04-30-18 EMS Agenda and Materials' CITY COUNCIL
EMS SUBCOMMITTEE
AGENDA
K7uzA
Monday, April 30,2018, at 6:00 p.m.
CityHall Council Chambers, 201 First Avenue East
A. CALL TO ORDER
B. DISCUSSION ITEMS
1. Review Draft EMS Report
C. PUBLIC COMMENT
Persons wishing to address the council are asked to do so at this time. Those addressing
the council are requested to give their name and address for the record. Please limit
comments to three minutes.
D. ADJOURNMENT
Page 1 of 1
MONTANA
City of Kalispell
Post Office Box 1997 - Kalispell, Montana.
59903
Telephone: (406) 758-7701 Fax: (406) 758-7758
MEMORANDUM
To: EMS Subcommittee
From: Doug Russell, City Manager
Re: Review of Draft EMS Report
Meeting Date: April 30, 2018
BACKGROUND: Earlier this fiscal year, council engaged the services of the Center for Public
Safety Management to review EMS operations and our service delivery model. Attached is their
draft report. At the EMS Subcommittee meeting, we will review the draft report, discuss
potential factual changes that need to be made in the report, and discuss a timeline for holding a
worksession with the full Council (pending completion of the final report by CPSM).
ATTACHMENTS: Draft EMS Report
EMS and FIRE
SERVICES ANALYSIS
Kalispell, Montana
DRAFT: March, 2018
CPSM (D
CENTER FOR PUBLIC SAFETY MANAGEMENT, LLC
475 K STREET NW, STE. 702 • WASHINGTON, DC 20001
WWW.CPSM.US • 716-969-1360
ICE MA
Exclusive Provider of Public Safety Technical Services for
International City/County Management Association
THE ASSOCIATION &THE COMPANY
The International City/County Management Association (ICMA) is a 100-year-old, nonprofit
professional association of local government administrators and managers, with approximately
9,000 members spanning thirty-two countries.
Since its inception in 1914, ICMA has been dedicated to assisting local governments in providing
services to their citizens in an efficient and effective manner. Our work spans all the activities of
local government — parks, libraries, recreation, public works, economic development, code
enforcement, Brownfields, public safety, etc.
ICMA advances the knowledge of local government best practices across a wide range of
platforms including publications, research, training, and technical assistance. Its work includes
both domestic and international activities in partnership with local, state, and federal
governments as well as private foundations. For example, it is involved in a major library research
project funded by the Bill and Melinda Gates Foundation and is providing community policing
training in Panama working with the U.S. State Department. It has personnel in Afghanistan
assisting with building wastewater treatment plants and has had teams in Central America
providing training in disaster relief working with SOUTHCOM.
The ICMA Center for Public Safety Management (ICMA/CPSM) was one of four Centers within
the Information and Assistance Division of ICMA providing support to local governments in the
areas of police, fire, EMS, emergency management, and homeland security. In addition to
providing technical assistance in these areas we also represent local governments at the federal
level and are involved in numerous projects with the Department of Justice and the Department
of Homeland Security. In each of these Centers, ICMA has selected to partner with nationally
recognized individuals or companies to provide services that ICMA has previously provided
directly. Doing so will provide a higher level of services, greater flexibility, and reduced costs in
meeting members' needs as ICMA will be expanding the services that it can offer to local
governments. For example, The Center for Productivity Management (CPM) is now working
exclusively with SAS, one of the world's leaders in data management and analysis. And the
Center for Strategic Management (CSM) is now partnering with nationally recognized experts
and academics in local government management and finance.
Center for Public Safety Management, LLC (CPSM) is now the exclusive provider of public safety
technical assistance for ICMA. CPSM provides training and research for the Association's
members and represents ICMA in its dealings with the federal government and other public
safety professional associations such as CALEA. The Center for Public Safety Management, LLC
maintains the same team of individuals performing the same level of service that it has for the
past seven years for ICMA.
CPSM's local government technical assistance experience includes workload and deployment
analysis using our unique methodology and subject matter experts to examine department
organizational structure and culture, identify workload and staffing needs, and identify and
disseminate industry best practices. We have conducted more than 269 such studies in 37 states
and 204 communities ranging in size from 8,000 population (Boone, Iowa) to 800,000 population
(Indianapolis, Ind.).
Thomas Wieczorek is the Director of the Center for Public Safety Management. Leonard
Matarese serves as the Director of Research & Program Development. Dr. Dov Chelst is the
Director of Quantitative Analysis.
Center for Public Safety
Management Project Contributors
Thomas J. Wieczorek, Director
Leonard A. Matarese, Managing Partner
Dov Chelst, Ph.D. Director of Quantitative Analysis
Joseph E. Pozzo, Senior Manager -Fire and EMS
Peter J. Finley, Jr., Senior Associate
Gerry Hoetmer, Senior Associate
Sarah Weadon, Senior Data Analyst
Ryan Johnson, Data Analyst
Dennis Kouba, Senior Editor
CPSACenter for Public Safety Management, LLC
CONTENTS
Tables............................................................................................................................. v
Figures.......................................................................................................................... vii
Section1. Introduction..................................................................................................1
Section 2. Scope of Project..........................................................................................2
Section 3. Organization and Management................................................................3
Governance and Administration....
3
KalispellFire Department.............................................................................................................................3
Kalispell Emergency Medical Services......................................................................................................6
Section 4. Community Risk Analysis............................................................................ 9
Tourism...........................................................................................................................................................13
HousingStock...............................................................................................................................................13
TargetHazards.............................................................................................................................................18
CallDemand............................................................................................................................................22
HazardousMaterials...............................................................................................................................25
FirePreplanning.......................................................................................................................................26
Section 5. Operational Response Approaches........................................................28
FireResponse...............................................................................................................................................28
EMS Response and Transport.......
Mutual Aid/Automatic Response
Workload Analysis
.32
.37
.40
Section 6. Response Time Analysis............................................................................47
Measuring Response Times ...............
Station Locations ................................
Kalispell Response Times ...................
.47
.50
.56
Section 7. Budget and EMS Revenue........................................................................59
Fire Budget
.....59
AmbulanceFund........................................................................................................................................60
EMSBilling......................................................................................................................................................61
Section 8. EMS Sustainability......................................................................................66
Staffing and Deployment of Fire and EMS Departments....................................................................66
Current state of the Fire and EMS system...............................................................................................72
Alternatives for a Sustainable EMS System.............................................................................................74
1. Maintain the Status Quo....................................................................................................................74
2. Private For -profit Model.....................................................................................................................75
3. Third -Service Model............................................................................................................................76
Section9. Data Analysis.............................................................................................19
Methodology...........................................................................................................................................19
Aggregate Call Totals and Runs..............................................................................................................80
Callsby Type............................................................................................................................................80
Callsby Type and Duration...................................................................................................................53
Average Calls per Day and per Hour.................................................................................................75
UnitsDispatched to Calls.......................................................................................................................97
Workload: Runs and Total Time Spent..................................................................................................
119
Runs and Deployed Time - All Units..................................................................................................
119
Workloadby Unit..................................................................................................................................
142
Analysisof Busiest Hours..........................................................................................................................
164
ResponseTime..........................................................................................................................................
186
ResponseTime by Type of Call..........................................................................................................
186
ResponseTime by Hour.......................................................................................................................
100
Response Time Distribution.................................................................................................................
242
TransportCall Analysis.............................................................................................................................
286
TransportCalls by Type.......................................................................................................................
286
Average Transport Calls per Hour.....................................................................................................
297
Callsby Type and Duration................................................................................................................
319
Transport Time Components............................................................................................................
3210
AttachmentI.............................................................................................................................................
331
AttachmentII............................................................................................................................................
342
AttachmentIII...........................................................................................................................................
353
TABLES
TABLE 4-1 : Age Profile of Housing Stock......................................................................................................13
TABLE 4-2: Building Permits by Building Type, 2012-2017..........................................................................15
TABLE 4-3: Sprinkler Status of High- to Mid -occupancy Buildings...........................................................20
TABLE 5-1 : Fire Calls by Type and Number, and Percent of All Calls.....................................................31
TABLE 5-2: Fire Calls by Type and Durations...............................................................................................31
TABLE 5-3: Fire Calls by Number of Units Responding...............................................................................32
TABLE 5-4: EMS Calls by Type and Number, and Percent of All Calls....................................................33
TABLE 5-5: Duration of EMS Responses........................................................................................................34
TABLE 5-6: Transport Calls by Call Type.......................................................................................................35
TABLE 5-7: Transport Call Duration by Call Type........................................................................................36
TABLE 5-8: Time Component Analysis for Ambulance Transport Runs by Call Type (in Minutes) .....
37
TABLE 5-9: Calls by Type, and Number, and Percent...............................................................................40
TABLE 5-10: Calls by Call Type and Number of Units Dispatched..........................................................42
TABLE 5-1 1 : Content and Property Loss - Structure and Outside Fires..................................................43
TABLE 5-12: Total Fire Loss Above and Below $20,000..............................................................................43
TABLE 5-13: Frequency Distribution of the Number of Calls....................................................................44
TABLE 5-14: Frequency of Overlapping Calls.............................................................................................44
TABLE 5-15: Call Workload by Unit................................................................................................................45
TABLE 6-1 : Average Response Time of First Arriving Unit, by Call Type..................................................57
TABLE 6-2: 90th Percentile Response Times of First Arriving Unit, by Call Type.....................................58
TABLE 7-1 : Kalispell FY 2016-2017 EMS Transport Payer Mix......................................................................62
TABLE 7-2: Kalispell EMS Transport Base Fee Schedule.............................................................................64
TABLE 7-3: Medicare and Medicaid Billing Examples...............................................................................65
TABLE 8-1 : KFD Staffing/Deployment Matrix...............................................................................................70
TABLE9-1 : Call Types.......................................................................................................................................80
TABLE 9-2: Calls by Type and Duration........................................................................................................53
TABLE 9-3: Calls by Call Type and Number of Units Dispatched.........................................................
108
TABLE 9-4: Annual Runs and Deployed Time by Run Type...................................................................
119
TABLE 9-5: Average Deployed Minutes by Hour of Day.......................................................................
131
TABLE 9-6: Call Workload by Unit...............................................................................................................
142
TABLE 9-7: Total Annual Runs by Run Type and Unit..............................................................................
142
TABLE 9-8: Daily Average Deployed Minutes by Run Type and Unit ..................................................
153
TABLE 9-9: Frequency Distribution of the Number of Calls....................................................................
164
TABLE 9-10: Frequency of Overlapping Calls..........................................................................................
164
TABLE 9-1 1 : Station Availability to Respond to Calls..............................................................................
164
TABLE 9-12: Top 10 Hours with the Most Calls Received.......................................................................
175
TABLE 9-13: Average Response Time of First Arriving Unit, by Call Type (Minutes) ...........................
197
TABLE 9-14: 90th Percentile Response Time of First Arriving Unit, by Call Type (Minutes) ................
208
TABLE 9-15: Average and 90th Percentile Response Time of First Arriving Unit, by Hour of Day...
100
TABLE 9-16: Cumulative Distribution of Response Time - First Arriving Unit - EMS ............................. 253
TABLE 9-17: Cumulative Distribution of Response Time - First Arriving Unit - Outside and Structure
Fires.................................................................................................................................................................. 275
TABLE 9-18: Transport Calls by Call Type.................................................................................................. 286
TABLE 9-19: Transport Calls per Day, by Hour.......................................................................................... 297
TABLE 9-20: Transport Call Duration by Call Type................................................................................... 319
TABLE 9-21 : Time Component Analysis for Ambulance Transport Runs by Call Type (in Minutes)
....................................................................................................................................................................... 3210
TABLE 9-22: Actions Taken Analysis for Structure and Outside Fire Calls ............................................ 331
TABLE 9-23: Workload of Administrative Units.......................................................................................... 342
TABLE 9-24: Content and Property Loss - Structure and Outside Fires ............................................... 353
TABLE 9-25: Total Fire Loss Above and Below $20,000........................................................................... 353
FIGURES
FIGURE 3-1 : KFD Table of Organization.........................................................................................................5
FIGURE 3-2: Kalispell Fire Department Response Area (in Red)................................................................6
FIGURE 3-3: KFD EMS Response Area Map...................................................................................................8
FIGURE 4-1 : Kalispell Population per Square Mile......................................................................................10
FIGURE 4-2: Age 65 and Older Population per Square Mile...................................................................1
1
FIGURE 4-3: Age 5 and Under Population per Square Mile.....................................................................12
FIGURE 4-4: Building Permits by Year, 2006-2017.......................................................................................14
FIGURE 4-5: Residential Construction, 2000-2017.......................................................................................16
FIGURE 4-6: Nonresidential Construction, 2000-2017................................................................................17
FIGURE 4-7: Medium- and High -risk Target Hazards..................................................................................19
FIGURE 4-8: High -hazard Occupancies with KFD Travel Times...............................................................22
FIGURE4-9: EMS Call Demand......................................................................................................................23
FIGURE 4-10: Fire Call Demand.....................................................................................................................24
FIGURE 5-1 : Fire Calls by Type and Percentage........................................................................................30
FIGURE 5-2: Cardiac Arrest Survival Timeline..............................................................................................32
FIGURE 5-3: EMS Calls by Type and Percentage.......................................................................................34
FIGURE 5-4: KFD and Automatic/Mutual Aid Partner Station Locations...............................................39
FIGURE 5-5: Calls by Number of Units Dispatched....................................................................................41
FIGURE 5-6: Total Incidents and Percentage Each Station First Due Area...........................................46
FIGURE 6-1 : Fire Growth from Inception to Flashover...............................................................................48
FIGURE 6-2: Fire Propagation Curve............................................................................................................49
FIGURE 6-3: Sudden Cardiac Arrest Chain of Survival..............................................................................49
FIGURE 6-4: 240-second Travel Time from Kalispell Fire Stations.............................................................52
FIGURE 6-5: 360-second Travel Time from Kalispell Fire Stations.............................................................53
FIGURE 6-6: 480-second Travel Time from Kalispell Fire Stations.............................................................54
FIGURE 6-7: 240-, 360-, 480-, and 600-second Travel Times from KFD Stations.....................................55
FIGURE 7-1 : Ambulance Fund Transfer........................................................................................................60
FIGURE 7-2: FY 2016-2017 Kalispell EMS Transport Payer Mix by Percentage.......................................63
FIGURE 7-3: EMS Transport Billing Charges and Credits............................................................................63
FIGURE 8-1 : Staffing and Deploying Fire and EMS Departments...........................................................67
FIGURE 8-2: Average Number of Personnel on Duty Each Day. July 1, 2016 -
December 31, 2017
............................................................................................................................................................................
71
FIGURE 9-1 : EMS and Fire Calls by Type.......................................................................................................31
FIGURE 9-2: Average Calls per Day, by Month..........................................................................................75
FIGURE 9-3: Calls by Hour of Day..................................................................................................................86
FIGURE 9-4: Calls by Number of Units Dispatched....................................................................................97
FIGURE 9-5: Average Deployed Minutes by Hour of Day........................................................................90
FIGURE 9-6: Average Response Time of First Arriving Unit, by Call Type - EMS
................................. 197
FIGURE 9-7: Average Response Time of First Arriving Unit, by Call Type - Fire ..................................
208
FIGURE 9-8: Average Response Time of First Arriving Unit, by Hour of Day ........................................ 231
FIGURE 9-9: Cumulative Distribution of Response Time -
First Arriving Unit -
EMS ............................. 242
FIGURE 9-10: Frequency Distribution of Response Time -
First Arriving Unit -
EMS ............................ 253
FIGURE 9-1 1 : Cumulative Distribution of Response Time
- First Arriving Unit
- Outside and Structure
Fires..................................................................................................................................................................
264
FIGURE 9-12: Frequency Distribution of Response Time -
First Arriving Unit -
Outside and Structure
Fires..................................................................................................................................................................
264
FIGURE 9-13: Average Transport Calls per Day, by Hour
CPSM6 Center for Public Safety Management, LLC
19111.2
SECTION 1. INTRODUCTION
CPSM was retained by the City of Kalispell to complete a comprehensive analysis of the city's
emergency medical services, which are a function of the city's fire department. Because the
EMS service is provided through the fire department CPSM included a review of the combined
operational EMS and Fire service delivery model. This analysis is designed to provide the city
with a thorough and unbiased review of its emergency medical services, and to provide a
benchmark of the city's existing fire and EMS service delivery performance and community risk,
as analyzed in the accompanying comprehensive data analysis and community risk assessment.
The Data Analysis and Community Risk Assessment were performed utilizing information provided
by the city and the Kalispell Fire Department (KFD), as well external sources such as the U.S.
Census Bureau. This data analysis provides significant value to the city as it now has a workload
analysis from which to move forward with future planning efforts. Also included in this report is
geographic information systems (GIS) data mapping to support the operational and risk analysis
discussions and recommendations.
During the study, CPSM analyzed performance data provided by the KFD and examined
firsthand the department's fire and EMS operations. Additionally, CPSM spent time interviewing
the fire department's executive secretary, who is responsible for EMS transport billing. To begin
the analysis, project staff asked the city for certain documents, data, and information. The
project staff used this information/data to familiarize themselves with the department's structure,
assets, operations, risk, and EMS billing procedures and revenues. The provided information was
also used in conjunction with the collected raw performance data to determine the existing
performance of the department and to compare that performance to national benchmarks.
These benchmarks have been developed by organizations such as the National Fire Protection
Association (NFPA), Center for Public Safety Excellence, Inc. (CPSE), Vision 20/20, and the ICMA
Center for Performance Measurement. KFD staff was also provided an electronic shared
information folder to upload information for analysis and use by the CPSM project management
staff.
Project staff conducted a site visit on January 3 and 4, 2018, to observe fire department and
agency -connected supportive operations, interviewing key department and city staff, and
reviewing preliminary data, operations, and community risk. Telephone conference calls were
conducted as well as e-mail exchanges between CPSM project management staff, the city,
and the KFD so that CPSM staff could affirm the project scope and elicit further discussion
regarding this operational analysis.
CPSM found the KFD to be a highly skilled and caring organization. The personnel with whom
CPSM interacted are focused on managing all aspects of service delivery to the best of their
abilities. A key focus of CPSM's analysis is providing observations and recommendations linked to
increasing the efficiency and effectiveness of the EMS service delivery model in Kalispell.
This report contains a series of observations and recommendations provided by CPSM that are
focused on delivering services more efficiently, effectively, and in some cases, safer.
Recommendations and considerations for continuous improvement of services are presented
throughout the report. CPSM recognizes there may be recommendations and considerations
offered that must be bargained, budgeted for, or for which processes must be developed prior
to implementing.
SECTION 2. SCOPE OF PROJECT
This report is intended to provide the City of Kalispell with a thorough and unbiased analysis of its
EMS service delivery model. Armed with this analysis, the department and city officials will have
an external perspective regarding the department's Fire and EMS -service delivery system, and
from which they can make more informed decisions regarding what is the most viable and
sustainable fire and EMS system for the city. This study provides a comprehensive operational
analysis of the KFD, the EMS component to include EMS transport billing, and a comprehensive
data response and workload analysis.
Local government officials often attempt to understand if their fire and EMS department is
meeting the service demands of the community, and commission these types of studies to
measure if their department is efficient, effective, and sustainable. In this analysis, CPSM provides
observations and recommendations where appropriate, and provides input on administrative
and operational matters for consideration by the department and the city.
Key aspects of this study include:
A forensic data analysis that has a focus on emergency medical services response types,
response times, time dedicated to hospital transport, peak call load times, and overall
workload of the entire fire and EMS department.
An analysis of the current functional and operational service delivery model for fire and EMS,
accompanied by recommendations on the most viable and sustainable fire and EMS service
delivery model.
A review and analysis of operational guidelines of the fire and emergency medical services -
service delivery system.
A review of current EMS billing processes with recommendations on maximizing EMS billing
revenues.
Provision of information that will enhance the overall efficiency and effectiveness of the fire
and emergency medical services -service delivery system.
SECTION 3. ORGANIZATION AND
MANAGEMENT
GOVERNANCE AND ADMINISTRATION
The City of Kalispell is in Flathead County, which is in the northwestern portion of Montana and is
contiguous with Canada on its northern border. Kalispell was incorporated in 1892; it is in the
south-central portion of Flathead County. Kalispell serves
as the county seat of the county and is the gateway to
Glacier National Park. The city encompasses an area of
just over 11 square miles and had a 2010 census
population of 19,927, which is a 40 percent increase from
the 2000 census.
Kalispell operates under a council-manager form of
government. The City Council is comprised of a Mayor
and eight council members, all of whom are elected on
a nonpartisan basis. The Mayor is elected for a four-year
term, while council members are elected by district to staggered four-year terms, with four
council members elected every two years. The City Manager is appointed by the City Council to
carry -out the governing policies and ordinances established by the council, and to oversee the
day-to-day operations of the city.
Kalispell operates under a traditional organizational chart. The City Manager reports directly to
the City Council, with major functional offices and departments reporting to the City Manager.
The major departments and offices reporting to the City Manager include Police, Fire, Public
Works, Finance, Human Resources, Building Official, Planning and Community Development,
Information Technology, City Clerk, and the City Attorney.
Chapter 9, Article 1, subsection 9-1 of the Kalispell Municipal Code establishes the Fire
Department of the city. Additional subsections of Chapter 9 provide for qualifications of
firefighters, certain disciplinary actions and appeal rights of collective bargaining unit members,
the powers and duties of the Fire Chief and Assistant Fire Chief, as well as operational matters of
the fire department and certain unlawful acts affecting fire department service delivery.
Subsection 9-7-1 establishes false alarm fees for both the fire and police departments.
Emergency Medical Services first response and transport is operated out of and managed by
the Fire Department.
KALISPELL FIRE DEPARTMENT
The Kalispell Fire Department (KFD) is a full -service public safety organization whose stated
mission is "to protect the community with the highest level of professionalism" "which is
accomplished through highly trained firefighters, a focus on community education and
nationally recognized emergency medical skills." The department staffs two fire stations, 24 hours
a day, 7 days a week, with a minimum of six personnel on duty each day.
Station 61, which also serves as the department's administrative headquarters, is located at 312
1 st Avenue, East, in downtown Kalispell. Engine 631, Reserve Engine 631, Medic 621, Engine 681
(Type 6/wildland), Haz Mat trailer 671 along with a state Haz Mat vehicle, and various
administrative, support, and command vehicles, are housed there.
Station 62 is located at 255 Old Reserve Dr. in the northern part of the city. It houses Engine 632,
Ladder 642, Medic 622, Engine 681 (Type 6/wildland), Fire Tender 692, Technical Rescue Trailer
673, and a reserve medic unit. Station 61 normally staffs Engine 631 with three personnel. The
medic unit is not staffed at this station unless city-wide on -duty staffing is at least eight personnel.
Station 62 normally cross -staffs Ladder 642 and Medic 622. If on -duty staffing permits, the reserve
medic unit will be staffed as well. This crew also staffs the other units on an as -needed basis. The
unit or units that respond are based upon the nature of the incident.
As a Montana Class 1 city with a population greater than 10,000, Kalispell is required by state law
to have a career fire department. The use of call or volunteer personnel is not permitted. KFD is
currently budgeted for one nonsworn staff member who serves as the executive secretary, and
31 sworn positions. The department also has a volunteer chaplains program that assists the
department with various tasks. At present, the department is comprised of the following:
Fire Administration, which is the administrative and management branch of the department
where the day-to-day operations of the department are coordinated and managed. This
includes fiscal (including billing for EMS transports), human resources, planning, records
management, fire prevention, and intergovernmental liaison functions.
Fire and Emergency Medical Services, which is the operational branch of the department that
provide emergency response to calls for assistance. In addition to normal fire and emergency
medical responses at the ALS level, the department provides mutual aid to neighboring
jurisdictions and has personnel trained to handle complex technical rescues, ice rescues, and
to support the Kalispell Police Special Response Team. The department is host to the Northwest
Hazardous Materials Response Team. Operations personnel also perform company level
training, fire prevention including company level inspections, fire preplanning, fire hydrant
inspections, and community -based programs.
Figure 3-1 illustrates the organizational chart of the KFD.
FIGURE 3-1: KFD Table of Organization
11111111111L.- J
Fire Chief
Chaplain Program
Volunteers assistant Fire Chief Executive Secretary
AShiRJ
I aShif
CShif
Station 61
Captain
Station 62
Lieutenant
Station 61
Captain
Station 62 J
Lieutenant
Station 61
Captain
Station 62
Lieutenant
Engineer
Engineer J
I EngineerJ
Engineer
I
Engineer J
I Engineer
Firefighter
Firefighter J
I FirefighterJ
Firefighter
I
Firefighter J
Firefighter
Firefighter
Firefighter J
I FirefighterJ
Firefighter J
I
Firefighter
Firefighter
Firefighter
Firefighter J
FirefighterJ
Firefighter J
I
Firefighter
Figure 3-2 illustrates the Kalispell Fire Department's current response area for fires (in red). Due to
annexation of unincorporated county areas into the city there are areas that are part of the city
that are not contiguous to it or are connected by just the center line of the highway. The
challenges of operating with limited staffing levels has prompted the creation of a robust
automatic and mutual aid response system that includes several other communities surrounding
the City of Kalispell. Surrounding communities that provide automatic or mutual aid into the city,
when necessary, include Evergreen (dark yellow), Smith Valley (light yellow), South Kalispell
(orange), and West Valley (light gray).
FIGURE 3-2: Kalispell Fire Department Response Area (in Red)
Kalispell Fire Respons
2017
West Valley.
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KALISPELL EMERGENCY MEDICAL SERVICES
Emergency medical service (EMS) operations are an important component of the
comprehensive emergency services delivery system in any community. Together with the
delivery of police and fire services, it forms the backbone of the community's overall public
safety net. As will be noted in other sections of this report, the KFD, like many, if not most, fire
departments respond to significantly more emergency medical incidents and low acuity
incidents than actual fires or other types of emergency incidents.
The EMS component of the emergency services delivery system is more heavily regulated than
the fire side. In addition to National Fire Protection Association (NFPA) Standard 1710,
Organization and Deployment of Fire Suppression Operations, Emergency Medical Operations,
and Special Operations to the Public by Career Fire Departments (2016 Edition), NFPA 450
Guidelines for Emergency Medical Services (EMS) and Systems, (2009 edition), provides a
template for local stakeholders to evaluate an EMS system and to make improvements based
on that evaluation. The Commission on Accreditation of Ambulance Services (CAAS) also
promulgates standards that are applicable to their accreditation process for ambulance
services. In addition, the State of Montana regulates EMS agencies, and certain federal
Medicare regulations are also applicable.
Emergency medical services (EMS) for the City of
Kalispell are provided at the advanced life support
(ALS)/paramedic level by the KFD. The department
has provided EMS services since 1932, long before
most fire departments expanded their missions to
include this service. It was the first formal EMS service
in the area, and originally provided service throughout
Flathead County. In 1994, the KFD implemented the
current ALS service with a goal of improving patient
outcomes, particularly for critical, life -threatening
emergencies. Prior to the implementation of the ALS service, when the fire department received
a call for a serious medical emergency, the ambulance, or another public safety responder
would respond to the hospital emergency room to pick up a nurse who could provide
advanced care during on -scene treatment and transport. When the ALS service was first
initiated the KFD provided the service to much of Flathead County. In the intervening years, as
more areas have initiated their own service at the paramedic level, the department's primary
response area has been significantly reduced.
Advanced life support or ALS-level care refers to prehospital interventions that can be brought
into the field by paramedics. Typically, this service level includes the ability to bring much of the
emergency room capability to the patient. Paramedics can administer intravenous fluids,
manage a patient's airway, provide drug therapy, utilize the full capabilities of a 12-lead
cardiac monitor, and provide a vital communication link to the medical control physician who
can provide specific medical direction based on the situation.
Of the KFD's current sworn personnel, 22 (70.9 percent) possess paramedic certification. The
remaining 9 are advanced emergency medical technicians, which still allows them to perform
many, but not all, of the advanced life support interventions. If the on -duty level of staffing
permits it, the department could, in theory, staff up to three ALS-capable ambulances. In reality,
the department normally staffs just one each day, a unit that is cross -staffed with the ladder at
Station 62. In other words, when an ambulance call is received the crew responds with the
ambulance, but the ladder truck is then out of service. With all the department's personnel
having advanced EMS training, and the majority being certified as paramedics, the fire
suppression units (engines and ladders) are also equipped with ALS capabilities that allow them
to provide critical lifesaving interventions, when necessary, while awaiting the arrival of an
ambulance transport unit.
I The Commission on Accreditation of Ambulance Services (CAAS) is an independent commission that
established a comprehensive series of standards for the ambulance service industry.
At the time of this assessment, the KFD provided first due EMS service to the entire city, as well as
to the South Kalispell Fire District, which protects unincorporated areas of the county, south of
the city. Figure 3-3 illustrates the areas to which the KFD responds for EMS incidents, as follows:
The light -yellow area designated as K61 _SK is the area of South Kalispell where the
department provides first due, automatic aid for EMS.
The two blue areas designated as K61 _SK_ALERT and KS61 _ALERT are areas where Alert Air
Ambulance provides the first due EMS response due to their remoteness. However, when the
helicopter is unavailable, or unable to fly, then the KFD provides response into the area.
The pink area labeled KS61_LQ is the Lakeside Quick Response Unit area which provides their
own BLS and ALS transport services, but if they are unavailable the KFD provides back-up.
The department also provides mutual aid response to adjoining areas such as Evergreen and
Smith Valley.
FIGURE 3-3: KFD EMS Response Area Map
SECTION 4. COMMUNITY RISK ANALYSIS
A critical aspect of community risk assessment is identifying the community's distinct
demographics and characteristics that impact risk as well as the vulnerability of the population
and property to these risks. Census bureau data, national fire incident reports, city planning
documents, housing survey data and reports, and local hazard maps all provide invaluable
information that help identify and determine the degree of risk a community faces.
The U.S. Census estimates Kalispell's 2016 population to be 22,761, which is a 13.5 percent
increase over 2010. The population growth in Kalispell is in conjunction with the growth of the
surrounding area, which has been growing at a rate of 22 to 25 percent over the past 20 years.
This is an important factor in hazard analysis and community risk planning.
Other data of interest include:
15.4 percent of Kalispell's population is over 65 years of age.
8.4 percent of the population is under the age of 5, and 25.1 percent is under 18.
54.1 percent are in owner -occupied housing.
18.5 percent of the population lives in poverty.
The population density is 1,955.4 people per square mile.
The U.S. Fire Administration, through the National Fire Incident Reporting System (NFIRS) and the
National Fire Protection Association (NFPA), issue annual reports on fire deaths and injuries and
fire losses. Since they were initiated these annual reports have shown that the highest fire death
rates are found to be among African -Americans, lower income groups, the indigent, the elderly
(over 65), the very young (under 5), and those that have less formal education. It is important to
note that almost one -fifth of Kalispell's population (18.5 percent) lives below the poverty line.
The number of people in poverty has increased due to the recent downturn in the economy.
According to the U.S. Census Bureau, the average per capita income in Kalispell is $22,134 and
the median household income is $39,371. The unemployment rate is estimated to be 4.7 percent
of the adult population.
The average number of persons per household is 2.45. In general, residents have a high level of
education (93.8 percent are high school graduates or higher) and speak English as a first
language (98 percent). The rate of movement within the community is relatively low; 82.2
percent of the population has lived in the same house for more than 12 months. Combined,
these factors suggest a relatively low risk/vulnerability for the community.
Figures 4-1, 4-2, and 4-3 show Kalispell's overall population density and the density for those
whose age puts them most at risk (over 65 and under 5 years of age). The highest density of
these two vulnerable groups are in the areas of the city just south of the Core and Rail
Redevelopment Project on both the east and west sides of Route 93 (see Figures 4-2 and 4-3).
2 U.S. Census Bureau, Quick Facts,
https://www.census.gov/qu ickfacts/fact/table/ka lispellcitymontana/PST045216.
3 U.S. Census Bureau, Quick Facts,
https://www.census.gov/qu ickfacts/fact/table/ka lispellcitymontana/PST045216.
4 U.S. Census Bureau, 2008-2012 American Community Survey.
5 U.S. Census Bureau, Quick Facts,
https://www.census.gov/qu ickfacts/fact/table/ka lispellcitymontana/PST045216.
Another section of high density of those persons over age 65 is around the medical/hospital
complex just north of city center and which is known locally as "pill hill."
FIGURE 4-1: Kalispell Population per Square Mile
KFD Station
Population per S
(2015 estimate)
< 150
<_ 600
<_ 1,050
<_ 2,075
5 2,800
<_ 3,700
<_6,957
IN
CPSACenter for Public Safety Management, LLC 10
FIGURE 4-2: Age 65 and Older Population per Square Mile
• KFD Station
Population Aged 65 and Older
per Sq. Mi.
(2015 estimate)
<_ 20
<_ 75
<_ 225 0
<_ 400 2
<_ 725
<_ 1,265
62,jj
U
El
A
t
h
93
61
n
0
CPSACenter for Public Safety Management, LLC 11
FIGURE 4-3: Age 5 and Under Population per Square Mile
KFD Station
Population Under 5
per Sq. Mi.
(2015 estimate)
_< 10
<_ 55
<_100
<_ 200
390
514
IS
CPSACenter for Public Safety Management, LLC 12
TOURISM
Kalispell has a significant and thriving tourism sector, particularly in the summer. There are an
estimated 1,785 hotel and motel beds in the city of Kalispell. A new 100-room Country Inn &
Suites by Radisson is scheduled to open in the summer of 2018.
In 2017, an estimated 803,000 nonresident visitors spent at least one night in Kalispell, and 2.2
million in Flathead County. Roughly 57 percent of these visitors are in town for vacation or
recreation; another 20 percent are visiting friends or relatives. The average length of stay in
Montana is 5.72 nights, with 55 percent of these nights in a hotel or motel. The demographics of
the visitor population is of relevance to emergency services, as more than half of these visitors
are over 65 years of age; 12 percent of visitors are 75 years of age or older, and another 39
percent are 65-74 years of age. In addition, more than one -quarter of the visitors (27 percent)
are visiting Montana for the first time.
HOUSING STOCK
The U.S. Census bureau estimates that in 2016 Kalispell had 9,187 housing units; the median value
of a home was $191,600. The housing stock includes some older homes, which may represent a
higher risk of fire or other emergency. Approximately 30 percent of the homes in Kalispell were
built prior to 1960.
TABLE 4-1: Age Profile of Housing Stock
Years Built
Number of
Housing
Structures Built
2010-2016
221
2000-2009
2,091
1990-1999
1,310
1980-1989
1,002
1970-1979
1,206
1960-1969
666
1950-1959
729
1940-1940
551
Before 1940
1,411
Total (2012)
9,187
Source: U.S. Census Bureau, 2008-2012 American Community Survey
Vacant housing can also represent a risk. According to the Census Bureau, there are 541 vacant
housing units in Kalispell, representing 5.9 percent of the total housing stock.
There is a cross-section of housing types in Kalispell, including single-family residences,
apartments and condominiums, and mobile homes. More than 60 percent of housing units are
detached, single-family homes. There is also demand for second homes, seasonal lodging, and
vacation housing. The Flathead County Growth Policy (2012) indicates that manufactured and
mobile homes are an integral part of a viable affordable housing program. There are currently
222 mobile homes.
In general, the city lacks sufficient affordable rental housing. This has contributed to changes in
the community. In the southern part of the city east and west of Main Street, older homes are
being renovated or converted into rental properties. Renovations could present issues to the fire
department because not all the renovations are being done to code. Among the changes are
garages that are being converted into apartments, single-family homes being split into
multifamily units, and so forth. Just north of this area, the city is converting an old rail line to
become a bike path. There is a considerable amount of new construction expected near this rail
line.
Like many cities, Kalispell was hit by the recession of 2008, and building construction slowed
considerably. Today, however, Kalispell is witnessing a resurgence of construction. As can be
seen in Figure 4-4, there were 290 building permits in 2017, up from just 178 five years prior.
FIGURE 4-4: Building Permits by Year, 2006-2017
2006 — 2017
GDo
SOO 490
432
v
400
t S 300 272 257 ib=' 208 229
r 200 i H
178
10
Source: 2017 Construction, Subdivision and Annexation Report, Kalispell, Montana, January 2017.
Table 4-2 breaks down permits issued over the past six years into building types, along with each
type's total value. As shown in the table, there were 21 permits for new or significant
commercial, office, industrial, or utility projects, compared to just 4 in 2012. There were 195
permits for new residential units in 2017, compared to 98 in 2012.
TABLE 4-2: Building Permits by Building Type, 2012-2017
2012
2013
2014
2015
2016
2017
Total Building Permits Issued
178
257
270 (1 void)
276
323
290
[all types]
Commercial. Office,
42
67
79
75
126
79
Industrial, Utility
Residential
113
164
156
163
173
186
Govemment,
10
15
13
16
3
10
Publicl4uasi Public,
Health Care
13
11
21
22
21
21
New cr Significant Commercial,
Office, Industrial or Utility
4
$
14
16
25
21
Permits ($250,000 or greater)
Value of New or Significant
Commercial, Office, Industrial,
$9,542,780
$13,196,425
$13,219,709
$19,841,582
$23,637,904
$39,641,5DO
Utility $ Remod or Additions
New Residential Units
98
124
98
184
222
195
Single Family,
Townhouse
56
124
98
86
136
151
andlor duplex units
Multi -family units
42
0
0
96
88
44
Value of All New
$11.905.250
S22,772,625
$20,470,148
S22,936,339
$31,782,525
S251558,959
Residential Units
Permits for New or Significant
Additions to Public(Quasi-
2
4
4
7
9
11
Public, Health Care ($250,000 or
greater)
Value of New or Significan
Public -Quasi -Public or Health
$30,237,000
$3,364,000
$6,287,655
$13.430,783
$69,480,917
$32.813,597
Care
Total Value all
$54,755,122
$46,366,438
$45,316,9013
$63,512,562
$123,914,228
$104,600,358
Construction Types
Source: 2017 Construction, Subdivision and Annexation Report, Kalispell, Montana, January 2017.
The city is hard-pressed to keep up with the growing demand for building permits and
inspections. Although the table shows that there is not unilateral year -over -year growth,
projections suggest that the city will continue to experience significant growth, which may put
further strain on the city's resources in the future.
Figure 4-5 illustrates where the residential construction has taken place between 2000 and 2017.
Figure 4-6 illustrates nonresidential construction.
FIGURE 4-5: Residential Construction, 2000-2017
P', 0RIT�
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LF
R-
CrTha
Rr EW
el
JL
US-2
ds
_ J,
h3ew Ttrxnhouse on Duplex unit �I _ I -
I _
+ hoew Mini-4amily Emit
New Single =arnRy Unit
Mks �O:ki CI^Cr -
sr ixrarir - a 1 2
CPSACenter for Public Safety Management, LLC 16
FIGURE 4-6: Nonresidential Construction, 2000-2017
T
NORTH
Rol s
a _L
IL
N'Rcic•aa'�'
�•` I -
RcLa-ar a
r.
F.io- b K%Vmi Poi z W:+Ci
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e
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T
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-eli.ifcle L—r4.,n
x
0cKyai Fauspell
CommerGai, Indastrlal, CrIIce orkieaCh Cade Cors-n.c *i
Goverrrnenk °uCPc, Quasi P.IGIII< Cors're0ai
Doririen' Patti: I:'.4rnUa19enoFr,2D1'. MmsTip4ar.Re*jdw.lalCxis-m.-HaUDDD-2w17.mx-
3owrEerd Nara*: F.g3NonResller.MCorsbucAar2DLI&20'7
ME:. 12129M17
CPSACenter for Public Safety Management, LLC 17
TARGET HAZARDS
The costs of providing fire protection and EMS to a community have the potential to escalate;
therefore, the need to examine the planning processes and deployment models involved in
providing services is paramount. The initial step in this planning process is determining the
community's risk. Each jurisdiction decides what degree of risk is acceptable to the citizens it
serves. This determination is based on criteria that has been developed to define the levels of risk
(e.g., of fire) within all sections of the community.6 To this end, a comprehensive planning
approach that includes a fire risk assessment and hazard analysis is essential in determining local
needs.
The term integrated risk management refers to a planning methodology that recognizes that
citizen safety, the protection of property, and the protection of the environment from fire and
related causes must include provisions for the reasonable safety of emergency responders. This
means assessing the risk faced, taking preventive action, and deploying the proper resources in
the right place at the right time. A fire department typically collects, organizes, and evaluates
risk information about individual properties to derive a "fire risk score" for each property. The fire
risk score is based on several factors, including:
Needed fire flow if a fire were to occur.
Probability of an occurrence based on historical events.
The consequence of an incident in that occupancy (to both occupants and responders).
The cumulative effect of these occupancies and their concentration in the community.
A community risk and vulnerability assessment is used to evaluate community properties and
assigns an associated risk as one of low, moderate, or high/maximum risk. The NFPA Fire
Protection Handbook defines these hazards as:
High -hazard Occupancies: Schools, hospitals, nursing homes, explosive plants, refineries, high-rise
buildings, and other high life safety -hazard or large fire -potential occupancies.
Medium -hazard Occupancies: Apartments, offices, and mercantile and industrial occupancies
not normally requiring extensive rescue by firefighting forces.
Low -hazard Occupancies: One-, two-, or three-family dwellings and scattered small business
and industrial occupancies.
As the rated properties are plotted on a map, fire station locations and staffing patterns can be
considered to provide a higher concentration of resources for worst -case scenarios or,
conversely, a lower concentration of resources based on a lower level of risk. (See the locations
of Kalispell's high- and medium -hazard occupancies in Figure 4-7.)
In addition to identifying occupancies of various hazard levels, a hazard analysis should include
critical facilities, such as police and fire stations, public works facilities, hospitals and shelters, 911
emergency call centers, the emergency operations center, and other critical facilities that are
vital to service delivery.
6 Compton and Granito, Managing Fire and Rescue Services, 39.
7 Cote, Grant, Hall & Solomon, eds., Fire Protection Handbook (Quincy, MA: NFPA 2008), 12-3
8 Fire and Emergency Service Self -Assessment Manual, 8th edition (Center for Public Safety Excellence,
2009), 49.
Identifying high -hazard occupancies or target hazards that would require a higher
concentration of fire department resources is an essential part of fire risk assessment. The process
of identifying target hazards and pre -incident planning are basic preparedness efforts that have
been key functions in the fire service for many years. In this process, critical structures are
identified based on the risk they pose. Then, tactical considerations are established for fires or
other emergencies in these structures. Consideration is given to the activities that take place
(manufacturing, processing, etc.), the number and types of occupants (elderly, youth,
handicapped, imprisoned, etc.), and other specific aspects relating to the construction of the
facility, or any hazardous materials that are regularly found in the building. Target hazards are
those occupancies or structures that are unusually dangerous when considering the potential for
loss of life or the potential for property damage. Typically, these occupancies include hospitals,
nursing homes, and high-rise and other large structures.
Figure 4-7 illustrates the location of high- and medium -risk target hazards in the city as identified
by the Kalispell Fire Department.
FIGURE 4-7: Medium- and High -risk Target Hazards
Red: Apartments; Detention/Correction; Educational; Group Home; Health; Hospital/Nursing; Hotel/Motel.
Blue: Assembly; Business; Mercantile; Restaurant; Retail. Green: Storage; Utility.
An identified high hazard for Kalispell is the number of high- to mid -occupancy buildings that do
not have sprinklers. Specific information about these buildings is shown in Table 4-3.
TABLE 4-3: Sprinkler Status of High- to Mid -occupancy Buildings
Building
Sprin-
Building
Sprin-
Building Name
Purpose
Location
klered
Building Name
Purpose
Location
klered
1018 8fh Sf W
Apartment
1018 8fh Sf W
No
Aero Inn
Hofel/motel
1830 Highway 93 S
No
1 120 Kenway Dr
Apartment
1 120 Kenway Dr
No
Americas Best
Hofel/motel
1550 Highway 93 N
No
Value
1 122 Kenway Dr
Apartment
1 122 Kenway Dr
No
Blue and White
Hofel/motel
640 e Idaho Sf
No
Mofel
1 124 Kenway Dr
Apartment
1 124 Kenway Dr
No
Vacafioner
Hofel/motel
285 7fh Ave EN
No
Mofel
1 126 Kenway Dr
Apartment
1 126 Kenway Dr
No
Travel Lodge Inn
Hofel/motel
350 N Main Sf
No
1 128 Kenway Dr
Apartment
1 128 Kenway Dr
No
Super 8 Mofel
Hofel/motel
1341 1 Sf Ave E
No
1030 8fh Sf W
Apartment
1030 8fh Sf W
No
Comforf Inn
Hofel/motel
1330 Highway 2 W
No
1032 8fh Sf W
Apartment
1032 8fh Sf W
No
Mofel 6
Hofel/motel
1540 Highway 93 S
No
716 1Sf Ave W
Apartment
746 1Sf Ave E
No
Kalispell Hillfop
Hofel/motel
801 E Idaho Sf
No
Inn
Big Sky Manor
Apartment
110 2nd Ave W
No
Kalispell Grand
Hofel/motel
100 S Main Sf
No
Hofel
esfgafe Senior
Apartment
516 Corporate Dr
No
Flathead
Counfy Library
Assembly
233 1Sf Ave E
Parfial
Cherry Orchard
Apartment
700 Liberty Sf
No
Rosebriar Inn
Apartment
24 1 Sf Ave W
No
Flathead High
Educational
644 4fh Ave W
Parfial
School
Glacier Manor
Apartment
506 1Sf Ave W
No
Buffalo Hills
I errace
Aparfmenf
40 Claremont St
Yes
GafeWay Village
Apartment
308 Two Mile Dr
No
Bethlehem
Assembly
603 S Main Sf
No
Lutheran
rinify Day Care
Educational
486 3Rd Ave WN A
No
Center Court
Aparfmenf
121 2nd Ave W
Yes
rinify Day Care
Educational
373 W Washington
No
amarifan
Aparfmenf
124 9fh Ave W
Yes
t
House
t. Matthews
Educational
602 S Main Sf
No
Fernwell
Aparfmenf
20 4fh Ave W
Yes
arfmenfs
School District 5
Educational
233 1Sf Ave E
No
Easfside Brick
Aparfmenf
723 5fh Ave E
Yes
Russel
Educational
227 W Nevada Sf
No
Signafure
Assembly
185 Hutton Ranch
Yes
Elemenfary
theafers
Rd
Peterson
Educational
1 1 19 2nd Sf W
No
Flathead
Detention /
920 S Main St
Yes
Elementary
Counfy
corrections
Detention Cfr.
Linderman
Educational
124 3Rd Ave E
No
Norfh West
Educational
79 7fh Ave EN
Yes
Education
Healfh
Kalispell Middle
Educational
205 Northwest Ln
No
Glacier High
Educational
375 Wolfpack Way
Yes
School
lSchool
Hedges
Educational
826 4fh Ave E
No
FVCC
Educational
777 Grandview Dr
Yes
Elemenfary
Gift of Love Child
Educational
602 S Main Sf
No
Adulf Menfal
Group
410 Windward Way
Yes
Care
Healfh
home
Elrod Elementary
Educational
412 3Rd Ave W
No
Willow Glen
Group
1600 Woodland
Yes
Group
home[Ave
Edgerton
Educational
1400 Whitefish
No
Sinopah House
Group
420 Windward Way
Yes
Elemenfary
Sfage Rd
home
Agape Home
Group home
40 Appleway Dr
No
Safe House
Group
412 Windward Way
Yes
Care
Adulf
home
Discovery
Group home
75 Glenwood Dr
No
Norfh West
Healfh
66 Claremont
Yes
Healfh
Renaissance
Group home
645 Liberty Sf A
No
Med Norfh
Healfh
2316 Highway 93 N
Yes
ssisfed Living
Ur enf Care
Lone Pine Lodge
Group home
1300 8fh Sf W
No
Kalispell
Healfh
310 Sunnyview Ln
Yes
Regional
Hope Pregnancy
Group home
40 1Sf Ave E
No
HCNW Rehab
Healfh
320 Sunnyview Ln
es
Center
Floor 2
CPSNICenter for Public Safety Management, LLC 20
Building
Sprin-
Building
Sprin-
Building Name
Purpose
Location
klered
Building Name
Purpose
Location
klered
Friendship House
Group home
606 2nd Ave W
No
Wel Life
Hospital/
156 Three Mile Dr
Yes
nursing
Flathead Youth
Group home
825 E Oregon Sf
No
Brendan House
Hospital/
350 Conway Dr
Yes
Home
nursing
Flathead
Group home
21 4fh Ave W
No
Prestige Assisted
Hospital/
125 Glenwood Dr
Yes
Industries
Livingnursin
Flathead
Group Home
2329 Merganser Dr
No
Immanuel
Hospital/
185 Cresfline Rd
Yes
Industries
Lutheran
Flathead
Group Home
2327 Merganser Dr
No
—nursing
Heritage Place
Hospital/
171 Heritage Way
Yes
Industries
nursing
Flathead
Group Home
1212 6fh Ave W
No
Red Lion Hofel
Hofel/motel
20 N Main St
Yes
Industries
Flathead
Group Home
1214 6fh Ave W
No
Holiday Inn
Hofel/motel
275 Treeline Rd
Yes
Industries
Express
Flathead
Group Home
110 31Rd Ave W
No
Hilfon Garden
Hofel/motel
1840 Highway 93 S
Yes
Industries
Inn
Woodland Clinic
Healfh
705 6fh Ave E
No
Hampton Inn
Hofel/motel
1120 Highway 2 W
Yes
hursfon
Healfh
125 Commons
No
Econol-odge
Hofel/motel
1680 Highway 93 S
Yes
Orthodontics
a
The Sleep
Healfh
200 Commons
No
Fairbridge Inn
Hofel/motel
1701 Highway 93 S
es*
Medicine
a
Poffhoff Dentistry
Healfh
195 Commons
No
frequently broken or inoperable
uife
Loop
Pathways
Healfh
200 Heritage Way
No
Montana
Healfh
1 103 S Main Sf
No
Woman
Glacier Prosfefic
Healfh
985 N Meridian Rd
No
Glacier Denfal
Healfh
1340 Airporf Rd
No
Clinic
Figure 4-8 overlays these high life -safety occupancies on a map of potential KFD travel times,
which are based on the current road network. It is important to note that these are travel times
only, and do not include dispatch time, turnout time, and hazardous or blocked roads. In a
review of the map, it can be seen that the largerst concentration of these occupancies are in
the four -minute travel time zones of each Kalispell fire station.
CPSNICenter for Public Safety Management, LLC 21
FIGURE 4-8: High -hazard Occupancies with KFD Travel Times
Call Demand
Call volume is an important part of hazard analysis. Knowing where the current calls originate
and predicting how changes to the community may affect this are important to creating a plan
that best meets the current and future needs of the community. Figures 4-9 and 4-10 show the
current calls for fire and EMS services, respectively. As can be readily noted, the frequency of
EMS calls is highest from the medical/hospital complex just north of the city center and other
CPS07Center for Public Safety Management, LLC 22
areas of the city that correlate to a high density of elderly population. The highest number of fire
calls originate from the older parts of the city just south of the current rail line that, as previously
discussed, is being redeveloped. This higher fire call frequency is also occurring where residences
are being renovated, subdivided, and being converted into rentals.
rIGURE 4-9: EMS Call Demand
• KFD Station
EMS Calls ,
(per 5q. Mi.)
Least Dense
iMost Dense
O
ON
CPSOTCenter for Public Safety Management, LLC 23
it
9
pi
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Ak
C1 S MI Center for Public Safety Management, LLC 24
Hazardous Materials
Hazardous materials from fixed facilities and transportation incidents pose possible threats. In
Flathead County, these hazards include petroleum products and agricultural chemicals.
Locations within Kalispell that report hazardous materials include:
Amerigas, 53 4th Ave.
Applied Materials, 3850 Highway 2.
Applied Materials, 655 W. Reserve.
AT&T Mobility, 851 Trumble Circle Rd.
Bonneville Power Administration, 1850 Whitefish Stage.
CHS, Inc, 150 1 st Ave. West.
CHS, Inc. 250 Auction Rd.
CHS, Inc., 505 W. Center.
Century Link, 1 1 1 1 st Ave. East.
Coca Cola, 230 S. Complex Dr.
Costco, 2330 US Highway 93.
Home Depot, 2455 Highway 93 North.
Horizon Air, 4170 Highway 2 East.
Lowes, 2360 Highway 93.
Plum Creek, 75 Sunset Dr.
Rocky Mountain Contractors, 2214 Highway 2.
Western States Equipment, 3500 Highway 95 South.
The Kalispell Regional Hazmat Team, a State of Montana resource, was established to assist local
jurisdictions with hazardous materials incidents. The team's response area borders Canada to
the north, Idaho to the west, Missoula's Regional Team to the South, and Great Falls' Regional
Team to the East. The team is staffed by Kalispell Fire Department personnel trained to the
Hazmat Technician level; their equipment is housed and available from Kalispell Fire Department
Station 61. Recently, the State of Montana has significantly reduced funding to support regional
hazmat teams.
Summary and Observations
The city is experiencing a new and high level of residential and commercial growth.
More than half of Kalispell's tourists are visitors that are 65 and older.
Many of the identified high -risk targets located in the City of Kalispell are within seven to eight
minutes total response time of a KFD station. Between just before midnight and the early
morning hours some of these high -risk locations receive a 10 minutes or more total response
time.
Many of these same identified high -risk targets are high life -safety risks because they are
occupied by elderly residents. Many of these high -risk structures are in the older identified
sections of the city that are undergoing renovation, areas that represent a high fire call and
EMS call frequency rate.
All the high -hazard risk locations pose either a difficulty for KFD to conduct evacuations and/or
fire attack.
The KFD, as most FDs, utilizes a quick and an aggressive fire attack to contain a conflagration
to the room of origin. However, a significant commercial or a large complex fire and/or a
multiple occupancy evacuation will quickly exhaust both the KFD and mutual aid partner
resources.
The city and the region are at risk of losing their hazmat response capability.
Fire Preplanning
An important part of risk management in the fire service is prefire planning inspections by fire
companies of large, high hazard, and complex buildings in each fire response zone. Conducting
prefire surveys by fire companies can have significant impact on both potentially reducing
structural fire loss and on reducing firefighter injuries. By improving firefighters' understanding of
complex building layouts, standpipe locations, etc. as well as, by identifying any structural
changes and possible code violations, suppression ground activities can be improved, and
potential firefighter injuries avoided.
The process of identifying target hazards and pre -incident planning are basic preparedness
efforts that have been key functions in the fire service for many years. In this process, critical
structures are identified based on the risk they pose. Then, tactical considerations are
established for fires or other emergencies in these structures. Consideration is given to the
activities that take place (manufacturing, processing, etc.), the number and types of occupants
(elderly, youth, handicapped, imprisoned, etc.), and other specific aspects relating to the
construction of the facility or any hazardous or flammable materials that are regularly found in
the building. Target hazards are those occupancies or structures that are unusually dangerous
when considering the potential for loss of life or the potential for property damage. Typically,
these occupancies include hospitals, nursing homes, and high-rise and other large structures.
Also included are arenas and stadiums, industrial and manufacturing plants, and other buildings
or large complexes.
NFPA's 1620, Recommended Practice for Pre -Incident Planning, identifies the need to utilize both
written narrative and diagrams to depict the physical features of a building, its contents, and
any built-in fire protection systems. Information collected for prefire/incident plans includes, but is
certainly not limited to, data such as:
The occupancy type.
Floor plans/layouts.
Building construction type and features.
Fire protection systems (sprinkler system, standpipe systems, etc.).
Utility locations.
Hazards to firefighters and/or firefighting operations.
Special conditions in the building.
Apparatus placement plan.
Fire flow requirements and/or water supply plan.
Forcible entry and ventilation plan.
The information contained in pre -incident fire plans allows firefighters and officers to have a
familiarity with the building/facility, its features, characteristics, operations, and hazards, thus
enabling them to more effectively, efficiently, and safely conduct firefighting and other
emergency operations. Pre -incident fire plans should be reviewed regularly and tested by
periodic table -top exercises and on -site drills for the most critical occupancies. The Kalispell Fire
Department has developed prefire plans for all the identified high -hazard structures (although
some these have not been entered into the CAD system) but not for all medium -hazard
occupancies in the city.
Recommendation:
Complete prefire plans for all high- and medium -hazard occupancies located in the city,
placing a high priority on those identified structures that are not protected by automatic
sprinkler systems.
SECTION 5. OPERATIONAL RESPONSE
APPROACHES
FIRE RESPONSE
With a population density of nearly 1,700 people per square mile, Kalispell is an urbanized
community. Many areas in the city's center core area have structures sited closely together. The
newer areas of the city have an assortment of commercial, industrial, and residential buildings. 11
a fire grows to an area in excess of 2,000 square feet, or extends beyond the building of origin, it
is most probable that additional personnel and equipment will be needed, as initial response
personnel will be taxed beyond their available resources. From this perspective it is critical that
KFD units respond quickly and initiate extinguishment efforts as rapidly as possible after
notification of an incident. It is, however, difficult to determine in every case the effectiveness of
the initial response in limiting the fire spread and fire damage. Many variables will impact these
outcomes, including:
The time of detection, notification, and ultimately response of fire units.
The age and type of construction of the structure.
The presence of any built-in protection (automatic fire sprinklers) or fire detection systems.
The contents stored in the structure and its flammability.
The presence of any flammable liquids, explosives, or compressed gas canisters.
Weather conditions and the availability of water for extinguishment.
Subsequently, in those situations in which there are extended delays in the extinguishment effort
or the fire has progressed sufficiently upon arrival of fire units, there is actually very little that can
be done to limit the extent of damage to the entire structure and its contents. In these situations,
suppression efforts may need to focus on the protection of nearby or adjacent structures
(exterior exposures) with the goal being to limit the spread of the fire beyond the building of
origin, and sometimes the exposed building. This is often termed protecting exposures. When the
extent of damage is extensive, and the building becomes unstable, firefighting tactics typically
move to what is called a defensive attack, or one in which hose lines and more importantly
personnel are on the outside of the structure and their focus is to merely discharge large
volumes of water until the fire goes out. In these situations, the ability to enter the building is very
limited and if victims are trapped in the structure, there are very few safe options for making
entry.
Today's fire service is actively debating the options of interior firefighting vs. exterior firefighting.
These terms are self -descriptive in that an interior fire attack is one in which firefighters enter a
burning building in an attempt to find the seat of the fire and from this interior position extinguish
the fire with limited amounts of water. An exterior fire attack, also sometimes referred to as a
transitional attack, is a tactic in which firefighters initially discharge water from the exterior of the
building, either through a window or door and knock down the fire before entry in the building is
made. The concept is to introduce larger volumes of water initially from the outside of the
building, cool the interior temperatures, and reduce the intensity of the fire before firefighters
enter the building. A transitional attack is most applicable in smaller structures, typically single
family, one-story detached units which are smaller than approximately 2,500 square feet in total
floor area. For fires in larger structures, the defensive type, exterior attacks generally involve the
use of master streams capable of delivering large volumes of water for an extended period of
time.
There are a number of factors that have fueled this debate. The first and most critical of these
factors is the staffing level. Since fire departments may operate with reduced levels of staffing,
and this staff may be arriving at the scene from greater distances, there is little option for a single
fire unit with three personnel but to conduct an exterior attack.
When using an exterior attack, the requirement of having the four persons assembled on -scene,
prior to making entry would not apply. Recent studies by UL have evaluated the effectiveness of
interior vs. exterior attacks in certain simulated fire environments. These studies have found the
exterior attack to be equally effective in these simulations. This debate is deep-seated in the fire
service and traditional tactical measures have always proposed an interior fire attack,
specifically when there is a possibility that victims may be present in the burning structure. The
long -held belief in opposition to an exterior attack is that this approach may actually push the
fire into areas that are not burning or where victims may be located. The counterpoint
supporting the exterior attack centers on firefighter safety.
The exterior attack limits the firefighter from making entry into those super -heated structures that
may be susceptible to collapse. From CPSM's perspective, there is at least some likelihood that a
single crew of three personnel will encounter a significant and rapidly developing fire situation. It
is prudent, therefore, that the KFD build at least a component of its training and operating
procedures around the tactical concept of the exterior fire attack when the situation warrants
such an approach.
Recommendations:
The KFD should build at least a portion of its training regimens and tactical strategies around
the exterior or transitional attack for when the fire scenario and the number of available
units/responding personnel warrants this approach.
In acknowledgement of the fact that the KFD operates in a minimal staffing mode and
recognizing the potential for rapid fire spread particularly in the more densely developed
areas of the city, the KFD should equip all its apparatus with the appropriate appliances and
hose as described herein. It should develop standardized tactical operations that will enable
arriving crews to quickly deploy high -volume fire flows of 1,200 to 1,500 gallons per minute (if
the water supply will permit this), utilizing multiple hose lines, appliances, and master stream
devices. This flow should be able to be developed within four to five minutes after arrival of an
apparatus staffed with three personnel.
As currently staffed, particularly when operating at the lower levels of staffing, the KFD will be
challenged to handle even fires in single-family dwellings that are limited in size and intensity
without the automatic aid provided by the Evergreen and Smith Valley Fire Departments.
Evergreen responds automatically with an engine with four personnel to any reported structure
fire in the city. Smith Valley also responds automatically with an engine, usually with two or three
personnel to any reported fires in commercial buildings or multi -occupancies. These two
departments provide the first response into the city since they have in -station staffing 24/7.
Together with the KFD, they provide an initial response force of about 12 personnel (assuming
the KFD has six on duty). Whitefish responds on the second alarm for all fires. However, it has
approximately an estimated 20-minute response to the city. Other fire departments that
9 "Innovating Fire Attack Tactics," U.L.COM/News Science, Summer 2013.
surround the city will be called in to assist with the occasional major fire. However, their reliability
can be inconsistent since they are staffed solely with volunteer personnel.
The achievability of this goal increases provided that the enhanced staffing levels and resource
deployment recommended in this report are implemented, there are no other incidents in
progress that will reduce the immediately available number of personnel, and the fire
department can arrive at the fire incident and take definitive action to mitigate the situation
prior to flashover occurring. If flashover has occurred, holding the fire to the building of origin is
achievable as well.
Table 5-1 and Figure 5-1 show the fire call totals for the 12-month period evaluated, including
number of calls by type, average calls per day, and the percentage of calls that fall into each
call type category. While fire call types were 15.6 percent of the total calls for service, actual fire
calls (structural and outside) were only 1.1 percent of the overall calls for service (approximately
0.1 calls per day or one actual fire -type call every 10 days) . The 37 actual fires represent 6.9
percent of the fire -related incidents. Hazardous conditions, false alarms, public service, and
good intent calls represent the largest percentage of fire -type calls for service. This experience is
typical in CPSM data and workload analyses of other fire departments.
FIGURE 5-1: Fire Calls by Type and Percentage
4%
17% Total Fire Calls: 537
■ False alarm
3% ■ Good intent
Hazard
■ Outside fire
44%
❑ Public service
21% ❑ Structure fire
1 1 %
TABLE 5-1: Fire Calls by Type and Number, and Percent of All Calls
Call Type
Number of Calls
Calls per
Day
Call
Percentage
False alarm
235
0.6
6.8
Good intent
59
0.2
1.7
Hazardous conditions
115
0.3
3.3
Outside fire
16
0.0
0.5
Public service
91
0.2
2.6
Structure fire
21
0.1
0.6
Fire Total
537
1.5
15.6
The data in Table 5-1 and Figure 5-1 tell us that:
Fire calls for the year totaled 537 (15.6 percent of all calls), an average of 1.5 per day.
Structure and outside fires combined for a total of 37 calls during the year, an average of one
call every 9.9 days.
A total of 21 structure fire calls accounted for 4 percent of the fire calls.
A total of 16 outside fire calls accounted for 3 percent of the fire calls.
False alarm calls were the largest fire call category, with 44 percent of the fire calls.
An additional analysis of fire response was conducted regarding the workload of incident types.
Table 5-2 shows that the largest amount of fire responses (74 percent) lasted less than thirty
minutes. The second largest amount of fire responses (20 percent) lasted 30 minutes to an hour.
TABLE 5-2: Fire Calls by Type and Durations
Call Type
Less than
30 Minutes
30 Minutes
to One Hour
More than
One Hour
Total
False alarm
197
33
5
235
Good intent
48
7
4
59
Hazard
60
40
15
115
Outside fire
8
5
3
16
Public service
73
14
4
91
Structure fire
10
7
4
21
Fire Total
396
106
35
537
Table 5-3 shows the workload of fire responses by number of units responding to these incident
types. This table tells us that single fire unit responses to fire incident types (65 percent) make up
the largest fire response workload. False alarms represent the largest response fire response
category for single fire unit and two fire unit responses. The data analysis shows us that Engine
631 has the highest fire apparatus response workload with 562 fire responses. The fire apparatus
at Station 62 (E-632, L-642) combined for a total of 241 fire responses.
TABLE 5-3: Fire Calls by Number of Units Responding
Call Type
Number of
Units
Total Calls
One
Two
Three or More
False alarm
117
117
1
235
Good intent
36
23
0
59
Hazard
105
9
1
115
Outside fire
12
3
1
16
Public service
75
16
0
91
Structure fire
6
14
1
21
Fire Total
351
182
4
537
EMS RESPONSE AND TRANSPORT
As a percentage of overall incidents responded to by the emergency agencies in most
communities, it could be argued that EMS incidents constitute the greatest number of "true"
emergencies, where intervention by trained personnel does truly make a difference, sometimes
literally between life and death.
Heart attack and stroke victims require rapid intervention, care, and transport to a medical
facility. The longer the time duration without care, the less likely the patient is to fully recover.
Numerous studies have shown that irreversible brain damage can occur if the brain is deprived
of oxygen for more than four minutes. In addition, the potential for successful resuscitation during
cardiac arrest decreases exponentially with each passing minute that cardiopulmonary
resuscitation (CPR), or cardiac defibrillation, is delayed (Figure 5-2).
FIGURE 5-2: Cardiac Arrest Survival Timeline
SURVIVAL VS. DELAY IN MINUTES
100
96 SURVNAL
0
1 2 3 4 5 6 7 8 9 10
DETECTION
OF COLLAPSE
REPORT OF
ALARM 911
OR DIRECT
EMSIFIRE RESP0NSETIIwlE
DISPATCH
UNITS
TURN
OUT
RESPONSE
TIME
SET
UP
TIME11ARIES
TIME DIRECTLY MANAGEABLE
The figure illustrates that the potential for successful resuscitation during cardiac arrest decreases
exponentially, by 7 percent to 10 percent, with each passing minute that cardio-pulmonary
resuscitation (CPR) or cardiac defibrillation and advanced life support intervention is delayed.
The figure also illustrates few attempts at resuscitation after 10 minutes are successful.
CPS07Center for Public Safety Management, LLC 32
Although the State of Montana requires by statute that every community provide fire protection
services, there is no similar mandate that emergency medical services response and transport
be provided. It is up to each individual community to decide if, and how, they will provide these
services.
The KFD provides EMS response and transport at the ALS level. As discussed earlier, the majority
of department personnel, and all department apparatus, are equipped to provide ALS level
care on the emergency scene. The department maintains three fully equipped ambulances for
transporting patients to the hospital.
Depending upon the department's staffing level each day, there is often not a crew that is
dedicated strictly to the ambulance. When staffing levels are at either six or seven personnel, the
ambulance is staffed from Station 62, however, the personnel are cross staffing the ambulance
along with the ladder truck. In the period from July 1, 2016 through December 31, 2017, the
department operated at these staffing levels 85 percent of the time. It is not until on -duty staffing
is eight or more that a two -person crew is dedicated to staff the primary ambulance. The
practical implication of this is that when staffing is at six or seven, and there is a fire call in
progress, there may be no ambulance staffed for immediate response. In this case, a fire
suppression unit may respond to provide initial care while a mutual aid ambulance responds for
transport.
Even when staffing levels are sufficient to assign a crew that is dedicated to the ambulance,
when a significant structure fire occurs, it is likely these personnel will still be unavailable for
immediate response due to the department's limited overall staffing. However, this situation
occurs infrequently in Kalispell.
Table 5-4 and Figure 5-3 show the EMS call totals for the 12-month period evaluated for this
study, including number of calls by type, average calls per day, and the percentage of calls
that fall into each call type category.
TABLE 5-4: EMS Calls by Type and Number, and Percent of All Calls
Call Type
Number of Calls
Calls per
Day
Call
Percentage
Breathing difficulty
202
0.6
5.9
Cardiac and stroke
327
0.9
9.5
Fall and injury
539
1.5
15.7
Illness and other
786
2.2
22.9
MVA
160
0.4
4.7
Overdose and psychiatric
103
0.3
3.0
Seizure and unconsciousness
310
0.8
9.0
EMS Total
2,427
6.6
70.6
FIGURE 5-3: EMS Calls by Type and Percentage
13%
Total EMS Calls: 2,427
■
7°I°
Breathing difficulty
13% ■
Cardiac and stroke
o
Fall and injury
■
Illness and other
❑
MVA
❑
Overdose and psychiatric
■
Seizure and unconsciousness
3'
The EMS call data tells us that:
EMS calls for the year totaled 2,427 (70.6 percent of all calls), an average of 6.6 per day.
Illness and other calls were the largest category of EMS calls with 786, which is 32 percent of
EMS calls.
Cardiac and stroke calls made up 13 percent of the EMS calls.
Motor vehicle accidents made up 7 percent of the EMS calls.
Most EMS -related incidents, including those that involve a transport to the hospital, do not take a
significant period of time to complete. From this perspective, the city and KFD benefit
tremendously from having the KRMC in the city. Approximately one-third (32.8 percent) of the
EMS incidents took less than 30 minutes to complete. An additional 55.7 percent took between
30 minutes and one hour to complete. Just 11.5 percent took more than one hour.
TABLE 5-5: Duration of EMS Responses
Call Type
Less than
30 Minutes
30 Minutes
to One Hour
More than
One Hour
Total
Breathing difficulty
45
140
17
202
Cardiac and stroke
72
216
39
327
Fall and injury
214
263
62
539
Illness and other
232
448
106
786
MVA
92
60
8
160
Overdose and psychiatric
32
60
11
103
Seizure and unconsciousness
108
165
37
310
EMS Total
795
1,352
280
2,427
Looking deeper into the duration of calls for EMS incidents we can see that:
On average, there were 0.8 EMS category calls per day that lasted more than one hour.
A total of 288 cardiac and stroke calls (88 percent) lasted less than one hour, and 39 cardiac
and stroke calls (12 percent) lasted more than an hour.
A total of 152 motor vehicle accidents (95 percent) lasted less than one hour, and 8 motor
vehicle accidents (5 percent) lasted more than an hour.
Table 5-6 shows the number of calls by call type broken out by whether a patient or patients
were actually transported to the hospital. Calls that involved a transport were identified by
requiring that at least one responding medic or aid unit had recorded both "beginning to
transport" time and "arriving at the hospital" time. Based on these criteria, note that 128 non -
EMS calls that resulted in transports are included in this analysis.
TABLE 5-6: Transport Calls by Call Type
Call Type
Number of Calls
Conversion
Rate
Non -transport
Transport
Total
Breathing difficulty
55
147
202
72.8
Cardiac and stroke
96
231
327
70.6
Fall and injury
251
288
539
53.4
Illness and other
291
495
786
63.0
MVA
124
36
160
22.5
Overdose and psychiatric
46
57
103
55.3
Seizure and unconsciousness
147
163
310
52.6
EMS Total
1,010
1,417
2,427
58.4
Fire Total
534
3
537
0.6
Other Total
348
125
473
26.4
Total
1,892
1,545
3,437
45.0
The data contained in this table shows us that:
Overall, 58 percent of EMS calls in Kalispell involved transporting one or more patients.
On average, there were 6.6 EMS calls per day, and 3.8 involved transporting one or more
patients.
Breathing difficulty calls had the highest transport rate, averaging 73 percent.
Motor vehicle accidents had the lowest transport rate, averaging 23 percent.
Table 5-7 shows the average duration of transport and non -transport EMS calls by call type.
TABLE 5-7: Transport Call Duration by Call Type
Call Type
Non -transport
Transport
Average
Duration
Number of
Calls
Average
Duration
Number of
Calls
Breathing difficulty
28.5
55
52.5
147
Cardiac and stroke
31.4
96
48.2
231
Fall and injury
27.7
251
49.1
288
Illness and other
31.5
291
48.3
495
MVA
23.4
124
49.8
36
Overdose and psychiatric
30.9
46
49.4
57
Seizure and unconsciousness
41.0
147
50.1
163
EMS Total
30.8
1,010
49.2
1,417
Fire Total
26.6
534
45.5
3
Other Total
20.7
348
59.6
125
Total
27.7
1,892
50.0
1,545
Note: Duration of a call is defined as the longest deployed time of any of the units responding to the same
call.
The data contained in this table tells us that, as would be expected, calls that involved a
transport to the hospital took longer than those that did not.
The average duration was 28 minutes for a non -transport EMS call.
The average duration was 50 minutes for an EMS call where one or more patients were
transported to a hospital.
On average, a transport call lasted 1.6 times as long as a non -transport EMS call.
Table 5-8 gives the average deployed time for an ambulance on a transport call, along with
three major components of the deployed time: on -scene time, travel to hospital time, and at -
hospital time.
The on -scene time is the interval from the unit arriving on -scene time through the time the unit
departs the scene for the hospital. Travel to hospital time is the interval from the time the unit
departs the scene to travel to the hospital through the time the unit arrives at the hospital. At -
hospital time is the time it takes for patient turnover at the hospital.
The 1,545 transport calls resulted in 1,546 transports, since more than one transport may occur on
a call. Thirty-five runs were excluded from this analysis due to missing arrival times and 12 runs
were excluded due to missing hospital travel times, leaving 1,499 runs for analysis. The at -hospital
time was calculated using "depart hospital time" when available, and "unit clear time" was
calculated for the remaining runs.
TABLE 5-8: Time Component Analysis for Ambulance Transport Runs by Call Type
(in Minutes)
Call Type
Avg.
Deployed
Time per Run
Avg. Time
on Scene
Avg.
Travel to
Hospital
Time
Avg.
Time at
Hospital
Number
of Runs
Breathing difficulty
52.5
15.4
5.7
24.7
144
Cardiac and stroke
47.8
15.5
6.1
19.5
225
Fall and injury
49.9
17.1
6.6
18.5
273
Illness and other
48.4
14.4
7.0
18.7
479
MVA
47.9
13.5
5.8
21.3
35
Overdose and psychiatric
49.2
13.1
7.1
21.4
56
Seizure and unconsciousness
49.9
17.9
6.3
19.1
161
EMS Total
49.2
15.6
6.5
19.6
1,373
Fire Total
45.5
11.9
8.4
16.0
3
Other Total
60.5
15.4
11.6
21.1
123
Total
50.2
15.5
6.9
19.8
1,499
Note: Average unit deployed time per run is lower than average call duration for some call types because
call duration is based on the longest deployed time of any of the units responding to the same call, which
may include an engine or ladder. Total deployed time is greater than the combination of on -scene,
transport, and hospital wait times as it includes turnout, initial travel, and hospital return times.
The data from the incidents that resulted in a transport to the hospital indicates that:
On average, an ambulance spent 16 minutes on scene, and then spent 7 minutes traveling
from the scene to the hospital.
The average time spent at the hospital, or other transport destination, was 20 minutes.
MUTUAL AID/AUTOMATIC RESPONSE
Mutual aid is an essential component of almost every fire department's operations. Except for
the largest cities, no municipal fire department can, or should, be expected to have adequate
resources to respond to and safely, effectively, and efficiently mitigate large-scale and complex
incidents. Mutual aid is shared between communities when their day-to-day operational fire,
rescue, and EMS capabilities have been exceeded, and this ensures that the citizens of the
communities are protected even when local resources are overwhelmed. Automatic aid is an
extension of mutual aid, where the resources from adjacent communities are dispatched to
respond at the same time as the units from the jurisdiction where the incident is occurring.
Automatic and mutual aid is generally provided without charge among the participants.
The KFD participates in a robust automatic and mutual aid system with its surrounding
departments. This includes both fire- and EMS -related incidents. Figure 5-4 illustrates the location
of KFD stations along with the location of automatic/mutual aid partner stations.
For any reported structure fire, the KFD utilizes the following dispatch protocols:
First Alarm: For one- and two-family residential occupancies, Kalispell units; plus, one engine from
Evergreen. For commercial and multi -family occupancies, KFD units plus one engine from Smith
Valley and one ladder from Evergreen.
Second Alarm: Page out off -duty personnel - total recall; additional mutual aid resources as
needed from South Kalispell (heavy rescue), Smith Valley (engine, if not already on the
assignment), Whitefish (engine), and West Valley (ladder for commercial/multifamily).
Third Alarm: One engine each from Creston, Bigfork, and Somers.
Fourth Alarm: One engine each from Columbia Falls, Badrock, and Marion. (For one- and two-
family residential, Marion does not respond until the 5th alarm.)
Fifth Alarm (One- and Two-family residential): One engine each from West Valley and Marion.
It is important to note that due to Kalispell's relatively remote location some of these mutual aid
resources have response times of 30 minutes or longer once they are actually en route to the
incident. Inclement weather during the winter can slow their responses even more.
The KFD also provides automatic and mutual aid to many of these same departments when
they are dispatched for a structure fire. For instance, Kalispell responds automatically to
Evergreen, Smith Valley, and South Kalispell on any reported structure fire. It responds to
Whitefish with a ladder for any structure fire. It also provides a water tender on mutual aid to
jurisdictions that do not have municipal water systems.
For EMS incidents, both Evergreen and Smith Valley provide assistance to the KFD when needed.
Both also operate ALS-level transport services. Additional mutual aid is available from Whitefish,
Lakeside, Three Rivers, Bigfork, West Valley, Big Mountain, and Marion. The KFD also reciprocates
on those services. It also provides primary EMS service to much of the South Kalispell Fire District.
FIGURE 5-4: KFD and Automatic/Mutual Aid Partner Station Locations
The Evergreen fire chief informed CPSM that in 2017 they responded 233 times into Kalispell. This
equates to about 6.8 percent of all incidents in the city. Conversely, the KFD responded just 30
times into Evergreen, with 6 of those being for fires.
The automatic/mutual aid agreements for fire responses are outlined in formal written
documents. The agreements for both EMS and interfacility transports are less formal and based
more on "handshake" agreements.
CPSOTCenter for Public Safety Management, LLC 39
WORKLOAD ANALYSIS
Nationwide, fire departments are responding to more EMS calls and fewer fire calls, particularly
fire calls that result in active firefighting operations by responders. This is well documented in
CPSM fire studies. Kalispell is consistent with these trends. Improved building construction, code
enforcement, automatic sprinkler systems, and aggressive public education programs have
contributed to a decrease in serious fires and, more importantly, fire deaths among civilians.
Table 5-9 shows the aggregate call totals for the 12-month study period analyzed by CPSM. This
includes call type, number, and percentage of overall calls. EMS calls represent the largest
percentage of calls for service at almost 70.6 percent; this is not unusual and is quite similar to
many communities we observe. While fire call types represent 15.6 percent of the total calls for
service, actual fire calls (structural and outside) represent only 1.1 percent of the overall calls for
service (approximately 0.1 calls per day or one actual fire -type call every 9.9 days).
TABLE 5-9: Calls by Type, and Number, and Percent
Call Type
Number of Calls
Calls per
Day
Call
Percentage
Breathing difficulty
202
0.6
5.9
Cardiac and stroke
327
0.9
9.5
Fall and injury
539
1.5
15.7
Illness and other
786
2.2
22.9
MVA
160
0.4
4.7
Overdose and psychiatric
103
0.3
3.0
Seizure and unconsciousness
310
0.8
9.0
EMS Total
2,427
6.6
70.6
False alarm
235
0.6
6.8
Good intent
59
0.2
1.7
Hazard
115
0.3
3.3
Outside fire
16
0.0
0.5
Public service
91
0.2
2.6
Structure fire
21
0.1
0.6
Fire Total
537
1.5
15.6
Canceled
230
0.6
6.7
Mutual aid
243
0.7
7.1
Total
3,437
9.4
100.0
The data further tells us that the KFD received an average of 9.4 calls, including 0.6 canceled
and 0.7 mutual aid calls, per day. Mutual aid calls made up 7.1 percent of the department's
total. As previously noted, EMS calls for the year totaled 2,427 (70.6 percent of all calls), an
average of 6.6 per day. Fire calls for the year totaled 537 (15.6 percent of all calls), an average
of 1.5 per day.
Figure 5-5 and Table 5-10 detail the number of KFD calls with one, two, or three or more units
dispatched overall and broken down by call type.
FIGURE 5-5: Calls by Number of Units Dispatched
EMS Calls by Responding Units
Average Dispatched Units: 1.4
3 Units or More, 1%
1 Unit. 6511/o
o
2 Units, 34 /o
Fire Calls by Responding Units
Average Dispatched Units: 1.4
3 Units or More, 1%
1 Unit, 65%
2 Units, 34%
TABLE 5-10: Calls by Call Type and Number of Units Dispatched
Call Type
Number of
Units
Total Calls
One
Two
Three or More
Breathing difficulty
125
76
1
202
Cardiac and stroke
141
185
1
327
Fall and injury
436
102
1
539
Illness and other
605
178
3
786
M VA
34
119
7
160
Overdose and psychiatric
76
26
1
103
Seizure and unconsciousness
162
146
2
310
EMS Total
1,579
832
16
2,427
False alarm
117
117
1
235
Good intent
36
23
0
59
Hazard
105
9
1
115
Outside fire
12
3
1
16
Public service
75
16
0
91
Structure fire
6
14
1
21
Fire Total
351
182
4
537
Canceled
190
39
1
230
Mutual aid
221
19
3
243
Total
2,341
1,072
24
3,437
Percentage
68.1
31.2
0.7
100.0
An examination of this data indicates that:
Overall
On average, 1.3 units were dispatched to all calls, and for 68 percent of calls only one unit
was dispatched.
Overall, three or more units were dispatched to 1 percent of calls.
On average, 1.4 units were dispatched per EMS call.
For EMS calls, one unit was dispatched 65 percent of the time; two units were dispatched 34
percent of the time; and three or more units were dispatched 1 percent of the time.
Fire
On average, 1.4 units were dispatched per fire call.
For fire calls, one unit was dispatched 65 percent of the time; two units were dispatched 34
percent of the time; and three or more units were dispatched 1 percent of the time.
For structure fire calls, three or more units were dispatched 5 percent of the time.
For outside fire calls, three or more units were dispatched 6 percent of the time.
During the study period, KFD responded to a total of 21 incidents that were classified as structure
fires. In analyzing the time spent on fire incidents, we found that on approximately 80.9 percent
of all structure fire calls, the call duration for these incidents was one hour or less. For 47.6
percent of these calls the duration was less than 30 minutes. This is indicative of minor
occurrences. Only four structure fire calls (19 percent) had a duration of greater than one hour.
This would indicate more significant events.
On 5 of the 21 structure fires (24 percent), and 7 of 16 outside fires (44 percent), extinguishment
was carried out by fire personnel.
In examining the fire incidents in more detail, it was determined that a total of 12 incidents (32.4
percent) resulted in fire loss being recorded. For structure fires it was determined that for 13 (61.9
percent) of these events there was no fire damage reported to the structure involved. Only three
incidents (14.3 percent) involved a damage amount exceeding $20,000. When looking at fire
loss comparisons nationwide for structure fires, NFPA estimates that in 2016 the average fire loss
for a structure fire was $16,609. Although the fire loss in Kalispell was fairly low, at any time a
single fire can occur that results in millions of dollars in fire loss.
Tables 5-1 1 and 5-12 depict fire loss data for the study period.
TABLE 5-11: Content and Property Loss - Structure and Outside Fires
Property Loss
Content Loss
Call Type
Loss Value
Number of Calls
Loss Value
Number of Calls
Outside fire
$6,500
4
$300
2
Structure fire
$149,625
8
$51,720
8
Total
$156,125
12
$52,020
10
Note: This includes only calls with recorded loss greater than 0.
This data also indicates:
Out of 23 structure fires, 8 had recorded property losses, with a combined $149,625 in losses.
8 structure fires also had content losses with a combined $51,720 in losses.
The average total loss for all structure fires was $8,754.
The average total loss for structure fires with loss was $20,134.
13 structure fires had no recorded loss.
The highest total loss for a structure fire was $100,000.
TABLE 5-12: Total Fire Loss Above and Below $20,000
Call Type
No Loss
Under $20,000
$20,000 plus
Outside fire
11
5
0
Structure fire
11
7
3
Total
22
12
3
10 Hylton J.G. Haynes, "Fire Loss in the United States during 2016," NFPA September 2017, 19.
As part of this analysis, data was tabulated and analyzed for each of the 8,760 hours in the year.
Table 5-13 shows the number of hours in the year in which there were zero to five calls during the
hour.
TABLE 5-13: Frequency Distribution of the Number of Calls
Calls in an Hour
Frequency
Percentage
0
5,998
68.5
1
2,175
24.8
2
512
5.8
3
63
0.7
4+
12
0.1
In 75 hours (1 percent of all hours) during the year, three or more calls occurred; in other words,
the department responded to three or more calls in an hour roughly once every five days.
Data was also analyzed on the frequency of overlapping calls, which is illustrated in Table 5-14.
TABLE 5-14: Frequency of Overlapping Calls
Scenario
Number of
Calls
Percent of
All Calls
Total Hours
No overlapped call
2,677
77.9
1,704.8
Overlapped with one call
692
20.1
211.2
Overlapped with two calls
66
1.9
10.7
Overlapped with three calls
2
0.1
0.6
During the year studied, 22 percent of calls overlapped with at least one other call.
The total number of calls that began while another call was still active was 760.
The total number of EMS transport calls that began while another EMS transport call was still
active was 155. This equates to an average of 0.42 incidents per day, or 1 every 2.3 days.
The total number of fire -related calls that began while another EMS call was still active was 27.
No fire -related calls began while two EMS transport calls were simultaneously active.
Table 5-15 provides a summary of each unit's workload overall.
TABLE 5-15: Call Workload by Unit
Total
Total
Avg.
Estimated
Station
Unit
Deployed
Annual
Deployed
Annual
Runs per
Days In -
Min. per
Hours
Min. per
Runs
Day
Service
Run
Day
61
Ambulance 621
40.3
194.2
157.4
289
3.9
74
Engine 631
23.1
574.6
96.3
1,495
4.2
358
62
Ambulance 622
38.4
1,323.8
221.2
2,066
5.8
359
Ambulance 624
38.5
298.5
81.0
465
2.1
221
Engine 632
35.0
1.8
52.5
3
1.5
2
Ladder 642
28.9
119.9
42.3
249
1.5
170
Tender 692
48.1
0.8
48.1
1
1.0
1
Wild Land 682
40.3
2.7
40.3
4
1.0
4
Note: Metrics for average deployed minutes per day and average runs per day were calculated using
estimates of the total number of days in service for each unit. A unit was considered in service if it
responded to at least one call that day.
This data set tells us Ambulance 622 made the most runs (2,066 or an average of 5.8 per day)
and had the highest total annual deployed time (1,324 hours or an average of 221 minutes
per day).
EMS calls accounted for 83 percent of the total runs and 87 percent of deployed time.
Structure and outside fire calls accounted for less than 0.1 percent of the total runs and less
than 0.1 percent of deployed time.
Engine 631 made the second most runs (1,495 or an average of 4.2 per day) and had the
second highest total annual deployed time (575 hours or an average of 96 minutes per day).
EMS calls accounted for 62 percent of the total runs and 60 percent of deployed time.
Structure and outside fire calls accounted for 2 percent of the total runs and 4 percent of
deployed time.
Ambulance 621 out of station 61 was in service as a dedicated ambulance only 74 days
during the year. This equates to just 20 percent of the time.
Figure 5-6 illustrates the number of incidents that occurred in each station's first due response
area.
FIGURE 5-6: Total Incidents and Percentage Each Station First Due Area
■ Station 61 ■ Station
CPSACenter for Public Safety Management, LLC 46
SECTION 6. RESPONSE TIME ANALYSIS
MEASURING RESPONSE TIMES
Response times are typically the primary measurement for evaluating fire and EMS services.
Response times can be used as a benchmark to determine how well a fire department is
currently performing, to help identify response trends, and to predict future operational needs.
Achieving the quickest and safest response times possible should be a fundamental goal of
every fire department. At the same time, the actual impact of a speedy response time is limited
to very few incidents. For example, in a full cardiac arrest, analysis shows that successful
outcomes are rarely achieved if basic life support (CPR) is not initiated within four minutes of the
onset. However, cardiac arrests occur very infrequently; on average they are 1 percent to 1.5
percent of all EMS incidents. There are also other EMS incidents that are truly life -threatening,
and the time of response can clearly impact the outcome. These involve full drownings, allergic
reactions, electrocutions, and severe trauma (often caused by gunshot wounds, stabbings, and
severe motor vehicle accidents, etc.). Again, the frequency of these types of calls are limited.
Regarding response times for fire incidents, the criterion is based on the concept of "flashover."
This is the state at which super -heated gasses from a fire are released rapidly, causing the fire to
burn freely and become so volatile that the fire reaches an explosive state (simultaneous ignition
of the all combustible materials in a room). In this situation, usually after an extended period
(often eight to twelve minutes after ignition but times as quickly as five to seven minutes), and a
combination of the right conditions (fuel and oxygen), the fire expands rapidly and is much
more difficult to contain. When the fire does reach this extremely hazardous state, initial
firefighting forces are often overwhelmed, larger and more destructive fire occurs, the fire
escapes the room and possibly even the building of origin, and significantly more resources are
required to affect fire control and extinguishment.
Flashover occurs quicker and more frequently today and is caused at least in part by the
introduction of significant quantities of plastic- and foam -based products into homes and
businesses (e.g., furnishings, mattresses, bedding, plumbing and electrical components, home
and business electronics, decorative materials, insulation, and structural components). These
materials ignite and burn quickly and produce extreme heat and toxic smoke.
As a benchmark, for an urban community, NFPA 1710 recommends the entire initial response of
15 personnel be on scene within eight minutes of dispatch. It is also important to keep in mind
that once units arrive on scene they will need to get set up to commence operations. NFPA 1710
recommends that units be able to commence an initial attack within two minutes of arrival, 90
percent of the time.
Although trying to reach the NFPA benchmark for travel time may be laudable, the question is,
at what cost. What is the evidence that supports such recommendations? NFPA 1710's travel
times are established for two primary reasons: (1) the fire propagation curve (Figure 6-2); and (2)
sudden cardiac arrest (Figure 6-3), where brain damage and permanent brain death occurs in
four to six minutes.
According to fire service educator Clinton Smoke, the fire propagation curve establishes that
temperature rise and time within in a room on fire corresponds with property destruction and
I Myers, Slovis, Eckstein, Goodloe et al. (2007). "Evidence -based Performance Measures for Emergency
Medical Services System: A Model for Expanded EMS Benchmarking." Pre -hospital Emergency Care.
potential loss of life if present. At approximately the ten-minute mark of fire progression, the fire
flashes over (due to superheating of room contents and other combustibles) and extends
beyond the room of origin, thus increasing proportionately the destruction to property and
potential endangerment of life. The ability to quickly deploy adequate fire staff prior to flashover
thus limits the fire's extension beyond the room or area of origin.
Regarding the risk of flashover, the authors of an IAFF report conclude:
Clearly, an early aggressive and offensive initial interior attack on a working structural fire
results in greatly reduced loss of life and property damage. Consequently, given that the
progression of a structural fire to the point of "flashover" (the very rapid spreading of the
fire due to super -heating of room contents and other combustibles) generally occurs in
less than 10 minutes, two of the most important elements in limiting fire spread are the
quick arrival of sufficient numbers of personnel and equipment to attack and extinguish
the fire as close to the point of its origin as possible.
Figure 6-1 illustrates the time progression of a fire from inception through flashover. The time
versus products of combustion curve shows activation times and effectiveness of residential
sprinklers (approximately one minute), commercial sprinklers (four minutes), flashover (eight to
ten minutes), and firefighters applying first water to the fire after notification, dispatch, response,
and set up (ten minutes). It also illustrates that the fire department's response time to the fire is
one of the only aspects of the timeline that the fire department can exert direct control over.
FIGURE 6-1: Fire Growth from Inception to Flashover14
12 Clinton Smoke, Company Officer, 2nd ed. (Clifton Park, NY: Delmar, 2005).
13 Safe Fire Fighter Staffing: Critical Considerations, 2nd ed. (Washington, DC: International Association of
Fire Fighters), 5.
14 Source: Northern Illinois Fire Sprinkler Advisory Board.
Figure 6-2 shows the fire propagation curve relative to fire being confined to the room of origin
or spreading beyond it and the percentage of destruction of property by the fire.
FIGURE 6-2: Fire Propagation Curve
Fire Propagation Curve
100
90
p
THE LINE REPRESENTS A RATE OF FIRE PROPAGATION
V
�i WHICH COMBINES TEMPEHATUHE HISS AND TIME. IT
80
ROUGHLY CORRESPONDS TO THE PERCENTAGE OF
PROPERTY DESTRUCTION. AT APPROXIMATELY TEN
70
N
MINUTES INTO THE FIRE SEQUENCE. THE HYPOTHETICAL
IiJ
ROOM OF ORIGIN FLASHES OVER, EXTENSION OUTSIDE
60
d
THE ROOM BEGINS AT THIS POINT.
50
W
CL
40
0
Ix
a
30
LL
O
20
3P
10
Minutes
a
0 1 2 3 4 5 8 7 8 9 10 11 12 1 2 3 4 5 6 7 8 8 10 11 12 13 14 15 15 17 18 19 20 21 22 23 24
Room of Origin —ami4 Beyond Room of Origin Doi
Source: John C. Gerard and A. Terry Jacobsen, "Reduced Staffing: At What Cost?" Fire Service Today
(September 1981), 15-21.
Figure 6-3 illustrates the chain of survival, which is a series of actions that, when put in motion,
reduce the mortality of sudden cardiac arrest. Adequate response times coupled with
community and public access defibrillator programs potentially can impact the survival rate of
sudden cardiac arrest victims by deploying early CPR, early defibrillation, and early advanced
care.
FIGURE 6-3: Sudden Cardiac Arrest Chain of Survival
r �
Early Early Early Early
Access CPR Defibrillation Advanced Care
Source: "Chain of Survival," http://en.wikipedia.org/wiki/Chain-of-survival
Since the 1970s, arriving within eight minutes of receipt of an emergency call, 90 percent of the
time, has been the recognized benchmark for determining the quality of an EMS system. Today,
the national standard of care benchmark based on stroke and cardiac arrest protocols has
evolved to have an emergency response unit on scene at a medical emergency within six
minutes of receipt of the call. Paragraph 4.1.2.1 (4) of NFPA 1710 recommends that for EMS
incidents a unit with first responder or higher level trained personnel and equipped with an AED
CPSNICenter for Public Safety Management, LLC 49
should arrive on scene within six minutes of the receipt of the emergency call (at the dispatch
center), and four minutes of response. An advanced life support (ALS) unit should arrive on
scene within ten minutes (eight minutes of response). According the NFPA 1710, "This
requirement is based on experience, expert consensus, and science. Many studies note the role
of time and the delivery of early defibrillation in patient survival due to heart attacks and
cardiac arrest, which are the most time -critical, resource -intensive medical emergency events
to which fire departments respond." CAAS recommends that an ambulance arrive on scene
within eight minutes, fifty-nine seconds (00:08:59) of dispatch. However, research in EMS
indicates that if emergency medical intervention is delayed as long as nine minutes, patient
survival of cardiac arrests approaches zero.
Typically, less than 10 percent of 9-1-1 patients have time -sensitive ALS needs. But, for those
patients that do, time can be a critical issue of morbidity and mortality. For the remainder of
those calling 9-1-1 for a medical emergency, though they may not have a medical necessity,
this 90 percent, still expect rapid customer service. Response times for patients and their families
are often the most important issue regarding the use the fire department's services and are
what most often refer to when they "rate" their local emergency responders. Regardless of the
service delivery model, appropriate response times are more than a clinical issue; they are also a
customer service issue.
Another important factor in the whole response time question is what we term as "detection
time." This is the time it takes to detect a fire or medical situation and notify 9-1-1 to initiate the
response. In many instances, particularly at night or when automatic detection systems (fire
sprinklers and smoke detectors) are unavailable or inoperable, the detection process can be
extended.
STATION LOCATIONS
The fire station is a critical link in service delivery and where these facilities are located is the
single most important factor in determining overall response times.
The KFD serves an estimated 2016 population of 22,761 people and a service area of 11.73
square miles. This equates to an average service area for each fire station of approximately 5.87
square miles.
In a FY 2011 Performance Measurement Data Report on Fire and EMS, ICMA tabulated survey
information from 76 municipalities with populations ranging from 25,000 to 100,000 people. In this
grouping the average fire station service area was 11 square miles. The median service area
for this grouping of communities was 6.67 square miles per fire station. Although Kalispell's
current population is slightly below the study group, it is close enough to be utilized for
comparison.
In addition, the NFPA and ISO have established different indices in determining fire station
distribution. The ISO Fire Suppression Rating Schedule, section 560, indicates that first -due engine
companies should serve areas that are within a 1.5-mile travel distance. The placement of fire
stations that achieves this type of separation creates service areas that are approximately 4.5
15 Eisenberg, M.S., et al., "Predicting Survival from Out -of -Hospital Cardiac Arrest: A Graphic Model," Annals
of Emergency Medicine; November 1993; pp. 1652-1658.
16 Comparative Performance Measurement, FY 2011 Data Report - Fire and EMS, ICMA Center for
Performance Measurement, August 2012.
17 Ibid.
square miles in size, depending on the road network and other geographical barriers (rivers,
lakes, railroads, limited access highways, etc.). The National Fire Protection Association (NFPA)
references the placement of fire stations in an indirect way. It recommends that fire stations be
placed in a distribution that achieves the desired minimum response times. NFPA Standard 1710,
section 5.2.4.1.1, suggests an engine placement that achieves a 240-second (four -minute) travel
time. Using an empirical model called the "piece -wise linear travel time function" the Rand
Institute has estimated that the average emergency response speed for fire apparatus is 35
mph. At this speed the distance a fire engine can travel in four minutes is approximately 1.97
miles. A polygon based on a 1.97-mile travel distance results in a service area that on average
is 7.3 square miles.
At 5.87 square miles Kalispell's fire station service area is 12 percent below the median size and
53 percent of the average response area size.
Illustrating response time is important when considering the location from which assets should be
deployed. When historic demand is coupled with risk analysis, a more informed decision can be
made. Figure 6-4 uses GIS mapping to illustrate the 240-second travel time bleed comparisons,
utilizing the existing road network from each KFD station. Although there are areas within the city
that are outside of the 240-second travel time, these are mostly more remote areas that have
been annexed into the city. The majority of the city's most developed areas are well within the
240-second travel time. This fact supports the previous recommendation that the city needs to
more closely analyze the reasons for more extended travel times and take steps to attempt to
reduce them. Also note that the 240-second response bleeds, particularly for station 62, extends
into unincorporated areas of Flathead County that have not been annexed into the city.
18 University of Tennessee Municipal Technical Advisory Service, Clinton Fire Location Station Study,
Knoxville, TN, November 2012. p. 8.
19 Ibid., p.9
FIGURE 6-4: 240-second Travel Time from Kalispell Fire Stations
Figures 6-5 and 6-6 illustrate response time probabilities showing city-wide 360-second and 480-
second travel time comparisons, respectively. Virtually the entire city is covered within the 360-
second response time, along with portions of the county. The entire city and large areas of the
county are within the 480-second response time, including much of Evergreen and into Smith
Valley. The significance of this is that it indicates that with staffed stations, both of these
departments can arrive in Kalispell on automatic or mutual aid within a reasonable time frame.
CPSOTCenter for Public Safety Management, LLC 52
FIGURE 6-5: 360-second Travel Time from Kalispell Fire Stations
CPSACenter for Public Safety Management, LLC 53
FIGURE 6-6: 480-second Travel Time from Kalispell Fire Stations
Figure 6-7 layers the 240-, 360-, 480-, and even 600-second travel times into one illustration. The
360-, 480-, and 600- second bleed times all extend well into Flathead County.
CPSACenter for Public Safety Management, LLC 54
FIGURE 6-7: 240-, 360-, 480-, and 600-second Travel Times from KFD Stations
Red=240 seconds Green = 480 seconds
Blue = 600 seconds
Collectively, the four stations (two in Kalispell, one in Evergreen, one in Smith Valley) being
dispatched simultaneously to structure fire incidents serves to increase the Effective Response
Force (ERF), particularly for fires in moderate -risk and high -risk occupancies. Deploying a larger
ERF simultaneously to fire incidents is beneficial to the city and its residents. Reciprocity by the
KFD also benefits the residents of Evergreen and Smith Valley. In addition, with both Evergreen
and Smith Valley providing ALS-level ambulance service from stations that are staffed 24/7,
Kalispell is provided with reliable mutual aid for times when there are multiple simultaneous or
CPSOTCenter for Public Safety Management, LLC 55
overlapping EMS incidents, or when there is an incident that involves multiple patients such as a
school bus accident or aircraft incident.
KALISPELL RESPONSE TIMES
There is no "right" amount of fire protection and EMS delivery. It is a constantly changing level
based on such things as the expressed needs of the community, community risk, and population
growth. So, in looking at response times it is prudent to design a deployment strategy around the
actual circumstances that exist in the community and the fire problem that is identified to exist.
The strategic and tactical challenges presented by the widely varied hazards that the
department protects against need to be identified and planned for through a community risk
analysis planning and management process as identified in this report. It is ultimately the
responsibility of elected officials to determine the level of risk that is acceptable to their
respective community. It would be imprudent, and probably very costly, to build a deployment
strategy that is based solely upon response times.
For the purpose of this analysis Response Time is a product of three components: Dispatch Time,
Turnout Time, and Travel Time.
Dispatch time is the time interval that begins when the alarm is received at the initial public
safety answering point (PSAP) or communications center and ends when the response
information begins to be transmitted via voice and/or electronic means to the emergency
response facility or emergency response units or personnel in the field.
Turnout time is the time interval that begins when the notification process to emergency
response facilities and emergency response personnel and units begins by an audible alarm
and/or visual announcement and ends at the beginning point of travel time. The fire
department has the greatest control over these segments of the total response time.
Travel time is the time interval that initiates when the emergency response unit is actually
moving in response to the incident and ends when the unit arrives at the scene.
Response time, also known as total response time, is the time interval that begins when the call is
received by the primary dispatch center and ends when the dispatched unit(s) arrives on the
scene of the incident to initiate action.
For this study, and unless otherwise indicated, response times and travel times measure the first
arriving unit only. The primary focus of this section is the dispatch and response time of the first
arriving units for calls responded to with lights and sirens (Code 3).
According to NFPA 1710, Standard for the Organization and Deployment of Fire Suppression
Operations, Emergency Medical Operations, and Special Operations to the Public by Career
Departments, 2016 Edition, the alarm processing time or dispatch time should be less than or
equal to 60 seconds 90 percent of the time. NFPA 1710 also states that turnout time should be
less than or equal to 60 seconds for EMS incidents, and 80 seconds (1.33 minutes) for fire and
special operations 90 percent of the time. As noted above, turnout time is the segment of total
response time that the fire department has the most ability to control. Travel time shall be less
than or equal to 240 seconds for the first arriving fire suppression or EMS unit (BLS ambulance for
first responder unit), 90 percent of the time. The standard further states the initial first alarm
assignment should be assembled on scene in 480 seconds, 90 percent of the time. Note that
NFPA 1710 response time criterion is a benchmark for service delivery and not a CPSM
recommendation.
Our analysis of KFD response times included all calls to which at least one KFD unit responded
with lights and sirens and excluded canceled and mutual aid calls, and those with an extended
response time (more than 30 minutes). Also, only units that had complete time stamps are
included so that each segment of response time could be calculated. Based upon this criterion,
a total of 2,574 calls are included in the analysis.
Table 6-1 provides average dispatch, turnout, travel, and total response time for the first arriving
unit to calls in the city, by call type. Analysis of Table 6-1 tells us:
Average dispatch time was 1.9 minutes.
Average turnout time was 1.7 minutes.
Average travel time was 5.3 minutes.
Average overall response time was 8.8 minutes.
Further analysis shows the average total response time for EMS calls was 8.8 minutes, and the
average response time for fire category calls was 9.1 minutes. For actual fire calls, the average
response time for structure fire calls was 8.3 minutes, and the average response time for outside
fire calls was 8.9 minutes.
TABLE 6-1: Average Response Time of First Arriving Unit, by Call Type
Call Type
Dispatch
Turnout
Travel
Total
Number of
Calls
Breathing difficulty
1.7
1.6
4.7
8.0
184
Cardiac and stroke
1.6
1.6
4.3
7.5
295
Fall and injury
1.9
1.6
5.9
9.4
465
Illness and other
2.0
1.6
6.1
9.7
669
MVA
2.9
1.7
3.5
8.0
139
Overdose and psychiatric
1.7
1.6
6.0
9.3
94
Seizure and unconsciousness
1.7
1.4
4.5
7.6
276
EMS Total
1.9
1.6
5.3
8.8
2,122
False alarm
1.8
2.1
4.8
8.7
204
Good intent
1.8
2.2
4.6
8.7
51
Hazard
2.1
1.9
4.8
8.8
99
Outside fire
2.8
1.5
4.6
8.9
14
Public service
2.5
1.5
7.4
11.4
65
Structure fire
1.1
2.7
4.5
8.3
19
Fire Total
1.9
2.0
5.2
9.1
452
Total
1.9
1.7
5.3
8.8
2,574
A more conservative and stricter measure of total response time is the 90th percentile
measurement. Simply explained, for 90 percent of calls, the first unit arrived within a specified
time, and if measured, the second and third unit. Table 6-2 depicts average dispatch, turnout,
travel, and total response times of first arriving fire units for fire category calls. The table also
includes the 90th percentile times for dispatch, turnout, travel, and total response time.
Observations taken from Table 6-2 tell us:
90th percentile dispatch time was 3.4 minutes. (Emergency medical dispatch has some
impact on EMS call processing time; however, both fire and EMS dispatching times are well
above the recommended NFPA benchmark.)
90th percentile turnout time was 2.8 minutes for EMS and 3.3 minutes for fire (well above the
NFPA 1710 benchmark of 1.0 minutes for EMS and 1.33 minutes for fire). Remember, this is the
one aspect of total response time the fire department has the most direct impact on.
Aggregate fire and EMS 90th percentile travel time was 9.2 minutes. (Fire alone is 9.1 minutes,
while EMS is 9.3 minutes, both well above the NFPA 1710 benchmark).
90th percentile total response time for EMS calls was 13.0 minutes, and the 90th percentile
response time for fire category calls was 13.6 minutes. Both significantly exceed the NFPA 1710
benchmarks of 6.0 and 6.33 minutes, respectively.
TABLE 6-2: 90th Percentile Response Times of First Arriving Unit, by Call Type
Call Type
Dispatch
Turnout
Travel
Total
Number of
Calls
Breathing difficulty
2.7
2.7
7.8
11.2
184
Cardiac and stroke
2.8
2.8
7.6
10.9
295
Fall and injury
3.3
2.8
9.9
13.2
465
Illness and other
3.5
2.8
10.1
14.0
669
MVA
6.0
2.9
5.7
12.1
139
Overdose and psychiatric
3.5
2.9
10.5
13.8
94
Seizure and unconsciousness
3.4
2.3
7.5
11.2
276
EMS Total
3.4
2.8
9.3
13.0
2,122
False alarm
2.8
3.3
7.7
12.6
204
Good intent
3.3
3.8
8.1
13.0
51
Hazard
3.8
3.3
8.1
12.4
99
Outside fire
5.6
3.6
8.2
16.1
14
Public service
5.1
2.9
11.1
16.8
65
Structure fire
2.1
4.8
7.6
11.4
19
Fire Total
3.4
3.3
9.1
13.6
452
Total
3.4
2.9
9.2
13.1
2,574
Recommendation:
The Kalispell Fire Department should take whatever steps are necessary to improve both the
dispatch time and incident turnout times for both fire and EMS incidents to reduce overall
response times to emergency incidents.
SECTION 7. BUDGET AND EMS REVENUE
FIRE BUDGET
The FY 2017/2018 fire department general fund budget is $2,883,815 (a modest increase over the
FY 2016/2017 budget). Of this, $2,295,854 or 80 percent is allocated to personnel services. The
personnel services allocated budget funds 22.9 full-time equivalent (FTE) positions. This is broken
down as follows:
Fire Chief: 0.5 FTE.
Assistant Fire Chief: 0.5 FTE.
Clerk: 0.5 FTE.
Building Inspector: 0.4 FTE.
Captain: 3 FTEs.
Lieutenants: 3 FTEs.
Engineer: 6 FTEs.
Firefighter: 9 FTEs.
The remaining .5 FTE for Fire Chief, Assistant Chief, and Clerk is funded by the Ambulance Fund.
Of the FTE count for the fire department budget, 21 positions or 92 percent of the budgeted
positions are allocated to field operations, signaling efficiencies at the administrative level of the
department. The 0.4 FTE funding is for a building inspector assigned to the Building Department
and who also performs fire prevention inspections. Increases in the personnel services budget
over a two-year period is incremental and based largely on an unexpected increase in actual
overtime in FY 2016/2017 and increases in retirement and health insurance costs. The negotiated
fire labor contract allows for a 2.8 percent general increase in FY 2017/2018.
Of the remaining $587,961, $350,000 or 60 percent, is allocated as a transfer to the Ambulance
Fund, which is discussed in the next section. Over a three-year period, the Ambulance Fund
transfer has been inconsistent, as illustrated in Figure 7-1. This creates impacts on the remaining
maintenance and operations budget lines. The 2017/2018 budget also includes funding for debt
retirement for a pumper apparatus in the amount of $40,000.
FIGURE 7-1: Ambulance Fund Transfer
Fire Department Budget:
Ambulance Fund Transfer
Budgeted FY 2017/2018 L 350,000
Actual FY 2016/2017 230,000
Actual FY 2015/2016 M 380,000
50,000 100,000 150,000 200,000 250,000 300,000 350,000 400,000
The FY 2017/2018 overall fire department budget also has number of grants from which the
department receives revenues for specific expenditures. These include:
Assistance to Firefighters Grant (includes a city match).
Round Up for Safety.
Hazardous Materials Grant.
The fire department also has available impact fee revenues from development. Impact fees are
available funds designated to offset capital expenditures that have a ten-year life.
AMBULANCE FUND
The Ambulance Fund was created by City of Kalispell Ordinance #439 on April 18, 1932. The
purpose of the Ambulance Fund was to receive and deposit all funds generated for the use and
operation of the city's ambulance, and in turn pay out expenditures from this fund for the
maintenance and operation of the city's ambulance. Pursuant to the ordinance, no moneys
may be paid out of the Ambulance Fund, except by order of the City Council. The Ambulance
Fund was converted to a Special Fund during the FY 2007/2008 budget process by the then
Finance Director.
The FY 2017/2018 Ambulance Fund budget is anticipated to raise $1,212,229 in revenues. The
revenues include $750,000 in net transport revenues, which will be discussed later in this report,
$1 10,000 in county EMS levy revenues, and $350,000 general fund transfer funds. The general
fund transfer originates in the fire department general fund budget as an expenditure.
Ambulance Fund expenditures for FY 2017/2018 are $1,188,097. Of this, $918,049 or 77 percent is
allocated to personnel services. The personnel services allocated budget funds 9.50 full-time
equivalent (FTE) positions. This is broken down as follows:
Fire Chief: 0.5 FTE.
Assistant Fire Chief: 0.5 FTE.
Clerk: 0.5 FTE.
Firefighter: 8 FTEs.
The remaining $270,047 is allocated to maintenance and operations. Of this, $172,517 or 64
percent is allocated to contract, administrative services, fees, and insurance. This leaves $97,530
for direct use supplies, materials, fleet services and fuel, and small equipment.
The overall goal of the Ambulance Fund is to operate close to revenue neutral, meaning a
reduced general fund transfer from the fire department budget would be required, which would
in turn potentially reduce the overall city general fund budget. To accomplish this goal, either
net EMS transport revenues have to increase, or the Ambulance Fund budget has to be
decreased either in personnel services or the operations and maintenance lines.
It is unlikely EMS transport fees will increase enough to cover the current gap in revenues for this
fund due to the current payer mix, which will be discussed in the next section of this report. An
increase in EMS transport fees, which occurred in FY 2016/2017, is not likely to increase net EMS
transport revenues either, as this is linked directly to the payer mix and subsidy programs, which
make up the greatest percentage of the payer mix, paying only predetermined amounts that
are significantly less than the transport fees.
In 2014, the city placed a question on the ballot asking voters to approve a dedicated EMS levy
to assist with funding the system. The proposed levy, which was projected to have generated
approximately $736,000.00, was defeated.
Flathead County has a Department of Emergency Medical Services which helps to coordinate
EMS services throughout the county. It does not have a direct EMS response role. The county
provides the certified emergency physician that serves as the medical director for the county
(including the city) and Alert Air. The department provides training and other support resources
for the EMS units in the county. In 2005, county voters approved an assessment of a 2-mil tax levy
to assist with funding EMS operations. The county distributes about $500,000 per year to EMS
agencies. Kalispell receives an allocated amount annually. Services such as the KFD which
provide EMS transport services receive an annual allocation for operational readiness. The
remainder of the funding provided is based upon call volume.
EMS BILLING
EMS transport billing in Kalispell is similar to cities and counties across the country with regard to
the billing model, payer mix, and actual revenues to overall billing. Nationally, EMS transport
billing is either performed as an internal local government service, or through a contracted third -
party billing agency. Kalispell performs billing services internally. This billing is performed by the
fire department's executive secretary, who is a certified ambulance coder. Third -party billing
companies charge a fee, which is a percentage of the collected fee for their service. Payer mix
is the percentage of claims that result from EMS transport incidents when billed to the different
main insurance payer groups. Typically, the major components in a payer mix are Medicare,
Medicaid, commercial Insurance, patient/self-pay, and in some cases, facility contract.
Actual revenues to overall billing vary by region of the country, and more importantly, by locality
being served by the EMS agency. This is based on the locality's demographics. For instance, in a
locality that has a large population of residents over the age of 65, or a large percentage of the
population that is at or near the poverty line and utilizes Medicaid, the payer mix shifts to a larger
percentage of government -funded Medicare and Medicaid health care, or patient/self-pay or
no -pay. In each of these cases, the billable amount is not fully recovered, as billable fees are
legislated (Medicare, Medicaid and other federally or state supported health care components)
or in some cases such as self -pay, not paid at all by the user of the service. In all these examples,
the revenue collected -to -billing percentage is lower than that of commercial payers, facility
contracts, special source, and other categories. Conversely, and related to community
demographics, younger populations tend to be healthier and utilize the EMS transport system on
a less frequent basis.
In Kalispell, the EMS FY 2016-2017 transport payer mix is illustrated first in Table 7-1, where the
payers are listed in descending order beginning with the largest payer, then in Figure 7-2, where
the payers are broken out by percentage. In FY 2016-2017, Kalispell collected $696,219.89 in EMS
transport revenue. The top payer was Medicare -Part B, which contributed 44 percent of the
collected revenue. Further broken down, the top four payers (Medicare Part-B, Insurance
Primary, Medicaid, and Insurance -Secondary) contributed 77 percent aggregately to the EMS
transport revenue fund for FY 2016-2017. In FY 2015-2016 these same top four contributed 82
percent aggregately to the EMS transport revenue fund. In FY 2014-2015, Special Source payer
(911 calls -hospital billed directly) replaced Medicaid in the top four payer contributors. The top
four in FY 2014-2015 contributed 78 percent aggregately to the EMS transport revenue fund.
Medicare was also the top payer in FY 2014-2015 and FY 2015-2016. Interestingly, Medicare as a
payer has decreased almost 9 percent from FY 2014-2015 to FY 2016-2017 while Medicaid as a
payer has increased 135 percent over the same period. This shift in payer mix potentially is due
to a shift in demographics.
Demographically, according to the 2010 census, Kalispell's 65 years of age and over population
represents 15.4 percent of the total population. The 2016 American Community Survey reports
that 14.2 percent of Kalispell's under 65 years of age population does not have health insurance.
Finally, the 2016 American Community Survey reports that 18.5 percent of the Kalispell
population is living below the poverty level. These factors, along with an unemployment rate20 of
5.6 percent in December 2017 and an increase in retirement communities and the transient
population reported by staff, creates the probability for negative impacts on EMS transport
billing revenue collections.
TABLE 7-1: Kalispell FY 2016-2017 EM5 Transport Payer Mix
Payer
Amount
Medicare -Part B
$310,680.87
Insurance -Primary
$1 17,254.82
Medicaid
$69,821.87
Insurance -Secondary
$46,588.99
Special Source
$35,186.67
Private Pay
$34,391.01
Veterans Admin.
$25,644.43
Medicare Co -pay Patient
$18,621 .66
Insurance -Auto
$16,306.70
Detention Center
$13,440.38
Insurance -Indian Health Services
$9,444.24
Worker's Compensation
$3,178.92
TriCare/Tri W est
$1,580.84
Medicare Sequestration Amount
- $5,921 .51
2016-2017 EMS Billing Revenues
$696,219.89
20 https://ycharts.com/indicators/kalispell_mt_unemployment_rate_micsa
FIGURE 7-2: FY 2016-2017 Kalispell EMS Transport Payer Mix by Percentage
Payer Mix 2016-2017
■ Medicare Co -Pay -Patient
■ Detention Center
Insurance -Auto
■ Insurance -Indian Health Services
Insurance -Primary
Insurance -Secondary
■ Medicaid
■ Medicare -Part B
■ Private Pay
■ Special Source
■ TriCare/TriWest
■ Veterans Admin.
Workers Compensation
Medicare Sequestration Amount
Figure 7-3 illustrates the net losses the current EMS transport billing suffers. In FY 2016-2017, the
gross transport billing was $1,710,617.93. Net revenues equaled $696,219.89, or a 41 percent net
collection rate. Overall, $1,014,398.04 was not collected for relevant reasons discussed later in
this section. In FY 2015-2016, the net collection rate was 54 percent, and in FY 2014-2015, the net
collection rate was 56 percent. Aggregately, $2,048,215.61 in EMS transport fees has gone
uncollected for material reasons over the last three fiscal years. Fund transfers over the last three
fiscal years from the General Fund to the Ambulance Fund to sustain this fund and ambulance
operations totals $920,000.
FIGURE 7-3: EMS Transport Billing Charges and Credits
EMS Billing
Charges/Credits
Credits Q Charges
1,800,000.00
1,710,617.93
1,600,000.00
1,400,000.00
1,152,569.68 1,147,479.93
1,200,000.00
1,000,000.00
800,000.00
644,933.32
621,29g 72
696,219.89
600,000.00
400,000.00
200,000.00
0.00
2014-2015 2015-2016
2016-2017
21 City of Kalispell FY 2016-2017, 2017-2018 Final Budget Documents.
CPSNICenter for Public Safety Management, LLC 63
A concern with the EMS transport billing is the ability to collect a higher percentage of the
actual charges, so that the General Fund budget transfer to sustain the Ambulance Fund can
be reduced or at some point in the future, eliminated completely. As a Special Fund, it is
generally anticipated the fund will collect enough revenue to cover expenses. Table 7-2 shows
the current base EMS transport fees for the city. There are ancillary charges such as mileage and
supplies that are included in the bill depending on the type of service provided.
TABLE 7-2: Kalispell EMS Transport Base Fee Schedule
Charge Description
Resident Fee Schedule
Nonresident Fee Schedule
ALS Level 2 Emergency
$1,138.08
$1,403.30
ALS Level 1 Emergency
$1,138.08
$1,403.30
ALS Non -emergency
$1,138.08
$1,403.30
BLS Emergency
$969.15
$1,234.37
BLS Non -emergency
$969.15
$1,234.37
Treatment/Non-transport
$107.47
$372.69
No Haul
$107.47
$372.69
Kalispell's collection of EMS transport fees is no different than any other EMS agency CPSM has
analyzed, in that EMS transport revenues do not offset EMS transport expenses. Because federal
government health care services such as Medicare, Veterans Administration, and Indian Health
Care Services, and state -supported health care systems such as Medicaid pay a lower transport
fee, EMS transport systems cannot collect 100 percent of these payer types' total EMS transport
bill. Medicare does allow billing and collection of 20 percent of the Medicare approved
transport amount when applicable (see Medicare Co -pay Patient in the Payer Mix Table
above) .
Raising EMS transport fees will not counter the collection issue in all payer categories, as federal
law prohibits the billing of the remaining amount of the EMS transport bill for certain protected
rates, such as Medicare and other federal health care services (Medicare is the highest
percentage of revenues and Medicaid is the third highest percentage). Hampering the
collection of EMS transport revenues further is Medicare sequestration. Simply put, there is a
claims payment reduction of 2 percent applied to all Medicare claims after determining
coinsurance, any applicable deductible, and any applicable Medicare secondary payment
adjustments.
Table 7-3 illustrates an actual Kalispell EMS transport bill for a Medicare patient and a Medicaid
patient. This depicts the disparity in amount billed versus amount received, as well as anomalies
associated with each type's fee schedules.
TABLE 7-3: Medicare and Medicaid Billing Examples
Medicare EMS Transport
Medicaid EMS Transport
ALS Transport Amount Billed
$1,282.34
ALS Transport Amount Billed
$1,138.08
Medicare Paid
$473.53
Medicare Paid
$257.70
Co-pay/Co-insurance Paid
$120.80
Co -pay Paid
$0.00
Adjustment/Write-off
$688.01
Adjustment/Write-off
$880.38
Total Amount Collected
$594.33
Total Amount Collected
$257.70
Percent of Bill Collected
467.
1 Percent of Bill Collected
23%
The Medicare bill includes the ALS-2 transport charge plus mileage.
The Medicaid bill does not allow for mileage or co -pay per the fee schedule.
In the Medicare example, the total allowed amount for payment (ALS-2 charge plus mileage)
per the Medicare fee schedule is $603.99. Of the allowed amount, only 80 percent of the
allowed charges are paid to the biller (City of Kalispell). In the case of Medicare, 2 percent
additional is deducted pursuant to the Budget Control Act of 2011 (Medicare sequestration in
this case). Medicare does allow patient direct billing or to a patient's secondary insurance to
close the 20 percent gap between the allowed amount and the 80 percent of the allowed
charges paid to the biller.
In the Medicaid example, the total allowed amount for payment is lower than Medicare.
Additionally, Medicare only allows billing for mileage in certain circumstances. For instance,
medically necessary transports inside the city limits of Kalispell from a patient's residence, a
place of business, or from the street to the emergency department will not qualify for mileage
reimbursement. Additionally, the Medicaid fee schedule does not allow direct billing to the
patient to close the gap between allowable payments and billable charges.
SECTION 8. EMS SUSTAINABILITY
A discussion about EMS sustainability in Kalispell must include the fire services component of the
system, as currently staffing is provided to both fire and EMS services through dual role personnel.
Sustaining one or both components as a viable city function includes an understanding of the
staffing of each, and how they integrate to provide a combined level of service.
STAFFING AND DEPLOYMENT OF FIRE AND EMS DEPARTMENTS
Staffing and deployment of fire and EMS services is not an exact science. While there are many
benchmarks that communities and management utilize in justifying certain staffing levels, there
are certain considerations that are data driven and reached through national consensus that
serve this purpose well. CPSM has developed metrics it follows and recommends that
communities consider when making recommendations regarding staffing and deploying of
these services. These are:
Fire Risk and Vulnerability of the Community: A fire and EMS department collects and organizes
risk evaluation information about individual properties and, based on the rated factors, then
derives a "fire risk score" for each property. Information is also collected on demographics,
environmental risks, demographics, socioeconomics, and population to identify potential risk
these components present for both fire and EMS services. The community risk and vulnerability
assessment is used to evaluate the community as a whole in the preparedness phase of staffing
and deployment planning.
Population, Demographics, and Socioeconomics of a Community: Population and population
density drives emergency and non -emergency local government service, particularly public
safety. The risk from fire, injury, and disease processes is not the same for everyone, with studies
telling us age, gender, race, economic factors, and what region in the country one might live in
contribute to the risk of death from fire. Studies also tell us these same factors affect demand for
EMS, particularly population increase and the use of hospital emergency departments more
frequently as many uninsured or underinsured patients rely on EDs for their primary and
emergent care, utilizing prehospital EMS transport systems as their entry point.
Call Demand: Demand is made up of the types of calls to which units are responding and the
location of the calls. This tells us what resources are needed and where.
Workload of Units: The types of calls to which units are responding and the workload of each unit
in the deployment model. This integrates with call demand and also tells us what resources are
needed and where.
Travel Times from Fire Stations and Fixed or Dynamic Response Points for EMS Response: Looks at
the ability to cover the response area in a reasonable and acceptable travel time when
measured against national benchmarks. Links to demand and risk assessment.
NFPA Standards, ISO, OSHA requirements (and other national benchmarking).
EMS Demand: Community demand; demand on available units and crews; demand on non -
EMS units responding to calls for service (fire/police units); availability of crews in departments
that utilize cross -trained EMS staff to perform fire suppression.
Critical Tasking: The ability of a fire and EMS department to comprise an effective response
force when confronted with the need to perform required tasks on a fire or EMS incident scene
defines its capability to provide adequate resources to mitigate each event.
Innovations in Staffing and Deployable Apparatus: The fire department's ability and willingness to
develop and deploy innovative apparatus.
Community Expectations: Measuring, understanding, and meeting community expectations.
Ability to Fund: The community's ability and willingness to fund all local government services and
understanding how the revenues are divided up to meet the community's expectations.
These factors are further illustrated in Figure 8-1.
FIGURE 8-1: Staffing and Deploying Fire and EMS Departments
FIFV * Stalling • Critical Tasking
Benchmarkin
• Risk Analysis
Appal at -Workload of
Deployment Units
to Fund 7 Innovations
. • Call Demand
Station .Travel Times
Location(s)
* EMS Demand
While each component presents its own metrics of data, consensus opinion, and/or discussion
points, aggregately they form the foundation for informed decision making geared toward the
implementation of sustainable, data- and theory -supported, effective fire and EMS staffing and
deployment models that fit the community's profile, risk, and expectations.
To effectively respond to and mitigate requests for emergency services, an agency must have a
thorough understanding of its community's risk factors, both fire and EMS. Once identified and
understood, each category or level of risk is associated with the necessary resources and actions
required to mitigate it. This is accomplished through a critical task analysis. The exercise of
matching operational asset deployments to risk, or critical tasking, considers multiple factors
including national standards, performance measures, and the safety of responders. Fire
departments that serve smaller communities, especially those that are somewhat isolated like
Kalispell, often face greater challenges attempting to handle higher risk and/or larger incidents
because the necessary staffing resources are simply not immediately available or may have an
extended response time when requested for assistance.
Critical tasks are those activities that must be conducted in a timely manner by responders at
emergency incidents to control the situation and stop loss. Critical tasking for fire operations is
the minimum number of personnel needed to perform the tasks required to effectively control a
fire. The same is true for EMS as there are specific patient care tasks that must be completed in
succession and often together to support positive prehospital care.
During fire incidents, to be effective, critical tasking must assign enough personnel so that all
identified functions can be performed simultaneously. However, it is important to note that
secondary support functions may be handled by initial response personnel once they have
completed their primary assignment. Thus, while an incident may end up requiring a greater
commitment of resources or a specialized response, a properly executed critical task analysis will
provide adequate resources to immediately begin bringing the incident under control. In dual
role agencies such as Kalispell, ambulance personnel integrate into the overall critical tasking
when available.
The specific number of people required to perform all the critical tasks associated with an
identified risk is referred to as an Effective Response Force (ERF). The goal is to deliver an ERF
within a prescribed time frame. NFPA 1710, as a nationally recognized consensus standard on
staffing and deployment for career fire departments, provides a benchmark for ERF. Asa
benchmark, NFPA 1710 states that the initial full alarm to a typical 2,000 square -foot residential
structure, the ERF, would be a minimum of 15 personnel deployed to the scene.
The NFPA Fire Protection Handbook classifies buildings and occupancies by their relative risk
and provides recommendations on the minimum ERF that will be needed to handle fire incidents
in them. These include:
Medium -hazard Occupancies: Apartments, offices, and mercantile and industrial occupancies,
not normally requiring extensive rescue by firefighting forces.
Operational Response: 3 pumpers, 1 ladder truck (or combination apparatus with
equivalent capabilities such as a quint), 1 chief officer, and other specialized apparatus
as may be needed or available; not less than 16 firefighters and 1 chief officer plus a
safety officer and a rapid intervention team.
Low -hazard Occupancies: One-, two-, or three-family dwellings and scattered small business
and industrial occupancies. This represents the majority of occupancies found in Kalispell.
Operations Response Capability: At least 2 pumpers, 1 ladder truck (or combination
apparatus with equivalent capabilities such as a quint), 1 chief officer, and other
specialized apparatus as may be needed or available; not less than 12 firefighters and 1
chief officer, plus a safety officer, and a rapid intervention team.
When considering critical tasking for the deployment of an ERF for fire suppression operations,
the KFD will need to consider both its own limited resources, as well as the fact that even units
from surrounding areas of Flathead County dispatched simultaneously with Kalispell may have
extended response times. The city does utilize automatic aid from Evergreen and Smith Valley.
Evergreen responds automatically with an engine with four personnel to any reported structure
fire in the city. Smith Valley also responds automatically with an engine, usually with two or three
personnel. For commercial fires and fires in multifamily occupancies, Evergreen also responds a
ladder truck. These two departments provide the first response into the city since they have in-
22 It is important to note that compliance with NFPA 1710 has not been mandated in the State of Montana
or by the federal government. It is considered a "best practice" that fire departments strive to achieve.
23 Cote, Grant, Hall & Solomon, eds., Fire Protection Handbook (Quincy, MA: NFPA 2008), 12-3
station staffing 24/7. Together with the KFD, they provide an initial response force of about 12
personnel (assuming the KFD has 6 on duty). In addition, one or both of the KFD chief officers
respond automatically to every reported structure fire providing an additional one or two
personnel. When additional assistance is needed, fire departments in the region respond;
however, the response is delayed due to distance these departments must travel.
CPSM believes that the adoption of this type of deployment and staffing model will enable the
KFD to effectively, efficiently, and safely handle a wider range of emergency incidents from
medical emergencies to structure fires throughout the city. With the continued use of automatic
aid, the department should be able to place between 12 and 16 personnel on the scene of a
low- to moderate -risk structure fire within a reasonable time frame. As a result, the department
will be better able to effectively and safely handle the myriad number of tasks that must be
performed during the initial stages of these types of incidents. These types of fire incidents,
primarily one- and two-family dwellings, comprise the largest percentage of structure fire
incidents to which the KFD responds.
Establishing an ERF for medical emergencies is significantly less labor intensive than it is for fire
incidents. NFPA 1710 provides guidance regarding staffing levels for units responding to EMS
incidents; however, the provision does not specify a minimum staffing level for EMS response
units. Instead, section 5.3.32 of the standard states: "EMS staffing requirements shall be based on
the minimum levels needed to provide patient care and member safety." It further recommends
that resources should be deployed to provide "for the arrival of a first responder with AED within
a 240-second travel time to 90 percent of the incidents," and, "when provided, the fire
department's EMS for providing ALS shall be deployed to provide for the arrival of an ALS unit
within a 480-second travel time to 90 percent of the incidents provided a first responder with
AED or BLS unit arrived in 240 seconds or less travel time."
EMS calls are typically managed with fewer personnel, and the majority of EMS calls can be
handled with a single ambulance staffed with two personnel. In the call -screening process,
those calls that require additional personnel are typically identified at the dispatch level and
additional personnel can be assigned when needed. These types of incidents could include
cardiac and respiratory arrest, unconscious persons, and other incidents where the initial call
seems to indicate a severe and imminent threat to life. NFPA 1710 suggests for these types of
emergencies that "personnel deployed to ALS emergency responses shall include a minimum of
two members trained at the emergency medical technician —paramedic level and two
members trained at the emergency medical technician —basic level arriving on scene within the
established travel time." In these cases, a fire suppression unit can also be dispatched to assist
the ambulance crew. However, these types of emergencies constitute a small percentage of
overall EMS incidents as identified herein. Of the department's uniformed personnel, 22 are
certified paramedics (EMT -Ps) and the remaining 9 are advanced emergency medical
technicians (A-EMTs).
In Kalispell, field personnel work a three -platoon system that is comprised of 24-hours on and 48-
hours off. On average, personnel work 46.77 hours per week. As agreed to in the current
collective bargaining agreement between the City of Kalispell and Local 547 of the International
Association of Firefighters, each member of the bargaining unit, which includes all uniformed
personnel except for the fire chief and assistant fire chief, receive a total of 20 Kelly days each
year. Kelly days are days when the member's shift is scheduled on -duty, but the member is
scheduled off to reduce the number of hours in the workweek. By law, fire personnel can only
work a 53-hour workweek before they must be paid at an overtime rate of pay. Kelly days are in
addition to vacation and other types of leave such the member receives as part of the benefit
package. The current number of Kelly days for each member equates to 16.7 percent of each
shift's total work days in the year. The number of Kelly days that each member earned was
increased from 13 in the previous contract to the current number in the CBA, which took effect
on July 1, 2016 and runs through June 30, 2019.
Table 8-1 illustrates the KFD personnel deployment based upon the staffing level up to a daily
staffing level of eight.
TABLE 8-1: KFD Staffing/Deployment Matrix
Staffing level
Station 61
Station 62*
Ladder 642 -
3
Engine 631 -
3
6 Personnel
OR
Medic 621 - OOS
Medic 622 -
3
Ladder 642 -
4
OR
Ladder 642 -
2
7 Personnel
Engine 631 -
3
Medic 622 -
2
OR
Medic 622 -
2
Medic 621 -
2
Ladder 642 -
3
Engine 631 -
3
8 Personnel
OR
Medic 621 -
2
Medic 622 -
3
* Station 62 personnel may also cross staff a water tender or engine when required.
Figure 8-2 illustrates the number of days the KFD was at each average staffing level of between
six personnel and nine personnel between July 1, 2016 and December 31, 2017. Since staffing
levels often fluctuate at various times throughout each 24-hour shift, the average on duty
staffing for the entire day was utilized. If the average staffing level was between whole numbers,
the daily average was rounded to the nearest whole number. Although the department
averaged seven personnel on duty 50 percent of the time during this time period, there was a
significant decrease in the number of days where there were seven or more personnel on duty
after January 1, 2017.
FIGURE 8-2: Average Number of Personnel on Duty Each Day. July 1, 2016 -
December 31, 2017
1DAY=10
PERSONNEL
■ 6 PERSONNEL ■ 7 PERSONNEL 8 PERSONNEL ■ 9 PERSONNEL
CPSACenter for Public Safety Management, LLC 71
CURRENT STATE OF THE FIRE AND EMS SYSTEM
The current state of the fire and EMS system in Kalispell, which includes external factors such as
available staffing, risk, EMS billing, future city growth, available funding, and demand for service
is, as analyzed and observed by CPSM:
From July 1, 2016 thru December 31, 2017 the KFD was staffed with six personnel on duty 193
days or 35 percent of the time, and with seven on duty 272 days or 50 percent of the time. The
number of days at six personnel increased in 2017. The on -duty staffing was eight or nine
personnel just 81 days or 15 percent of the time.
With current minimum staffing level of six, only two units are staffed for all fire and EMS
responses, either two fire suppression units or one fire unit and one EMS unit.
When a single fire response unit is available, with staffing of three personnel, tactical fire and
rescue options will be limited.
When staffing is at six the EMS unit that is staffed responds out of Station 62, which increases
response time for the ambulance into Station 61 's area, which is nearly twice as busy. When
this occurs the fire suppression unit (Ladder 642) is out of service.
When staffing is at six and a second EMS incident comes in, the remaining fire suppression
unit (Engine 631) responds to this incident to provide patient care until a mutual aid
ambulance arrives. When this occurs, there is no fire suppression unit available for
immediate response.
The city has a limited number of fires; however as analyzed in this report, the city does have a
significant level of risk.
When staffing is at seven, the operational gain is that four personnel can be assigned to
station 62. When an EMS call occurs, two personnel can staff the ambulance and two
personnel can remain at the station to staff the apparatus. The two personnel remaining at
Station 62 can then still respond with the ladder apparatus to a fire incident. To optimize the
use of this staffing, the remaining two personnel can also staff a second ambulance from
station 62 (the second ambulance would have to be located at station 62).
The city planning department anticipates continued growth and development of around 2
percent per year and 21 percent in the next decade. This translates into increased fire and
EMS risk resulting in increased demand and services.
When staffing is at six or seven, there may be no EMS transport unit readily available if both fire
units are out on a fire -related incident.
There is no dedicated EMS unit staffed until staffing reaches eight personnel, which happened
just 81 times (15 percent) in the 18 months between 7/1 /16 and 12/31 /17.
Nearly 25 percent of the population of the city falls into higher risk categories of 65 years old or
older (15.4 percent) and under age 5 (8.4 percent).
More than 800,000 nonresidents spent at least one night in Kalispell in 2017. Of these, more
than 50 percent were age 65 or older.
EMS incidents represent the highest percentage (71 percent) of total calls for the KFD. The EMS
risk includes: 35.5 percent of EMS incidents are potentially life -threatening difficulty breathing,
cardiac or stroke, and unconscious or seizure calls where time of onset to treatment in the
prehospital setting and transfer to a hospital facility has impacts on positive outcomes.
Just 58 percent of EMS incidents result in a transport to the hospital. This is an average of 3.8
per day.
Although there were 760 incidents in 2017 that overlapped with at least one other incident
(22.1 percent of all incidents), just 155 (20.4 percent) of those occurred during an EMS
transport. This equates to an average of 0.42 per day, or 1 every 2.3 days. This works in favor of
the current staffing model availing ambulance staffing to respond to another EMS call or fire
call for service.
The Ambulance Fund was initially established as an Enterprise Fund but was changed in FY
2008 to a Special Fund.
The overall goal of the Ambulance Fund is to operate closer to revenue neutral, which
would require a reduced general fund transfer from the fire department budget, which
would in turn potentially reduce the overall city general fund budget.
To accomplish this goal, either net EMS transport revenues have to increase, or the
Ambulance Fund budget has to be decreased either in personnel services or the operations
and maintenance lines.
The FY 17 actual budget transfer was $230,000.
The FY 18 budgeted transfer is $350,000.
The current payer mix will not sustain the goal of reducing the general fund transfer from the
fire department to the Ambulance Fund.
The city increased EMS rates in 2016 and 2017.
Raising EMS transport fees will not counter the collection issue in all payer categories, as
federal law prohibits the billing of the remaining amount of the EMS transport bill for certain
protected rates, such as Medicare and other federal health care services (Medicare is the
highest percentage of revenues and Medicaid is the third highest percentage).
The current collective bargaining agreement allows 20 Kelly Days per year. This allows those
covered in the agreement a 46.77-hour work week. This is an increase of 7 days from the 13
given in the previous agreement. This increase in Kelly Days equates to an additional 203 shifts
per year that personnel can take off, which directly impacts staffing.
Anytime a mutual aid EMS transport unit responds into Kalispell from a neighboring fire
department, such as Evergreen, Kalispell is not able to collect that EMS transport revenue.
KFD provides first due EMS service to much of South Kalispell Fire District at no cost other than
the third -party billing. There is a soft agreement that there will be no fee for service, as South
Kalispell responds into Kalispell on fire responses.
Surrounding areas are increasingly relying on KFD for EMS, since the number of their available
volunteers, particularly on the EMS side, is declining.
KFD and Kalispell Regional Medical Center (KRMC) are the anchors in the area for EMS
delivery.
ALTERNATIVES FOR A SUSTAINABLE EMS SYSTEM
1. Maintain the Status Quo
Like many fire and EMS department's today, the KFD is not really a fire department that does
EMS, it is an EMS department that provides fire services. There are two common models utilized.
In a dual -role system, personnel are trained as both firefighters and EMTs/ paramedics and
perform both fire and EMS duties. In a single -role system, the department has an EMS division or
section, but its personnel, and often management, are kept separate from fire suppression and
perform EMS duties only.
This alternative sustains an integrated fire and EMS agency designed to provide a quality dual
service utilizing dual -role personnel, which makes optimal use of personnel to handle both
functions.
As a Montana Class 1 city, Kalispell must have a fully career fire department as prescribed in
statute. Dual function fire/EMS personnel help to achieve an initial effective response force
(ERF) for fire service incidents.
Advantages of this alternative include:
Fire stations are already part of neighborhoods and positioned to meet response time and
demand.
Firefighters are highly respected within community and provide a high degree of comfort to
citizens for sustainability of EMS.
Fire/EMS department managers are directly responsible to local government elected officials,
thus allowing oversight to ensure accomplishment of key performance goals.
Facilitates day -to -to management oversight.
Enhances versatility of workforce, providing flexibility for management.
Greater employee job satisfaction; lower attrition rate.
Disadvantages include:
Measured on level of effort (LOE) rather than performance results.
Uses fixed -base (static) resource deployment model, which may limit efficiency in managing
the system status during peak times when applicable.
Use of 24-hour shift schedule results in excessive resources during nonpeak hours and
inadequate resources during peak hours.
Fire service heavily organized, resulting in competitive compensation and retirement
programs; adds degree of complexity, often limiting organization's ability to manage system.
As with most government models, only serves patients who request care through 9-1-1 systems.
Nonemergency patient transport needs are usually delegated to local private providers.
Model Cost (Assumptions)
Same as existing model of Fire/EMS service delivery.
Z. Private For -Profit Model.
In the private for -profit model, emergency ambulance service is provided through contracts
between private providers and local government. Nonemergency services may be included. As
with the fire service, these contracts may be level of effort or performance -based, with a focus
on results. Management and oversight of clinical care, day-to-day operations, assets, and
capitalization are all accomplished in the private sector, and the level of involvement and
financial support of local government is completely negotiable.
Advantages of this alternative include:
Local government not directly tied to day-to-day operations of the service. Focus is on solid
contracting, established performance results, and quality assurance.
No investment in physical resources, e.g., buildings, ambulances, equipment, or staff; no
maintenance or replacement costs.
Clear scorecards with which to assess the performance of contractors, thus facilitating
benchmarking efforts against similar communities.
Local officials can hold contractors accountable and replace if warranted.
Motivated by satisfying customers and making profit, private for -profit companies focus on
practices that increase efficiency and keep costs down. Usually heavily engaged in
nonemergency market as well to help offset costs of serving the emergency market.
Disadvantages include:
Locating a private third -party contractor interested in providing service in the local
government's location.
Aggressive billing procedures.
Lack of accountability and transparency.
Performance data may not be accessible.
Follow-up on complaints and inquiries may be inconsistent.
Financial oversight often limited.
Unregulated competition —especially true within nonemergency transport market, where
ability to pay mix is more lucrative than in emergency environment. Clear local regulation
and contracting can curtail problems.
Sudden withdrawal of the provider from the market is also a potential concern. This may occur
if provider decides the market doesn't provide enough revenue to support its service, or it can
be due to internal financial issues that force downsizing. The community needs to clearly
address this in the contract and remain alert to the potential need for another contractor if
one is available and willing to take on the contract to provide service on short notice.
Less attractive for field providers. Lower wages, less opportunity for advancement, and higher
expectations for productivity are all factors that may contribute to turnover.
Model Cost (Assumptions)
Dependent on level of service/expectations from contracting local government (number of
deployed units, performance goals):
Current dual -role fire -based model deploys one to two ambulances. All overhead costs
inclusive to local government budgets.
Local government subsidy (potentially up to 15 percent or more) dependent on transport
billing recovery rate (cash for service) versus level of service contracted for (number of
ambulances deployed, system status, and response time performance measures).
The current status -quo model would most likely lose dual -role personnel (those budgeted in
the ambulance fund). The city would have to make a decision as to whether any of these
positions would be absorbed directly into the fire department budget. This would potentially
increase the fire department budget, as the current general fund transfer from fire to the
Ambulance Fund, to maintain fire service delivery. Therefore, there would potentially be no
savings to the general fund budget.
3. Third -Service Model
The least prominent model of emergency ambulance service is the third -service model; it is often
referred to as the "holy grail." It involves a stand-alone department within a city or county
government, like the fire or police department, and which is dedicated to emergency medical
service. It is traditionally staffed with civilian employees and, like its public -safety counterparts, is
completely owned, financed, and operated within local government structure. This model is
often perceived by providers as favorable because it is dedicated to emergency ambulance
service and appears to provide parity between EMS and its public safety peers.
Advantages of this alternative include:
Public ownership of the emergency ambulance component of the EMS system. While also true
of fire -based model, this alternative has a single service delivery focus. Everyone charged with
and working on the delivery of emergency medical service, and management, are still
directly responsible to local officials. Allows government to have direct control over day-to-
day operations of the service.
Typically uses civilian workforce. Allows department to offer wages that are competitive to the
market, but still reasonable. Offers some flexibility in developing schedules that match
resources to the call volume demand.
Disadvantages include:
Often requires dual response with the fire department for high -priority calls as well as some
low -priority calls such as patient -lift assists and when no ambulance is available.
As with fire service models, it is common for third -service organizations to be evaluated by a
level of effort approach instead of performance outcomes. This means no repercussions exist if
the service does not meet performance goals. Poor performance is often addressed by simply
adding resources.
Cost containment.
Control of expenditures is dependent upon local government's own budgetary and
managerial processes. Without other motivations like competing and bidding to ensure
competitive pricing, there is less of a drive to keep costs down.
Frequently assigned less value than public safety peers, and leadership shares many of the
same struggles for recognition as other models.
Emergency market does not serve the nonemergency patient population.
Model Cost (Assumptions)
Increased cost to local government as this model adds overhead and personnel costs.
Administrative and supervisory staff is duplicated as well as some clerical. Duplication in
capital and equipment cost depending on delivery model. This would increase the general
fund support for EMS.
May not utilize the total capacity of the available system components, such as static staffed
fire personnel and resources.
Recommendations:
■ The optimum daily staffing is eight personnel, to manage the potential fire risk identified herein,
and the EMS transport response when a second ambulance is needed, however CPSM
understands the current funding and department daily staffing/leave model does not support
this staffing level. Given these current challenges:
o CPSM strongly recommends the city maintain the status quo of a dual -role fire/EMS
service delivery model to maximize available staffing, and to maintain local control EMS
services;
Review the current staffing model and collective bargaining agreement to seek
alternatives to increase staffing to seven personnel as often as possible;
o The higher level of this recommendation is seven personnel as a minimum staffing level
at all times.
■ This staffing level will ensure a staffed engine at station 61 with three personnel;
This will ensure a minimum staffing level of four at station 62, which will allow the
effective cross -staffing of both an ambulance and ladder at station 62, which will
optimize available staffing;
• At station 62, on fire responses the staffing will be four on the ladder, which
will supplement the initial effective response force with Engine 61 (staffing of
three).
• In cases of a single unit response when Engine 61 is committed to an
incident, Station 62 staffing of four will allow staffing of a single fire unit
(staffing of four), or an initial response of an ambulance (staffing of two) and
a fire unit (staffing of two).
• Additional optimization of station 62 staffing at four allows the staffing of two
ambulances at those times when EMS transport calls overlap, and the
second 2-person crew at station 62 is available (not committed to a fire
incident).
• As the data shows, the city can operate the majority of the time with one
EMS transport unit, and there is not a high percentage of overlapping EMS
incidents, both transport and non -transport. However, having the ability to
staff the additional EMS unit when necessary will eliminate the need for most
EMS mutual aid into the city, which reduces the potential for additional
revenue loss.
If staffing cannot be increased more often than indicated in this report, CPSM recommends
maintaining the status -quo minimum staffing at six personnel. This will ensure a minimum
staffing of three personnel at each station. CPSM recommends that when station 62 receives
an EMS alarm, and the EMS transport unit responds, the unit respond with a staffing of two
only. The additional person remains available to respond to fire incidents in a utility vehicle
with the remaining KFD fire unit at station 61 to increase resources for the initial effective
response force.
CPSM further recommends the city review all options for increasing EMS revenues. This should
include the continual review of in-house EMS billing to ensure collection of revenues is
maximized to the fullest extent allowable by law, with a focus on closing the gap between
billed services and collected revenues; consideration of service fees with areas outside of the
city boundaries that the KFD provides EMS transport to; and reconsideration of the city EMS tax
levy at a rate sufficient to offset general fund transfers needed to sustain the ambulance fund.
SECTION 9. DATA ANALYSIS
This data analysis was prepared as a key component of the study of the Kalispell Fire
Department (KFD). This analysis examines all calls for service between July 1, 2016, and June 30,
2017, as recorded in the Flathead County 911 Emergency Communication Center's computer -
aided dispatch (CAD) system and the KFD's National Fire Incident Reporting System (NFIRS).
This analysis is made up of five parts. The first part focuses on call types and dispatches. The
second part explores time spent and workload of individual units. The third part presents an
analysis of the busiest hours in the year studied. The fourth part provides a response time analysis
of KFD units. The fifth and final part is an analysis of unit transports.
During the year covered by this study, KFD operated out of two stations, utilizing three type 1
engines, two type 6 engines, one 105-foot ladder truck, three ambulances, one water tender,
and three administrative vehicles.
During the year studied, the department responded to 3,437 calls, of which 71 percent were EMS
calls. The total combined workload (deployed time) for all KFD units was 2,516 hours. The
average dispatch time for the first arriving unit was 1.9 minutes and the average response time
of the first arriving KFD unit was 8.8 minutes. The 90th percentile dispatch time was 3.4 minutes
and the 90th percentile response time was 13.1 minutes.
Methodology
In this report, CPSM analyzes calls and runs. A call is an emergency service request or incident. A
run is a dispatch of a unit (i.e., a unit responding to a call). Thus, a call may include multiple runs.
We received CAD data and NFIRS data for the Kalispell Fire Department. We first matched the
NFIRS and CAD data based on incident numbers provided. Then, we classified the calls in a
series of steps. We first used the NFIRS incident type to identify canceled calls and to assign EMS,
motor vehicle accident (MVA), and fire category call types. EMS calls were then assigned
detailed categories based on their EMS Criteria Based Dispatch codes (CBD codes). Mutual aid
calls were identified based on the information recorded in the CAD data's quadrant description
field.
Finally, units with no corresponding call, and units with no en route or arrival time, were removed.
Then, calls with no responding KFD units were removed. In addition, a total of 13 incidents to
which the command or administrative units were the sole responders are not included in the
analysis sections of the report. However, the workload of administrative units is documented in
Attachment II.
In this report, canceled and mutual aid calls are included in all analyses other than the response
time analyses.
AGGREGATE CALL TOTALS AND RUNS
During the year studied, KFD responded to 3,437 calls. Of these, 21 were structure fire calls and
16 were outside fire calls within KFD's jurisdiction. Each unit dispatched to a call is considered a
separate "run." As multiple units are dispatched to some calls, there are more runs than calls.
The department's total runs and workload are reported in the second part of this analysis.
Calls by Type
Table 9-1 and Figure 9-1 show the number of calls by call type, average calls per day, and the
percentage of calls that fall into each call type category for the 12-month period studied.
TABLE 9-1: Call Types
Call Type
Number of Calls
Calls per
Day
Call
Percentage
Breathing difficulty
202
0.6
5.9
Cardiac and stroke
327
0.9
9.5
Fall and injury
539
1.5
15.7
Illness and other
786
2.2
22.9
MVA
160
0.4
4.7
Overdose and psychiatric
103
0.3
3.0
Seizure and unconsciousness
310
0.8
9.0
EMS Total
2,427
6.6
70.6
False alarm
235
0.6
6.8
Good intent
59
0.2
1.7
Hazard
115
0.3
3.3
Outside fire
16
0.0
0.5
Public service
91
0.2
2.6
Structure fire
21
0.1
0.6
Fire Total
537
1.5
15.6
Canceled
230
0.6
6.7
Mutual aid
243
0.7
7.1
Total
3,437
9.4
100.0
FIGURE 9-1: EMS and Fire Calls by Type
13%
7'
3'.
EMS Calls
Total EMS Calls: 2,427
■ Breathing difficulty
13% ❑ Cardiac and stroke
❑ Fall and injury
❑ Illness and other
❑ VIVA
❑ Overdose and psychiatric
■ Seizure and unconsciousness
Fire Calls
4%
17% Total Fire Calls: 537
■ False alarm
3% ❑ Good intent
❑ Hazard
❑ Outside fire
44%
❑ Public service
21% ❑ Structure fire
11%
Observations:
Overall
■ The department received an average of 9.4 calls per day, which includes 0.6 canceled and
0.7 mutual aid calls.
EMS calls for the year totaled 2,427 (71 percent of all calls), an average of 6.6 per day.
Fire calls for the year totaled 537 (16 percent of all calls), an average of 1.5 per day.
EM c
Illness and other calls were the largest category of EMS calls at 32 percent of EMS calls.
Cardiac and stroke calls made up 13 percent of the EMS calls.
Motor vehicle accidents made up 7 percent of the EMS calls.
Fire
Structure and outside fires combined for a total of 37 calls during the year, an average of one
call every 9.9 days.
A total of 21 structure fire calls accounted for 4 percent of the fire calls.
A total of 16 outside fire calls accounted for 3 percent of the fire calls.
False alarm calls were the largest fire call category, with 44 percent of the fire calls.
Calls by Type and Duration
Table 9-2 shows the duration of calls by type using three duration categories: less than 30
minutes, 30 minutes to one hour, more than an hour.
TABLE 9-2: Calls by Type and Duration
Call Type
Less than
30 Minutes
30 Minutes
to One Hour
More than
One Hour
Total
Breathing difficulty
45
140
17
202
Cardiac and stroke
72
216
39
327
Fall and injury
214
263
62
539
Illness and other
232
448
106
786
M VA
92
60
8
160
Overdose and psychiatric
32
60
11
103
Seizure and unconsciousness
108
165
37
310
EMS Total
795
1,352
280
2,427
False alarm
197
33
5
235
Good intent
48
7
4
59
Hazard
60
40
15
115
Outside fire
8
5
3
16
Public service
73
14
4
91
Structure fire
10
7
4
21
Fire Total
396
106
35
537
Canceled
221
9
0
230
Mutual aid
61
115
67
243
Total
1,473
1,582
382
3,437
Observations:
EMS
A total of 2,147 EMS category calls (88 percent) lasted less than one hour, 280 EMS category
calls (12 percent) lasted more than one hour.
On average, there were 0.8 EMS category calls per day that lasted more than one hour.
A total of 288 cardiac and stroke calls (88 percent) lasted less than one hour, and 39 cardiac
and stroke calls (12 percent) lasted more than an hour.
A total of 152 motor vehicle accidents (95 percent) lasted less than one hour, and 8 motor
vehicle accidents (5 percent) lasted more than an hour.
A total of 502 fire category calls (93 percent) lasted less than one hour, 35 fire category calls
(7 percent) lasted more than one hour.
On average, there were 0.1 fire category calls per day that lasted more than one hour.
A total of 17 structure fires (81 percent) lasted less than one hour, 4 structure fires (19 percent)
lasted between more than one hour.
A total of 13 outside fires (81 percent) lasted less than one hour, 3 outside fires (19 percent)
lasted more than one hour.
A total of 230 false alarms (98 percent) lasted less than one hour, and 5 false alarms
(2 percent) lasted more than an hour.
Average Calls per Day and per Hour
Figure 9-2 shows the monthly variation in the average daily number of calls handled by the KFD
during the year studied. Similarly, Figure 9-33 illustrates the average number of calls received
each hour of the day over the course of the year.
FIGURE 9-2: Average Calls per Day, by Month
w
a
EMS
0 Fire
❑
Other
102
10.5
10.5
9.5
B.8
Jul-16 Aug-16 Sep-16 Oct-16 Nav-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17
Month
CPSOTCenter for Public Safety Management, LLC 7
FIGURE 9-3: Calls by Hour of Day
EMS
Fire
❑
Other
m _.....__...__....._.....__...__....._.....__...__.....__...__....._.....__...__....._.....__...__....._
....................._.-.-....
.....................-........_............-..._R............._.....__...__....._.....__...__....._.....__...__....._.....__...__....._.
0.6
0-1
0
0 B
0-7
0-6
0-5
0'1
a1
0.5
0-1
0-5
0-1
Q........................... ................... ................... ................... .... .._....._.................
0.1
0.1
..................................................................................
D.1
0.4
0.4
v
0.4
0.1
0 ti
0 -,
0.1
-
0
0-,
0.1........................................
0.1
0.1
0.3
0.3
0 1
0.1 0.3
_
0. 0.1
0.7
0.1 0.3
o.z
0 z 0.1
0-4
0.a
0.4
OA
aL...-._.........................................
0-2 0.2
0A
0.4
0 a
0.4
.
0.4
0.3
D.3
0.3
0.3
0.2 0.2 0.2
0.2 D.2 0.2
0.2 0'7 0.7 0.1 0.1
Ll
0
0 1 2 3 4 5 6 7
8
9
10
15 16
17
18
19
20 21 22 23
11
12
13
14
Hour
Interval
Observations:
Average Calls per Month
- Average calls per day ranged from a low of 7.9 calls per day in November 2016 to a high of
10.5 calls per day in February 2017 and May 2017. The highest monthly average was 33
percent greater than the lowest monthly average.
Average EMS calls per day ranged from a low of 5.3 calls per day in November 2016 to a high
of 7.4 calls per day in February 2017.
Average fire calls per day ranged from a low of 1.1 calls per day in September 2016 and June
2017 to a high of 2.0 calls per day in August 2016.
Average other calls per day ranged from a low of 1.0 calls per day in October 2016 and
January 2017 to a high of 1.6 calls per day in December 2016, February 2017, and May 2017.
The highest number of calls received in a single day was 19, which occurred on
August 5, 2016.
Average Calls per Hour
Average hourly call rates ranged from 0.2 to 0.6 calls per hour.
Call rates were highest between 9:00 a.m. and 5:00 p.m., averaging 0.6 calls per hour.
Call rates were lowest between 1:00 a.m. and 7:00 a.m., averaging 0.2 calls per hour.
CPS07Center for Public Safety Management, LLC 8
Units Dispatched to Calls
Figure 9-4 and Table 9-3 detail the number of KFD calls with one, two, or three or more units
dispatched overall and broken down by call type.
FIGURE 9-4: Calls by Number of Units Dispatched
1 Unit, 65%
1 Unit, 65%
EMS Calls by Responding Units
;rage Dispatched Units: 1.4
nits or More, 1%
2 Units, 34%
Fire Calls by Responding Units
;rage Dispatched Units: 1.4
nits or More, 1%
2 Units, 34%
TABLE 9-3: Calls by Call Type and Number of Units Dispatched
Call Type
Number of
Units
Total Calls
One
Two
Three or More
Breathing difficulty
125
76
1
202
Cardiac and stroke
141
185
1
327
Fall and injury
436
102
1
539
Illness and other
605
178
3
786
M VA
34
119
7
160
Overdose and psychiatric
76
26
1
103
Seizure and unconsciousness
162
146
2
310
EMS Total
1,579
832
16
2,427
False alarm
117
117
1
235
Good intent
36
23
0
59
Hazard
105
9
1
115
Outside fire
12
3
1
16
Public service
75
16
0
91
Structure fire
6
14
1
21
Fire Total
351
182
4
537
Canceled
190
39
1
230
Mutual aid
221
19
3
243
Total
2,341
1,072
24
3,437
Percentage
68.1
31.2
0.7
100.0
Observations:
Overall
■ On average, 1.3 units were dispatched to all calls, and for 68 percent of calls only one unit
was dispatched.
Overall, three or more units were dispatched to 1 percent of calls.
EMS
- On average, 1.4 units were dispatched per EMS call.
For EMS calls, one unit was dispatched 65 percent of the time; two units were dispatched 34
percent of the time; and three or more units were dispatched 1 percent of the time.
On average, 1.4 units were dispatched per fire call.
For fire calls, one unit was dispatched 65 percent of the time; two units were dispatched 34
percent of the time; and three or more units were dispatched 1 percent of the time.
For structure fire calls, three or more units were dispatched 5 percent of the time.
For outside fire calls, three or more units were dispatched 6 percent of the time.
WORKLOAD: RUNS AND TOTAL TIME SPENT
The workload of each unit is measured in two ways: runs and deployed time. The deployed time
of a run is measured from the time a unit is dispatched through the time the unit is cleared.
Because multiple units respond to some calls, there are more runs than calls and the average
deployed time per run varies from the total duration of calls.
Runs and Deployed Time - All Units
Deployed time, also referred to as deployed hours, is the total deployment time of all units
deployed on all runs. Table 9-4 shows the total deployed time, both overall and broken down by
type of run, for KFD units during the year studied.
TABLE 9-4: Annual Runs and Deployed Time by Run Type
Call Type
Avg.
Deployed
Min. per
Run
Total
Annual
Hours
Percent
of Total
Hours
Avg.
Deployed
Min. per
Day
Total
Annual
Runs
Avg.
Runs
per
Day
Breathing difficulty
38.5
179.8
7.1
29.6
280
0.8
Cardiac and stroke
35.5
304.4
12.1
50.0
515
1.4
Fall and injury
35.7
384.6
15.3
63.2
646
1.8
Illness and other
37.7
609.0
24.2
100.1
970
2.7
MVA
23.6
116.6
4.6
19.2
296
0.8
Overdose and psychiatric
35.4
78.6
3.1
12.9
133
0.4
Seizure and unconsciousness
38.3
294.9
11.7
48.5
462
1.3
EMS Total
35.8
1,967.9
78.2
323.5
3,302
9.0
False alarm
17.4
102.7
4.1
16.9
355
1.0
Good intent
22.9
31.3
1.2
5.1
82
0.2
Hazard
34.3
73.3
2.9
12.0
128
0.4
Outside fire
31.0
10.8
0.4
1.8
21
0.1
Public service
23.7
42.3
1.7
7.0
107
0.3
Structure fire
41.1
25.3
1.0
4.2
37
0.1
Fire Total
23.5
285.8
11.4
47.0
730
2.0
Canceled
9.8
44.4
1.8
7.3
271
0.7
Mutual aid
48.7
218.1
8.7
35.9
269
0.7
Total
33.0
2,516.2
100.0
413.6
4,572
12.5
Observations:
Overall
■ Total deployed time for the year was 2,516 hours. The daily average was 6.9 hours for all units
combined.
There were 4,572 runs, including 269 runs dispatched for mutual aid calls. The daily average
was 12.5 runs.
EMS
EMS runs accounted for 78 percent of the total workload.
The average deployed time for EMS runs was 35.8 minutes. The deployed time for all EMS runs
averaged 323.5 minutes per day.
Fire runs accounted for 11 percent of the total workload.
The average deployed time for fire runs was 23.5 minutes. The deployed time for all fire runs
averaged 0.8 hours per day.
There were 58 runs for structure and outside fire calls combined, with a total workload of
36 hours. This accounted for 1 percent of the total workload.
The average deployed time for outside fire runs was 31.0 minutes per run, average deployed
time for structure fire runs was 41.1 minutes per run.
FIGURE 9-5: Average Deployed Minutes by Hour of Day
CPS07Center for Public Safety Management, LLC 12
TABLE 9-5: Average Deployed Minutes by Hour of Day
Hour
EMS
Fire
Other
Total
0
9.6
1.7
0.8
12.1
1
6.8
1.0
0.9
8.8
2
7.8
1.5
1.6
10.9
3
5.8
1.3
1.9
8.9
4
5.7
0.9
0.7
7.4
5
6.3
1.4
1.1
8.9
6
8.8
0.8
1.3
10.9
7
10.5
1.3
2.0
13.8
8
11.2
2.0
1.7
14.8
9
16.0
2.8
1.8
20.7
10
19.5
2.8
2.0
24.3
11
21.4
2.6
1.7
25.8
12
22.3
2.7
1.8
26.9
13
20.8
2.2
2.8
25.7
14
21.2
2.8
2.4
26.4
15
18.7
2.1
2.0
22.8
16
19.3
2.1
2.0
23.4
17
18.1
2.4
2.3
22.7
18
15.3
1.8
1.8
18.9
19
14.5
3.0
2.3
19.8
20
12.4
3.3
2.1
17.8
21
11.8
2.3
2.2
16.3
22
9.6
1.2
2.0
12.9
23
10.0
0.9
1.8
12.6
Daily Avg.
323.4
47.0
43.2
413.E
Observations:
■ Hourly deployed time was highest during the day from 9:00 a.m. to 5:00 p.m., averaging
between 21 minutes and 27 minutes.
Average deployed time peaked between noon and 1:00 p.m., averaging 27 minutes.
Hourly deployed time was lowest between 4:00 a.m. and 5:00 a.m., averaging 7 minutes.
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ANALYSIS OF BUSIEST HOURS
There is significant variability in the number of calls from hour to hour. One special concern
relates to the resources available for hours with the heaviest workload. We tabulated the data
for each of the 8,760 hours in the year. Table 9-9 shows the number of hours in the year in which
there were zero to five calls during the hour. Table 9-12 shows the 10 one -hour intervals which
had the most calls during the year.
TABLE 9-9: Frequency Distribution of the Number of Calls
Calls in an Hour
Frequency
Percentage
0
5,998
68.5
1
2,175
24.8
2
512
5.8
3
63
0.7
4+
12
0.1
TABLE 9-10: Frequency of Overlapping Calls
Scenario
Number of
Calls
Percent of
All Calls
Total Hours
No overlapped call
2,677
77.9
1,704.8
Overlapped with one call
692
20.1
211.2
Overlapped with two calls
66
1.9
10.7
Overlapped with three calls
2
0.1
0.6
TABLE 9-11: Station Availability to Respond to Calls
Station
Calls in
Area
Total
Arrivals
First Due
Responded
First Due
Arrived
First Due
First
Percent
Responded
Percent
Arrived
Percent
First
61
1,931
1,813
1,225
1,145
1,045
63.4
63.2
57.6
62
1,194
1,139
1,098
1,047
1,005
92.0
91.9
88.2
Note: For each station, we count the number of calls occurring within its first due area. Then, we count the
number of calls to where at least one KFD unit responded. Next, we focus on units from the first due station
to see if any units responded, arrived, or arrived first.
TABLE 9-12: Top 10 Hours with the Most Calls Received
Hour
Number
of Calls
Number
of Runs
Total
Deployed Hours
8/18/2016 - 7:00 p.m. to 8:00 p.m.
5
5
2.5
2/19/2017 - 2:00 p.m. to 3:00 p.m.
4
7
5.3
2/16/2017 - 9:00 a.m. to 10:00 a.m.
4
7
3.7
10/29/2016 - 8:00 p.m. to 9:00 p.m.
4
6
3.2
12/12/2016 - 7:00 a.m. to 8:00 a.m.
4
5
2.6
7/31 /2016 - 9:00 p.m. to 10:00 p.m.
4
5
2.4
2/19/2017 - 10:00 a.m. to 11:00 a.m.
4
5
1.6
4/13/2017 - 2:00 p.m. to 3:00 p.m.
4
4
2.2
1 /31 /2017 - 1 :00 p.m. to 2:00 p.m.
4
4
1.5
8/18/2016 - 8:00 p.m. to 9:00 p.m.
4
4
1.3
Note: Total deployed hours measure the total time spent responding to calls received
in the hour, and which may extend into the next hour or hours. The number of runs and
deployed hours only includes KFD units.
Observations:
In 75 hours (1 percent of all hours) during the year, 3 or more calls occurred; in other words, the
department responded to 3 or more calls in an hour roughly once every 5 days.
During the year studied, 22 percent of calls overlapped with at least one other call.
The highest number of calls to occur in an hour was 5, which happened once.
The hour with the most calls was 7:00 p.m. to 8:00 p.m. on Aug 18, 2016. The hour's 5 calls
involved 5 individual dispatches resulting in 2.5 hours of deployed time. These 5 calls included
4 hazard calls and 1 public service call.
The hour with the second most calls was 2:00 p.m. to 3:00 p.m. on Feb 19, 2017. The hour's 4
calls involved 7 individual dispatches resulting in 5.3 hours of deployed time. These 4 calls
included 2 illness and other calls, 1 cardiac and stroke call, and 1 motor vehicle accident.
RESPONSE TIME
In this part of the analysis we present response time statistics for different call types. We separate
response time into its identifiable components. Dispatch time is the difference between the time
a call is received and the time a unit is dispatched. Dispatch time includes call processing time,
which is the time required to determine the nature of the emergency and types of resources to
dispatch. Turnout time is the difference between dispatch time and the time a unit is en route to
a call's location. Travel time is the difference between the time en route and arrival on scene.
Response time is the total time elapsed between receiving a call to arriving on scene.
In this analysis, we included all calls to which at least one non -administrative KFD unit responded,
while excluding canceled and mutual aid calls. In addition, nonemergency calls and calls with a
total response time of more than 30 minutes were excluded. Finally, we focused on units that
had complete time stamps, that is, units with all components recorded, so that we could
calculate each segment of response time.
Based on the methodology above, we excluded 473 canceled and mutual aid calls, 4
nonemergency calls, 85 calls where no units recorded a valid on -scene time, 9 calls where the
first arriving unit response was greater than 30 minutes, and 292 calls where one or more
segments of first arriving unit's response time could not be calculated due to missing data. As a
result, in this section, a total of 2,574 calls are included in the analysis.
Response Time by Type of Call
Table 9-13 provides average dispatch, turnout, travel, and total response time for the first arriving
unit to each call in the city, broken out by call type. Figures 9-6 and 9-7 illustrate the same
information. Table 9-14 gives the 90th percentile time broken out in the same manner. A 90th
percentile time means that 90 percent of calls had response times at or below that number. For
example, Table 9-14 shows a 90th percentile response time of 13.1 minutes which means that 90
percent of the time a call had a response time of no more than 13.1 minutes.
TABLE 9-13: Average Response Time of First Arriving Unit, by Call Type (Minutes)
Call Type
Dispatch
Turnout
Travel
Total
Number of
Calls
Breathing difficulty
1.7
1.6
4.7
8.0
184
Cardiac and stroke
1.6
1.6
4.3
7.5
295
Fall and injury
1.9
1.6
5.9
9.4
465
Illness and other
2.0
1.6
6.1
9.7
669
MVA
2.9
1.7
3.5
8.0
139
Overdose and psychiatric
1.7
1.6
6.0
9.3
94
Seizure and unconsciousness
1.7
1.4
4.5
7.6
276
EMS Total
1.9
1.6
5.3
8.8
2,122
False alarm
1.8
2.1
4.8
8.7
204
Good intent
1.8
2.2
4.6
8.7
51
Hazard
2.1
1.9
4.8
8.8
99
Outside fire
2.8
1.5
4.6
8.9
14
Public service
2.5
1.5
7.4
11.4
65
Structure fire
1.1
2.7
4.5
8.3
19
Fire Total
1.9
2.0
5.2
9.1
452
Total
1.9
1.7
5.3
8.8
2,574
FIGURE 9-6: Average Response Time of First Arriving Unit, by Call Type - t►wS
CPSACenter for Public Safety Management, LLC 19
FIGURE 9-7: Average Response Time of First Arriving Unit, by Call Type - Fire
TABLE 9-14: 90th Percentile Response Time of First Arriving Unit, by Call Type
(Minutes)
Call Type
Dispatch
Turnout
Travel
Total
Number of
Calls
Breathing difficulty
2.7
2.7
7.8
11.2
184
Cardiac and stroke
2.8
2.8
7.6
10.9
295
Fall and injury
3.3
2.8
9.9
13.2
465
Illness and other
3.5
2.8
10.1
14.0
669
MVA
6.0
2.9
5.7
12.1
139
Overdose and psychiatric
3.5
2.9
10.5
13.8
94
Seizure and unconsciousness
3.4
2.3
7.5
11.2
276
EMS Total
3.4
2.8
9.3
13.0
2,122
False alarm
2.8
3.3
7.7
12.6
204
Good intent
3.3
3.8
8.1
13.0
51
Hazard
3.8
3.3
8.1
12.4
99
Outside fire
5.6
3.6
8.2
16.1
14
Public service
5.1
2.9
11.1
16.8
65
Structure fire
2.1
4.8
7.6
11.4
19
Fire Total
3.4
3.3
9.1
13.6
452
Total
3.4
2.9
9.2
13.1
2,574
Observations:
■ The average dispatch time was 1.9 minutes.
The average turnout time was 1.7 minutes.
The average travel time was 5.3 minutes.
The average response time was 8.8 minutes.
The average response time was 8.8 minutes for EMS calls and 9.1 minutes for fire calls.
The average response time for structure fires was 8.3 minutes, and for outside fires was 8.9
minutes.
The 90th percentile dispatch time was 3.4 minutes.
The 90th percentile turnout time was 2.9 minutes.
The 90th percentile travel time was 9.2 minutes.
The 90th percentile response time was 13.1 minutes.
The 90th percentile response time was 12.9 minutes for EMS calls and 13.6 minutes for fire calls.
The 90th percentile response time for structure fires was 11.4 minutes, and for outside fires was
16.1 minutes.
CPSM`*1 Center for Public Safety Management, LLC 21
Response Time by Hour
Average dispatch, turnout, travel, and total response time by hour for calls in the city are shown
in Table 9-15 and Figure 9-8. The table also shows 90th percentile response times.
TABLE 9-15: Average and 90th Percentile Response Time of First Arriving Unit, by
Hour of Day
Hour
Dispatch
Turnout
Travel
Response
Time
90th Percentile
Response Time
Number
of Calls
0
1.7
2.4
6.3
10.4
15.1
77
1
2.1
2.4
6.2
10.7
14.6
54
2
1.8
2.6
6.3
10.6
13.3
57
3
1.7
2.7
6.2
10.6
14.0
49
4
1.7
2.9
5.6
10.2
13.6
42
5
1.6
2.5
6.0
10.1
13.6
50
6
1.8
2.1
5.2
9.1
13.0
63
7
2.0
1.5
6.0
9.5
14.4
84
8
1.9
1.7
5.4
9.1
13.6
109
9
1.8
1.6
4.6
8.0
12.0
153
10
2.1
1.4
5.2
8.7
13.5
140
11
1.7
1.5
4.8
8.0
12.1
180
12
1.9
1.5
5.4
8.8
13.1
170
13
1.9
1.5
4.7
8.1
11.9
143
14
1.9
1.4
5.2
8.5
13.0
152
15
1.8
1.4
4.9
8.1
11.7
154
16
2.0
1.5
4.7
8.3
12.8
155
17
2.2
1.4
4.8
8.4
13.3
141
18
1.8
1.5
5.2
8.5
12.1
131
19
1.9
1.5
5.1
8.4
11.7
114
20
1.9
1.5
5.0
8.4
12.5
118
21
2.1
1.5
5.9
9.4
13.5
82
22
2.1
1.7
5.5
9.3
13.9
79
23
1.7
2.1
6.7
10.5
15.0
77
FIGURE 9-8: Average Response Time of First Arriving Unit, by Hour of Day
Observations:
r Average dispatch time was between 1.6 minutes (5:00 a.m. to 6:00 a.m.) and 2.2 minutes (5:00
p.m. to 6:00 p.m.).
Average turnout time was between 1.4 minutes (10:00 a.m. to 1 1:00 a.m., 2:00 p.m. to 4:00
p.m., and 5:00 p.m. to 6:00 p.m.) and 2.9 minutes (4:00 a.m. to 5:00 a.m.).
Average travel time was between 4.6 minutes (9:00 a.m. to 10:00 a.m.) and 6.7 minutes (1 1:00
p.m. to midnight).
Average response time was between 8 minutes (9:00 a.m. to 10:00 a.m. and 11:00 a.m. to
noon) and 10.7 minutes (1:00 a.m. to 2:00 a.m.).
90th percentile total response time by hour ranged from 11.7 minutes (3:00 p.m. to 4:00 p.m.
and 7:00 p.m. to 8:00 p.m.) and 15.1 minutes (midnight to 1:00 a.m.).
CPS07Center for Public Safety Management, LLC 23
Response Time Distribution
Here, we present a more detailed look at how response times to calls are distributed. The
cumulative distribution of total response time for the first arriving unit to EMS calls is shown in
Figure 9-9 and Table 9-16. Figure 9-10 shows response times for the first arriving KFD unit to EMS
calls as a frequency distribution in whole -minute increments.
The cumulative percentages here are read in the same way as a percentile. In Figure 9-9, the
90th percentile of 12.9 minutes means that 90 percent of EMS calls had a response time of 12.9
minutes or less. In Table 9-16, the cumulative percentage of 59.3, for example, means that 59.3
percent of EMS calls had a response time under 9 minutes.
FIGURE 9-9: Cumulative Distribution of Response Time - First Arriving Unit - EMS
100
90
80
;g 70
60
P
d 50
m
a
40
E
3
U 30
20
10
0
ISO h pemnfl e i utes 12.9 minutes
0 1 2 3 4 5 8 7 8 0 10 11 12 13 14 15 16 17 15
Minutes
CPSOTCenter for Public Safety Management, LLC 24
FIGURE 9-10: Frequency Distribution of Response Time - First Arriving Unit - EMS
TABLE 9-16: Cumulative Distribution of Response Time - First Arriving Unit - EMS
Response Time
(minute)
Frequency
Cumulative
Percentage
< 1
0
0.0
1 - 2
2
0.1
2-3
14
0.8
3-4
45
2.9
4-5
125
8.8
5-6
224
19.3
6-7
297
33.3
7-8
311
48.0
8-9
241
59.3
9 - 10
240
70.6
10 - 1 1
158
78.1
11 - 12
149
85.1
12 - 13
108
90.2
13 - 14
75
93.7
14 - 15
42
95.7
15 - 16
30
97.1
16- 17
19
98.0
17+
42
100.0
FIGURE 9-11: Cumulative Distribution of Response Time - First Arriving Unit -
Outside and Structure Fires
FIGURE 9-12: Frequency Distribution of Response Time - First Arriving Unit -
(li ifeirrA rinrl Cfrl u-fl lrA Firee
CPSACenter for Public Safety Management, LLC 26
TABLE 9-17: Cumulative Distribution of Response Time - First Arriving Unit -
Outside and Structure Fires
Response Time
(minute)
Frequency
Cumulative
Percentage
< 1
0
0.0
1 -2
1
3.0
2-3
0
3.0
3-4
0
3.0
4-5
1
6.1
5-6
5
21.2
6-7
5
36.4
7-8
2
42.4
8-9
5
57.6
9 - 10
6
75.8
10 - 1 1
1
78.8
11 - 12
4
90.9
FL12 - 13
1
93.9
13+
2
100.0
Observations:
■ For 48 percent of EMS calls, the response time of the first arriving unit was less than 8 minutes.
For 21 percent of structure and outside fire calls, the response time of the first arriving unit was
less than 6 minutes.
TRANSPORT CALL ANALYSIS
In this section we present an analysis of KFD unit activity that involved transporting patients, the
variations by hour of day, and the average time for each stage of transport service. We
identified transport calls by requiring that at least one responding medic or aid unit had
recorded both "beginning to transport" time and "arriving at the hospital" time. Based on these
criteria, note that 128 non -EMS calls that resulted in transports are included in this analysis.
Transport Calls by Type
Table 9-18 shows the number of calls by call type broken out by transport and non -transport
calls.
TABLE 9-18: Transport Calls by Call Type
Call Type
Number of Calls
Conversion
Rate
Non -transport
Transport
Total
Breathing difficulty
55
147
202
72.8
Cardiac and stroke
96
231
327
70.6
Fall and injury
251
288
539
53.4
Illness and other
291
495
786
63.0
MVA
124
36
160
22.5
Overdose and psychiatric
46
57
103
55.3
Seizure and unconsciousness
147
163
310
52.6
EMS Total
1,010
1,417
2,427
58.4
Fire Total
534
3
537
0.6
Other Total
348
125
473
26.4
Total
1,892
1,545
3,437
45.0
Observations:
■ Overall, 58 percent of EMS calls in Kalispell involved transporting one or more patients.
On average, there were 6.6 EMS calls per day, and 3.8 involved transporting one or more
patients.
Breathing difficulty calls had the highest transport rate, averaging 73 percent.
Motor vehicle accidents had the lowest transport rate, averaging 23 percent.
Average Transport Calls per Hour
Table 9-19 and Figure 9-12 show the average number of EMS calls received each hour of the
day over the course of the year and the average number of transport calls. Transport calls
categorized as fire, mutual aid, or canceled have been excluded from the table.
TABLE 9-19: Transport Calls per Day, by Hour
Hour
Number of
EMS Calls
Number of
Transport Calls
Transport
Calls per Day
EMS Calls
per Day
Conversion
Rate
0
75
40
0.1
0.2
53.3
1
55
26
0.1
0.2
47.3
2
51
33
0.1
0.1
64.7
3
44
27
0.1
0.1
61.4
4
44
23
0.1
0.1
52.3
5
42
26
0.1
0.1
61.9
6
65
46
0.1
0.2
70.8
7
73
46
0.1
0.2
63.0
8
94
61
0.2
0.3
64.9
9
134
82
0.2
0.4
61.2
10
138
86
0.2
0.4
62.3
11
162
99
0.3
0.4
61.1
12
159
104
0.3
0.4
65.4
13
143
77
0.2
0.4
53.8
14
160
93
0.3
0.4
58.1
15
146
74
0.2
0.4
51.0
16
153
84
0.2
0.4
54.9
17
134
73
0.2
0.4
54.5
18
123
71
0.2
0.3
57.7
19
101
55
0.2
0.3
54.5
20
103
58
0.2
0.3
56.3
21
80
53
0.1
0.2
66.3
22
76
40
0.1
0.2
52.6
23
73
40
0.1
0.2
54.8
FIGURE 9-13: Average Transport Calls per Day, by Hour
Observations:
■ Transport call rates were highest from 1 1 :00 a.m. to 1:00 p.m. and 2:00 p.m. to 3:00 p.m.,
averaging 0.3 calls per hour.
Transport call rates were lowest between 1:00 a.m. and 3:00 a.m., averaging fewer than 0.1
transports per hour.
The percent of EMS calls resulting in a transport was highest between 6:00 a.m. and
7:00 a.m., averaging 71 percent.
CPS07Center for Public Safety Management, LLC 30
Calls by Type and Duration
Table 9-20 shows the average duration of transport and non -transport EMS calls by call type.
TABLE 9-20: Transport Call Duration by Call Type
Call Type
Non -transport
Transport
Average
Duration
Number of
Calls
Average
Duration
Number of
Calls
Breathing difficulty
28.5
55
52.5
147
Cardiac and stroke
31.4
96
48.2
231
Fall and injury
27.7
251
49.1
288
Illness and other
31.5
291
48.3
495
MVA
23.4
124
49.8
36
Overdose and psychiatric
30.9
46
49.4
57
Seizure and unconsciousness
41.0
147
50.1
163
EMS Total
30.8
1,010
49.2
1,417
Fire Total
26.6
534
45.5
3
Other Total
20.7
348
59.6
125
Total
27.7
1,892
50.0
1,545
Note: Duration of a call is defined as the longest deployed time of any of the units responding to the same
call.
Observations:
■ The average duration was 28 minutes for a non -transport EMS call.
The average duration was 50 minutes for an EMS call where one or more patients were
transported to a hospital.
On average, a transport call lasted 1.6 times as long as a non -transport EMS call.
Transport Time Components
Table 9-21 gives the average deployed time for an ambulance on a transport call, along with
three major components of the deployed time: on -scene time, travel to hospital time, and at -
hospital time.
The on -scene time is the interval from the unit arriving on -scene time through the time the unit
departs the scene for the hospital. Travel to hospital time is the interval from the time the unit
departs the scene to travel to the hospital through the time the unit arrives at the hospital. At -
hospital time is the time it takes for patient turnover at the hospital.
The 1,545 transport calls resulted in 1,546 transports, since more than one transport may occur on
a call. Thirty-five runs were excluded from this analysis due to missing arrival times and 12 runs
were excluded due to missing hospital travel times, leaving 1,499 runs for analysis. The at -hospital
time was calculated using "depart hospital time" when available, and "unit clear time" was
calculated for the remaining runs.
TABLE 9-21: Time Component Analysis for Ambulance Transport Runs by Call
Type (in Minutes)
Call Type
Avg.
Deployed
Time per Run
Avg. Time
on Scene
Avg. Travel
to Hospital
Time
Avg.
Time at
Hospital
Number
of Runs
Breathing difficulty
52.5
15.4
5.7
24.7
144
Cardiac and stroke
47.8
15.5
6.1
19.5
225
Fall and injury
49.9
17.1
6.6
18.5
273
Illness and other
48.4
14.4
7.0
18.7
479
MVA
47.9
13.5
5.8
21.3
35
Overdose and psychiatric
49.2
13.1
7.1
21.4
56
Seizure and unconsciousness
49.9
17.9
6.3
19.1
161
EMS Total
49.2
15.6
6.5
19.6
1,373
Fire Total
45.5
11.9
8.4
16.0
3
Other Total
60.5
15.4
11.6
21.1
123
Total
50.2
15.5
6.9
19.8
1,499
Note: Average unit deployed time per run is lower than average call duration for some call types because
call duration is based on the longest deployed time of any of the units responding to the same call, which
may include an engine or ladder. Total deployed time is greater than the combination of on -scene,
transport, and hospital wait times as it includes turnout, initial travel, and hospital return times.
Observations:
On average, an ambulance spent 16 minutes on scene, and then spent 7 minutes traveling
from the scene to the hospital.
The average time spent at the hospital, or other transport destination, was 20 minutes.
ATTACHMENT I
TABLE 9-22: Actions Taken Analysis for Structure and Outside Fire Calls
Action Taken
Number of Calls
Outside Fire
Structure Fire
Action taken, other
1
0
Fire control or extinguishment, other
2
4
Extinguishment by fire service personnel
7
5
Salvage & overhaul
2
3
Control fire (wildland)
1
0
Remove hazard
0
1
Ventilate
0
5
Operate apparatus or vehicle
1
0
Restore fire alarm system
0
1
Shut down system
0
1
Provide manpower
1
0
Incident command
0
3
Investigate
9
13
Total
24
36
Note: Totals are higher than the total number of structure and outside fire calls because some calls had
more than one action taken.
Observations:
A total of 7 outside fires were extinguished by fire service personnel, which accounted for
44 percent of outside fires.
A total of 5 structure fires were extinguished by fire service personnel, which accounted for
24 percent of structure fires.
ATTACHMENT II
TABLE 9-23: Workload of Administrative Units
Unit ID
Unit Type
Annual
Hours
Annual
Runs
601
Chief
16.1
32
602
Assistant Chief
19.9
38
662
Support Utility
0.0
1
CPSACenter for Public Safety Management, LLC 34
ATTACHMENT III
TABLE 9-24: Content and Property Loss - Structure and Outside Fires
Property Loss
Content Loss
Call Type
Loss Value
Number of Calls
Loss Value
Number of Calls
Outside fire
$6,500
4
$300
2
Structure fire
$149,625
8
$51,720
8
Total
$156,125
12
$52,020
10
Note: This includes only calls with recorded loss greater than 0.
Observations:
- Out of 17 outside fires, 4 had recorded property losses, with a combined $6,500 in losses.
2 outside fires also had content losses with a combined $300 in losses.
Out of 23 structure fires, 8 had recorded property losses, with a combined $149,625 in losses.
8 structure fires also had content losses with a combined $51,720 in losses.
■ The average total loss for all structure fires was $8,754.
■ The average total loss for structure fires with loss was $20,134.
TABLE 9-25: Total Fire Loss Above and Below $20,000
Call Type
No Loss
Under $20,000
$20,000 plus
Outside fire
11
5
0
Structure fire
11
7
3
Total
22
12
3
Observations:
12 outside fires and 13 structure fires had no recorded loss.
No outside fires and 3 structure fires had $20,000 or more in loss.
The highest total loss for an outside fire was $3,000.
The highest total loss for a structure fire was $100,000.
- END -
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