As seen in the fall/winter 2003 issue of Texas Fire Chief Magazine
Dannie C. Smith assumed the position of fire chief for the City of Sugar Land on Feb. 24, 2003. His first task was to review current levels of service within the department and identify existing opportunities for improvement.
With cities throughout Texas facing a slower moving economy, future financial impacts of legislation and unfunded mandates, budget planners are increasingly tightening belts and making tough decisions. It’s certainly not uncommon to read about cities considering staff and service reductions to achieve balanced budgets, and unfortunately, fire departments are not immune from the budget axe. It’s clear that our challenge in this economic environment is to maintain service levels in an environment of dwindling resources. As Sugar Land approached the fiscal year 2003-2004 budget process, department heads were challenged to reduce base budgets by 2 percent while maintaining current services. The Sugar Land Fire Department viewed this directive as an opportunity to reexamine business practices. What we discovered was an opportunity to expand services within current resources to meet critical needs in a way that achieves long-term savings.
The Challenge
Sugar Land is a fast-growing city of approximately 68,000 located southwest of Houston. As of the last Census, the City had grown 158 percent, ranking Sugar Land first in growth among the state’s largest 45 cities. With a diverse population of mostly college-educated professionals, expectations for quality services are high. The Sugar Land Fire Department (SLFD) has been successful in meeting the community’s expectations, as evidenced by the City’s 2002 Citizen Survey. The Fire Department received some of the highest ratings, with 96.2 percent of respondents ranking fire services as excellent or good. To build on this high level of customer satisfaction, we recently identified several key areas for improvement, mostly relating to our ability to provide an elevated level of emergency medical services and hazardous materials response.
Observations of Current Levels of Service
In 2001, SLFD placed a 1.5-ton emergency response vehicle in service that was designed to respond to non-fire-related calls, as medical emergencies and car accidents account for more than 60 percent of all calls in Sugar Land. The original plan was to utilize the smaller apparatus for emergency medical response, motor vehicle accidents, non-emergency service calls and hazardous materials spills, prolonging the life of the Fire Department’s heavy duty fleet and reducing maintenance costs. This was an excellent strategy at the time, but the following response statistics for the Squad gave cause to take a hard look at the unit’s role in the department:
- In 2002, the squad responded to 1,017 EMS calls and 450 fire calls.
- Because the squad responded to every structure fire in the City, fire calls represented duplication of services.
- The 1,017 EMS calls occurred within four of the city’s six fire response districts, which represents 250 calls per station annually or less than one additional call per station per day.
With SLFD engines running 1 to four calls per day, it was clear the Squad was not accomplishing its original mission. Moreover, a new fire station is expected to open in the near future that will provide relief for the district where the Squad makes the majority of its calls. Clearly the dynamics of the department have changed since the Squad was placed in service.
Resource Reallocation: An Opportunity
Specifically, the department plans to reassign the Squad to respond solely to hazardous materials incidents, one of the original missions of the apparatus. The number of hazardous materials response calls in Sugar Land doesn’t merit 24-hour staffing of a haz-mat vehicle; therefore, the Squad will be assigned to a station staffed on all shifts with hazardous materials technicians. If there is a haz-mat incident, a unit will be available for immediate response.
With respect to staffing, the firefighters previously needed to operate the Squad would accommodate the department’s current need for two additional firefighters per day to cover unscheduled absences related to personal issues or family illness and allow an increase in opportunities to utilize benefit time. The reallocation of Squad personnel also provides two additional personnel units for overall operations. In financial terms, our directive from City management to identify a 2 percent reduction in SLFD’s budget equates to $122,000. Reassignment of the Squad represents an overall savings of about $225,000.
This resource reallocation prevents the Squad from being taken out of service and elevates the level of service provided by the Sugar Land Fire Department.
Emergency Medical Services
In looking at alternatives to better utilize the Squad, departmental leaders felt the Fire Department’s role as an EMS responder could be leveraged and expanded. In April 2002, SLFD implemented an EMT-I pilot program for firefighters assigned to the Squad. Under the guidance of Sugar Land’s medical director, firefighters in the program have received advanced training recognized by the Texas Department of Health to the EMT-Intermediate and EMT-Paramedic level. All other Sugar Land firefighters are certified EMT-basic, allowing them to administer oxygen, apply bandages/splinters and conduct emergency defibrillation.
Reassignment of the Squad provides an opportunity to expand the EMT-I program to every apparatus in the City. There are currently 24 Sugar Land firefighters trained to the advanced level. Eighteen of the 24 personnel are needed to staff Sugar Land’s six stations with one EMT-I firefighter per shift. The remaining six firefighters will be used to cover vacations, holidays and unscheduled absences. This plan utilizes existing resources, but more importantly, it makes advanced lifesaving services more accessible to the community with no increase in the Fire Department’s base budget.
According to the American Heart Association, more people can survive sudden cardiac death if the following sequence of events is carried out in a very rapid manner: early access, early CPR, early defibrillation and advanced care. Brain cells deprived of oxygen after four minutes start to die, a process that is often irreversible. Seconds can make the difference between whether someone lives or dies, a central factor in SLFD’s decision to expand the EMT-I program.
Sugar Land has historically relied on Fort Bend County Emergency Medical Services to provide Advanced Life Support service (ALS). According to the county, area cities have first responders who most likely will arrive on a scene before a county ambulance -- it could be over 10 minutes before a county ambulance arrives. Because the Sugar Land Fire Department’s vehicles are more numerous and more dispersed throughout the City than the county ambulances, they averaged a response time of approximately five minutes for EMS calls in 2002. Expansion of the EMT-I program is expected to further improve the delivery of advanced lifesaving services.
Hazardous Materials Response
SLFD currently has 30 firefighters trained as haz-mat technicians. Like many suburban departments, Sugar Land has limited capabilities, such as identifying materials, containing spills, stopping leaks and, to some extent, the rescue of trapped victims. Building on SLFD’s plan to reassign the Squad to haz-mat duties, the department has been involved in a countywide effort that resulted in the purchase of $60,000 in haz-mat equipment. Fire chiefs in the county have been working together to facilitate an improved regional response, with the focus being to combine resources and create a regional haz-mat team that would be available for major incidents seven days a week, 24 hours a day, 365 days per year. SLFD is spearheading the creation of this team. Additional grant funding has been secured from a Texas Domestic Preparedness Assessment.
Conclusion
It’s rare to see a department embrace EMS and haz-mat training in the way the young men and women of SLFD have. Eighty percent of what most departments do today is EMS. This enhancement of services to the community not only provides an elevated level of service but also has positively affected morale in terms of professional development and additional compensation for utilization of special skills.
SLFD’s reallocation of resources accomplishes many important purposes. It’s a way to work smarter and achieves financial savings, but most significantly, it addresses the department’s primary goal, which is to save lives. Sugar Land firefighters are typically the first responders to emergency calls. Because time is of the essence when delivering lifesaving services, what we’re providing is an opportunity to survive.