HomeMy WebLinkAboutStaff Report 2502-4221CITY OF PALO ALTO
Finance Committee
Regular Meeting
Tuesday, April 01, 2025
Agenda Item
3.Evaluation of Fire and Ambulance Service Expansion Options (Follow-up from 11/19/24
Meeting) Staff Presentation
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Finance Committee
Staff Report
From: City Manager
Report Type: ACTION ITEMS
Lead Department: Fire
Meeting Date: April 1, 2025
Report #:2502-4221
TITLE
Evaluation of Fire and Ambulance Service Expansion Options (Follow-up from 11/19/24
Meeting)
RECOMMENDATION
Staff recommends the Finance Committee evaluate Fire Department fire and ambulance service
expansion options and provide feedback for further consideration.
EXECUTIVE SUMMARY
During the Fiscal Year 2025 Budget Hearings, the Finance Committee requested the Palo Alto
Fire Department (PAFD) to return with options to increase fire and emergency medical service
(EMS) resources to meet service needs. The Fire Department presented data on three staffing
options to Finance Committee on November 19, 2024. During that meeting, the Finance
Committee reviewed the options and requested additional data and additional staffing options
to achieve the staffing of Engine 64 and a peak hour ambulance.
As part of the Mid-Year budget actions this month, Council approved staffing of Engine 64 and
Medic 64 in a cross-staffed model with the addition of 3 positions to be filled on overtime.
This report includes specific follow-up data requested, including additional options for staffing
Fire Station 4 and a peak hour ambulance for 12-Hour daily, and details on the creation of a
new classification of single-role civilian EMS staff and establishing a single-role division
(modified from the original proposal made in the November meeting). It also includes a
proposed implementation timeline to illustrate the steps necessary to create the new division.
BACKGROUND
The November 19, 2024 Staff Report, (Attachment A) included information on existing City-
wide Fire Department service demands and system performance, as well as options to increase
resources by adding a fire engine at Station 4 and a peak call time 12-Hour ambulance (peak
ambulance) to the current Palo Alto Fire Department deployment model. Three staffing options
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considered in November included: A. Contract with a private ambulance company B. Current
model staffing with additional firefighters, or C. Creation of a new classification of single-role
civilian EMS staff and establishing a single- role division.
ANALYSIS
1. Details of “Other Calls” in Table 1 "Calls for Service” of the November report
•Good Intent Calls: Good Intent calls capture incidents where there may have been an
emergency, but it turned out to be non-emergent or nothing at all. For example,
someone could smell smoke and call 9-1-1, but after firefighters arrive and investigate,
they may find that the odor was from burnt popcorn down the hall.
•False Alarms and False Calls: These are primarily alarms that are automatically triggered
during construction or other non-emergency causes such as steam from a shower, dust,
insects, or smoke from cooking. This category also covers situations where someone
negligently triggered a fire alarm or made an intentionally false report.
•Service Calls: These calls are for situations where the department is providing a service,
but it’s not an emergency. This can include clean up calls for smoke removal, water
evacuations or other hazards; assisting with non-emergency falls in the home; people
trapped in an elevator or elevator overrides.
•Hazardous Materials and Others: Most of these are utilities-related, such as a natural
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gas leak, wiring problem, powerlines down, but it also includes gasoline, diesel, or oil
spills, chemical releases or other biological hazards.
Table 1. Detail of "All Other" Calls for Service in FY 2024
Count Proportion of
“All Other”
Proportion of Total
Calls for Service
Good intent call 1,379 41%15%
False alarm or false call 1,246 37%13%
Service Call 655 19%7%
Hazardous condition and Others 116 3%1%
Subtotal “All Other “ 3,396 100%36%
EMS 5,884 N/A 62%
Fires 136 N/A 1%
FY 2024 Total Calls for Services 9,416 N/A 100%
2. Stanford Call for Service Details
The City of Palo Alto provides fire service protection under contract to Stanford University. The
current contract began in July 2018, after being renegotiated with the closure of station 7 at the
Stanford Linear Accelerator Center (SLAC). This contract was renewed to be effective through
June 30, 2028, with re-negotiations for services beyond that date due to commence on or
before July 1, 2026. The contract covers Fire Services only and explicitly excludes any costs
associated with ambulance transport services. The cost model developed to calculate the
charge to Stanford is complex and ensures that only the services covered by the contract,
specifically resources staged at Station 6 and corresponding pro rata share of shared resources,
are charged. The calculation equates to approximately 19% of the Fire Department budget.
Table 2. Fiscal Year 2024 Stanford and Palo Alto Calls for Service
Palo Alto Stanford Total
EMS 5,154 730 5,884
Good intent call 1,234 145 1,379
False alarm or false call 851 395 1,246
Service Call 583 72 655
Fire 110 26 136
Hazardous condition and Others 100 16 116
TOTAL 8,032 1,384 9,416
Ambulance Transports 3,595 395 3,990
Stanford University accounts for fifteen percent (15%) of all calls for service. The call volume
trends are similar to that of the rest of the city, with the majority of calls for emergency medical
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services (53%). However, false alarms make up a greater proportion of Stanford call volume
(29%) in comparison to Palo Alto (11%). Stanford University makes up ten percent (10%) of
transports.
3.Mountain View Call Volume Comparison
1. In that report the following calls for service data is provided:
Table 4. City of Mountain View Fire Department Calls for Service Comparison
Mountain View (FY23)Palo Alto (FY24)
Count Percentage Count Percentage
EMS*5,747 72%5,884 62%
Good intent call 546 7%1,379 15%
False alarm or false call 718 9%1,246 13%
Service Call 539 7%655 7%
Fire 196 2%136 1%
Hazardous condition and
Others
231 3%116 1%
TOTAL 7,977 100%9,416 100%
*Mountain View does not provide medical transport services, during this period they are serviced by
County of Santa Clara EMS
4. Chart that shows history of deployment and cross-staffing
5.Potential Revenue increases
1 https://www.mountainview.gov/home/showpublisheddocument/8329/638423818087870000
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6. Alternative Options for staffing Fire Station 4 and the 12-Hour Peak Ambulance that
were not presented in the November report
The November 19, 2024 Staff Report presented the following options for adding a dedicated
fire engine to station 64 and a new 12-Hour ambulance:
•Option A: Contract with a private ambulance company
•Option B: Current model staffing with additional firefighters, or
•Option C: Creation of a new classification of single-role civilian EMS staff and
establishing a single-role division
Additional options are limited that will increase resources and provide the same service level
enhancements as Options A through C. Two Alternatives have been identified that are steps
towards a Long-Term implementation of Option C.
Fire Engine Staffing
Permanent alternatives to bring Engine 64 to full-time staffing are limited. To provide some
clarity on staffing needs for an engine, below outlines operational and budgetary staffing
details. “Daily positions” represents the number of employees on each unit at any given time
providing services to the community. This is how many people must be assigned to the unit for
it to be in service. A fire engine requires 3 daily positions to operate. In total, the current
staffing model operates with 3 daily staff. All engines operate 24 hours a day, seven days a
week, 365 days per year which requires three shifts (i.e. “battalions”); therefore, each daily
position must be multiplied by three battalions:
3.0 daily positions on an engine x 3 battalions = 9 total employees to staff one dedicated
engine + Backfill staffing
Additional firefighters are authorized in the service delivery model to provide leave coverage
and are called “backfill.” The Department has 0.5 FTE backfill positions for every daily position.
When adding 3 daily positions, at least 1.0 FTE firefighter would be necessary as a backfill
position. Therefore, a total of 10 FTE would need to be added to fully staff a dedicated engine.
Table 5: Fire Engine Staffing
Position Classification Daily Staffing Budgeted Staffing (FTE)
Fire Captain 1 3.0
Apparatus Operator 1 3.0
Fire Fighter 1 4.0
Total Staffing 3.0 daily staffing 10.0 budgeted staffing (FTE)
Alternative Options
Options A through C presented in the November report are long-term options to fully staff
Engine 64 and a 12 HR Peak Ambulance. The Finance Committee asked the Department to
explore alternative options for Fire Station 4 and a 12-Hour Peak Ambulance.
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Since the November meeting, City Council approved Engine 64 to be placed into service by
cross-staffing the unit with Medic 64 on overtime in the FY 2025 Mid-Year Budget Review. This
is a swift and initial action to place a fire engine in service allowing the City time to explore
additional resource options to invest in the system.
•Adds 3.0 FTE Fire Captain positions to Cross-Staff Engine 64 and Medic 64
Fire Station 4
Option E: Establish Single-Role Division with 12 Hour Peak Ambulance
•Adds 7.0 FTE to launch Single-Role Division with 12 HR Peak Ambulance
Single-Role
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Option F: Establish Single-Role Division with 2 Full-Time Ambulances, Add Engine 64 and 12 HR
Peak Ambulance on Overtime
•Add 12-hour peak ambulance on firefighter overtime
•Adds 16.0 FTE to launch single-role division with 2 24-hour ambulances
•Adds Engine 64 full-time by reassigning current firefighters from ambulances
Single-Role
This creates the single-role division that allows for the full-time staffing of Fire Engine 64, the
transition of 2 full-time ambulance staffed with single-role positions, instead of firefighters. This
option includes management and administrative staff to help build the single-role division and
set the City up for further expansion into the single-role model.
By adding enough single-role positions for 2 full-time ambulances, the firefighters on the
ambulances will be reassigned to staff up Engine 64. The chart below shows how this results in
a reduction of 3.0 FTE firefighters.
Table 6. Firefighter Position Changes with Option F
2 Ambulances Engine 64 Difference
Daily Staffing 4.0 3.0 (1.0)
Budgeted Staffing
(x3 Battalions)
12.0 FTE 9.0 FTE (3.0) FTE
Fire Station 4
This option brings firefighting capacity to Fire Station 4 and Fire Engine 64 into full-time staffing,
adding it as a resource to the system. Option F will improve key areas of performance by
reducing response times and improving Unit Hour Utilization for all units in the system.
Peak Ambulance
The 12 -hour peak ambulance is still an important resource add to improving response times,
and reducing reliance on Santa Clara County‘s ambulance. In this option, it will be staffed on
firefighter overtime. This allows for that resource to be easily deployed in a cost-effective
manner while the Department works toward the long-term Option C.
Attachment C, Staffing Options Summary, compares Options A through C presented in the
November report, and the alternatives presented above. All cost are shown in Fiscal Year 2025
figures.
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7. Details on the timeline for adding Single-Role Civilian staffing
Single-role refers to an organizational model that will be new to Palo Alto, and has been
adopted by other fire departments in California that provide an ambulance service. Currently all
PAFD ambulances are staffed with firefighter Emergency Medical Technicians (EMT) and
paramedics, working as an EMS provider and firefighter.
The single-role organizational model establishes a new type of ambulance employee that does
not have firefighting duties. The “single-role” will have the singular role as an ambulance
employee and not a firefighter. This new position classification requires engagement with labor
related to salaries and benefits. Staff have engaged labor in discussions on adding
classifications for the positions of EMT and Paramedic, so the City will have the administrative
ability to proceed with a new single-role staffing approach if approved.
Single-role EMTs and paramedics market salary is typically 30% lower than those of firefighters,
and there is potential for additional savings with pension benefits. CalPERS does not have
uniformity on whether these job classifications would have safety or non-safety (miscellaneous)
pensions. Across jurisdictions in the state, there are examples of different CalPERS
classifications for these roles; for example, the City of Berkeley provides a safety pension for
their single-role civilian staff, and the City of Chula Vista provides a non-safety pension. Palo
Alto’s Human Resources staff has already communicated with CalPERS about the City’s intent to
create the new job classifications, but has been informed that a determination cannot be made
until final job descriptions are submitted to CalPERS.
Hiring costs and timeframes are expected to be reduced with the single-role staff. Hiring
timelines may be shortened, as the selection and training process for single-role staff is
significantly shorter than it is for firefighters. Single-role staff will be required to complete
approximately three weeks of training as compared to the 20-week academy for firefighters.
This will allow the Department to fill vacancies for ambulance staff more rapidly. The associated
expenses related to the hiring and training of new single-role staff is lower compared to the
costs of firefighters.
The single-role model is expected to create a more flexible staffing structure that will allow for
faster and more cost-efficient expansion of EMS services in the future. This staff model could
increase the resources provided to the community with a lower financial impact in both the
short and long term. There is a possibility of a higher turnover rate with single-role personnel,
however, that is something we would have to monitor to quantify.
This model will create a hiring pipeline and assist with recruitment and diversity in hiring. The
Department can tap into the more diverse candidate pool of civilian EMTs and paramedics,
many of whom would be attracted to joining PAFD in the pursuit of a career in the fire service.
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It would create a hiring pipeline for civilian EMS workers to gain exposure and experience in the
fire service.
Timeline
FY25
• IAFF Negotiations
• E64 Cross-Staffed on Overtime
FY26
(Jul-Dec)
• 12 HR Ambulance on Overtime
• E64 Cross-Staffed on Overtime
• Preparation for Single-Role Division (if approved)
FY26
(Jan-Jun)
• Hire Single-Role Admin Staff
• Hire Single-Role EMTs & Paramedics
• Conduct training & transition
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FISCAL/RESOURCE IMPACT
STAKEHOLDER ENGAGEMENT
ENVIRONMENTAL REVIEW
ATTACHMENTS
APPROVED BY:
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Finance Committee
Staff Report
From: City Manager
Report Type: ACTION ITEMS
Lead Department: Fire
Meeting Date: November 19, 2024
Report #:2406-3310
TITLE
Evaluation of Fire and Ambulance Service Expansion Options
RECOMMENDATION
Staff recommends the Finance Committee review the evaluation of Fire Department fire and
ambulance service expansion options and provide feedback for further consideration.
EXECUTIVE SUMMARY
During the Fiscal Year 2025 Budget Hearings, the City Council instructed the Palo Alto Fire
Department (PAFD) to return with options to increase fire and emergency medical service
(EMS) resources. This report includes information on current service demands and system
performance, and options to increase resources by adding a fire engine at Station 4 and a peak
call time 12-Hour ambulance (peak ambulance) to the current Palo Alto Fire Department
deployment model.
The three options for staffing the proposed new fire engine and peak call time ambulance are:
A. Contract with a private ambulance company
B. Current model staffing with additional firefighters, or
C. Creation of a new classification of single-role civilian EMS staff and establishing a single-
role division.
Feedback from the Finance Committee and potential recommended direction to the City
Council will guide budget development and labor negotiations or changes in administrative
processes.
BACKGROUND
Emergency Response service demands continue to grow, with calls increasing for the last three
years. The draw on the current fire and EMS resources have impacted response times and
overall system performance.
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Table 1. Calls for Service
Fiscal Year EMS Fires
All Others
(Service Calls, False
Alarms, Good Intent)
Total
FY2019 5,490 133 3,220 8,843
FY2020 5,029 126 2,956 8,111 (-8%)
FY2021 4,940 144 2,125 7,209 (-11%)
FY2022 5,260 117 2,957 8,334 (+16%)
FY2023 5,670 138 3,411 9,212 (+11%)
FY2024 5,884 136 3,396 9,416 (+2%)
Most emergent calls for service are medical in nature (63% of calls). The Palo Alto Fire
Department’s current deployment has prioritized ambulance services. PAFD has three (3) full-
time (24/7) ambulances that respond to medical emergencies for patient treatment and
transport. Two of the three ambulances share a fire station with a fire engine (Stations 1 and 2),
and Fire Station 4 has a single ambulance assigned to the station.
County Ambulance Mutual Aid
There are times that all three ambulances are
unavailable due to simultaneous calls; PAFD
requests mutual aid from the Santa Clara County
ambulance provider. In FY 2024, there were a
total of 4,286 calls requiring an ambulance. The
county covered 327 (7.6%) of those calls for PAFD.
County ambulances take significantly more time
to arrive on scene than PAFD ambulances. The 90th percentile response time for county
ambulance in FY2024 was 29:53 minutes while PAFD ambulance was 12:02 minutes. The
County established standard for an ambulance response time is 12 minutes 90% of the time in
an urban environment. Patients that experience an emergency when all PAFD units are
unavailable face a response time that is significantly longer than the standard.
Shorter times to get patients with emergent medical needs from the field to a hospital is
correlated with improved patient outcomes, especially with strokes, heart attacks and other
severe trauma.
Santa Clara County contracts with a for-profit ambulance provider to respond to all transport
needs in the cities within the County, other than Palo Alto. The county provides back up
coverage for Palo Alto, however, the County provider is challenged with meeting standards in
their primary jurisdiction and is less reliable for back up coverage.
The county ambulance service provider is not currently meeting the contractual performance
goals as outlined in their contract with Santa Clara County. With no plans to change providers at
Table 2. County Ambulance Requests
Fiscal Year County Requests
FY2019 114
FY2020 117 (3%)
FY2021 96 (-18%)
FY2022 214 (+123%)
FY2023 272 (+27%)
FY2024 327 (+20%)
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the county level, other city fire departments throughout the county have begun to staff full-
time ambulances with firefighters to meet a minimum level of service for their communities. As
of this year, the following cities, that have not historically provided ambulance services, are in
the process of staffing up ambulances: Mountain View Fire with one ambulance; Santa Clara
Fire with two ambulances; San Jose Fire with eight ambulances; and Milpitas with two
ambulances.
Table 3. LAFCO Report Comparison Data
Metric Palo Alto Mountain View Santa Clara
Population 84,772**84,038 127,151
Square Miles 31.53 12 20
Calls for Service*8,149 4,695 9,259
Incidents per 1,000 residents 107 64 69
Firefighters 87 68 132
Fire Response Units 7 8 13
Ambulances 3 0 0
90th Percentile Response Time*9:41 8:15 8:03
*Data is averaged from 2018-2022
**Includes Stanford population
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The LAFCO report combines multi-year data and presents response times for all urgent calls
into one response time metric. This is different than what is shown in the City’s annual budget
document1. The City budget presents response time percentiles isolating for EMS and Fire calls
and for that specific fiscal year with approximately 75% of fire emergencies responded to
within 8 minutes and 99% of medical emergencies calls within 12 minutes.
Two primary measures are used in fire and emergency response for performance:
Response Time: Response time is the time from receipt of a 9-1-1 call to the time the
first unit arrives on scene. The standard in the field is to measure the 90th percentile response
time, i.e. 90% of the responses are at or below the set time standard. The adopted standard
for PAFD is a 90th percentile response time of 8:00 minutes or less for the first unit to respond
to EMS and fire emergency calls and 12:00 minutes or less for an ambulance to arrive on
scene.
Unit Hour Utilization (UHU): Unit Hour Utilization measures workload for each
response unit. This is the percentage of time during the day the unit is actively responding to
a call. This measure shows how busy the system is and if units have enough availability to
respond to the service demand of an area. UHU measurements also capture if there is
enough time in the day for the firefighters on the unit to complete necessary daily tasks, such
as report writing, training, and required breaks, etc. The maximum UHU recommended is
10% which allows a system to be primarily self-sufficient and may reduce the likelihood of
staff injury.
Once UHU reaches 10% for a primary responding unit, a fire department will see increased
challenges to meet the standard 90th percentile response time due to the unavailability of
resources for immediate response. An agency would need to add resources or experience
reduced call volume to meet response time standards.
Highlights from the 2023 LAFCO report findings for PAFD include the following:
•Palo Alto’s adopted standard response time is 8:00 minutes or less 90% of the time.
The study period between 2018 to 2022 shows Palo Alto’s 90th percentile response
time is 9:41 minutes. (In FY 2024 the 90th Percentile Response time was 9:12 minutes)
•Palo Alto has a high percentage of on-duty units that exceed a 10% UHU and
significantly exceeds the average incidents per 1,000 people in Santa Clara County.
The study notes that PAFD is “excessively busy” and recommends that PAFD should
add additional resources to manage the call volume and improve response time
performance effectively.
•PAFD has one engine at 10.7% UHU and three ambulances with UHUs between 18.5-
1 FY 2025 Adopted Operating Budget, https://www.cityofpaloalto.org/files/assets/public/v/1/administrative-
services/city-budgets/fy-2025-city-budget/adopted/palo-alto-adopted-operating-budget-book_final2.pdf
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22.3%. The four remaining engine companies are over or close to 9% UHU. The
report specifically notes a concern for Fire Station 4, “Two of the medic units are
stationed with another response unit. However, Medic 64 operates with a 19.1%
UHU and is the only resource assigned to Station 4.”
•Given the growth projected for the City and the existing unit utilization level, there
are challenges for PAFD to meet the current and projected demand for service for
ambulances and four of the five fire engine companies. An additional engine
company assigned to Fire Station 4 is necessary to improve performance, and an
additional ambulance would improve the sustainability and performance of the EMS
transport response system citywide.
PAFD presented the full LAFCO Countywide Fire Service Review report and summary on March
11, 2024 to City Council. Staff report #2401-24932.
Assessing Service Levels
PAFD utilizes a predictive analytics software that allows for deployment comparisons and
effectiveness. This program pulls historical incident data and processes simulations of different
staffing models to predict outcomes for response times, UHU, and reliance on mutual aid
resources, e.g. county ambulance.
The modeling showed the most effective increase to City emergency response resources is
adding a fire engine at Fire Station 4, and a 12-Hour peak ambulance. This will make a
significant impact in reducing overall response times, UHU, and reliance on county ambulance
services. Reduced response times will provide greater fire and life safety coverage throughout
the City. Reducing UHU will also assist PAFD with training completion rates, while reducing
burnout and injury rates.
Revenue Streams
The Finance Committee also instructed PAFD to research potential revenue sources to assist in
offsetting existing department operations and the costs of service level expansions discussed in
this report. PAFD has made progress and is confident that some additional revenue can be
generated. These include increases to the base Ambulance Transport fee as a result of the
citywide municipal fee study that is planned for completion in early 2025; increases in
Ambulance Transport revenue from the growing call volume; and the renewed consideration of
a First Responder Fee. These revenue increases will be brought forward for City Council
consideration through the annual budget processes over the next two fiscal years. These new
revenues are not contingent upon implementing any of the options included within this report.
2 https://cityofpaloalto.primegov.com/portal/viewer?id=3801&type=0
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ANALYSIS
Based on the assessment of service needs and the predictive analytics, staff focused on
researching alternate staffing models for a full-time Fire Engine at Station 4, and a peak
ambulance. All models reflect these resource additions, the difference is the source for the
additional staff resources, whether contracting out, increasing internal staffing under the
current model, or creating a new internal position limited to the EMS role.
A. Contract with a private ambulance company,
B. Staffing with additional firefighters under the current staffing model (International
Association of Fire Fighters Union, Local 1319 (IAFF) staff), or
C. Creation of a new Single Role Civilian EMS Division within the Department.
A two-year implementation timeline is assumed for all three options. The first year would
implement the peak ambulance in order to immediately impact response times and EMS
coverage. The second year Engine 64 would be upstaffed to coincide with the completed
remodel of Fire Station 4. Costs for each option are shown as the annual operating costs for
the plan for direct comparison of the overall financial impact.
The table on the next page outlines the key information points of each option, and below each
option is discussed in more detail.
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Table 4. Staffing Options Summary*
Cost Components &
Timeframe A. Contract Ambulance
B. Current Model
Firefighters (IAFF) C. Single Role Civilian
Ongoing Costs (Annual Operating Costs)
Fire Costs $2.6M $2.6M ($0.7M)
EMS Costs $0.8-1M $0.7M (Overtime) $3.8-4.0M
Ongoing Cost Total $3.4-3.6M $3.3M $3.1-3.3M
One-Time Costs (May be spread over multiple fiscal years)
Hiring & Training
Costs (one-time) $2.1M $2.1M $0.6M
Fleet Fire Engine 64
$1.2-1.9M
Fire Engine 64
$1.2-1.9M
Reserve Ambulance
$0.5M for replacement
Fire Engine 64
$1.2-1.9M
Reserve Ambulance
$0.5M for replacement
One Time Total $3.3-4.0M $3.8-4.5M $2.3-3M
Timeframe and Other Components
Increased Headcount 10 FTE 10 FTE 22 FTE (net)
Labor Negotiations required N/A Negotiations required
Peak Ambulance
Timeframe
18+ Months 3 Months 12-18 Months
Implementation
Elements
RFP Process IAFF Staff Assignment
Bidding Process
Establish new division
and classifications
Other Considerations •Bundled Rate
•Quality Control
•Staff Supervision
•Easy to Implement
•Higher Long-Term
Pension and Benefit
Liability Costs
•Long Term Savings
•Easy Upstaff for Higher
Demand
•Hiring Pipeline
•Training Coverage
*All options presented include Engine 64 and a peak ambulance
Option A: Contract Ambulance
Costs and Implementation Time:
The Fire Department contacted local private ambulance service providers and ascertained a
range from $0.9 to $1.0 million in annual costs for a peak ambulance. In this scenario 10 FTE
would be added to upstaff Fire Engine 64, with a total annual operating cost of $2.6M.
If selected, the ambulance service contract would be for work that is currently done by IAFF
employees, and therefore, would require a meet and confer process before the City could
contract with a private provider. The timeframe to secure a contract and having ambulance
services in place is estimated to take over 18 months. Time will be impacted both by the length
of the meet and confer process, potentially leading to impasse procedures as well as a request
for proposal (RFP) to secure official bids from potential contractors.
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To staff Engine 64, one-time hiring costs for the 10 FTE Firefighters that would be added are
estimated at $2.1 million which includes testing, uniforms and Personal Protective Equipment
(PPE). Additional staff costs for the 20-week Fire Academy and associated staffing backfill costs
while firefighters are in the Fire Academy will also be incurred typically materializing in
increased overtime costs.
Other Considerations
Option B: Additional Firefighter Staffing (Current Model)
Costs and Implementation Time
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Other Considerations
This is the administratively most standard option and therefore greatest ease of
implementation. This option, follows typical logistics of hiring existing classifications and placing
an additional unit in service. This retains consistent quality control and assurance processes
with direct PAFD supervision and training of City staff.
Option C: Single-Role Civilian Division
This option takes learnings from models implemented by other city fire departments in
California, and utilizes single-role civilian EMT staff for ambulance service delivery.
This proposal adds a peak ambulance and convert two of PAFD’s three full-time ambulances to
single-role civilian staffing. Current firefighter staff will be shifted to upstaff Engine 64.
If selected, a new EMS Division will be created within PAFD with a separate hiring, training and
management team as there are different requirements for single-role civilian EMTs and
paramedics. A total of 25 new FTE will be added to the Fire Department with an annual cost of
$3.8-$4 million. This plan also includes a reduction of 3.0 FTE firefighter positions recently
added in FY 2025 Adopted Budget which will create $0.7 million in annual savings. This brings
the estimated ongoing net cost to $3.1-3.3 million annually.
Impacts to centralized benefit costs, such as worker’s compensation insurance, retiree health
and long term pension liability, are not included in the estimated cost as this will require the
assistance of actuaries.
The table provides the proposed positions for the single-role civilian EMS Division.
Table 5. Single Role Civilian EMS Division Staff Summary
2 x 24 Hour, and One Peak Ambulance (3 Total)
FTE Job Title Description/Role
1.00 EMS Manager Hiring, training, program management
1.00 Administrative Associate III Administrative process, purchasing, and HR support
10.00 Paramedic Single Role Civilian Paramedics assigned to the Peak or 24-Hour
Ambulance Schedules.
10.00 EMTs Single Role Civilian EMTs assigned to the Peak or 24-Hour
Ambulance Schedules.
3.00 Hourly Medics Hourly Single Role Civilian Paramedics to fill in shift gaps, and
coverage for vacation, sick, etc.
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The single-role civilian positions would be new classifications and will require a meet and confer
process with labor organization as well as consultation with CalPERS on retirement benefit
structures. There is not uniformity on benefit packages in this landscape. The City of Berkeley
provides a sworn benefit package for their single-role civilian staff, and the City of Chula Vista
provides a non-sworn benefit package. Human Resources staff is in communication with
CalPERS to obtain further guidance.
Other Considerations
5
1
8
3
benefit of this plan is providing coverage for firefighters to complete mandatory training which
is currently complete while on-duty and can often be interrupted due to calls for service.
FISCAL/RESOURCE IMPACT
STAKEHOLDER ENGAGEMENT
ENVIRONMENTAL REVIEW
ATTACHMENTS
APPROVED BY:
Palo Alto Fire Department
The chart below shows resource staffing at each Fire Station from Fiscal Year 2011 through Fiscal Year 2025. Only years where changes were made are shown.
BC = Battalion Chief
E = Engine
M = Medic/Ambulance
R = Rescue
T = Truck
XS = Cross Staffing
Fire Station FY2011 FY2012 FY2014 FY2015 FY2016 FY2018 FY2021 FY2022 FY2025 (Current)
Station 1 E61 (3)
M61 (2)
E61 (3)
M61 (2)
E61 (3)
M61 (2)
E61 (3)
M6 (2)
E61 (3)
M61 (2)
E61 (3)
M61 (Peak, XS in PM)
BC (1)
E61 (3)
M61 (Peak, XS in PM by
E63)
BC (1)
E61 (3)
M61 (2)
BC (1)
E61 (3)
M61 (2)
BC (1)
Station 2 E62 (3)
R62 (3)
M62 (Peak, XS in
PM)
E62 (3)
R62 (3)
M62 (Peak, XS in
PM)
E62 (3)
M62 (2)
E62 (3)
M62 (2)
E62 (3)
M62 (2)
E62 (3)
M62 (XS)
E62 (3) Brown Out
M62 (XS)
S62 (2)
M62 (2)
E62 (3)
M62 (2)
Station 3 E63 (3) E63 (3) E63 (3)
M63 (XS in PM)
E63 (3)
M63 (XS in PM)
E63 (3)
M63 (XS in PM)
E63 (3)
M63 (XS in PM)
E63 (3)
M63 (XS in PM)
E63 (3) E63 (3)
Station 4 E64 (3)E64 (3)E64 (3)E64 (3)E64 (3)
M64 (XS)
E64 (3)
M64 (XS)
E64 (3)
M64 (XS)
M64 (2)M64 (2)
Station 5 E65 (3) E65 (3) E65 (3) E65 (3)
M65 (XS)
E65 (3)E65 (3) E65 (3) E65 (3) E65 (3)
Station 6 E66 (3)
T66 (3)
BC (1)
E66 (3)
T66 (3)
BC (1)
E66 (3)
T66 (4)
BC (1)
E66 (3)
T66 (3)
M66 (2)
E66 (3)
T66 (3)
M66 (2)
E66 (3)
T66 (3)
M66 (2)
E66 (3)
T66 (3)
M66 (2)
E66 (3)
T66 (3)
E66 (3)
T66 (3)
Station 7 (SLAC)E67 (3) Closed Closed Closed Closed Closed Closed Closed Closed
Fire Units 9 8 7 7 7 7 7 6 6
Ambulance
Units
1.5 1.5 2 2 2 1.5 1.5 3 3
Total Daily
Staffing
Day: 32
Night: 30
Day: 29
Night: 27
Day: 27
Night: 27
Day: 27
Night: 27
Day: 27
Night: 27
Day: 26
Night: 24
Day: 26-23
Night: 24-21
Day: 24
Night: 24
Day: 25
Night: 25
Changes SLAC Closed Removed Rescue
4th person to Truck
M62 24hours
M63 XS in PM
Cross-Staffed E65
with M65
Moved Cross-
Staffed M65 To
station for as M64
New Stanford Contract
Cross-Staffing Model
3 person Truck
Moved M62 to M66
M61 reduced to Peak
COVID Fiscal Crisis
Brown out of E62/M62
(86% of time)
Ended Cross-Staffing
Removed M61 Peak
E62 changed to Squad
S62 changed to
Engine 62
7
3
8
6
Palo Alto Fire Department
Staffing Options Summary
The table below compares Options A through C from the November report, and Options D through E as the alternatives. All costs are shown in Fiscal
Year 2025 figures.
Table 7. Staffing Options Summary
Metric A. Contract B. IAFF C. Single-Role
Civilian
D. Cross-Staff E64 E. Single-Role Peak
Hour Ambulance
F. Single-Role & Fully
Staff E64
1 Fire Units 7 7 7 7 6 7
2 Ambulance
Units
3.5 3.5 3.5 2.0* 3.5 3.5
3 Annual
Operating Cost
$3.4-3.6M $3.2M $3.1-3.3M $0.9M $1.2M $2.5-2.7M
4 Headcount 10 FTE
Firefighters
10 FTE Firefighters 25 FTE Single-Role
-3 FTE Firefighters
3 FTE Firefighters 7 FTE Single-Role 16 FTE Single-Role
-3 FTE Firefighters
5 Labor Negotiations
required
N/A Negotiations
required
Meet/Confer Negotiations
required
Negotiations required
6 12HR
Ambulance
Timeframe
18+ Months 3 Months 12-18 Months No 12 HR
Am2bulance added
12-18 Months 3 Months
7 Implementation
Elements
RFP Process IAFF Staff
Assignment Bidding
Process
Establish new
division
N/A Establish new
division
Establish new division
8 Hiring Costs $1.2M $1.2M $0.6M $0.4M $0.1M $0.4M
9 Fleet Fire Engine 64
($1.2-$1.9M)
Fire Engine 64 ($1.2-
$1.9M)
Reserve Ambulance
($0.5M)
Fire Engine 64
($1.2-$1.9M)
Reserve Ambulance
($0.5M)
Fire Engine 64
($1.2-$1.9M)
Reserve Ambulance
($0.5M)
Fire Engine 64
($1.2 - $1.9M)
Reserve Ambulance
($0.5M)
10 One Time Total
(Hiring + Fleet)
$2.4-3.1M $2.9-3.6M $2.3-3.0M $1.6M-2.3M $0.6M $2.1-2.8M
11 Other
Considerations
•Bundled Rate
•201 Rights
•Quality Control
•Staff
Supervision
•Easy to
Implement
•Higher Long Term
Liability Costs
•Long Term
Savings
•Easy Upstaff for
Higher Demand
•Hiring Pipeline
•Training Coverage
•Adds firefighting
capacity to FS4
•Increases
workload on FS4
Crew
•Reduces
availability of
Medic 64
•Move towards
Single-Role
•Improves
ambulance
availability
•Reduces reliance
on SCC
Ambulance
•Fully staffs E64 &
Peak Ambulance
•Improves ambulance
availability
•Reduces reliance on
SCC Ambulance
•Long Term Savings
•Hiring Pipeline
•Training Coverage
*Engine 64 and Medic 64 are Cross-Staffed
Evaluation of Fire and
EMS Service
Expansion Options
April 1, 2025 www.cityofpaloalto.org
1
Introduction
•FY2025 Budget Hearings
•November 19, 2024 Meeting
•FY2025 Midyear Actions
2
Background
•Community Needs for Emergency
Response
•Calls for Service
•Reliance on Back Up from County
Ambulance
•System Performance
•Response Times
•Unit Hour Utilization
•Resource Levels
Fiscal Year Calls for Service County
Requests
FY2019 8,843 114
FY2020 8,111 (-8%)117 (3%)
FY2021 7,209 (-11%)96 (-18%)
FY2022 8,334 (+16%)214 (+123%)
FY2023 9,212 (+11%)272 (+27%)
FY2024 9,416 (+2%)327 (+20%)
3
Fire Service Staffing and the Integrated System
•24 Hour Staffing Model
•Daily Positions
•Battalions (x3)
•Budgeted FTE
•Integrated System
•Resource allocation
•Automatic Vehicle Location
•Capacity management
4
Resource Analysis and Options
•Finance Committee on November 19, 2024 Meeting:
•Options to add Full-Time Fire Engine at Station 4 & 12 Hour Peak Ambulance
•Committee requested data and additional options to consider
Options A. Contract B. IAFF C. Single-Role Civilian
Fire Units 7 7 7
Ambulance Units 3.5 3.5 3.5
Annual Operating Cost $3.4-3.6M $3.2M $3.1-3.3M
Headcount 10 FTE Firefighters 10 FTE Firefighters 25 FTE Single-Role
-3 FTE Firefighters
Implementation
Elements
RFP Process IAFF Staff Assignment
Bidding Process
Establish new division
5
Option D: Cross Staff Engine 64, No Capacity Added
Annual Cost: $0.9 Million
One-time Costs: $1.6-2.3 Million (Hiring & Engine purchase)
•3.0 FTE Fire Captain positions would be added to the Department to cross-staff Engine 64
•This option adds Firefighting capacity to Fire Station 4, it does not add capacity to the integrated system
Considerations:
•Cross-staffs Engine 64 with Medic 64 at Fire Station 4,does not include a 12-hour peak ambulance
•Adds firefighting capacity to Fire Station 4
•Increases workload on Fire Station 4 crew
•Reduces availability of Medic 64
6
Option E: Single Role Peak Ambulance, No Engine at FS4
Annual Cost: $1.2 Million
One-time Costs: $0.6 Million (Hiring & Ambulance purchases)
•A new Single Role Civilian EMS Division would be established, starting with a Peak
12-Hour Ambulance
•7.0 FTE Single Role EMS Division staff would be added to the Department
•There will be no Fire Engine at Fire Station 4, it would be staffed with Medic 64 only
Considerations:
•Fire Station 4 staffed with Medic 64 only, and adds a peak ambulance
•Move towards Single-Role
•Improves ambulance availability
•Reduces reliance on SCC Ambulance
7
Option F: Single Role & Fully Staff Engine 64
•Annual Cost: $2.5-2.7 Million
•One-time Costs: $2.1-2.8 Million (Hiring & Engine and ambulance purchases)
•Two of the 24-hour ambulances would be changed to Single Role staffing, and
those firefighters would be shifted to Engine 64 in 2027
•A total of 16.0 FTE Single Role Division Staff including management and support
would be added, and 3.0 FTE Firefighters would be reduced
•A 12 HR Peak ambulance will be staffed with firefighter overtime
Considerations:
•Fully staffs E64 and M64 at Fire Station 4 & adds a Peak Ambulance
•Improves ambulance availability
•Reduces reliance on SCC Ambulance
•Long Term Savings compared to the traditional staffing model
•Hiring Pipeline
•Training Coverage
8
Ambulance Billing and Revenue
•Ambulance transport revenue increasing
•Muni fee study
•Increase in base ambulance transport fees
•New First Responder Fee
•Reduction in County picking up transports
FY2024 Ambulance Transport Payer Mix
Medicare Medicaid Commercial Self Pay Total
2102 595 1102 209 4008
52%15%27%5%100%
9
Next Steps
•Feedback from Finance Committee
•Potential negotiations and administrative processes
•Budget planning
•Muni Fee Study in late April