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HomeMy WebLinkAboutRFA 2015-05-13 COMPLETE AGENDA PACKETDate Place: Time oCity f Tukwila AGENDA Regional Fire Authority Annexation Steering Committee Wednesday, May 13, 2015 Tukwila Fire Station 51 Training Room 444 Andover Park E, Tukwila, WA 98188 (206) 575 -4404 5:00 — 5:30 p.m. Refreshments 5:30 — 7:30 p.m. Steering Committee Meeting I. General Discussion /Questions /Follow -up Seal and Wilson, Co- Chairs Emergency Mgmt. and Fire Prevention Services II. Tukwila Standard of Coverage Chris Flores, Interim Chief III. Kent RFA Standard of Coverage Larry Rabel, Captain IV. FD Cares Mitch Snyder, Division Chief V. Governance Work Group Moira Bradshaw VI. Adjourn Attachments: Committee Minutes - 4/8/15 Memo and Scenario Questions — Fire Prevention and EM FD Cares Executive Summary FD Cares Powerpoint Presentation Phone: 206u433µ/800. City Hal/ 4x 206.43 ,/ 3. e sftc -, mvW.'rukWil 11l . i �c M of Tukwila x�oa Minutes Regional Fire Authority Annexation Steering Committee April 8, 2015 Call to Order Co -Chair Kathleen Wilson called the meeting to order at 1730 hours.. Committee Members David Cline, City Administrator; Moira Bradshaw, Senior Planner; Chris Flores, Tukwila Interim Fire Chief; Jim Schneider, Kent RFA Chief; Joe Duffie, Tukwila Councilmember; Merle Brooks, Tukwila firefighter, Alan Codenys, Tukwila firefighter; Dawn Judkins, Union President of Tukwila firefighters; Mike Denbo, KCFPD 37 Commissioner, board member of Kent RFA; Ray Shjerven, Captain Kent RFA, Union President; Brian Snure, Attorney for Kent RFA board; Genevieve Christensen, Assistant General Manager for the Westfield Mall; Roxanne Knowle, Senior Real Estate Manager for CBRE; Jessica Jerwa, Tukwila citizen representative; Jerry Thornton, Tukwila citizen representative; Kathleen Wilson, Tukwila citizen representative. Also present: Vicky Carlsen, Deputy Finance Director; Norita Deckard, Admin. Support Tech. UN INOTPTt •1 •IJ,I It was moved and seconded that the minutes for the meeting on 3/11/15 be approved with a correction to the spelling of Mike Denbo's name. The motion was approved. Review of Draft Revised Procedures There was discussion about the procedures to follow for citizens that wish to speak at the meetings. Should the public submit their statements in writing before the meeting, and if they don't, will they still be able to speak to the committee? Councilmember Duffie felt that no one should have to submit statements or questions in writing first. Ms. Wilson said that it was helpful when she was on the Tree and Environment Advisory Committee when written comments were received. Ultimately, there was Committee agreement that it is important to make sure the public knows that they are invited to attend the meetings, but that it is the committee's meeting and that the Co- chairs may need to use their discretion with each Agenda. Councilmember Duffie recommended that the Committee decide on a time limit for citizen comments. There was unanimous agreement to limit each citizen to 2 minutes. Revision to the Draft Procedures to reflect a 2 minute citizen comment was seconded and the Procedures were approved. Regional Fire Authority Annexation Steering Committee Minutes Page 2 of 5 April 8, 2015 2014 Fire Exploratory Committee Recommendation City Administrator David Cline summarized the findings of the 2014 Fire Exploratory Committee. That committee recommended the formation of a steering committee with a broader representation of the community to continue exploring the feasibility of a possible annexation to the Kent Regional Fire Authority. The Regional Fire Authority Annexation Steering Committee's purpose is to make a recommendation to the City Council on whether to proceed with the annexation process. General Business Jerry Thornton volunteered to compile a list of fire depa Interim Chief Flores presented an organizational chart • Administration • Operations • Emergency Management • Fire Prevention nyms and their definitions. isions in the fire department: The Administrative division provides policy and direction to the rest of the fire department and interacts with other City departments. The Administrative Division consists of a fire chief, assistant chief of operations, an assistant to the chief, and an administrative support technician. There are 70 full -time employees, which includes 54 full -time firefighters in fire suppression positions. The Tukwila Fire Department supplies two full -time captains to the South King County Regional Training Consortium. The two training captains still report to the Tukwila Assistant Chief. The department's participation in the training consortium has resulted in improved training opportunities and better training documentation thru the Training Tracker program. The Fire Department not only provides fire suppression and emergency medical services, but also deals with rescue, marine response, and hazardous materials incidents. Fire prevention provides code enforcement, conducts inspections and issues permits. Other services are public education and outreach, and emergency management. The Tukwila Fire Department Explorer Scout Group has joined with the Zone 3 Explorers Group which encompasses all of south King County. Tukwila Fire also has a chaplaincy program. All of these other categories support the fire suppression and emergency medical responses. Some logistics (maintenance of vehicles), financial, legal and IT support services are important services that are external to the department and provided through other City departments. Currently, in the Tukwila Fire Department firefighters have a greater degree of responsibly and may be tasked with different jobs such as maintaining the inventory, repairs of personal protective gear or other small tools. The advantages to being part of a regional fire authority would be that more staff 2 Regional Fire Authority Annexation Steering Committee Minutes April 8, 2015 Page 3 of 5 allows diversification and specialization. With more resources, maintaining firefighting equipment and supplies could be more efficient. City Administrator Cline pointed out that the reason the committee is learning about emergency management and fire prevention is because the City will have the option of either keeping these services or contracting with the Kent Regional Fire Authority to provide these services. Emergency Management Battalion Chief Marty Grisham presented an overview of the Emergency Management Division. In 1980 the responsibility for emergency management was assigned to the Fire Department. In the mid - 1990's it was administered by Public Works. In 2009, following the Howard Hanson Dam threat, emergency management was transferred back to the Fire Department and administered through the Fire Department budget. The Revised Code of Washington (RCW) state requires and governs the establishment of an emergency management division. The mayor has authority to assign a director from any city department. In 2010 the powers and duties of emergency management were updated in with a significant rewrite of the Emergency Management section of the Administration and Personnel Chapter of the Tukwila Municipal Code (TMC 2.57.) One of the primary purposes of the emergency management division is planning and preparation for emergencies. The Fire Chief is the "Director of Emergency Management "; the division is staffed by an Emergency Manager, and an Emergency Management Specialist. Funding comes primarily from the City budget, but also from state and federal grants. Emergency management provides public outreach thru' education and public training programs such as Community Emergency Response Team (CERT) training. It also provides logistical and planning support for other City departments during real life incidents such as the "Take Back the Boulevard." Emergency management is responsible for generating and maintaining a Comprehensive Emergency Management Plan and participating in county and state wide emergency drills such as the Cascadia Subduction Zone Rising Drill. Emergency' management also manages all of the emergency radios in the City. Tukwila Fire Marsha Battalion Chief Don Tomaso presented an overview of the Fire Marshal's Office. Staff includes a fire marshal, two deputy fire marshals, a fire project manager, who is a certified plans examiner, and an administrative support technician. The Fire Marshal duties include: business license review; assigning addresses; backup plan review — building, mechanical, fire alarm, and sprinkler; code enforcement; fire investigations with limited criminal follow -up; public record requests; public works project reviews; impact fee administration; assists with economic development; construction inspections back -up; hotspots committee; city land use and street design review; code questions; state association memberships. 3 Regional Fire Authority Annexation Steering Committee Minutes April 8, 2015 Page 4 of 5 The Deputy Fire Marshal duties include: construction, sprinkler and fire alarm inspections; suppression responses; investigating alarm problems; hazardous materials inspections; following -up on confidence test reports with problems; fire investigation; B occupancy inspections, which include offices and commercial services; and some public education. The Fire Project Manager duties include: review of building, mechanical, fire alarm, sprinkler, public works and tank installation plans; main project oversight; review of operational permits, temporary tent permits, and tank removals; code questions. The Fire Marshal's Office also processes 18 -month fire and life safety business inspections and sends inspection letters; processes operational and construction permits; maintains business files, and fire alarm and sprinkler plans; verifies addresses; and processes public records requests. For 2014 the total number of construction and 18 -month inspections totaled 3,850 of which 1,400 where firefighter crew inspections. The Fire Marshal's Office had 3,495 calls for service and attended 381 fires which resulted in 161 fire investigations. management Chief Schneider explained that the cities of Kent a prevention, fire investigation and emergency manE administer and manage those programs. We hau the KRFA meets or exceeds the permit turnarounc department review of construction applications is t As an example of how we've been able to ensure cities, the Kent RFA hired a civilian inspector who Department, and he now provides fire prevention The City of Covington performs its emergency id SeaTac, who are statutorily responsible for fire gement, chase to contract with the Kent RFA to good working relationship with our cities and pectations. The advantage of having the fire one of our primary concerns is firefighter safety. d working knowledge and relationships with the ✓ously worked for the City of SeaTac Fire ices for the City of SeaTac through the KRFA. e KRFA for fire prevention and investigative services but Duties in- house. With regard to fire investigation, the KRFA fire investigative division has three investigators and a supervisor who work shift assignments. Each fire investigator is a certified police officer, who can carry a weapon and make arrests' in the field. Each investigator can also follow his cases all the way thru to completion. The KRFA has high closure and conviction rates. General Business The topic of the next meeting will be standard of coverage: how to define the level of service, and whether joining with the KRFA would result in a different or better level of service. Chief Schneider will also include a discussion of the KRFA's FD cares program because of the impact that program has on their service level. The ultimate goal of this steering committee is to make recommendations to the Tukwila City Council on whether to proceed with the annexation process. The services discussed tonight will be affected because an annexation of the Tukwila Fire Department to the KRFA will change the current model of El Regional Fire Authority Annexation Steering Committee Minutes April 8, 2015 Page 5 of 5 service delivery and program administration. If the Committee's recommendation is to proceed and the City Council agrees, then the KRFA Plan will need to be amended to indicate whether some or all of the services discussed tonight will be part of a contractual agreement. If they are provided by the KRFA, then the details on contracting for services, such as costs, will be negotiated through an Interlocal agreement between the City of Tukwila and the KRFA. Adjournment At 1921 hours Co -chair Wilson declared the regional fire authority steering committee meeting adjourned. Minutes taken ands 5 A City of Tukwila Jim Haggerton, Mayor MEMORANDUM To: Regional Fire Authority Annexation Steering Committee From: Moira Bradshaw Date: 6 May 2015 Subject: Fire Prevention /Investigation /Public Education /Emergency Management ISSUE The first agenda item for May's meeting is a discussion on the pros and cons of contracting with the Kent RFA for the above services should a fire service annexation vote be positive. BACKGROUND At the April Steering Committee Meeting, Tukwila's Interim Fire Chief Chris Flores and Battalion Chiefs Marty Grisham and Don Tomaso made presentations on the general functions of the Tukwila Fire Department with a focus on the above four services. The attachment to this memo contains scenarios that typically occur for Fire Prevention or that Emergency Management plans for in their training. FINANCIAL IMPACT The Finance Committee is developing a conceptual budget for a Kent RFA that includes Tukwila. An indication of how the City would like these specific services provided is requested. RECOMMENDATION Review the attached questions, consider some of your own concerns, and bring your thoughts to the Committee meeting on May 13 for discussion. ATTACHMENT Scenario Questions VA Scenario Questions for Pros /Cons Discussion Fire Prevention Attachment 1) You are doing a short plat or lot line adjustment and you have fire hydrant and fire turnaround questions and issues. What are the steps involved in getting answers? How do you resolve the issues and get an exception granted? How long is the process? 2) Your business is adding high piled storage racks and you have fire sprinkler questions. How do you get copies of the existing sprinkler locations within the building? Where does the business or contractor go with questions? 3) My neighbor is parking in the driveway that is a fire lane, I want you to tow his car! The Police Dept says they can't do anything, because it is private property. Who comes out and does this? Who do you go to with questions, complaints? Emergency Management 4) A severe winter storm is forecasted for our area. Who will coordinate efforts between: Fire Department and Police Department, the emergency responders, and the Public Works Department, who will be sanding and plowing streets? 5) There is a large hazardous materials release in the Southcenter district, creating a need to evacuate and shut down streets. How would the RFA respond and what kind of Incident Command structure would be set up to manage this incident? 6) An active shooter is at the mall. What resources would the RFA send and how would Tukwila response efforts be coordinated with the RFA response resources? Do you think the services provided by the Kent RFA for the above scenarios would be different than the services that Tukwila currently provides? Do you think they would be better, worse, or just different? Would it matter? Rl Executive Summary — Over the last 30 years, the fire service has expanded the number of stations and personnel in order to meet a 400 percent increase in the number of requests for Emergency Medical Services (EMS). The expansion of fire -based emergency medical response has inextricably linked the fire service and the U.S. health care system. The U.S. healthcare system is currently under enormous public and congressional pressure to reform due to the lack of access to services, the poor quality of care, and the high costs of care. Critics of the US healthcare system cite fire -based EMS as an example of a public service that contributes to America's over utilization of EMS and increasing national healthcare expenditures amounting to 18 percent of the Gross Domestic Product (GDP). Is this criticism of fire -based EMS valid? Fire departments respond to a wide array of requests for medical service. The fire service is well recognized for their capacity to respond rapidly to emergencies with quality care as demonstrated by recent increases in cardiac arrest survival rates nationwide. However, a large proportion (estimated up to 40 %) of medical service requests are for non - emergent medical problems and a majority of these requests are attributed to a subset of frequent users of EMS. Despite these facts, fire -based EMS personnel, response times, and medical interventions are standardized for medical emergencies. Consequently, 911 callers with non - emergent issues typically receive emergency- oriented care, which often times results in the unnecessary transport of patients to an Emergency Department (ED) for more definitive care. The National Quality Forum (NQF) estimates that this response model contributes to an estimated $38 billion in wasted health care expenditures each year. Moreover, because fire -based EMS and EDs are designed for the episodic treatment of emergent medical problems, clients with non - emergent medical problems, who often have multiple chronic diseases and psychosocial issues, experience poor quality outcomes, poor follow up care, and poor continuity of care. The result is subsequent and repeated use of the EMS system. Why now should the fire service change their medical response model? The Patient Protection and Affordable Care Act (PPACA) is changing the landscape of the U.S. health care system. Provisions in the PPACA are making insurance payers and hospitals accountable for the quality and costs of EMS care, driving the adoption of healthcare delivery organizations and innovative solutions that improve the value of EMS. The PPACA directly challenges the inefficiencies of the fire service's "one -size -fits -all" response model. How can fire departments improve the value of fire -based EMS? Fire departments should adopt a new tier within their current response model that responds directly to non - emergent medical and psychosocial problems and proactively contacts frequent callers of 911, frequent users of the ED, and patients at high -risk of hospital readmission. This Non - Emergency Medical Service (NEMS) division should be fully integrated into the operations of fire departments. The Kent Fire Department Regional Fire Authority (KFD /RFA) in Washington State has developed a NEMS division, called FDCARES (Fire Department Community Assistance, Referral, and Education Services). FDCARES is staffed 24 hours per day, 365 days per year with an Emergency Medical Technician (EMT) and a Registered Nurse (RN), who are available to respond directly to 911 callers with non - emergent medical and psychosocial requests for service. Using a non - emergency response vehicle, FDCARES staff responds to non - emergent callers within 20 minutes. FDCARES staff delivers a wide range of services aimed at addressing clients' immediate and long -term medical and psychosocial needs. These services include medical stabilization, care navigation and coordination, transport to alternative care settings (e.g., urgent care, primary care, etc.), medication reconciliation, patient education, referrals to social services, and injury and illness prevention. When not responding to non - emergent 911 callers, FDCARES staff proactively contacts and delivers services to frequent 911 callers, frequent users of the ED, and individuals at high risk of hospital readmission. Adopting and integrating FDCARES into a fire department's existing response model, improves emergency unit reliability and response times, reduces over - utilization of EMS and the associated costs, increases access to quality care, and improves outcomes for residents by ensuring that they receive the right service, at the right time, in the right place, and in the right way. 10 Professionally and Compassionately 14eIping People Fire Department Community Assistance Referral. and Education Services DEFINING THE FUTURE Em r ed• ry a Vision Statement FDCARES has fully integrated EMS into the broader healthcare system to improve the health outcomes of individuals in need of non - emergency services. We provide the proper level of response, education, advocacy, and medical systems navigation. Utilizing a combination of public and private resources, FDCARES has increased access to the appropriate level of healthcare and social services in a timely and cost effective manner. t e 'vision FDCARES staff is addressing: ➢ Low acuity /non - emergent 911 incident response ➢ Navigation of patients to lower cost, appropriate care facilities ➢ Proactively addressing High Utilizers of the 911 system ➢ Proactively addressing High Utilizers of the local Emergency Departments )%- Emergency Department and Hospital admission and readmission prevention ➢ Improved Continuity of patient care CARE COORDINATORS tors Establishing what level of training is needed for this type of work and who is best suited to perform these duties. The Kent Fire Department will be using Firefighter EMT's and Registered Nurses. NEM R Non - Emergency Medical Services ➢ Smaller response vehicles ➢ Appropriate response times ➢ Addressing chronic and incident causation � Advocating for patients (not case management) are Coordinators take the time to determine the underlying cause of the 911 request. Determine the most appropriate solution to the problem. Stabilize patients in their home when appropriate. Navigate patients to appropriate care provider. Primary Care Walk in clinics Urgent Care Crisis Clinic's Sobering Clinic's Establish the most appropriate transportation method. = = = Developing long term solutions and providing non-emergent resource for patients. 253-856-CARE (2273) Patient needs assessment Proactive services No n E Q • e cene Partnering h Hospitals Avoidable readmissions Pneumonia >CHF >Acute MI >COPD >Geriatric Fall Patients a ad sion Pr v n on, Definitions: 911 high utilizer - Any patient who utilizes the 911 system 3 or more times in a 12 month period. ED high utilizers - Any patient who is admitted to an emergency department 4 or more time in a 12 month period. System abuser - Any patient who utilizes a combination of the 911 system and admits to an emergency department 25 or more times in a 12 month period for tow acuity events. t 11/ED f P • FDCARES DATABASE: Data is a critical component for the day to day operations of NEMS. ➢ General Patient Information ➢ Clean data for optimizing patient Identification ➢ Proactive workload prioritization rit"4 i T pRfoRliyAtc,0 F[T _-` tier Enter cc t ct to tae FDC::RES Database then follow this algorit! - :m to r_ sta5i. sh the correct Tier— Pr'or;ty level. Has the F called S11 THREE OR MORE times in the past 12 months Has the F utilized an ED FOUR OR MORE times in the past 12 months has the rt utilized an ED FOUR OR MORE times in the pas= _2 months' Dees :he .: ha-.,e a his:cry c= S'_bs :ari_eA.buse cr Mental -eal-h 1Ilness? AGE 4 1 I=ces the Pt. E:aye a history c= Substance Abuse or :Mental Health Illness? Does the Pt have a histor.,. of Substance Abuse or .Mental Health Issues? T= Gi._ To. = .G= TIER 6 GO TO PAGE 7 TIER 2 GO TO- G E NO TIER 5 GO TO PAGE 6 Was the Pt Referred? YES hlN0 TIER 1 PATIENT Is the Pt a diabetic Is this a fall Pt? YES rE.S HIGH PRIORITY 1.1.1 YR,I.10 FIIGH PRIORITY 1, 1, 2,YR.M0 HIGH PRIORITY 1,1.3 YR.M0 NO HIGH PRIORITY 1.1.4.YR.rv'1O APRIL 27th 2G i 3 - /zlivered to die Gcverr2r P AREft, G L I ._._I. NJ building mise caloilati -ns %6A I 6 _ 60 II 6 66, 4-7 ■pea. - - r .06. • • r I• 1 = C a n 4.4 ssoc ed s \..... \ 1... \ _.... More cost effective low acuity medical response >Reduced repetitive use of the 911 system >Improved costs associated with unit reliability versus staffing additional emergency units >Improved emergency response times 16.00% 14.00% 12.00% 10.00% 8.00% 6.00% 4.00% 2.00% 0.00% of Time Devoted to Y -Code Incidents A70 A71 E71 E72 E73 E74 A74 L74 E m E75 E76 E77 n E78 m 2012 2011 2010 abi 1 A n n , _ ,, u a _ ,_,, . ,_ m „t„,„7_,_„,_,! .0--- r Better Defining Medical Call Types EMS = Advanced Life Support BLS = Basic Life Support NEMS = Non Emergency PAVS = Pro - Active Visit Services Downgraded Re o Annual Fire Department Response Numbers and Percentages FIRE -624 3.01% ▪ Service -639 3.07% ▪ Haz Mat -284 1.36% Other -1698 8.17% • EMS /ALS -1302 6.28% BLS -6914 33.3% NEMS -2000 9.64% PHV's -5000 24.07% Downgrade -2304 11.10% Hospital /Emergency Departments Reduced low acuity admissions and readmissions ➢ Reduced number of uninsured /underinsured patients ➢ Reduced overcrowding ➢ Reduced admissions and readmissions (30 day) � Improved patient outcomes and patient satisfaction. >Healthcare Partnerships >Payer Partnerships >Employer Insurance provider Partnerships Mitch Snyder www.FDCARES.com helms hand y 253 -856 -CARE 125 3-a 2273. °':::1-:Firefighters 53cif�rd aE1 Assists-a Living N 00