Bend, Oregon
In just over two years, Bend, Oregon has seen major benefits to restructuring its emergency response system, including reduced response times, increased reliability and an improvement in gender balance in fire department staff.
But much of this would not have happened without the support and skilled management tactics of professional City Manager, Eric King, according to Drew Norris, administrative captain and basic life support (BLS) program manager with the Bend Fire and Rescue Department.
King was instrumental in the successful implementation of a tiered response system that has enlisted the help of several basic life support EMTs or ambulance operators. King fosters creative thinking at all levels of the city, and offers the perspective of the practical possibilities of the proposal, said Norris.
As the city investigated using BLS staff to alleviate emergency responders of the most basic calls, King posed questions to Fire Chief, Larry Langston, which materially helped hone a proposal that would win the favor of city council. He allowed Langston to bring an emergency physician with powerful supporting testimony to a council meeting, and worked with the chief to keep the focus on how the project would help city operations, create cost savings and better serve the community.
“Thanks goes to the voters who in 2014 supported an operating levy that allowed us to hire Basic Life Support ambulance crews,” said King. “The levy allowed us to change the way we do business. This new program helps the City provide public safety services more efficiently and responsibly.”
“I’m proud of the innovative leadership in Bend Fire who have earned tremendous support and trust from the community that they serve by reducing costs, improving response times and having exceptional survivability rates in cardiac arrest calls,” King added.
Levy Approved
In May, 2014, the Bend (pop. 83,500) voters approved a local option levy to launch a new tiered emergency response system that keeps advanced life support (ALS) units available for life-threatening emergencies. Eighty-one percent of fire department calls are EMS i
n nature but 40 percent are not life threatening and are suitable for BLS trained EMTs/ambulance operators.
The new BLS system uses appropriately trained ambulance operators to respond to less critical medical calls. As the BLS ambulance operators respond to an incident, a paramedic also responds in a separate Quick Response Vehicle (QRV) or engine to give advanced life support when necessary. The paramedic provides direct clinical oversight for appropriate triage by the EMTs. Assessment, treatment interventions, and transport are provided for all patients. A QRV medic serves dual roles, with the ability to join an engine crew to augment staffing in the event of a fire emergency.
The first BLS medic and QRV were placed in service in May, 2015 and the second in January 2016. The units are deployed at slightly more than half the cost of a fully manned ALS unit.
Response times have decreased by more than 90 seconds, despite an increase in call volume, tourism and road construction. Station reliability increased by 80%, keeping advanced life support apparatus available for true life threatening. Norris expects the positive trend to continue.
The EMTs or ambulance operators, are hired as limited term (less than three years) employees, allowing the city to pay a reduced rate but still offer great service. Another major consideration in switching to this new plan was the need for these new employees to be non-represented, which also keeps costs down. The local firefighters union was in full support of this idea and participated in planning for the system. The Bend Firefighters Association and the city viewed this concept as a cost-effective way to give top-notch medical care and to keep the advanced units for critical emergencies.
While this system is based on models used elsewhere, it has been modified for Bend and will be evaluated continually to make sure goals are met, Norris said. The QRV concept is a completely new idea and other departments in the Northwest are observing the program to measure its effectiveness and assess its suitability for their departments.
Program Benefits
The city has experienced several positive results from the BLS program:
- Reduced overall response times, from 9:13 to 7:40 minutes;
- Increased in station reliability by 80%. This means fire trucks and ambulances in station and available to respond to life threatening emergencies or fires;
- Offloaded 40% of the call volume from ALS medics to BLS ambulance operators; and
- Employed five female basic level EMTs improving gender balance. In 2014 one female worked in the department of 64. Today 6 of the 92 staff are female and 20% of the ambulance operators are female.
“It’s exciting to see the impression that it makes on young women when they see women in ambulances and fire trucks and that that’s something they are capable of doing,” says Ali Small, a new Bend BLS EMT. Watch a video about her and the other female ambulance operators here. The city created several other videos about the program, listed here:
https://www.youtube.com/watch?v=Ac5RGcdm7R8
https://www.youtube.com/watch?v=ykxV_S9NaP8
https://www.youtube.com/watch?v=WSgl3qx_F8U
Meet the Manager
Eric King
City Manager
Longmont, Colorado
Longmont, Co. lies at the foot of the Rocky Mountains. The area is strikingly flat in comparison to what lies just 30 minutes away in the National Park that celebrates the mountain chain. That drastic drop in elevation leads to major runoff as waters flow east off of the mountains and in 2013, Longmont suffered catastrophic flooding, especially along the St. Vrain Creek.
The city was lucky to escape any loss of life, but the damage to property and infrastructure was severe and resulted in more than $25 million in repairs, says Public Information Specialist, Jennifer Loper.
The city just recently finished those repairs and is now making progress toward restoration, sharing information on the projects through a specialized website, videos and events, such as the November 2016 Bike and Learn ride with the mayor.
The seven-mile, round-trip trek attracted more than 50 cyclists who heard from city engineers and project planners about the ongoing restoration of the St. Vrain Greenway trail, development of an 80-acre open space nature area, widening of the creek flood plain and reconstruction of wiped out infrastructure. Mayor, Dennis Coombs, joined the group at the last stop. (see the video)
“[Coombs] gets from one place to another on his bike,” said Rigo Leal, Longmont’s public information officer. “He’s really the inspiration for a bike and learn event.”
Building Citizen Trust
These events, monthly “coffee with council” and the city manager, a broad communications campaign during the disaster and ongoing information sharing build trust in the community of 92,000 and have helped it get through the flood and move on, said Leal. The citizens approved $20 million in bonds for the flood restoration and have approved a 3/4 cent street tax every 5 years since 1986. Amid the flood restoration the street tax was renewed for 10 years until 2026.
“I think this shows the trust between the city and the populace,” Leal added.
Major flood recovery work, including repair and rebuilding of damaged streets, parks, water resources, irrigation ditches, drainage systems, power lines and public buildings began immediately after the flooding and was completed in September 2016. This included the repair and widening of Sunset Street Bridge, which was washed out by flood waters but now hosts designated bike and walking lanes.
A Bigger Project
Along with the repairs, the city realized the need to prepare for future flooding by restoring and revitalizing the creek channel and launched the Resilient St. Vrain project that is expected to cost between $120-$140 million in combined federal, state and local funds, said Loper. Work could take up to ten years to complete and is being done in stages. The city hosts a video about the project on its website and created print collateral to explain the project to citizens.
“The City decided do more than just repair the creek corridor after the 2013 flood,” Longmont City Manager Harold Dominguez said. “It became an opportunity to restore the greenway in a way that ultimately improves this incredible amenity for the Longmont community.”
Through the restoration work, the city plans to move more than 800 acres and more than 525 structures out of the floodplain and will restore 8 miles of St. Vrain Greenway, the “crown jewel” of the area’s trail system. Design work on Resilient St. Vrain began in 2014. Construction work in the first section of the project, the Sandstone Reach, began in December 2016, and work on the second section, known as City Reach 1, will begin in early 2017. Planning and work also has begun on the Dickens Farm Nature Area within the 80 acres of open space. It will include recreational access to the creek, which was not easily accessible in the past. The plan also includes a creek path for tubers and recreational kayakers with several man-made drops.
The Resilient St. Vrain project has received a “Finding of No Significant Impact” designation from FEMA. In the Sandstone Reach, engineers are using the natural path of the creek that was re-established during the flooding, working around nesting bald eagles and re-using tree root wads for softer diversion tactics.
City Manager Harold Dominguez, along with Public Works & Natural Resources General Manager Dale Rademacher, were instrumental in quickly and efficiently working with FEMA to start the flood recovery process and giving timely status updates to the community and the City Council.
Meet the Manager
Harold Dominguez
City Manager
