Additional Further Response to Recommendations of Civil Grand Jury

SAN FRANCISCO

FIRE COMMISSION

ADDITIONAL FURTHER RESPONSE TO

 

RECOMMENDATIONS OF THE 2003-2004 CIVIL GRAND JURY

 

 

INTRODUCTION

 

The Grand Jury Report was issued in June, 2004 and the Fire Commission responded in August, 2004. At the request of the Controller's Office, a further response was made in July, 2005. The Controller has now requested an additional response.

 

Following completion of the 1996 merger of the Department of Public Health's

EMS services with the Fire Department, the Fire Department has moved forward with implementation of the EMS Reconfiguration, which was approved by the Fire Commission on March 24, 2005 . Resolution No. 05-4, approving the Reconfiguration, is attached to the July, 2005 further responses as Appendix 1. The EMS Reconfiguration is designed to improve the provision of EMS service to the public, while also improving working conditions for Paramedics and EMTs. The Reconfiguration's major changes include the dynamic deployment of ambulances to further improve response time and efficiency; the hiring of additional paramedics and EMTs to staff the dynamically deployed ambulances on ten-hour rather than twenty-four hour shifts to reduce fatigue; and the deployment of additional Advanced Life Support (ALS) engines. On July 14, 2005 the Fire Commission further resolved that the new classes of paramedics and EMTs established by the Reconfiguration will be uniformed members of the Department with the same public safety benefits as other Department members.

 

With the approval of the Fire Commission, the Fire Department sought and obtained approval from the Department of Human Resources to amend the existing H-3 classification to expand the scope to include three functional levels: H-3 Level 1 - EMT; H-3 Level 2 EMT-P (Paramedic); and H-3 Level 3, fully cross-trained Firefighter/Paramedic. When the decision of the Department of Human Resources was appealed to the Civil Service Commission, that Commission unanimously upheld the decision to amend the classification to include the three functional levels. The first class of H-3 Level 2 Paramedics has just been hired and is currently undergoing training in the Department's

Fire Academy . This class is scheduled to graduate on May 5, 2006 and will be deployed in the field following that date. Thus, the Department has proceeded with implementation of the EMS Reconfiguration, which will enhance the level of EMS service to the public while improving the working conditions of the Department's EMS members.

 

STATUS OF GRAND JURY RECOMMENDATIONS TO FIRE COMMISSION

 

The following is the status of Grand Jury recommendations to the Fire Commission with which the Commission agreed. This additional further response lists each such Grand Jury Recommendation, the Fire Commission's original response, the Commission's further response and the Commission's additional further (current) response:

 

Grand Jury Recommendation:

 

1a. SFFD and DPH should establish specific criteria for measuring the success of the merger. They should determine the steps necessary to complete the merger. Steps to be taken and the establishment of timelines should be delineated and agreed upon as soon as possible.

 

Fire Commission Response:

 

1a. Agree. The Commission agrees with this recommendation to the extent that it suggests the establishment of specific criteria for measuring the success of the Department's provision of Emergency Medical Services. This recommendation will be implemented, understanding that the Commission views the merger as having already been completed , but with the view that goals and timelines for further improvement should be established and articulated and accomplishment of those goals measured.

 

Fire Commission Further Response:

 

1a. Reference is made to the attached Fire Commission Resolution 05-4, which provides that the EMS Reconfiguration is to be measured as follows:

 

Success of the reconfiguration will be monitored and reported on a continual basis and measured by the following factors: maintenance or improvement of current patient outcomes; maintenance or improvement of current response times; achievement of uniform response times among the City's battalion districts; compliance with accepted and applicable standards for the provision of pre-hospital emergency care; compliance with EMSEO Section and Department agreed upon standards and Continuous Quality Improvement guidelines; reduction in the current level of fatigue experienced by EMS responders and transporters; fiscal accountability; and the effect on the ability of the Department to provide a balanced response to all types of emergencies;

 

The Chief of Department shall report to the Commission on a quarterly basis, or more often as circumstances warrant, on the progress and success of the reconfiguration, and shall make recommendations to the Commission concerning any proposed changes to the hiring and deployment schedule outlined above;

 

It should be noted that the EMS Reconfiguration is at the beginning stages, with no new personnel or apparatus deployed as yet. It is anticipated that the first new ten hour shift Paramedic/EMT ambulances will be deployed in January 2006.

 

The Fire Commission continues to receive regular reports from the Chief of Department and her administration concerning the Department's provision of

EMS services, including response times, quality of service, significant events and the progress of the EMS Reconfiguration.

 

Fire Commission Additional Further Response

 

1a. Agree as previously stated and implemented. At this time, no further Commission action is necessary or anticipated on this recommendation.

 

Grand Jury Recommendation:

 

1b. Once criteria and timelines are established, the Chief and the Fire Commission should be held accountable by the Mayor for achieving them.

 

Fire Commission Response:

 

1b. Agree, as noted in 1a, above. The Commission is accountable to the Mayor and agrees that it should be accountable for all goals established for the Fire Department.

 

Fire Commission Further Response:

 

1b. The Commission continues to agree that it should be accountable for all goals established for the Fire Department, and remains accountable for such.

 

Fire Commission Additional Further Response

 

1b. Agree as previously stated and already implemented. At this time, no further Commission action is necessary or anticipated on this recommendation.

 

Grand Jury Recommendation:

 

1e. Department leadership should define and communicate the values of the department so that

EMS is seen to be at least as important as fire suppression, as stated in SFFD's mission statement. The Fire Commission, the Chief and Department leadership should promote and support EMS by communicating the value of its mission throughout the Department.

 

Fire Commission Response:

 

1e. The Commission agrees with this recommendation, which has already been implemented. The Commission, in its Annual Statement of Purpose posted on the Commission web site, recites that the provision of emergency medical services, together with fire suppression and fire prevention is an integral part of the Department's mission. The Commission has also communicated the importance of the Department's

EMS mission in public statements during both regular and special Commission meetings.

 

In addition, at a special meeting convened by the Commission on

August 12, 2003 specifically for the purpose of considering steps to take to improve the progress of the merger and to respond to complaints from Firefighter-Paramedics, the Commission sought and obtained public comment from members. Following this meeting, two Commissioners undertook a series of individual meetings with all stakeholders in regards to the merger and the complaints since reiterated in the Report. These Commissioners publicly announced and repeated the importance of the EMS mission during the November 25, 2003 Commission meeting. (See minutes of August 12, 2003 Special Meeting and November 25, 2003 Regular Meeting.) Additionally, in communications with Department membership and administration, Commissioners have stressed the importance of a team approach of all segments of the Department in carrying out its mission to provide fire prevention, emergency medical services, fire suppression, rescue and hazardous materials response. The Chief of Department has clearly and unequivocally communicated the same message.

 

Fire Commission Further Response:

 

1e. The Commission continues to stress the importance of the

EMS mission of the Department. This is evidenced by Resolution 05-4 and continues to be publicly stated by individual Commissioners during Commission meetings. The Chief of Department and her administration continue to communicate this message.

 

Fire Commission Additional Further Response

 

1e. Agree as previously stated and previously implemented. At this time, no further Commission action is necessary or anticipated on this recommendation.

 

Grand Jury Recommendation:

 

1f. Given that most alarms are false and those that are not medical in nature, SFFD should respond with appropriate staff and equipment.

 

Fire Commission Response:

 

1f. This recommendation has already been implemented. Additionally, the

EMS configuration study is currently underway to refine the Department's delivery of EMS services and ensure that the most effective and efficient combination of resources is brought to bear on medical and other emergencies. The Commission does not agree with the inference that there has been a disproportionate emphasis on fire suppression, but agrees with the recommendation that the Department should respond with appropriate staff and equipment.

 

Fire Commission Further Response:

 

1f. The EMS Reconfiguration has been developed by the Department and approved by the Commission as a means of further enhancing the provision of Fire-based

EMS service to the public. The Department continues to respond with appropriate staff and equipment to fire, medical and other emergencies.

 

Fire Commission Additional Further Response

 

1 f. This recommendation has already been implemented as previously stated. At this time, no further Commission action is necessary or anticipated on this recommendation.

 

Grand Jury Recommendation:

 

3a. Resource allocation and staffing should reflect the Department's change in workload from fire suppression to

EMS .

 

Fire Commission Response:

 

3a. Agree. This recommendation has already been implemented and is also undergoing further evaluation through the EMS Configuration process. It should be pointed out that although the medical dispatches amount to approximately 70% of the current dispatch volume, this medical workload has been layered on top of the Department's pre-merger fire and emergency response. These additional calls do not obviate the need to respond to suppression and other emergencies. Given the age and density of

San Francisco 's predominantly wood frame structures, quick and aggressive response by a sufficient number of personnel and apparatus is necessary to extinguish fires before they spread, which could otherwise result in conflagration. Resources cannot be allocated based solely on the daily series of dispatches, but must also be ready to respond to the regular occurrence of fire and the risk of earthquake, conflagration and other anticipated major events.

 

Fire Commission Further Response:

 

3a. As noted in the Commission's response, above, the recommendation has already been implemented. Since the response, the EMS Reconfiguration has been approved by the Commission as a means of further enhancing the Department's provision of emergency medical services.

 

Fire Commission Additional Further Response

 

3a. Agree as previously stated and previously implemented. At this time, no further Commission action is necessary or anticipated on this recommendation.

 

Grand Jury Recommendation:

 

3b. The Mayor, Board of Supervisors and the Fire Commission should direct and support the Chief in making resource allocation changes that properly support the

EMS mission.

 

Fire Commission Response:

 

3b. Agree. This recommendation has already been implemented and is continuing. The Commission has overseen the deployment of Department resources to carry out the

EMS mission of the Department since the inception of the merger as noted in the Introduction to this response.

 

Fire Commission Further Response:

 

3b. Since the above response, the Fire Commission has approved the EMS Reconfiguration to further enhance the Department's provision of emergency medical services to the public.

 

Fire Commission Additional Further Response

 

3b. Agree as previously stated and previously implemented. At this time, no further Commission action is necessary or anticipated on this recommendation.

 

Grand Jury Recommendation:

 

5a. Department leadership should identify stations where harassment is occurring. Those engaging in harassing behavior should be appropriately disciplined. The range of discipline should include suspension with or without pay and/or firing, depending on the degree of harassment. Harassers who are not fired should be assigned to different stations.

 

Fire Commission Response:

 

5a. The Commission agrees with, and has already implemented and pursued a policy that harassment of any type, including harassment of firefighter/paramedics, will not be tolerated. The Department should continue to investigate specific claims of harassment and, if verified, impose appropriate discipline, up to and including potential termination. The Department should take steps to eliminate structural impediments that are perceived as preventing enforcement of the Department policy that harassment will not be tolerated. The Commission recently terminated a member it found guilty of harassment.

 

Fire Commission Further Response:

 

5a. Since the Commission's response, the Commission has heard additional disciplinary matters concerning incidents predating the Grand Jury Report and has appropriately disciplined those members found guilty of harassment. The Commission also disciplined an officer who did not take appropriate steps to stop harassment. There are currently no complaints of harassment before the Commission. Neither the Fire Commission, nor individual Commissioners, have received any complaints that harassment of Firefighter Paramedics, Paramedics or women members has occurred since the issuance of the Grand Jury Report to the present date.

 

Fire Commission Additional Further Response

 

5a. Agree as previously stated and previously implemented. At this time, no further Commission action is necessary or anticipated on this recommendation.

 

Grand Jury Recommendation:

 

5b. Ranking officers should be held accountable for their actions or inaction related to harassment. Officers who participate in or allow those under their supervision to participate in harassment should be disciplined. The range of discipline should include suspension without pay, demotion and/or firing.

 

Fire Commission Response:

 

5b. The Commission agrees with this recommendation, which has already been implemented.

 

Fire Commission Further Response:

 

5b. Since the Commission's response, the Commission has heard additional disciplinary matters concerning incidents predating the Grand Jury Report and has appropriately disciplined those members found guilty of harassment and an officer who did not take appropriate steps to stop the harassment. There are currently no complaints of harassment before the Commission. Neither the Fire Commission, nor individual Commissioners, have received any complaints that harassment of Firefighter Paramedics, Paramedics or women members has occurred since the issuance of the Grand Jury Report to the present date.

 

Fire Commission Additional Further Response

 

5b. Agree as previously stated and previously implemented. At this time, no further Commission action is necessary or anticipated on this recommendation.

 

Grand Jury Recommendation:

 

5c. The Fire Commission should hold Department leadership accountable for eliminating harassment.

 

Fire Commission Response:

 

5c. The Commission agrees with this recommendation, which has already been implemented.

 

Fire Commission Further Response:

 

5c. The Department leadership continues to be vigilant in eliminating harassment, as demonstrated above.

 

Fire Commission Additional Further Response

 

5c. Agree as previously stated and previously implemented. At this time, no further Commission action is necessary or anticipated on this recommendation.

 

CONCLUSION

 

As noted in the original Response, since its inception in 1996, the merger has accomplished a substantial and dramatic improvement in the quality of emergency medical services to the public. As stated in the Further Response, the Department is continuing to enhance its provision of emergency medical services through on-going assessment and improvement of service delivery and quality, and through implementation of the EMS Reconfiguration, with monitoring and oversight by the Fire Commission.

 

This Additional Further Response reiterates that, as to all of the recommendations with which the Fire Commission originally agreed, there continues to be agreement as stated. All of those recommendations have been implemented and at this time, no further Commission action is necessary or anticipated on those Grand Jury recommendations.

 

Adopted at the Regular Meeting of the

San Francisco Fire Commission on April 27, 2006 .

 

Ayes: Conroy, Nakajo, Clarke, Lau, Makras

Absent:

 

 

______________________________

Tania Bauer, Commission Secretary