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Public Safety Requires Adequate Staffing

This article explores the impact of worker fatigue on public safety, emphasizing the importance of adequate staffing and rest for firefighters. Research shows that worker fatigue increases the risk of illnesses, injuries, and accidents. It also highlights the effects of fatigue on healthcare workers and the associated costs for employers. The article concludes with a discussion on the predictable effects of fatigue on productivity and the safety hazards it presents in transportation operations.

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Public Safety Requires Adequate Staffing

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  1. Public Safety Requires Adequate Staffing Firefighter Safety Requires Adequate Rest

  2. OSHA: Effects of Worker Fatigue ◾Worker fatigue increases the risk for illnesses and injuries. Accident and injury rates are 18% greater during evening shifts and 30% greater during night shifts when compared to day shifts. ◾ Research indicates that working 12 hours per day is associated with a 37% increased risk of injury. In a 2005 study reporting on a survey of 2737 medical residents, every extended shift scheduled in a month increased by 16.2 % monthly risk of a motor vehicle crash during their commute home from work.

  3. OSHA: Effects of Worker Fatigue ◾ Increased sleep problems and risk for injury among full-time employees in relation to the number of hours worked per week. ◾ Errors in patient care, increased needlesticks and exposure to blood and other body fluids and increased occupational injuries among healthcare workers. ◾ Direct or indirect links to increased costs from lost productivity, increased injury and illness costs, increased time off the job due to illness and increased workers' compensation costs.

  4. OSHA: Effects of Worker Fatigue An estimated annual cost of $136.4 billion from fatigue-related, health-related lost productive work time to employers.

  5. OSHA: Effects of Worker Fatigue • Weariness • Sleepiness • Irritability • Reduced alertness • Impaired decision-making • Lack of motivation, concentration, memory • Heart Disease • Stomach, digestive problems • Musculoskeletal disorders • Reproductive problems • Some Cancers • Breast Cancer • Prostate Cancer • Depression • Sleep disorders • Poor eating habits, obesity • Worsening of existing chronic disorders: • Diabetes • Epilepsy

  6. Fatigue - US National Library of Medicine National Institutes of Health Fatigue has predictable effects, such as slowed reaction time, lapses of attention to critical details, errors of omission, compromised problem solving (Van-Griever and Meijman, 1987), reduced motivation, and decreased vigor for successful completion of required tasks (Gravenstein et al., 1990). Thus, fatigue causes decreased productivity; tired workers accomplish less, especially if their tasks demand accuracy (Krueger, 1994; Rosa and Colligan, 1988). The U.S. Department of Transportation identifies fatigue as the number-one safety problem in transportation operations, costing more than $12 billion a year. Sleepy drivers are as much a danger as alcohol-impaired drivers, says the U.S. National Highway Traffic Safety Administration (NHTSA).9 Two recent Australian studies10 demonstrate that being awake for 18 hours produces impairment equal to a blood alcohol concentration (BAC) of 0.05 percent and 0.1 percent after 24 hours; 0.08 percent is considered legally drunk.

  7. Fatigue - US National Library of Medicine National Institutes of Health Working in jobs with overtime schedules was associated with a 61% higher injury hazard rate compared to jobs without overtime. Working at least 12 hours per day was associated with a 37% increased hazard rate and working at least 60 hours per week was associated with a 23% increased hazard rate. A strong dose-response effect was observed, with the injury rate (per 100 accumulated worker-years in a particular schedule) increasing in correspondence to the number of hours per day (or per week) in the workers’ customary schedule.

  8. East Fork Personnel or Calls Affected by Understaffing Many times we’ve had significant or two significant incidents simultaneously that overwhelmed our system. It’s common for our system to have all staffed, 1st out ambulances, committed on medical calls with a delay in on scene times for a transporting ALS ambulance. 3-4 more personnel per day, regardless of what rig they’re assigned, can make a significant difference on incidents with suppression, rehab and manpower when needed.

  9. Saturday, Aug. 20, 2016 • Carson River Resort Fire, Alpine County • Structure Fire that spread into Wildland • After suppressing the Structure Fire, E14 crew had only a short break before deploying hose packs up a mountain to suppress a wildland fire due to lack of resources. • Crew members were fatigued from night before calls, lack of resources on scene and overworked on incident without proper rehab. • Results - Two injured employees • Cardiac, life threatening injury (notated, 2017 SOC, pg. 4) • Knee injury

  10. Sunday, Oct. 2, 2016 • Frontage Fire • Lost two structures – a house and a garage • Wind driven fast moving fire with limited water and resources until mutual aid resources arrived. Very quickly overwhelmed our system. • First arriving understaffed resources overworked to hold what they had to prevent loss of additional structures. • Results - Two injured employees • Smoke inhalation • Eye injury

  11. Monday, July 24, 2017 Preacher Fire & Stockyard Fire Two incidents, back to back, same day. Very quickly overwhelmed our system and without mutual aid resources and staffing back stations with off-duty personnel, outcome would have been much different.

  12. Monday, Oct. 23, 2017 • S. Riverview Wildland Fire and Sterling Ranch Structure Fire • 22 minutes apart • Delayed response to Structure Fire due to Wildland Fire. • Wildland Fire left understaffed because of lack of resources to handle both incidents. One employee injury on structure fire. • Injured employee • Knee injury

  13. Sunday July 8, 2018 • Topaz Lake, Masonic Dr., Wildland/Structure Fire • E4 arrived to find a wildland fire that had extended into a structure. USFS E621 arrived shortly after and made a wildland fire attack while E4 made a Structure fire attack. Both units ran out of water with no nearby water source and waited approx. 8-10 minutes until Tender 5 arrived. • Second due (career) resources were R14 with 2 personnel and B12 and T12 approx 15 minutes later due to 7 and 14 being committed to another incident. • Another significant incident at same time in town and station 7 and 14 units committed to that. • Delayed 2nd due resources • 2 calls simultaneously that quickly overwhelmed our system. • 3-4 additional personnel per day could have made a significant difference • Fortunately, no injuries

  14. Staffing Request Timeline

  15. PMP Evaluation – 3% concession by association During the recession in 2007-2011, discussions were taking place to address the future needs for increased staffing, not only from a safety standpoint, but for geographic reasons and call trends. The Association gave voluntary concessions during negotiations in their Evaluation System (PMP) of 3%, in good faith, in order to help plan for these future needs.

  16. Standards of Cover 2012 Assumptions Stable population growth Building permits for Douglas County doubled in 2013 over 2012, and tripled and nearly tripled in 2014 over 2012 respectively.

  17. 2012 SOC assumptions Stable participation of volunteers at 2011 Levels Call volume steady with +/- 3% annual changes 8,399 (2018 trending, see Spillman)

  18. “A 12% increase in call volume has been realized since the last Standard of Cover was developed.” 2017 SOC, pg. 51 Call Volume 8,399 (2018 trending, see Spillman)

  19. Spillman – YTD Call Comparison 2016-18 8/9/2018 is week 32. Average calls per week 161.5. 2018 on-trend for 8,399 calls

  20. Standards of Cover 2012, page 132. • #12. "The Districts should strive for a minimum daily staffing of 3 personnel on each of the following fire engines: E-7, E-12, E-14." • Standards of Cover 2012, Page 133, Additional Recommendations from District Chief: • "The efficiency of a three-person engine company is well documented. While four-person companies are the obvious preference, the financial consideration make that an impractical option for most agencies within the region and certainty here in East Fork. Three-person engine companies within the East Fork Fire and Paramedic District must continue to be a priority objective when funding becomes available."

  21. 2016 East Fork Staffing, 2017 SOC, pg. 50 “A comparison of on-duty firefighters to our jurisdictional population, East Fork has 0.53 personnel per 1,000 residents…The national median is 1.34 and the western states regional median is 0.85 firefighters per 1,000 residents.”

  22. 2012 SOC • Pg.5 • 57 line members • 94 volunteers across 14 stations • UP to 22 career personnel, including seasonal firefighters on duty each day • 7 stations all volunteer staffed • 2 stations combination staffed • 3 career staff only • 2 stations house reserve apparatus • Pg. 115 Recommendations • Develop Station 6 to provide service to airport, commercial centers and residential areas at the back of Johnson Lane not currently met by an 8-minute response time frame.

  23. Staffing: “a Priority”2017 SOC, pg. 86 When funding is available, 3 additional Firefighters/A-EMT should be assigned to Engine 7 Following the assignment to Engine 7…establish Rescue 12 as a 40-hour Rescue ambulance with sworn firefighters assigned to it To allow a phased-in approach with available funding, hire two additional firefighters to staff this resource seven days a week Once funding is found for six personnel, move the Rescue to a 24-hour resource

  24. Workforce Development2017 SOC, pg. 94 • “The East Fork Fire Protection District will attempt to establish an environment and competitive compensation package with a focus on recruitment and retention of staff… • …Our data and the various standards being considered reinforce the need for additional staffing. In priority the district should consider the following: • Provide 3 additional personnel to complete three person engine staffing • Establish a “day car” to provide a fourth ambulance on a 40-hour week • Expand the “day car” to a 24-hour resource: Estimated cost”

  25. Forced Shifts in hours Aaron Harvey: 408 Cameron Farmer: 406.5 Andrew Chrzanowski: 398 Aaron Leising: 384 2018 YTD 155 408 (8,097.5 YTD) Average 1,156.79 Forced Overtime hours per month

  26. Forces requiring Firefighters to work 96 hours or more, July 2017-July 2018 96 hrs (4 days) straight;183 times 120 hrs (5 days) straight;20 times 144 hrs (6 days) straight;5 times 168 hrs (7 days) straight;3 times 192 hrs (8 days) straight;3 times 288 hrs (12 days) straight;1 time 21,336 Total Hours 215 times -This only includes the Firefighter rank, not the engineers or captains who were also forced 96 hrs or more on multiple occasions. -This doesn’t include any of the several 72-hour forces at the firefighter rank -This also doesn’t include any the voluntary OT shifts or ESTAFF shifts firefighters were doing in order to avoid or reduce the number of times they were looking at being forced.

  27. Cancelled Vacation Leave July 2018 July 1 – 1 Personnel July 3 – 2 Personnel

  28. Spillman – Ambulance Response Times 2012 2018 Pre-Dispatch : From address accept to first unit enroute or first unit on scene (whichever comes first) Travel : From first unit enroute to first unit on scene Response : From address accept to first unit on scene At scene : From first unit on scene to call cleared Total : From address accept to call cleared **:**:** : Not possible to calculate time (No Radio log) (N) : Number of calls considered in calculating Avg

  29. Spillman – Ambulance Response Times – 2018

  30. Average Ambulance Response TimesPending Spillman Data.Anecdotally, it’s been noted by engine crews that ambulances on-scene times are getting more frequently delayed because they’re busy on other calls or out of place returning from other calls.

  31. SAFER Grant proposalCarlini Staffing Letter May 2016 October 1, 2016 – April 12, 2017 2.65 shifts with OT or Forced OT October 1, 2017 to April 12, 2018 4.22 shifts per day with OT or Forced OT 3 positions for Engine 7 to bring the District up to minimum staffing requirements, as defined by the 2012 and 2017 Standards of cover 2 positions for a 40-hour ambulance to alleviate UHU’s for existing Rescues “We are dealing with averages…we will have certain periods of time whereby we may still be filling 3 to 4 positions a day. We can only hope that we will not have as many long-term vacancies due to injury of any type or kind.” In addition: 3 positions to be assigned “above minimum staffing for Spring 2019 as suitcase positions”…”contingent that we are meeting our revenue projections at mid-year”

  32. Non-SAFER Grant proposalCarlini Staffing Letter May 2016 3 positions for Engine 7 to bring the District up to minimum staffing requirements, as defined by the 2012 and 2017 Standards of Cover for the Fall Academy - or- To be used as “suitcase personnel”…necessary over the additional firefighter on Engine 7 due to financial constraints of the District that stress that the additional overtime is causing on staff…we would consider a SAFER application the following year.” “Proposing to hire a second Fire Inspector at mid-year, once again, pending mid-year revenue status.”

  33. FY 17-18Final FY17/18 approved May 2017 OT = $1,058,500Actual amended FY17/18 budget approved May 22, 2018 OT $2,107,478Augmented OT between March and May 2018 = $233,664 Overtime Budget Augmentation Patterns FY 16-17FY16/17 budget (original) OT $814,753Actual amended FY16/17 final $1,630,664 FY 18-19FY18/19 approved OT = $1,405,000If FY18/19 is on trend with FY16/17 and FY17/18, OT costs will exceed $2.8 M

  34. Final Budget Presentation FY 18/19Chief Carlini presentation to Fire Board, May 22, 2018 FY 18/19 Projected ending fund balance = 18.2% ($2,661,645)

  35. Minimum Staffing Cost Savings vs. OT Estimate 1 position per day: $350,000 - $375,000 per year

  36. Apparatus UHU’s January 2017 – April 2017 Engine 4 - 2% Engine 7 - 8% Engine 12 - 6% Engine 14 - 9% Rescue 7 - 19% Rescue 14 - 25% Rescue 107 - 21%

  37. Apparatus UHU’s

  38. Over-hire information March 20, 2018 Fire Board Meeting Minutes: Motion to approve to allow the District’s administration to over-hire full time firefighter/medic positions as necessary up to 3 positions to fill actual and potential staff vacancies related to employee separations either voluntary or due to hiring impacts of other agencies. Approved unanimously, hired one person out of three. That person left after three weeks to go to Truckee Meadows.

  39. NFPA 1710 vs. EFPD - 2012 East Fork Minimum Personnel Recommendations, SOC 2012 NFPA Standard 1710 guidelines for 2,000 sq. ft. residential structure fire

  40. Summary: Our situation today is dangerous to both our public and our employees, pushing personnel to unsafe exhaustion and fatigue levels causing injuries including life threatening cardiac emergency. We’ve experienced a 12% increase in call volume between 2012 and 2017. The 2017 SOC document outlined a 40-hour ambulance as a last resort option to help staff a part time rescue if revenues weren’t adequate. The 3% concession made in 2011, and the $3.5M FY18/19 budget augmentation provides sustainable funding for necessary staff positions as well as keeping an acceptable end fund balance.

  41. 2010 Nevada CodeTITLE 23 PUBLIC OFFICERS AND EMPLOYEESChapter 288 Relations Between Governments and Public EmployeesNRS 288.150 Negotiations by employer with recognized employee organization: Subjects of mandatory bargaining; matters reserved to employer without negotiation. 3. Those subject matters which are not within the scope of mandatory bargaining and which are reserved to the local government employer without negotiation include: (c) The right to determine: (1) Appropriate staffing levels and work performance standards, except for safety considerations

  42. 2010 Nevada CodeTITLE 23 PUBLIC OFFICERS AND EMPLOYEESChapter 288 Relations Between Governments and Public EmployeesNRS 288.150 Negotiations by employer with recognized employee organization: Subjects of mandatory bargaining; matters reserved to employer without negotiation. 2. The scope of mandatory bargaining is limited to: (r) Safety of the employee.

  43. 2010 Nevada CodeTITLE 23 PUBLIC OFFICERS AND EMPLOYEESChapter 288 Relations Between Governments and Public EmployeesNRS 288.150 Negotiations by employer with recognized employee organization: Subjects of mandatory bargaining; matters reserved to employer without negotiation. (3) The quality and quantity of services to be offered to the public; and (d) Safety of the public

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