companies and businesses in the private sector constantly review their practices to maximize efficiencies and improve returns, we strive to operate our city as safely and efficiently as possible. We want to ensure that the city of Las Vegas avoids the financial hardships so common among local governments right now, including municipalities in our state."

Best Practices

Best practices already in place identified by the review include the following:

- LVFR is well equipped with state-of-the-art fire and EMS equipment and apparatus

- LVFR is staffed and deployed to handle an array of emergencies

- LVFR has appropriately identified gaps in response

- LVFR is planning future fire station locations appropriately based on projected growth, community development and contiguous jurisdiction/automatic aid station alignment with Clark County and the city of North Las Vegas.

" LVFR is an accredited fire department.

EMS Issues

While the LVFR has implemented many best practices, the ICMA believes there are significant issues with how the city deploys emergency medical services (EMS) from the fire department. These issues include a static (fixed-base) deployment model that is not aligned with dynamic needs and service demands; a low transport target goal in a system that has high transport demand; revenue is not being collected by the city due to a low EMS transport workload; a lack of decision-making protocol when both LVFR and private ambulance companies are on the scene at the same time (which occurs frequently). During the analysis period, LVFR made 28 percent of the total transport trips to the hospital while the private ambulance service made 72 percent. The ICMA believes LVFR has the capacity with its current fleet to comfortably handle additional transports anytime of the day or night. Using the current EMS deployment model, the city is paying a significant cost for this service while realizing only a fraction of the available revenue return.

Priority Recommendations

Overall, the ICMA report includes 23 total recommendations with eight considered priority. The priority recommendations include the following:

1. Develop a decision-tree protocol for EMS transport when the private ambulance company is on scene with LVFR focusing on efficient patient care and transport. Protocol should specify maximum length of time a LVFR unit should wait for private ambulance regardless of the patient's condition.

2. Based on the current LVFR EMS transport model, the city should consider one of two alternatives:

- Discontinue the LVFR EMS transport service, allowing private ambulance services to manage all EMS response. This option would realize a savings to the city of approximately $14 to $18 million in personnel and equipment savings.

- Option two is to have LVFR transport all patients without assistance from the private ambulance company. Estimated revenue generated from this model is $12 to $14 million.

- In the short term, the ICMA recommends LVFR work closely with AMR to establish a global view of the total EMS system to improve communications, efficiency and effective service delivery. In the long term, the ICMA recommends LVFR consider a more active role in EMS

3. The ICMA found that the firefighters' collective bargaining agreement (CBA) restricts management's ability to staff accordingly to cover scheduled and unscheduled leave, creating a staffing imbalance which drives overtime and, therefore, expense. The ICMA's short-term recommendation is to maintain additional staffing to ensure the maximum authorization of relief employees permitted by the CBA. In the long term, LVFR should continue its efforts in future CBAs to focus on staffing efficiencies utilizing fulltime employees in lieu of overtime to cover scheduled and unscheduled leave.

4. Upon review of LVFR's 24/7 staffing model, the ICMA found that LVFR has underutilized capacity with a large percentage of fire and EMS calls made by one unit. The ICMA recommends demand-based staffing through a combination of 12-hour and 24-hour shifts.

5. The ICMA recommends updating current inter-local agreements for fire and EMS services, as well as the Fire Alarm Office (FAO), across jurisdictions (Clark County and the city of North Las Vegas) to allow remuneration for extended services. The ICMA further recommends LVFR enter into agreements with the cities of Henderson and Boulder City and neighboring states for the sharing of resources in large emergency events.

6. The ICMA recommends LVFR offload administrative duties (payroll, human resources) from the deputy chief to other designated personnel, allowing the chief to focus more on critical duties of the division, specifically fire prevention and plans review.

7. The ICMA recommends that LVFR review specific data from property insurance carriers to determine community financial benefits, if any, in maintaining the current Insurance Services Office (ISO) rating. At the same time the ICMA recommends LVFR continues to maintain the Center for Public Safety Excellence accreditation to ensure ongoing quality.

8. ICMA recommends a review of the 10-14 shift schedule currently utilized by the bomb squad/fire investigations unit with the goal of finding a more efficient schedule that reduces overtime.

Other Recommendations
The majority of the remaining recommendations focus on periodic review of the current LVFR strategic business plan, accreditation, internal risk management, training and succession planning, better tracking of nonemergency activities and communication.

Sick leave and overtime pay are addressed in this set of additional 15 recommendations and include the following:

- The ICMA recommends LVFR work with local labor unions to review sick-leave usage and absence guidelines with the goal of eliminating excessive sick-leave use and, where this impacts overtime, seek ways to reduce expenditures. This recommendation is based upon the finding that within all city offices the fire department was the highest user of sick leave in 2011 at 4.8 percent of total available time and third highest in 2012 at 4.3 percent, with 18 percent of fire employees, using sick leave on weekends and holidays.

- The ICMA recommends that city management further analyze overtime usage and establish a policy that eliminates the potential of combining paid time off with overtime pay.

"As members of the city of Las Vegas family, employees of our fire department are highly skilled professionals who we care about deeply," Fretwell continued. "While public safety is and always will be the city's top priority, the current rate of fire department budgetary growth is simply not sustainable. If left unchecked, it will eventually create a huge budget shortfall and severely impact funding for other critical services that make Las Vegas a real community."

The cost of the study was $155,000 with potential savings resulting from study recommendations estimated into the millions of dollars. "This study is an investment in the city's future financial health," said Fretwell. "Given the potential to realize considerable budgetary savings without jeopardy or impact to public safety, we believe the study is well justified. We are confident the recommendations line out a path we can follow to achieve our goal of creating a sustainable fire department budget that still provides excellent public safety."

ICMA

The ICMA is a 100-year-old nonprofit professional association with approximately 9,000 members in 28 countries. The organization has extensive experience in analyses of public safety agencies and has completed more than 500 projects since 1989 for local communities around the world, including some in our valley. Currently the ICMA is doing a review of the Henderson Police Department. The ICMA team, which included three retired fire chiefs and four Ph.D.s, was comprised of 11 individuals with considerable experience in fire and emergency medical services, finance and risk management.

Methodology

The comprehensive review analyzes information pulled directly from computer-aided dispatch records and includes analysis of key performance indicators identified in standards and safety regulations and by special interest groups, including the International Association of Fire Chiefs (IAFC), the International Association of Fire Fighters (IAFF) , the Association of Public-Safety Communication Officials International and through the ICMA's Center for Performance Measurement. In addition, the ICMA team analyzes key operational documents, interviews key stakeholders, observes physical facilities and reviews literature, statutes, regulations and other information relevant to the project's scope of work.

AttachmentSize
ICMAfirestudy.pdf6.1 MB


Copyright © 2013 LexisNexis, a division of Reed Elsevier Inc. All rights reserved. Terms and Conditions | Privacy Policy


Las Vegas Report: All In or All Out of EMS


Connect: Have a thought or feedback about this? Add your comment now
Related Topics: News, Las Vegas

 
What's Your Take? Comment Now ...

Featured Careers & Jobs in EMS





 

Get JEMS in Your Inbox

 

Fire EMS Blogs


Blogger Browser

Today's Featured Posts

 

EMS Airway Clinic

Innovation & Progress

Follow in the footsteps of these inspirational leaders of EMS.
More >

Multimedia Thumb

Community Paramedicine Expanding in Maine

Eight departments receive a grant for use towards the new program.
Watch It >


Multimedia Thumb

New Ambulance, Fire Engine Approved for Illinois Department

Officials approve new purchases for Bloomington.
Watch It >


Multimedia Thumb

Alabama Officials Worry over Ambulance Coverage

County officials work to find best solution.
Watch It >


Multimedia Thumb

Car Crashes into Texas Ambulance

Ambulance hit while responding to a call.
Watch It >


Multimedia Thumb

San Diego Fire-Rescue Responds to Plane Crash

Small plane crashes in shopping center parking lot.
More >


Multimedia Thumb

California Beach Lightning Strike MCI

More than a dozen injured in Venice Beach lighting strike.
More >


Multimedia Thumb

VividTrac offered by Vivid Medical - EMS Today 2013

VividTrac, affordable high performance video intubation device.
Watch It >


Multimedia Thumb

Field Bridge Xpress ePCR on iPad, Android, Kindle Fire

Sneak peek of customizable run forms & more.
Watch It >


Multimedia Thumb

LMA MAD Nasal™

Needle-free intranasal drug delivery.
Watch It >


More Product Videos >