How little Placentia broke a fire powerhouse’s back

Burly men packed the room, arms folded across their barrel chests. There wasn’t enough space for them all. Hundreds spilled into overflow rooms.

Dangerous. Destined to fail. Deceitful. Horrific mistake. 

One after another, firefighters and their union reps paraded to the microphone, trying to scare the bejeezus out of the mild-mannered councilfolk of little Placentia.

Risky gamble with people’s lives. Half-baked. Untested. Extreme.

It was 2019 and the wee city was contemplating the unthinkable — being the first to pull out of the regional (and very expensive!) Orange County Fire Authority (with its state-of-the-art water-dropping helicopters and bulldozers and hazmat equipment and swift water boats) to form its own “Fire and Life Safety Department.”

But it wasn’t just that. Placentia would do the even more unthinkable: Cleave firefighting duties from emergency medical duties.

No more (very expensive!) firefighters who are also paramedics at every call. No more 25-ton fire trucks arriving beside ambulances for routine medical mishaps. No more fire trucks and their (constant-staffing as per union contract) four-man crews accompanying those ambulances to the hospital and waiting (“wall time”) until the patient is taken by the E.R. before returning to service.

In Placentia’s proposed revolutionary setup (which is really only revolutionary in Orange and Los Angeles counties), firefighters would do the firefighting and a private ambulance company would do the emergency medical/paramedic/lifesaving.

To the old guard in that room that night, this was Armageddon. The crack that could bring down the entire dam. It had to be stopped.

“A Placentia Police Department officer, God forbid, gets shot on these streets — I tell you right now they’ll be the first ones, as they’re bleeding out, wishing OCFA was en route, not a new fire department with volunteers,” Frank Lima of the International Association of Fire Fighters told the city council. “This dangerous decision is going to put somebody standing in front of a church at a funeral and you will own it. This vote’s going to follow you and we’ll make sure of that.”

And so it went. For hours. “Your consultants are selling you snake oil. You can’t get more with less. Your consultants — I’m going to tell you right to your face,” snarled Brian Rice, president of California Professional Firefighters, searching the audience for them. “If one member, whether they’re OCFA or one of these volunteers, gets injured, I’m going to come back and I’m going to sue your ass for everything you’ve got.”

We recall thinking that Placentia was, indeed, a bit crazy at the time. Providing services regionally is, at least theoretically, the more efficient way to go.

But these are fire services we’re talking about. Unions and management have agreed to staff up to handle extreme scenarios, despite their rarity, resulting in some crazy costs.

To wit: A Los Angeles city firefighter made more than $500,000 in overtime alone last year. An Alameda County firefighter made more than $400,000 in overtime alone. An Orange County Fire Authority firefighter made more than $290,000 in overtime alone. Surely, there has to be a better way.

Understand that little Placentia – population of approximately 52,000 – has teetered on the brink of bankruptcy. Its OCFA bill jumped a stunning 47% over a decade, for zero extra personnel or services. Its general fund budget increased only 12% over that time, and its police department budget was sliced 9% to help make way for the increased costs.

Craig Green was a city councilmember that fateful night. He gazed out the giant picture windows of the trendy Golden State Coffee Roasters in the heart of Old Town and grinned. “No dead bodies in the streets,” he said.

Four years later, the results of Placentia’s “half-baked,” “dangerous,” “reckless” experiment are in. And they may be the old guard’s worst nightmare.

Costly and outdated

City Administrator Damien Arrula was the rudder that kept the ship steady through stormy waters. Young, energetic, plain-spoken and well-versed in economic development and management analytics, he fought back at the fear-mongering and intimidation. He laid out painstakingly detailed, data-driven analyses of the city’s actual emergency needs and how they could be met with improved safety for less money.

” ‘Unproven,’ ‘untested,’ ‘half-baked’ — these claims are false, absolutely false,” Arrula told the city councilmembers.

In fact, 56 out of California’s 58 counties already provide 911 advanced life support with private paramedic services providers. That includes nearby Riverside, San Bernardino, Ventura and San Diego counties.

“This is not only the primary model in California, but throughout most of the U.S.,” he said. “Only two counties in California do not currently use private 911 ALS paramedic services – Orange and Los Angeles.”

The city’s consultants did an enlightening “workload analysis” examining OCFA data. They found that:

• Placentia averaged 7.1 emergency medical calls per day, and 2 calls for other emergencies, for a total of 9.1 calls.

• That means nearly 80% of those 911 calls — 4 out of 5  — were for medical, not fire.

• Only 0.8% of calls were for structure fires, and only 8 of those had losses exceeding $20,000.

• 90% of calls were handled with one engine.

• The average call duration was 23.2 minutes, with 6 to 8 minutes of response time.

• The actual workload of an on-duty firefighter was 3.9 hours per 24-hour work period.

And despite all the chatter about how deadly a “volunteer” fire department would be, Arrula said Placentia’s new Fire and Life Safety Department would be a professional operation with professional firefighters and reserves who could help in a pinch. It would have two trucks in the city, just as OCFA did, each staffed with three rather than four firefighters. It would have two Lynch EMS ambulances carrying four trained and licensed paramedics on duty 24/7, an increase in lifesaving personnel.

OCFA’s service and firefighters are great, the city council concluded. But its model is costly and outdated. Despite intimidation and outright threats — mutual aid might be withheld by surrounding fire departments during a big emergency — the council decided that a local department controlled directly by the city would better meet its residents’ needs. Its goals were to reduce response time, improve fire prevention and improve quality of emergency medical care.

Four years down the road, the numbers speak for themselves. According to Placentia:

• Under OCFA, the response time for fire calls was 9 minutes and 30 seconds.

• Under Placentia’s new fire department, that shrank to 6 minutes and 21 seconds.

• Under OCFA, the response time for emergency medical calls was 9 minutes and 30 seconds.

• Under Lynch EMS, that shrank to 4 minutes and 48 seconds.

• Among cardiac arrest patients in Placentia, Lynch paramedics were able to restore a pulse 58.8% of the time in 2021-22 and 54.2% of the time in 2022-23 — more than twice the national averages.

On the fiscal front, this improved performance has saved the city more than $1 million each year over what it would have paid OCFA — savings that’s expected to average out to $3 million a year over the next decade as OCFA costs continue to rise. That’s real money over the long haul: more than $30 million saved by 2032, and close to $60 million saved by 2038, according to Placentia’s projections.

And overtime? The firefighter with the most overtime pay in Placentia earned just shy of $51,000 in OT — a fraction of what the top OT earners rake in at other agencies.

“It’s been an amazing few years,” an almost-astonished Walt Lynch of Lynch EMS told the city council earlier this month. “If you asked me back then if I’d be sharing this with you today, I’m not sure I would have said yes.”

Councilmember Rhonda Shader was mayor that night back in 2019, retaining poise in the onslaught of threats. “The nimbleness of this model, it’s turning out to be more than we hoped for,” she said.

Arrula was vindicated. “This is really amazing work when you talk about fundamentally saving lives,” he said. “Really unprecedented.”

Change

So what do all the purveyors of doom have to say about all this?

We reached out to several unions and union reps who had warned of death and destruction. No one was chatty on the record, but there was suspicion about the veracity of Placentia’s data.

Predictions that Placentia would be so weak it would need constant backup from surrounding agencies? The 2021 data showed 128 mutual aid calls into Placentia under the new department, versus 806 under OCFA in 2019. (It responded to 104 mutual aid calls in 2021 versus 457 in 2019; Placentia is now called upon less by its neighbors. A snub?)

In an emailed statement, OCFA said this:

“The OCFA recognizes that there are a few jurisdictions in the state that utilize a non-fire-based EMS delivery systems due to their budgetary constraints. OCFA is fortunate and proud that our leadership supports a robust and proven Fire & EMS system that puts two firefighter/paramedics (along with two additional firefighters) to the side of our patients with speed, efficiency, competence, and care.”

The takeaway here is that there are other, more economical and efficient ways to deliver emergency services, but that the forces working against change are enormous. The old guard tried hard to thwart Placentia, asking surrounding cities not to enter into mutual aid agreements to help in emergencies, asking other agencies not to bid on Placentia’s fire and life safety contracts, threatening the city with lawsuits.

But change arrived nonetheless in Placentia, and it’s coming for everyone else.

“The DNA of fire departments is to respond to EVERYTHING and help EVERY TIME,” says a white paper called “21st Century Fire and Rescue,” co-chaired by retired Anaheim Fire Chief Randy Bruegman.

“While fires may be diminishing due to better engineering, codes and enforcement along with an increased focus on community risk reduction activities, calls for service are up for every department. These calls are for help, and the calls received today are much broader in scope. The services required often fall outside the traditional scope of fire and emergency services.”

Bruegman sees real opportunity here to deploy resources differently and more effectively, as has been done in Anaheim: sending nurse practitioners or behavioral health workers or community paramedics when that makes sense, rather than running four people on a 50,000-pound fire apparatus to everything.

“We need to look at what our statistics and data are telling us: Our demand for fire and rescue calls have gone down over the last 30 years, but call volume has skyrocketed,” he said. “It’s about how we address those calls in the most efficient and effective manner.”

As technology improves, precision will increase: Soon our wearable fitness devices will be able to transmit medical information to dispatch centers. Cars will alert first responders to traffic accidents. Smart buildings will send data instantaneously on emergencies.

“That’s going to change the way we do business in the future,” said Bruegman, president and founder of the Leadership Crucible Foundation. “There’s going to be a need for fire suppression, response and rescue for many, many years to come, maybe forever, but I think it will become a small component of our overall system.”

Many folks in Placentia agree. According to its most recent audit, the city that once teetered on the bankruptcy abyss had a 17% cushion for its general fund (for you numbers types, that’s a $7.2 million unassigned fund balance, compared to expenses of $42.1 million).

Back in 2012, that fund balance was in negative territory.

Green, the former city councilman who was on the dais when the decision was made back in 2019, had served on the OCFA board of directors and has great respect for the agency. “But Placentia doesn’t need helicopters. Placentia doesn’t need bulldozers,” he said. “We wanted our city to be fiscally sustainable, and now it is. We wanted to do this — and lo and behold, it works.”

Source: Orange County Register