Thread by @shayshinecastle

New thread for the Fire Master Plan. I hate covering master plan stuff bc it's just so.... plan-y. Much jargon.

But the $$ stuff is important. Here's an overview of the three funding levels (and therefore choices) before council.

Well, they're just accepting the plan tonight, but still. These are the options.

Funding levels
$200,000 extra on top of current budget (to maintain status quo)
+$9.39M over 5 yrs; $1.878M/yr (action level; replacing stations 2 and 4 and putting firefighter paramedics on each engine + some equipment purchase for advanced ALS; 2 units)

+$17.79M over 5 yrs; $3.558M/yr (vision level, full ALS deployment; 5 units)

Reminder: ALS = advanced life services.
it goes beyond basic EMT, including things like administering medicine and performing cardiac interventions, etc.

Boulder currently contracts out ALS with American Medical Response. As a result, the city ends up subsidizing EMT wages so they make a living wage ($17.42/hr in 2020, I believe) to the tune of $535,000 a year or so.

Denver and Loveland use model Boulder currently does (Contracts ALS)

Colorado Springs and Longmont provide ALS but no transport (action level investment)

Adams, Arvada, Colorado Springs, Boulder rural, Castle Rock, Cunningham, Lafayette, Littleton, Louisville, North Metro, Mountain View, Rocky Mountain, South Metro, West Metro, Westminster all do full ALS

Yates: I want to be really clear that by adopting this plan, we're not committing to spend $$ on anything in the plan. We might, but it's not what we're voting on tonight.

Wallach: I'm concerned by the process. When we adopt a master plan, I think we create an expectation in the community.

"Expectations that are entirely unrealistic in the community when we're unable to deliver on some of these objectives. ... We're advertising what we'd like to do. If that is divorced from what we're actually capable of doing, I'm starting to question if this is a useful process."

Weaver: I'm concerned about the function of the master plan vs. the function of budgeting.

"If we're setting expectations we're not going to be able to budget for, I think we're setting ourselves up for disappointment," Weaver says.

Yates: To those who worked on this great plan, it's nothing to do with you. "We're struggling with what a master plan is."

Yates to fire dept:

Friend: "I found that page where we compare ourselves to other cities pretty humiliating." If there's one place we don't want to be in last place .... it's providing care.

Mike Calderazzo, Fire Chief: "What we're really asking you to adopt is the goals themselves."

Let us know if we're on the right track, if our approach is right. We can adjust everything else if we can't fund them, Calderazzo says.

"Everything we do, we need to be thinking about people," Calderazzo says. "The people we serve and the people doing the serving."

124 FTEs in the dept; 97 firefighter/EMTs, 8 wilidland responders, 8 community risk staff

7 fire stations + one woodland facility

There are four areas of focus in the master plan, which Planning Board already OK'd:
Expedient hazard and emergency medical response
Improving community preparation / response to disasters
Infrastructure improvements
Workforce

Several goals under each.

"If you have a cardiac event in this country, it's not a very good outcome," Calderazzo says — about 8% chance of survival without major brain damage or other complications.

Boulder wants to get that to 12% by 2025

They also want to reduce response times from current average of 10min, 46sec to 8 minutes flat

That's for ALS.

Our facilities are "very old," Calderazzo says. They don't support the services we provide today. Station No. 3 is in the process of being relocated; Stations No. 2 and 4 need replaced as well.

Those will be v expensive to do. I wish I remembered exactly, but I'm fairly certain it's north of $25M, with conservative estimates.

Regarding the workforce goal of having more female firefighters: That's difficult, Calderazzo says. It would be an accomplishment to get to 25% in 10 years.

I'd like to take this opportunity to address the story I wrote. I think based on Calderazzo's feedback, his humor and lightheartedness didn't come across. I certainly know he meant it that way, but I think I failed to convey that. boulderbeat.news/2020/01/05/bou…

He had a funny quote which I loved and included. He didn't mean it disrespectfully, and I didn't mean it to read that way.

You can read his comment, which I published in full.

Anyway, Planning Board wanted to know why the fire dept was focusing on gender rather than ethnic or racial diversity. We're actually doing pretty well on that, Calderazzo says. Better than the city gov't as a whole (which, he acknowledged in our interview, is a low bar)

But the dept will definitely use the racial equity tool when it's fully developed, he said. And they are making efforts at increasing diversity; it was just that the female piece got pulled out bc it's the department's weakest spot.

Back to fire station replacements: No. 4 "worked as a temporary location 60 years ago when they built it, which is what they were told," Calderazzo says. It fits 3 firefighters and can't fit a wildland firefighting truck

Just realized my Mac is auto correcting wildland to woodland. Consider this a correction to previous tweets

Back to ALS vs BLS emergency medical response

Basic Life Support: Provides care by entry-level providers using minimal or no invasive or drug-based interventions

Advanced Life Support: Provides care by advanced-level providers using the full-scope of the Colorado EMS provisions including: Life-saving drugs, Invasive procedures, Full-scope of Cardiac Resuscitation

Firefighter/EMTs provide BLS; contracted ambulances do ALS. That's why it takes ~10 min for ALS response times.

Every minute that passes without treatment during a cardiac arrest reduces the chances of survivability by 7-10%. But there are other ways to boost survival rates than doing full-out ALS in the fire dept.

Providing CPR training to the public; putting more defibrillators around town, etc. Calderazzo says.

That could be done with ~$20,000 in new funding

For $1.78 million in annual costs and $1.14 million in capital investments (over 5-10 years) there could be a firefighter/paramedic on each response vehicle. Fire dept could provide ALS but still contract out for transport to the hospital

For an additional $5.45 million in annual operating costs and an additional $1.68 million in capital investments, Fire Dept could do ALS *with* transport; full rollout in ~10 yrs time.

Again, council just supposed to be accepting (or not) the goals of the Master Plan

Also realized I had zero idea how to spell defibrillator

Several firefighters have had to leave on calls.

Sorry for the silence; we're talking financials and I'm having difficulty following.

Here's some more info I do understand, from a Fitch And Associates report on ALS:
Base calls with ALS per year: 9,125
% of call resulting in transport: 60%
Annual growth in calls: 1.9%
Average patient charge: $1,414
Annual growth in rate charged: 1%
Gross collection rate: 38%

Base collection: $2.4M
Avg. revenue per transport: $435

This matters bc Boulder will start collecting revenue as it takes on more ALS. Not all of it, though, if we still contract out transport.

The interesting figure for me is the average patient charge: $1,414 for an ambulance ride with ALS. Ouch.

Wallach q: You reference $800/sq ft for construction cost of a new fire station. Is that specialty equipment or... that can't be construction cost.

Calderazzo: It's figuring in Boulder inflation, plus we need special concrete for the fire trucks, land acquisition "which we all know is not cheap" and lots of other special features that are specific to fire stations.

Swetlik: Does CU pay anything for utilizing ALS?
No, Calderazzo says.

Swetlik: I think the most striking thing is the comparison to other cities. We pride ourselves on how great we are.

Maybe we shouldn't, Adam.

"I think we might get more public comment if this was called Keeping People Alive Master Plan. I'd love to see more participation surrounding topics this important," Swetlik says.

Calls for "wealthy" community member or business to donate land for fire stations. "Even if it means having Google on the side of our fire stations."

Friend: CU offered to buy at least one fire truck if we put Buffs on it, some years ago. We rejected that.

Audible "oof" from council and audience members.

Young: I agree that this is one of the most important things, if not the most important thing, that a city is responsible to citizens for. However, I think we need to be patient with ourselves and considering the whole picture with the financial strategy.

"Not to diminish other master plans, but this one had some real performance (metrics) to it, tied to dollars," she says.

Brockett also praising the plan as "incredibly specific."

"While your vision plan is not cheap, it's also no sky-high and unattainable, and ties into important outcomes and goals."

We can't budget it tonight from the dais, Brockett says, but I would hope we prioritize this, bc health and safety of our citizens is of the utmost priority.

Weaver: "I think members of our community would be very disappointed if they saw where we were relative to our peer cities."

Ultimately I think we want to end up at the vision plan. I think we want to do our own transport. But we don't have to start there, Weaver says.

Yates brings up the idea of using the Community, Culture, Safety tax — which expires in 2021 — for ALS or fire station relocation.
Generates $10M/yr, roughly, he says. "There's any number of things" to use it for, but we can talk about what $10M a year can do for the fire dept.

Swetlik moves to adopt the Fire Master Plan. Friend seconds.

Everbody in favor. Plan adopted unanimously.

@threadreaderapp please unroll. Thanks!