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Fire Department Service Level Review

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Fire Department Service Level Review DATE: June 13, 2018 TO: Honorable Mayor Jerry Smith City Council FROM: Patty Hoppenstedt, Interim City Manager Eric Hicks, Fire Chief SUBJECT: Fire Department Service Level Review. I. Summary The Fire Department reviews service level needs on a routine basis to ensure it is effectively providing emergency service to the citizens and visitors of the City in a safe and expedient fashion. As the mission statement of the Fire Department states: “We are committed to providing the highest level of service to the citizens of DeKalb and those who visit. We strive to continuously seek innovative and effective ways to protect the lives and property of those we serve through suppression, emergency medical services, education, prevention, and training.” Emergency medical services provided by the Fire Department continue to increase and enhancements in pre-hospital care provided in the field are always evolving. Fire operations and special teams continue to provide needed emergency service to the citizens and businesses in our community. Public Education remains an essential component to lowering a community's fire losses. The Fire Department strives to find ways to reach citizens and teach fire safety to the community. Vehicle maintenance and respiratory protection teams assist the department in keeping the aging fleet and aging equipment in top working order and keep repair costs at a minimum. The Fire Department currently has seven vehicles nearing or at the end of their service life. Two emergency advanced life support ambulances are aged beyond their serviceable life. Capital equipment replacement needs continue to multiply each year as a result of unfunded replacement of capital needs. The City instituted the Commercial Building Inspection program in June of 2015 and the Fire Department became responsible for the commercial building inspection program as well as all commercial building outside property maintenance inspections and complaint follow-up for commercial and industrial properties. Staffing and the non-personnel budget remain below the 2008 levels, yet the Fire Department continues to perform efficiently and effectively with increased workload, call volume and added unfunded mandates to the budget. The Fire Department has achieved this by reducing training, reducing public education, reducing special team equipment replacement, and eliminating youth firesetter intervention supplies However, due to the dedication of the professionals working in the Fire Department, service has not diminished, it has been enhanced, as shown in the attached Fire Department Annual Report. II. Prior Council Action On January 8, 2018, City Council supported a new budget process for the FY2019 Budget to clearly tie the City Council’s goals to budget action plans. On January 24 and February 20, 2018, City Council identified and prioritized goals to set five short-term goals to be completed in 12 to 18 months and five long-term goals that extend beyond 18 months. On March 20, 2018, the Police and Information Technology Departments presented service level reviews for City Council. City Council deferred the line item budget options discussion to the March 26, 2018, Regular City Council meeting. On March 26, 2018, Finance Director Talkington presented City Council with several options for incorporating a review of the FY2018 Budget as part of the FY2019 Budget Workshops. Council reached a consensus that line item review utilizing the detailed budget report (presented as Attachment B) is preferred. On April 4, 2018, City Council reviewed the City Manager’s Office service level presentation and the Fiscal Year 2018 line item budget for Legislative and the City Manager’s Office. A review of the Community Development Department service level was completed by the City Council on April 17, 2018. Additional information was requested on service delivery with additional resources and tax increment financing for smaller projects. The Budget Basics video was debuted at the April 17, 2018, Special Council meeting. This video is an overview of what services the City of DeKalb provides and how an annual budget is created to provide those services. Page | 2 . City Council provided direction on modifications to the Architectural Improvement Program for smaller projects within Tax Increment Financing districts at the City Council Meeting of the Whole on May 14, 2018. On June 6, 2018, City Council reviewed the Finance and Public Works Departments service level presentations and the Police and Information and Technology Department line item budget reports. III. Discussion 1. Emergency Medical Services The Fire Department provides emergency pre-hospital care of the sick and injured, responding with advanced life support (ALS), state-of-the-art equipped ambulances. Paramedic licensure (EMT-P) is the highest Emergency Medical Service (EMS) level that the Illinois Department of Public Health (IDPH) offers. The Fire Department is a member of the Kishwaukee Emergency Medical Services System, which is a part of Northwestern Medicine EMS. The Fire Department operates six ALS ambulances and three ALS fire engines. Ambulances are staffed with two paramedics and fire engines are staffed with one paramedic and one EMT. This ensures there is a paramedic on every response. Of the 57 sworn personnel in the Fire Department, 53 are paramedic certified. Over the last decade, EMS has seen a steady increase in requests for service for primary health care. Coupled with a lack of state resources in mental health care, prescription drug coverage, and less home health care availability, paramedics routinely treat and transport patients suffering from lack of mental health care, illness due to unavailable primary health care, and assisting the elderly and disabled with falls and other mobility issues. In 2009, the Fire Department responded to 217 calls relating to mental health. In 2017, that number increased to 423 calls, a 94.93% increase. Nationwide, the United States has seen it opioid addiction problems skyrocket due to illicit drugs such as heroin and narcotic prescription abuse. DeKalb Paramedics long have been trained to handle such overdoses but have seen a steady rise in opioid abuse calls. Emergency medical services provided by the Fire Department include: . Routine Medical Care: Treatment of patients due to various injuries or illness. 12-Lead Echocardiogram (ECG): Advanced diagnosis of cardiac origin illness which may result in long-term injury or death. Trauma Care: Care for patients that sustained injury that has the potential to cause prolonged disability or death. Treatment includes advanced airway, cardiopulmonary resuscitation, cardiovascular support, and pain management. Page | 3 . Advance Cardiac Life Support (ACLS): Paramedics are certified in ACLS to identify heart attacks, stroke, and abnormal heart rhythms and to treat using medications and defibrillator. Pediatric Life Support (PALS): Paramedics are certified in PALS which is a systematic approach to pediatric assessment, basic life support, treatment algorithms, effective resuscitation, and team dynamics. The goal of PALS is to improve the quality of care provided to seriously ill or injured children, resulting in improved outcomes. Mass Casualty Incident Care: Personnel are trained to systematically triage, treat, and transport volumes of victims injured during a disaster. Code STEMI (ST-Elevation Myocardial Infarction): Northwestern Medicine Kishwaukee Hospital is a STEMI center for the treatment of acute heart attacks and boosts a 56- minute door to cardiac catheter lab time. This is well below the 90-minute national timeframe. DeKalb Paramedics are trained for early detection, treatment, and rapid transport of heart attacks, which is a critical link in raising the patient’s survivability. Stroke Alert (Code BAT – Brain Attack Team): Northwestern Medicine Kishwaukee Hospital is an acute stroke ready hospital with a timeline to upgrade to a primary stroke center in 2018. DeKalb Paramedics receive semi-annual training focusing on identification, treatment, and activation of the stroke protocol. This is a critical link in raising the patient’s survivability. The Brain Attack Team responds to patients suspected of having a stroke and includes a coordinated team. Sepsis Alert: Early identification, treatment, and reporting for Sepsis for advanced care of the systematically ill patient. DeKalb Paramedics receive regular training to treat sepsis, which is the presence of bacteria, other infectious organisms, or toxins created by infectious organisms in the bloodstream, which spread throughout the body that can lead to tissue damage, organ failure and death. Tactical Medicine: Paramedics are specially trained and equipped to treat and transport multiple patients and other first responders injured from gun fire as part of a hostile encounter. Advanced Pain Management Protocol: Paramedics are trained and equipped with a variety of pain-reduction medications for the treatment of pain, which is proven to improve a patient’s long-term outcome. Athletic Medicine: Paramedics are specially trained to handle trauma involved in high school and collegiate sports and provide EMS standby at such events for the treatment and transport of athletes. Biohazard/Chemical Warfare/Hazardous Materials EMS: Paramedics have the ability to identify, medically treat, decontaminate, and transport patients that have been exposed to lethal chemicals, whether for industrial use or used as a weapon of mass Page | 4 destruction. Special procedures,
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