HomeMy WebLinkAboutStaff Report 1463City of Palo Alto (ID # 1463)
City Council Staff Report
Report Type: Consent Calendar Meeting Date: 3/7/2011
March 07, 2011 Page 1 of 2
(ID # 1463)
Council Priority: Emergency Preparedness
Title: Amendment to agreement with Sys Planning/Tri Data
Subject: Approval and Authorization for City Manager to enter into amendment
No. 1 to contract with Sytems Planning Corporation/Tri Data Divisionto add
$40,000 for preparation of an EMS study for a total contract amount not to
exceed $87,000. Authorize the City Manager to sign an amendment to the
agreement with Systems Planning Corporation/ Tri Data Division in the amount
of $34,500 to complete the City of Palo Alto Emergency Medical Services
Resources, Services and Utilization Study
From:City Manager
Lead Department: City Manager
Recommendation
Approval and Authorization for City Manager to enter into amendment No. 1 to contract with
Systems Planning Corporation/Tri Data Division, to add $40,000 for preparation of an EMS
study for a total contract amount not to exceed $87,000.
Background
This study was originally approved by the Fire Department in the fall of 2009 for completion by
a different company. Unfortunately, the company that was originally hired to complete the
EMS Study was terminated in November 2010 for non-performance. As a result, it is now
necessary for the City to engage another firm to conduct the study.
Staff recommends that Council authorize the City Manager to sign an amendment to the
agreement with Systems Planning Corporation/Tri Data Division in the amount of $40,000
($34,500 plus expenses) to complete the City of Palo Alto Emergency Medical Services (EMS)
Resources, Services and Utilization Study.
Discussion
In January 2011, Systems Planning Corporation/Tri Data, along with the International
City/County Management Association Consulting group, completed the Fire Department
Resources, Services and Utilization Study for the City. Because the firm has knowledge of the
City of Palo Alto, the fire department and its staff, as well as collected quite a bit of data
March 07, 2011 Page 2 of 2
(ID # 1463)
through the City's computer aided dispatch (CAD) system, it follows that the firm could get a
jump start on completing this very important, overdue study for the City. In addition, Tri Data
has successfully completed similar EMS operations studies for other jurisdictions.
Staff requested a proposal from Tri Data and the cost will be $40,000 ($34,500 for consulting
and not to exceed $5500 for expenses) and will be paid through the Fire Department
contingency/consulting services line item. This is consistent with what staff has received in
terms of costs from other firms when the original RFP was issued in fall 2009. The original
contract with Tri Data was $47,000 and this amendment to completed the EMS Study will bring
those costs to $87,000 total.
A copy of the scope of work and task steps are included as Attachment A.
Timeline
The consultant will begin the work immediately following approval by Council and estimates
that the study will be completed by the end of the fiscal year.
Attachments:
·Tri Data EMS Work Plan (PDF)
Prepared By:Pam Antil, Assistant City Manager
Department Head:James Keene, City Manager
City Manager Approval: James Keene, City Manager
PROPOSAL
Emergency Medical Services Add-on
! to Current Fire Services Utilization
,I
"
and Resources Study
Submitted to:
Greg Pustelnik, Purchasing Manager
City of Palo Alto
Purchasing and Contract Administration - M Level
250 Hamilton Avenue, Mail Stop MB
Palo Alto, CA 94301
Submitted by:
Philip Schaenman, President
TriData Division, System Planning Corporation
3601 Wilson Boulevard, 5th Floor
Arlington, VA 22201
(703) 351-8300
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Proposal-City of Palo Alto, CA
Emergency Medical Services Add-on
Dr. Harold C. Cohen, another TriData senior project manager. Dr. Cohen has managed
many TriData studies, including the EMS studies listed above He has over 30 years of EMS and
fire service experience, including 22 years with a large, combination, fire and EMS system.
Harold has a Ph.D. in Health Services, M. S. in Emergency Health Services Administration and
Management, and was an IAFCINFPA Fellow to the Harvard University/JFK School of
Government in the Senior Executives in State and Local Government programs. He is a graduate
of the National Fire Academy Executive Fire Officer Program and instructs with this program.
Harold is also a Fellow of the American College of Healthcare Executives (ACHE) and is board-
certified in Healthcare Management.
Dr. Cohen will report to Steve Brezler in the manner that other staff and consultants are
currently doing fire study. TriData's administrative staff will provide project support.
JeffDyar, is a senior TriData consultant who specializes in EMS system planning and
evaluation. Mr. Dyar is the former chair of the National Fire Academy EMS Curriculum and
Acting Branch Chief for Executive Programs. He was awarded the James O. Page EMS
Leadership Award by the International Association of Fire Chiefs. Jeffhas also been a firefighter
and paramedic, rising through the ranks to battalion chief. Mr. Dyar has served on several
TriData projects including, the New Jersey State EMS System Evaluation, the Orange County,
FL EMS study, and the City of Alameda, CA EMS study.
SCOPE OF WORK
The scope of work section contains specific areas that will be research. Also included is a
list of tests related scope of work.
Current Status of EMS in Palo Alto
Our evaluation begins with the initial stage of emergency response, 911 access and
identifies each constituent group within the township. Excluding any stage of EMS response
limits the township from seeing the complete picture and often leads to faulty recommendations.
EMS Dispatch-We will examine each primary and secondary access and dispatch
points to determine the effect that call processing time has on EMS response. Our examination of
medical priority dispatch (or similar programs) will help determine the efficiency of weight of
response, and possibly find ways to reduce unnecessary responses that effect safety, cost, and
control overuse of valuable volunteer human resources.
Fire Service First Response -we will examine current first responder service provided
by the Palo Alto Fire Department including, response times, service forecasting, and level of
TriData Division, 2
System Planning Corporation
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Proposal· City of Palo Alto, CA
Emergency Medical Services Add-on
service provided. Level of service provision includes determining the need for providing basic or
advanced life support.
EMS Transportation -TriData will evaluate EMS transportation provided by the city
and by the County EMS provider. We will attempt determine whether the City and County is
meeting their response time goals and providing appropriate levels of service.
County EMS System -California operates on a County-based EMS where local
municipalities usually depend on the County EMS transportation. Palo Alto is one of the small
number of cities that provides full-service EMS. We will examine relationship between Santa
Clara County EMS system and City fire department. This will include the administrative,
operational, and financial dealings between these government agencies.
All ofTriData's EMS system assessments emphasize a systemic approach, with citizen
concerns and participation at all levels. Weare experienced at conducting community-based
participation and mediation, having done so in our New Jersey and Lee County, Florida EMS
studies. At each level, we assure the opportunity for all constituents to offer input into the
evaluation and recommendation process.
Risk and Demand
One of TriData's premier services is a risk and demand assessment for the communities
that we serve. We use the latest assessment technologies, including ARC 9.3 GIS mapping, and
SPSS 15 statistical software to produce quantitative and qualitative measurements to guide
current and strategic initiatives. Most of the risk and demand section leader or the fire
department study. Our addendum focuses on specific EMS.
Possible Future Delivery Models
The township is interested in determining its EMS needs for the next decade. Any model
proposed will be operationally and financially sound, with citizen needs being a priority. We will
examine several possible EMS models including career, volunteer, fire-based, municipal service,
. hospital, commercial, or a combination of these models.
Determining Possible Delivery Models -Our approach is to offer models that
(\ demonstrate resonant simplicity that is operationally and fiscally sound. These EMS delivery
models often require a strategic mixing of different first responder and EMS transportation
services that promote quick response, high levels of care, and cost effectiveness.
Any reasonable EMS delivery model will be considered. Any suggested transitions will
be data-driven, and scientifically-based, but will be practical for the City. In addition to
operational models, we will also recommend possible administrative oversight models. These
models will include planning and executive management, and managing day-to-day
administrative services.
TriData Division, 3
System Planning Corporation
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Proposal· City of Palo Alto, CA
Emergency Medical Services Add-on
• Initial data we would like to obtain is as follows:
• Map of the entire EMS protection area
• EMS department organization charts
• Map of each EMS squad area
• Land use, zoning and demographic data, especially population projections and future
land use plans
• Personnel deployment (number of personnel on each unit)
• Several annual reports (if any)
• Expected major capital improvements that would present new risks or affect existing
risks or travel times (e.g., major roads)
• Capital improvement and ambulance replacement programs used by each squad
• EMS, hazmat, and rescue, and trend data for the past 5-10 years
• Response time profiles for EMS calls, by geographic area. Alternatively, a database
from which this can be computed is satisfactory.
• EMS vehicles by station (age; manufacturer; type; last major refurbishment, if any),
including front-line and reserve units
• Mutual and automatic aid agreements
• General obligation bond commitments and promises
• General information about the ambulance stations, e.g., size, year built, construction,
number of bays, etc.
For the response time analysis we will need:
• CAD data, to include incident number, date, address, call type, time received, time
dispatched, units dispatched, en route times, arrival times, clear times, and in station
times. If CAD data is not available, the equivalent data will need to be assembled into
an Excel document.
• NEMSIS data from EMS patient care reports, removing any patient identifiers.
Review of this above information serves as "homework" before the first series of
meetings with fire department and city officials. It also tells us about data availability. Some of
this data will be collected during the course of the study if not readily available at the triage visit.
After reviewing the initial background information, we will conduct a two-day triage of
issues visit. The project team will meet first with the township leadership and emergency
TriData Division, 5
System Planning Corporation
Proposal· City of Palo Alto, CA
Emergency Medical Services Add-on
services officials, including the township manager, EMS chiefs, EMS medical director, and other
career and volunteer public safety officials. We would also like to meet with planning officials to
get a better idea of future expectations.
The main purposes of our visit are to become familiar with EMS aspects in Palo Alto,
and to bridge the gaps between the fire and EMS portions of the study. We conclude our visit
with a meeting between TriData's EMS researcher, and the township project EMS team to
debrief the visit and to verify any details concerning the project.
We will perform a comprehensive, systematic evaluation of all aspects of EMS starting
with the 91 I system and dispatch (including Medical Priority Dispatch), continuing with EMS
administration and operations, and also including hospitals, and support organizations. Our
evaluation will include interviews, review of documents, and meetings with key leaders of
appropriate organizations.
Our assessment will include meetings with County EMS officials, medical directors,
healthcare administrators, labor leaders, and other participants to assure that each interested party
has an opportunity to provide input. These meetings will be similar to those we held during our
State of New Jersey, Southwest Lee County, Florida, and other studies.
Another aspect of our evaluation will include as assessment of between 5 and 10 local
EMS systems, comparing them to the current Palo Alto model. This will include operational
measures, clinical proficiency, and financial perspectives.
After gathering the data, we will make appropriate conclusions and recommendations.
These initial recommendations will focus on any immediate needs that the City of Palo Alto
Our analysis will be a continuation of the work began during the fire suppression phase.
Based on the information gathered above, TriData will:
• Identify trends affecting fire and emergency protection in the township, including
population growth, demographics, and risk.
• Analyze trends in the number and size of, EMS first responder, and other incidents in
the past 5 years.
• Analyze incident reports or dispatch data to identify the run frequency by area of the
township and by EMS agency.
TriData Division, 6
System Planning Corporation
Proposal' City of Palo Alto, CA
Emergency Medical Services Add-on
• Use statistical extrapolation and expert judgment regarding the factors of influence to
develop projections of future demand for EMS calls, and other rescue incidents over
the next 10 years
• Convert the demand estimate to an estimate of workload by unit and location
The future demand for service is the product of demand per capita and population served.
One needs to consider both elements in projecting demand, not just increase in population. We
estimate future demand in two ways to form an envelope of projections. The high estimate
projects the trend in demand per capita, multiplied by the projected population for each year. The
low estimate assumes that per capita demand will remain about at its current level, and that
demand will therefore be approximately proportional to population growth.
We project trends by type of call. We disaggregate demand estimates by area of the
township, where possible. We consider the types of high-hazard occupancies that exist but may
not have had any serious incidents, and the hazards that are likely to be built in the near future.
The results of this analysis are compared to the existing capabilities to determine present unmet
needs, and projections on when additional resources might be needed. The results of this task
will be used in the EMS station location, EMS unit, and staffing analysis.
We will consider the degree to which demand for service needs vary throughout the
township. We use township planning projections for growth in population, business, and any new
risks expected to be introduced in the next decade.
TriData analysts will discuss with the City the current response time goals in light of
national standards such as NFP A. We will consider the desired goals but also what is feasible
and affordable. Where appropriate we will indicate the costs to meet national standards, and any
evidence in terms of fire injuries, deaths, and dollar loss that the current system is or is not
posing a problem.
Response times includes call processing and dispatch time, time to turnout, and the drive
time. We will analyze the actual response data for the past 5 years. We will compute the average
response times overall and by area of the township, and the cumulative frequency distribution of
response times or fractile response times (i.e., the percent of calls responded to in 4 minutes, 6
minutes, 8 minutes, etc.). We review response times by area of the township and by type of call
(EMS first response, and rescue). This is based on the existing fire response data, and assumes it
is available in machine-readable format.
We consider not only response times for first-due units, but also second-in times and the
time needed to assemble an adequate force for different types of risks. We consider simultaneity
of calls and the availability of back-up resources. We consider how demand varies by area of the
city, time of day, and day of week. This response time analysis is applied to the operational
analyses where the alternatives are evaluated.
TriData Division, 7
System Planning Corporation
Proposal· City of Palo Alto, CA
Emergency Medical Services Add-on
TriData will also evaluate current automatic and mutual aid agreements. These
agreements are important in determining where station locations and service will be needed. We
will identify weak areas and suggest ways to improve cooperation as necessary.
We will develop an EMS master plan to include each major component of the EMS
process. This includes designing a service model, staffing, capital expenses, and quality
management. The plan will be presented in phases, and include specific milestones and time
goals.
We will base our recommendations based on quantitative and qualitative data, political
considerations, and finances. We will create a suggested timeline for implementation based on
realistic expectations. Our recommendations will also consider legislative requirements that are
often challenging in California.
TriData firmly believes that financial considerations are an integral part of any
recommendations, and that they do not stand alone. Due to economic constraints and the
complexity of the township EMS system, we feel that in this case, a separate section is
warranted. It is often difficult to appreciate the true cost-benefit of a specific EMS model, but we
have the experience to understand the nuances of these financial challenges. For example, in
Orange County, FL, we showed how the County assuming additional services could increase
revenues without increasing taxes. Conversely, we showed in Southwest Florida, that local
jurisdictions would not financially benefit from providing full EMS service. We cite these
opposing examples to emphasize that we provide a professional, honest, thorough approach that
is tailored toward our customer, and not the views of a particular organization.
Our financial evaluation will be based on models including: NFP A 1710, the American
Ambulance Association, the Center for Public Safety Excellence, and the Commission on
Ambulance Accreditation. These models are used only as guidelines, because our
recommendations are tailored to our client's needs.
TriData's financial recommendations will include human resource needs, capital projects
and equipment, and projected revenue possibilities. In many cases, services can be increased and
costs reduced by consolidation of equipment and services or combining delivery profiles.
TriData Division, 8
System Planning Corporation