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HomeMy WebLinkAboutAgenda - 12-13-2011 - 8eo~ ~- ao~ 1- 0~7 ORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: December 13, 2011 Action Agenda Item No. ~e SUBJECT: Study/Assessment for Emergency Medical Services and E911 Communications Center and Approval of Budget Amendment #5-B DEPARTMENT: Emergency Services PUBLIC HEARING: (Y/N) No ATTACHMENTS: 1. 11/17/11 Meeting Abstract - Discussion with the Board of County Commissioners Regarding Plans to Improve the Emergency Medical Services Delivery System 2. 11/17/11 Meeting Abstract - E911 Communications Center Improvement Plan 3. Solution for Local Government Scope of Services - Comprehensive Assessment of Emergency Medical Services 4. Solutions for Local Government Scope of Services - 911/Communications Center Operations Study 5. Client/Project List -Solutions for Local Government INFORMATION CONTACT: F. R. Montes de Oca: 919-245-6100 Michael Talbert: 919-245-2153 PURPOSE: To provide the Board with a recommendation regarding the County's Emergency Medical Services System and E911 Communications Center by contracting with a consultant to assist the department to develop a multiyear strategic plan; and to approve Budget Amendment #5-B. BACKGROUND: The Orange County Emergency Medical Services System (EMS) provides pre-hospital care and transport to residents and visitors throughout the County. Originated from volunteer services, Orange County Emergency Medical Services beganproviding advanced life support ambulances in the 1980's. Emergency Medical Services is a branch of the Orange County Emergency Services Department and is staffed by dedicated paramedics and Emergency Medical Technicians around the clock. The EMS branch is the largest and highest- profile group within the department providing emergency response, patient care and patient transport from 400 square miles covering densely-populated urban settings to rural areas throughout the County. In addition to responding to 13,000+ calls annually, EMS must be able to address extraordinary events such as multi-casualty incidents (MCIs), large sporting events, 2 stock car races and mass gatherings, assist at fires, evacuations and other disaster situations affecting public safety. The Orange County 911 Center is the public safety answering point for residents to access emergency services agencies. It originated in the former Orange County Sheriffs Office at Columbia and Rosemary Streets in Chapel Hill. It is a branch of Orange County Emergency Services and is staffed by dedicated professionals around the clock. At a work session on November 17, 2011, the Board discussed the Emergency Medical System Delivery and E911 Communications Center improvements. There was consensus that the County needed to develop a strategic plan to improve the County's Emergency Management Services Delivery System and E911 Communications Center. The County requested and has received a proposal from Solutions for Local Government, Inc. to assess and study the operations of both the County's Emergency Medical Services and E911 Communications Center. Attachments 3 and 4 are the proposed scope of services for each area provided by Solutions for Local Government. Mr. Steve Allan, President of Solutions for Local Government, has over eighteen years of experience providing consulting services to local governments. Attachment 5 is a list of projects and local governments Mr. Allan has provided consulting services for in North Carolina over the past twelve years. FINANCIAL IMPACT: The cost to contract with Solutions for Local Government, Inc. to assess and study the operations of both the County's Emergency Medical Services and E911 Communications Center will not exceed $26,400. The Emergency Telephone System Fund has adequate fund balance to cover this cost. Budget Amendment #5-B will appropriate $26,400 of Emergency Telephone System Fund Balance for professional services to complete the proposed scope of services. RECOMMENDATION(S): The Manager recommends that the Board: 1) Approve $26,400 to contract with Solutions for Local Government, Inc. to develop a multi-year strategic plan addressing Emergency Medical Services System and E911 Communications Center needs; 2) Approve Budget Amendment #5-B to appropriate $26,400 of Emergency Telephone System Fund Balance for professional services to complete the proposed scope of services, and 3) Authorize the Manager to sign the contract with Solutions for Local Government, Inc. ~}- 1 ORANGE COUNTY BOARD OF COMMISSIONERS ~~~~ ~~~~ ACTION AGE Meeting Da November 17, 201 Action Age ~a Item No, SUBJECT: Discussion with the Board of County Commissioners Regarding Plans to Improve the Emergency Medical Services Delivery System DEPARTMENT: Emergency Services ATTACHMENTS: 1) Ambulance Mileage Comparison 2) Ambulance Accident Disposition 3) EMS Response Zones Map PUBLIC HEARING: {YIN) No INFORMATION CONTACT: F. R. Montes de Oca: 919-245-6100 Michael Talbert: 919-245-2153 PURPOSE: To receive background and historical information regarding the County's Emergency Medical Services System and to authorize the Manager to contract with a consultant to assist the department with development of a multiyear strategic plan. BACKGROUND: The Orange County Emergency Medical Services System provides prehospital care and transport to residents and visitors throughout the County. Originated from volunteer services, Orange County Emergency Medical Services (EMS) began providing advanced life support ambulances in the 1980's. Emergency Medical Services is a branch of Orange County Emergency Services Department (OCES) and is staffed by dedicated paramedics and Emergency Medical Technicians around the clock. The EMS branch is the largest and highest-profile group within the department providing emergency response, patient care and patient transport from 400 square miles covering densely-populated urban settings to rural areas throughout the County. in addition to responding to 13,000+ calls annually, EMS must be able to address extraordinary events such as multi-casualty incidents (MCIs), large sporting events, stack car races and mass gatherings, assist at fires, evacuations and other disaster situations affecting public safety. The following is a history of the achievements within the EMS System supported by the Board of County Commissioners. The Emergency Medical Services delivery system evolved from two "divisions" -the career County paramedic (treatment) division and the volunteer EMS (transport) squads in 2005. Prior to that, the County provided funding to the volunteer squads to cover fuel, supplies and other operational costs. As the costs rose, the County decided to join the two divisions into one EMS delivery system. 1968: Orange County Rescue Squad was established 1971: South Orange Rescue Squad was established 1980's: Orange County Emergency Medical Services Hired Permanen# Paramedics 1993: Orange County Adopted a Franchise Ordinance 1993: Orange County franchises convalescent ambulance services 1995: Orange County adapts the Initial Response Vehicle EMS System 1999: Two Rescue Squads Merged into Orange County EMS and Rescue Squad, Inc. 3 4 2002: Squads separate info South Orange Rescue Squad and Orange EMS and Rescue 2005: County merges treatment and transport and rescue squads granted BLS non transport 2008: The Franchise Ordinance was revised. 2008: Emergency Services Director recommends ambulances be increased from 3%2 to eight 2009: Initial Response Vehicle program shifted to ambulance-based system On May 5, 2009, the Emergency Services Director reported to the Board a need for additional resources including staffing and equipment to improve response times, which at the time were 17 minutes rather than the goal of 12 minu#es and resulted in 235 instances when an ambulance was not immediately available to respond. On March 25, 2010, the Director of Emergency Services reported to the Assembly of Governments on the continued need for resources to reduce increasing response times (over 17 minutes). In-early 2011, the department entered into an innovative partnership with Durham Tech. With #en available paramedic positions, a "Paramedic Academy" was created with the goal of training up to ten field-ready paramedics in a shorter time than normal recruitment and hiring processes typically take. When a vacancy occurs, it can take up to six months to recruit, interview, process and hire a candidate. Following the County's vetting process, it then takes an additional 4-6 months to field train and clear the medic through required testing and credentialing. The plan was to begin training personnel already hired and vetted and develop Orange County paramedics able to operate within the County's medical protocols and departmental policies and procedures. An additional benefit was employee loyal#y, which would help to stem the revolving-door process that many employees undertook when a competitive salary was offered elsewhere. With the addition of up to eight additional paramedics, the department will be able to staff another peak load unit (12-hour) with permanent employees. This was achieved by giving up senior management positions and did not increase the department's personnel line costs. This initiates the process of "right sizing" the EMS branch to accomplish the goal of reducing overtime expenditures. As this was accomplished, immediate deficiencies were addressed; however, the department was unable to add additional ambulances to reduce the growing response time or improve service. Current and Future Stations Currently, the department operates from five stations: Station 1 -Revere Road, Hillsborough: This is the only station that is wholly owned and operated by Orange County and was realized following refurbishing the old Anima! Services Building. It is minimally furnished, i# does not have backup power to accommodate disaster operations, and units are stored outside in the weather. The station opened for business in 2009. Security is adequate, but not excellent, the surrounding parking access parking !ot is littered with potholes, and ingress/egress is challenging due to its blind-spot access onto Revere Road. This station renovation was the result of BOCC budgetary support during FY 2008/2009. Station 2 -Robeson Street, Carrboro: OCES has operated from this station, which is owned and operated by the South Orange Rescue Squad, for over twenty years. It has served the unit 5 well, but there are challenges operating out of a facility not owned by the County. The facility is filled to maximum capacity with South Orange vehicles and equipment so much that the County ambulance must park outside in the elements. It is not in an optimal location as growth in that area is moving north and west. The area can be served much better from the UNC (Medic 5) station and deserves relocation to another site within the Carrboro area with quick access to Highway 54. Station 3 -Mason Farm Road, Chapel Hill (UNC): The University of North Carolina and Orange County worked for two years to secure a facility maximizing service to the UNC campus, Chapel Hill and parts of southern Orange County. This location's close proximity to the UNC Medical Center and campus and south-central Chapel Hill is a strategic for improving response times. The station opened for business in 2011 with the support of the Board of County Commissioners in an effort to continue reducing response times. This facility does not have a structure that facilita#es keeping the ambulance out of the elements. Station 4 -Mount Willing Road, Efland: Owned by the former Efland Rescue Squad, it is managed by the Efland Fire Department with OCES operating from it since 1985. It was cleaned and cosmetically renovated for approximately $5,000 in 2009 and offers basic comfort and convenience to the crews. !t is a metal skin butler building served by a forty year plus septic system, has no parking for the crews, and does not include a structure that accommodates an ambulance. The one room station is minimally furnished, it does not have backup power to accommodate disaster operations, and units are s#ored outside in the weather. The one room crew quarters does not lend itself to adequate living conditions. It is in an excellent location to serve the west side of the County both north and south of its location due to its proximity to I-85/140. The building is a metal skin over metal frame building that wilt need significant upgrading should the County wish to continue operating from it in the near future. It does not provide shower facilities, requiring the crews to stop into another station should they need to decontaminate following a significant event or call. Station 5 -Eubanks Road, North Chapel Hill: This station opened for business in 2011 and the unit currently operates 12 hours daily, seven days a week from the Operations Base of the Solid Waste Department. It is an excellent site strategically serving the New Hope, Orange Grove and North Chapel Hill areas. The site is used simply as a rest area for the crews allowing them to stop in between calls, catch up on incident and patient reports and fix a light meal. This is another example of innovative use of County assets supported by the Board to further serve the public need. Response is impacted by call processing time, distance to the call and readiness of the resources to respond. A robust roadway system in Orange County does not exist, with reliance on two major thoroughfares (Old Highway 86 and New Highway 86) for north-south access and two major thoroughfares(I-40 and I-85) far east-west access to access the bulk of the population. Therefore it is necessary to develop and maintain a system of strategically placed points of delivery--EMS stations -throughout the community served. Staff recommends additional resources to reduce response Times and recommends that a consultant be engaged to review and determine feasibility of those recommendations to assist the department in the development of a strategic plan. 6 To address the growing need to provide upgraded service to the northern and western areas of Orange County, the department needs to establish stations strategically located to adequately serve the community. Stations should be established north of US 70 and in the southwest area of Orange County to address rising response times. Whenever practical, new stations should be co-located with VIPER tower locations to share backup generation systems, safe traffic access. Not including the land cost, a station is estimated to cost between $500,000 and $600,000. The attached map indicates general areas where stations should be placed to best serve the County. The limited roadway system in the rural areas necessitates the distribution of stations to adequately deliver acceptable response times while partnering with first responders for their immediate basic care skills. An adequate matrix of stations allows for system flexibility to address call surges, crew and unit transfers supporting personnel development and sufficient resources to accommodate MCIs and disaster event response. Further, placing additional units in strategic locations helps to reduce response times to allow for fire departments to clear medical scenes, provide assistance necessary during fires, evacuations, extended events, hostage situations and mass gatherings. Growth of the system allows for backup capability to provide for first responder support and protection as necessary during fires, evacuations, extended even#s, hostage situations and mass gatherings. Equipment Needs The department has very limited capabilities to manage a multi-casualty incident (MCi) or significant surge in activity with current equipment. A 1990 converted delivery truck has been used in the past as a hazardous materials/command unit, but its extended wheelbase and mechanical and electrical issues make it difficult to use. Current trends in the Indus#ry are to design multi-use (MCI/Rehab/Evacuation) capable units to handle multiple uses. In the event EMS had to treat 25-50 trauma patients as would be seen at a school bus accident, the department would be hard-pressed to safely or effectively accommodate this need. Concurrent with the need to "treat" trauma victims, as the population ages more events surrounding nursing and assisted care facilities will be experienced. Whether to cool or heat evacuees or rehabilitate first responders at all types of events, a replacement of the department's multi-purpose vehicle is warranted. Cast is estimated at $50,000 for converting (re-tasking) an older F450 ambulance. Cardiac monitor-defibrillators currently in the department's fleet are rapidly nearing their life expectancy. In 1999, Orange County paramedics were trained to record and interpret 12 lead electrocardiograms and to thus recognize acute heart attacks. Medtronic Lifepak 12s were purchased and have since been the standard of care. These units are 12 years old and must be replaced within the next 12-18 mon#hs. The Medtronic Lifepak 12's are no longer manufactured and are replaced by the newer model Lifepak 15's, which cost approximately $36,000 each to provide excellent standards of patient care. These monitors allow paramedics to monitor critical vital signs during treatmen# and transport. The entire fleet of fourteen (14) needs to be replaced and an additional six (6) should be added to accommodate additional medic units and the increasing numbers of spacial events. At the current per unit cost, the total would be $720,000. Laptops are used to record patient data at the scene; securely submit patient reports; and incorporate Global Positioning System (GPS) "reckoning" #or responding units. Units must be 7 rugged enough for field use, but expandable for longevity of life. Current models are $3,000 per unit, although cheaper tablets may be worth consideration. Depending on the number of additional stations needed based on the consultant's recommendation, an ambulance will need to be added to the fleet of frontline units. Backup ambulances are needed to ensure system reliability (the typical schedule is one backup for every three frontline units). FY 2012113 $360,000 X10) Medtronic Lifepack 15 $36,000 The current models have reached the end of their useful life and will no longer be serviceable after 2016. 20) Replacement Panasonic Tough books $3,000 $60,000 The current madels have reached the end of their useful life and their "no fault" warranty has expired should any unit break they are very costly to repair because the model is no longer supported. All patient care reporting and billing is generated from the tough book. 2) Replacement Ambulance $230,000 $460,000 These ambulances replace the aging 2005 F-450 models which are twice as costly to operate per mile as compared to the new medium duty chassis model EMS Equipment Funding Requested FY 2012113 $880,000 FY 2013114 (10) Medtronic Lifepack 15 $36,000 $360,000 The current models have reached the end of their useful life and will no longer be serviceable after 2016. ,~2) Replacement Ambulances $230,000 $460,000 These ambulances replace the aging 20051=-450 models which are twice as costly to operate per mile as compared to the new medium duty chassis model. 1) Mass Casualty/Rehab Response Unit $50,000 This unit replaces the F800 1990 unit to provide vital surge and rehabilitation equipment to mass casualty scenes, special even#s, and extended emergency responses. EMS Equipment Funding Requested FY 13!14 $870,000 FY 2014115 ' (4) Replacement Tough books $3000 $12,000 The current models have reached the end of their useful ii#e and their "no fault" warranty has expired should any unit break they are very costly to repair because the model is no longer supported. All patient care reporting and billing is generated from the tough books. 1) Replacement Ambulance $230,000 This ambulance replaces the aging 2006 F-450 model which is twice as costly to operate per mile as compared to the new medium duty chassis model. (2) Remount MD Ambulances $110,000 $220,000 To replace the aging chassis and to extend the life of the box up to four times atone half the original cost of the new ambulance. EMS Equipment Funding Requested FY 2014115 $462,000 Staffing Needs: ' To allow for employee leave, illnesses/injuries and other absences, a unit requires replacement staffing equivalent to about 40% more than the eight personnel necessary to staff the unit 24 hours per day. Therefore, each unit`s staffing should represent 11.2 personnel. Although there has been no definitive staffing matrix established yet, current authorized positions allow the EMS Branch to field five twenty-four hour units every day and one 12 hour unit daily. Ambulances are staffed with one paramedic and one emergency medical technician (EMT) as a minimum. in some cases there may be two paramedics, but this is usually to accommodate the training or skills upgrading for an individual. In the early 2000's the calf volume began to outpace available EMS resources because staffing was not adequately addressed. Orange County relied on temporary staff and the use of overtime to add an additional 12 hour transport unit to increase the number of transport units to 3'/. In 2008 the addition of 4 permanent EMTs allowed the department to increase the number of ambulances to 4. In May of 2009 after the redeployment of the Initial Response Vehicle (IRV) paramedics, the department increased the number of ambulances to 4'/z. The 9 department operates a mixed shift system with a 24/72 rotation and a modified 12 hour DuPont schedule. The 24172 shift means an individual is on for one 24 hour period and is then off for 72 hours. This requires four shifts to provide around the clock coverage. The 12 .hour modified DuPont schedule requires two shifts to provide peak load coverage seven days a week. Currently there are four 24 hour units and one 12 hour unit serving the County seven days a week. The department is currently training staff to add at least one additional 12 hour unit to the system to address peak workloads and betfer manage personnel costs. This addition will also increase unit availability. In 2007/2008 the system utilized the 24/48 staffing model to place more units on the road, but the impact to overtime spending was severe. This increased workload on staff !ed to increased worker's compensation claims, increased turnover within the department and early retirements. In fiscal year 2007'!2008 overtime (department wide} was $663,360. A common myth is that adequate staffing negates the need for overtime. Although overtime is reduced when sufficient numbers of units are fielded to address system needs, overtime is necessary to accommodate absences due to employee leave, illnesses and mandatory training. Most EMS systems utilizing best practices address these issues by having sufficient resources that allow staffing above the critical level. For example, a neighboring system deploys as many as seventeen ambulances but identifies minimum staffing at thirteen units before overtime is utilized to re-staff above critical levels. Over the years, overtime has been reduced by nearly ten percent per year since '200712008. fn fiscal year 2090!2011, overtime expended to maintain EMS, E911 and mandatory support coverage was $484,290 department wide, a 27% reduction in overtime spending since FY 2007108. This reduction in overtime was achieved by re-tasking available assets, flexibly redeploying resources, and working diligently with Human Resources to reduce recruitment and hiring timeframes. )n addition, staffing needs were being addressed to begin right-sizing the system. Those efforts are still underway to further reduce overtime spending. Addi#ional staffing is necessary to improve EMS response time and reduce overtime spending by putting additional ambulances into the system. To accomplish this with the Boards support, the EMS system needs to add staff. FINANCIAL IMPACT: The approval of these recommendations will have a financial impact on a multi-year basis regarding capital and equipment additions and improvements and additions in staffing. (Agenda Item #5 for this November 17, 2011 meeting provides a summary of the potential costs associated with Emergency Services Coverage, Capacity and System Improvements addressed in this and other agenda items.) REC4MMENDATION(S}: The Manager recommends that the Board authorize the Manager to contract with a consultant to assist the department with the development of a multi-year strategic plan addressing EMS station locations, equipment and personnel needs. The purpose of the study is to provide a comprehensive and scheduled approach with associated costs for Board review and approval. ~}}acl,,,~„~ ~ ORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGEND T ~~ Meeting Da November 17, 2011 Action Agenda Item No. SUBJECT: E911 Communications Center Improvement Plan DEPARTMENT: Emergency Services ATTACHMENTS: 1) May 2009 Report to the BOCC 2} March 2010 Report to the Assembiy of Governments 3) November 17, 2011 Updated Report Data PUBLIC HEARING: (YIN) No INFORMATION CONTACT: 1=. R. Montes de Oca, 919-245-6100 Michael Talbert, 919-245-2153 PURPOSE: To receive background and historical information regarding the Orange County Emergency 911 Center and needs for improvements. BACKGROUND: The Orange County 911 Center is the public safety answering point for residents to access emergency services agencies. It originated in the former Orange County Sheriffs Office at Columbia and Rosemary Street in Chapel Hill. It is a branch of Orange County Emergency Services and is staffed by dedicated professionals around the clock. The following is a history of the achievements within the 911 Center supported by the Board of County Commissioners: - 1977: Orange County accepts responsibility for answering all emergency calls - 1981: 911 center moves to residential structure at 1914 New Hope Church Road - 1990: Center became an enhanced 911 center (E911) - 1991: Center moves to the basement of 1914 New Hope Church Road - 1992: implements computer-aided dispatch (CAD) - 1996: Adopted Emergency Medical Dispatch (EMD} - 2001: Began discussions to upgrade communications technology - 2004: Grants received to fund VIPER project - 2007: Received communications and first responder radio equipment - 2009: 911 Center moves to 510 Meadowlands Drive - 2009: Transitioned to VIPER Previous Emergency Services Reports On May 5, 2009, the Emergency Services Director reported to the Board a need for additional resources including staffing and equipment to improve response times, which at the time were 17 minutes rather than the goal of 12 minutes. 10 On March 25, 2010, the Director of Emergency Services reported to the Assembly of Governments on the continued need for resources to reduce increasing response times. 11 The 911 Center dispatched 181,974 calls for service in fiscal year 2010/2011. In fiscal 200812049, 186,225 calls were handled; and in fiscal year 2009/2010, the center dispatched 183,611 calls for service. The numbers are based an the times a Call for Service {CFS} report is created. There was no standardized CFS coding system until the latter part of the 2009; therefore many calls handled by the 911 Center never received a consisten#ly-coded CFS report. For example, a resident who calls for information, or a mistaken dial in which an agency was not dispatched but handled by the telecommunicator and determined as no resource needed, was not consistently documented in a CFS Report. Multiple agencies dispatched to one incident location were counted as one CFS Report. Currently, all calls are now required to receive a CFS Report with documentation of the action. The center interacts with up to 13 fire and rescue departments, seven law enforcement agencies, emergency medical services agencies, and support agencies within and surrounding Orange County such as Animal Services. To accomplish this daily balancing act, telecommunicators receive all 911 calls, process them for accuracy and agency appropriateness, dispatch multiple units often representing different agencies, monitor multiple channels and continue the process until the call is completed, in addition to continuous monitoring of law enforcement channels due to frequent events of officers initiating calls. Addressing the workload in the Center requires six {6) consoles to be staffed that handle: 1 telecommunicator: 2radio channels for Sheriff's Department and answer phones 1 telecommunicator: 2radio channels for Chapel Hill Police Department and answer phones 2 telecommunicators: 4radio channels for Carrboro and Hillsborough Police Department and answer phones 2 telecommunicators: 13 radio channels for EMS/Fire/Rescue and answer phones The supervisor would then be available to monitor the daily operations and relieve as needed for breaks, trainings, remedial training and focusing on major events. Minimum staffing is currently 5 telecommunicators, including the supervisor who works a console; however this does not accommodate additional duties assigned. The 911 Center is responsible for .handling all record check requests through the Division of Criminal Information for any agency authorized to receive these transactions (law enforcement, Department of Corrections, Housing and Development, attorneys). Center staff are also tasked with handling al! resident requests after hours and on weekends for contacting Animal Services, Public Works, Department of Social Services, Probation/Parole Officers and any o#her governmental agency with on-call staff. Major events impact the ability for telecommunicators to focus on the responders due to the continued responsibility far answering phones and assigned radio channels. Other additional duties include monitoring alarm systems, monitoring cameras, answering administrative telephone lines, and utilizing Emergency Medical Dispatch to assist a patient prior to the arrival of an ambulance thus reducing the availability of the telecommunicator to answer other phones but still monitor radio traffic. This is accomplished consistently with four console positions plus a supervisor who currently staffs a console. When a1128 positions are staffed, an additional fwo positions could potentially be posted daily. However this could not be realistically accomplished without causing considerable overtime due to employee leave, illnesses, turnover and mandatory training. 12 Once an employee is hired by the County, it takes between 12 and 24 weeks to train, orient, credential and release as a Stn position that is still monitored by the Supervisor to reduce liability prior to the 1 year anniversary of awell-trained telecomunicator. The turnover rate has remained a major factor due to the competition of other 911 Centers who have the same pay scale or higher with fewer responsibilities. Although the equipment in the Center represented newer technology, afour-year installation delay resulted in expired warrantees and aged technology. Much of the equipment was received in 2006, but not instaited until 2008 and then not fully utilized until 2009. Much of .the current dispatching backbone equipment has reached its life expectancy and must be replaced. Older {analog} technology is required to ensure communications with several agencies throughout the area who cannot afford to outfit responders with newer equipment and results in the telecommunicators "simulcasting" on digital and analog communications equipment when dispatching calls. Analog is susceptible to distortion and inaccuracy due to competing signals, whereas digital is more powerful and not as susceptible. Digital is easier to transmit data for actions such as automatic vehicle location, station paging and calls-in-service transmissions to mobile data terminals. Although this procedure a{lows communications among all users, it doubles the workload of communications staff and occasionally results in dispatching errors, staff fatigue and in some occasions missed transmissions. Regulatory agencies requiring Projec# 25 standards, which encompasses maintaining the capability to communicate on the State's VIPER system coupled with the communications industry, is driving the need for equipment upgrades and replacement. Orange County Emergency Services is committed to reducing call processing and response times. The public has become accustomed to instant messaging, texting, social media and instan# feedback requiring Next Generation Internet-based equipment enhancements.. The State 911 Board strongly recommends centers adopt computer aided dispa#ch software standards to achieve regional communications interoperable capabilities. OSS( software is commonly used in the area for computer aided dispatching. Automatic vehicle location equipment further enhances reduction of response times by providing the telecommunicator with instant information to appropria#ely deploy assets. This technology, coupled with cutting edge technology such as OSSI software, can be programmed #o au#o-select the mast appropriate resources, allowing the telecommunicator to monitor calls in progress to ensure first responder safety. While some equipment can wait 24-36 months for replacement, some will need upgrading or replacement within the next 12-18 months. EQUIPMENT Urgent Needs FY 2012113 Phase 1 911 Center Radio Console Replacements: {7} $616,000 Once the State moves to Project 25 (2012/2013), it will require these to be replaced. Mobile Repeaters: (2 @ $20,000 each} $40,000 To provide a redundant fink to the VIPER network in areas with low VIPER coverage Backup Radio System: $200,000 Ensures adequate communication capability following catastrophic system failure 13 Communications Phone System Emergency Telephone Switch: $400,000 To accommodate the moves in technology that the State and other agencies are implementing will require the upgrade of the current telephone switch. Total Communications Equipment Funding Needs - FY 2012/13: $1,256,000 Needs FY 2013114 ~SSI Computer Aided Software Replacement $1,000,000 Provides a stable platform integrating more effectively with local and regional agencies Station and Uni# Paging System: $200,000 To move toward specific station and unit dispatch Mobile Data Terminals (40 MDTs with Mobile CAD Licenses): $375,000 To provide immediate access to dispatch information enhancing response Automated Vehicle Location Software (40 Licenses) $125,000 To organize allocation of resources in order to dispatch closest unit enhancing response Total Communications Equipment Funding Needs - FY 13114 $1,700,000 Needs FY 2014115 Phase 2: 911 Radio Consoles Additions: (4) $350,000 In response to the States recommendation of consolidating multiple PSAPs within a County, this will help prepare for the additional volume. Emergency Fire and Police Dispatch Software: $160,000 To standardize dispatch protocol for fire and police responses Recording Server: $40,000 To replace current recorder purchased in 2408 to record all telephone and radio traffic. Computer Aided Dispatch Servers (4): $25,000 To replace two of the current CAD servers which were purchased in 2008 and add two additional CAD servers to accommodate the addition of mobile data terminals Portable Radio Upgrades: (200 @ $4,000 each} $800,000 To replace radios purchased in 2006, which have reached life expectancy. Mobile Radio Upgrades: (100 @ $5,040 each} $500,000 To replace radios purchased over five years ago which have reached life expectancy Total Communications Equipment Funding Needs - FY 14115 $1,875,000 14 STAFFING NEEDS Additional staffing is necessary to: improve 911 call processing time, which improves emergency response times, ensuring first responder safety and begin preparing far the technology change from passive communications to interactive caller use -digital platforms, automatic vehicle location, data sharing, texting, web-based 911 caller requests and video receipt and re-transmission. The goal is #o improve service delivery and enhance first responder safety by reducing call processing time, adopting new, interactive communications formats and ensuring system fidelity with backup capabilities. To accomplish this wi#h the Board's support, additional staff is needed. The following is an overview of the personnel needs with timelines. Personnel Adding staff prepares for the increase in call volume, allowing telecommunicators to focus on Tess agencies to ensure safer measures, increased monitoring of field activity and enhanced safety to first responders, preparation for the State's recommendation towards consolidation, ability to handle "NextGen" population through text messaging, Internet, video, and reduce overtime without utilizing staff to cover for employee leave, sick and other leave, and stabilize and improve the training process. FY 2012/2013 {4) Grade 13 Telecommunicators - $200,000 (1) Grade 16 Communications Trainer - $50,000 FY 201312014 (4} Grade 13 Telecommunicators - $200,000 (1) Grade 16 Radio System Technician - $50,000 FY 2014/2815 {4) Grade 13 Telecommunicators -- $200,000 FINANCIAL IMPACT: The approval of these recommendations will have a financial impact on the County related to equipment additions and improvements as well as staffing additions. Should the Board accept staff recommendations, it will necessitate amulti-year plan to address resource needs to improve system performance. {Agenda Item #5 for this November 17, 2011 meeting provides a summary of the potential costs associated with Emergency Services Coverage, Capacity and System Improvements addressed in this and other agenda items.} RECOMMENi3ATION(S}: The Manager recommends that the Board approve the plan fior improving capabilities within the E911 Communications Center subjec# to annual budget appropriation decisions and an approved Capital Investment Plan for the project. It is understood tha# the Board will approve applicable financing actions to accomplish this task. /~-,n~ .3 15 Scope of Services to Provide a Comprehensive Assessment of Emergency Medical Services for Orange County, North Carolina Project Understanding Orange County has asked that a comprehensive assessment be conducted of the emergency medical services (EMS) currently provided within and by the County. In discussions with County staff, a number of areas of interest and related questions were discussed. Subsequently, it was requested that the study address, but certainly not limit itself to at least the following: • EMS call volume(s) First response capabilities ^ Call distribution & demographics Staffing • Unit response times and workload Performance criteria • Base locations and conditions Annual operating costs • Level of service being provided Annual billings/revenue • Rural vs. urban characteristics impact ing Fleet and Equipment condition service delivery Proposed Work Plan The Work Plan Outline that follows identifies the major tasks and activities proposed to be undertaken by the consultant. It is formatted to address both the topical concerns of the County as well as how the consultant intends to conduct the study. The tasks and activities described have been organized in the approximate sequence that they may occur. However, various activities are likely to occur simultaneous with others, or continuously throughout the study period. Ultimately, the County can be assured that the Work Plan that follows will address and result in the specific assessments and objective, detailed analyses and options it is seeking. Work Plan Outline Task 1. Data Development 1.1. Collect available/published data, reports, and materials from established sources; i.e., County Finance/Budget Office, GIS, Emergency Services, EMS, 911/Communications Center, etc. 1.2. Depending upon availability, the information may include but will not be limited to: ^ Service reports ^ County EMS Plan ^ County EMS and Fire/First Responder District maps ^ EMS annual budget allocations; five (5) years ^ Communications Center CAD reports ^ Situation Analyses reports ^ Call volume & time interval reports ^ Department (EMS) Protocol and Policy Manual(s) ^ Relevant documentation re: County population 1 Solutions for Local Government, Inc. 16 Orange County, North Carolina Comprehensive Assessment of Emergency Medical Services 1.3. Research & document applicable legal requirements, policy applications, practice guidelines, and service delivery standards regarding the provision of emergency medical services by County government in North Carolina ^ North Carolina Statutes ^ Orange County Ordinances ^ Professional association/agency standards; i.e., - NC Office of Emergency Medical Services - NC Association of Rescue & EMS - NC Emergency Management Association - NC Association of EMS Administrators ^ National agency/organization guidelines -American College of Emergency Physicians (ACEP) - National Emergency Number Association (NENA) -American Academy of Emergency Medicine (AHEM) - National Fire Protection Association (NFPA) 2. Administrative 2.1. Conduct individual interviews with designated County Interviews administrative personnel, and any relevant Department Managers, in order to; ^ Ascertain the prevailing concerns with regards to the delivery of emergency medical services in Orange County, • Clarify and/or expand upon preliminary/ stated objectives and priorities for inclusion/consideration during development of the Study. 2.2. Conduct additional or follow-up interviews with individuals that may affect or be effected by EMS operations and/or the specific issues identified in the study; ^ Emergency Services Director ^ County Medical Director ^ EMS Operations Manager ^ EMS Shift Personnel ^ County Fire Marshal ^ Communications Center personnel ^ Finance/Budget Director ^ Medical Director ^ Others, as identified 3. Current Operations 3.1. Organize and schedule times to visit each EMS base location; ^ Assess general facility conditions and inventory of vehicles available for duty ^ Observe operations and related activities if/as applicable ^ Understand current staffing and deployment ^ Observe and discuss communications processes in place ^ Review existing procedures with on-duty personnel ^ Query EMS personnel with regards to any issues of concern to them Solutions fior Local Government, Inc. 17 Orange County, North Carolina Comprehensive Assessment of Emergency Medical Services 3.3. Conduct and participate in specific fact-finding activities that will include, but not be limited to: ^ Attendance at relevant staff/department/squad meetings ^ Adequacy of existing base facility locations ^ Additional information regarding specific vehicles or major items of equipment in use ^ Communications & paging procedures ^ Response and related performance issues 3.4. Providing source information is available, collect, organize and document.performance of Orange County EMS to include at least the following with regards to emergency calls dispatched; ^ Annual call volume; five (5) years ^ Call distribution by day and hour ^ Response time intervals; chute-time, travel time ^ Situation found reports ^ On-scene man-hours logged ^ Current & past FY operating budget s ^ Current & past year amounts billed & revenue received 3.5 Identify the existing role of paid and volunteer Fire Departments within Orange County as "first responders" to 911 dispatched medical emergencies; source information will include but not be limited to; ^ 911 Center unit/agency call response data ^ EMS call data ^ Existing Fire Department station locations & district maps ^ Additional interviews with EMS Director, Fire Marshal, local Fire Chiefs and others if/as necessary 3.7. Identify and summarize initial issues of concern; i.e. ^ As expressed during individual interviews and meetings ^ As identified by the consultant -Organizational -Staffing, scheduling & deployment - Performance - Communications, equipment & technology - Facilities -Costs & Revenues 4. County Growth 4.1. Research, develop, and document projected growth and/or anticipated changes in future Orange County populations; ^ General population experienced, current & projected ^ Economic /private/public development efforts not otherwise addressed that may impact growth ^ Other factors identified that may affect or otherwise impact the future delivery of EMS services in the County Solutions for Local Government, tnc. 18 Orange County, North Carolina Comprehensive Assessment of Emergency Medical Services 4.2. Assess County geography and physical characteristics either are or may impact the delivery of emergency medical services; ^ Impediments; i.e., bodies of water, woodlands, lack of access, active railroads, etc. ^ Assets; i.e., highways, EMS base locations, etc. 4.3 With the information developed in subtasks 4.1 and 4.2, present and discuss findings with; ^ Emergency Services Director ^ EMS Operations Manager ^ Others, as identified 4.3. Develop materials that graphically illustrate above findings ^ Growth projection scenario(s) ^ Development densities ^ Relevant demographics ^ Geographic/physical features 5, Initial Management 5.1 Review study findings and issues of concern identified to date Review with the County Manager and/or his designated representative(s) ^ Data developed to date ^ Significant issues of concern ^ Study tasks remaining ^ Format and sequence of suggested public meetings ^ Receive input and discuss topics which may require additional research, study and/or development 6. Public Meetings 6.1 Based upon preliminary discussions with the County four (4) public meetings are anticipated at this time to discuss study purpose and solicit input ^ Two (2) meetings with EMS (Data Review) Committee ^ Two (2) meetings with volunteer Fire Department s ^ One (1) meeting to which the general public is invited ^ One (1) presentation to the Board of County Commissioners at a regularly scheduled Work Session 6.2 Schedule, plan for & facilitate the referenced EMS Committee, Fire Department and public meetings for the purpose of soliciting public/citizen input regarding concerns, issues, and experiences, and regarding emergency medical services currently available and/or desired now and in the future. ^ Coordinate w/County to secure times, dates & location(s) ^ If requested by County, provide "copy" for media use in announcement/advertising the meetings ^ Prepare presentation materials ^ Facilitate meeting discussions, receive comments & feedback ^ If/as appropriate, present preliminary findings for information Solutions for Local Government, Inc. 19 Orange County, North Carolina Comprehensive Assessment of Emergency Medical Services ^ Solicit and record all comments 6.3 Review Fire Department & Public meeting activities, comments, and information developed ^ Collate and organize all comments received ^ Transcribe for use/distribution ^ Identify major concerns expressed, and potential influence on preliminary recommendations, organization of priorities, etc. 6.4 Initiate further investigation/study of those issues of concern expressed at the public meeting if not previously addressed; ^ Determine significance of concern ^ Quantify needs, services, and potential costs ^ Incorporate significant findings as appropriate 6.5 At such time as designated by the County, prepare all necessary study materials for presentation to the Board of County Commissioners at a scheduled Work Session. lvorE:ltisrecognized that this meeting may very well occur at or near the completion of the study itself. It is included here as a component of the major task sub-heading 'Public Meetings': 7. Final Data Analysis 7.1. Collect, summarize and review all information gathered to & Recommendations date; i.e. reports, budgets and statistics, interview notes, operations & facility audits, research findings regarding costs and regulatory issues, etc. ^ Confirm and refine initial issues of concern identified in task 3.7 ^ Incorporate priorities identified during study ^ Identify implications and scenarios for development and/or implementation 7.2 Prepare specific summary recommendations that coincide with the issues identified 8. Costs 8.1. Identify and document current and recent historical costs of/for the emergency medical services provided in Orange County; minimum (five)5 years if available 8.2 Identify and document current and recent year revenues; minimum five (5) years if available 8.3 Organize recommendations identified in 7.2 by type/category 8.4 Identify estimated cost(s) of each recommendation ^ Capital (Facilities & Vehicles) ^ Equipment ^ Personnel ^ Operations related Solutions far Local Government, Inc. 20 Orange County, North Carolina Comprehensive Assessment of Emergency Medical Services 8.5 Identify revenues that may result from implementation of stated recommendations; ^ Experienced/known ^ Projected ^ Alternative/additional 8.6 Prepare a timeline and schedule for implementation of plan recommendations; ^ Item/Recommendation/Action ^ Projected Recommendation/Activity Cost ^ Cumulative expenditures; annually-for years 2012-2021 8.7 Illustrate approximate timeframe for realization of estimated revenues ^ Cumulative annually; for years 2012-2021 9. Final Management 9.1 Review study findings and recommendations with County Review Manager and/or designated representatives ^ Major findings ^ Significant concerns ^ Priorities for implementation ^ Costs and timeline ^ Receive comments ^ Edit findings/recommendations if/as required 10. Documentation +10.1 Prepare final study document ^ Narrative, graphic illustrations, and tables ^ Print, collate, & bind all copies ^ Deliver printed and electronic copies to County Deliverables-General We will be prepared to begin work upon notice to proceed and will be immediately accessible and available to the County throughout the project. A major percentage of the work will be done in Orange County where we in turn intend to be accessible to all participating County personnel. While the specific results of the study to be undertaken cannot be quantified at this time, Solutions for Local Government is committed to the effective and timely completion of the tasks required and to providing the County with: • A thorough evaluation of what exists; ^ Documentation of issues identified during the evaluation that concern service delivery, performance, and costs; • Recommendations of what is needed that coincide with the issues cited; • Facts to support the needs identified; • Costs associated with the recommendations provided, and • A plan for implementation. Solutions for Local Government, Inc. 21 Orange County, North Carolina Comprehensive Assessment of Emergency Medical Services Deliverables-Specific 1. Time on site as required to participate in necessary meetings and conduct and/or participate in each of the major tasks and activities described in the Work Plan Outline; estimate 14-16 days. 2. Preparation and presentation of findings, data, issues identified, and preliminary recommendations at both Initial and Final Management Review Meetings with the County Manger and/or his designated representative(s). 3. Development of necessary materials for and facilitation of two (2) EMS Data Review Committee meetings, two (2) Fire Department meetings and one (1) Public meeting to share information regarding study process and objectives solicit input and comment regarding Emergency Medical Services currently provided. 4. Formal presentation of findings and recommendations to the Board of County Commissioners, at such time as determined by the County. 5. Collate, print, bind, and deliver to the County twelve (12) copies of the final. report document. 6. A copy of the final report document, together with the Board of County Commissioners presentation materials will be provided the County in electronic format. Fees , The costs that make up the proposed fee are based on: ^ Man-hours; both on-site and "in-office", and ^ Project related expenses for travel, per diem, communications, materials preparation, and document production. At this time it is estimated that the tasks and activities necessary to complete this project will require between 180-190 man-hours. Therefore, based on the stated project requirements and the major tasks and project deliverables identified in the Scope of Services Work Plan Outline provided, our fee, including all related project expenses for travel, per diem, document production and printing, are estimated at, and will not exceed; $20,900.00. Our practice is to bill monthly (typically on or about the 1S.`) based on the percentage of the work completed during the previous month. Once the fee is agreed upon, we do not add service or administrative fees, or any form of miscellaneous overhead charges to our billing at any time during the project. In addition, we will withhold billing the final 10 percent of our fee until you have received the agreed upon copies of the report document and are satisfied with the work that has been done. Solutions for Local Government, Inc. 22 Orange County, North Carolina Comprehensive Assessment of Emergency Medical Services Schedule Based upon the Scope of Services outline presented here, a schedule of 8-10 weeks is suggested to accomplish Tasks 1-8 assuming that the Fire Department and Public meetings will be able to occur during that time. The formal presentation to the Board of County Commissioners would of course occur at such time as requested by the Manager. The delivery of the final report document, pending any additional work requested, would occur within ten (10) days of the formal presentation to the Board or within two (2) weeks of the referenced Final Management Review (Task 9) should the County wish that the final document be complete and printed prior to the Commissioners meeting, whichever the preference of the County. Additional Firm Information Solutions for Local Government, Inc. is a legal, Sub-Chapter 'S' Corporation, authorized and registered with the North Carolina Secretary of State; SOSID: 0624915. Federal IRS Employer Identification Number: 81-0546253 Our business location is; 2301 Valencia Terrace Charlotte, NC 28226 Telephone: 704.366.9719 Toll free: 1.866.300.3545 Solutions for Local Government, Inc. 8 ' ~-}~ac~,Me.ti}- ~ 2 3 Orange County, North Carolina Communications Center Operations Study Scope of Services to Provide a 911/Communications Center Operations Study for Orange County, North Carolina Project Understanding Orange County has asked that coincidental with the Comprehensive Assessment of its EMS program, that an additional study be undertaken to address various workload, staffing, data capabilities, and costs at the County's 911/Communications Center. In brief discussions with County staff, the focus of the study will include: ^ Center Staffing • Performance & workload • Data availability ^ Dispatch costs ^ Existing CAD capabilities (shortcomings) Proposed Work Plan Thee Work Plan Outline that follows identifies the major tasks and activities proposed to be undertaken by the consultant. It is formatted to address both the topical concerns of the County as well as how the consultant intends to conduct the study. The tasks and activities described have been organized in the approximate sequence that they may occur. However, various activities are likely to occur simultaneous with others, or cointinuously throughout the study period. Work Plan Outline Task HCLI V ILy 1. Center Orientation Meet with Emergency Services Director, Communications Operations Manager, Center Supervisors and staff to discuss project scope and initial information requested, receive initial tour of current facilities, and observe operations in process in order to identify 1.2. Communications Center Organization • Number of positions; FT and PT • Position classification(s) • ROles/responsibilities of each 1.3. Services provided (agencies dispatched) 1.4. Call processing procedures (initial/basic) ^ Emergency ^ Non-emergency • Individual agency/jurisdiction response -Direct users -Remote users 1 Solutions for Local Gni'crnmcnt, tic. 24 Orange County, North Carolina Communications Center Operations Assessment 2. Data In conjunction with Task 1, collect available data and reports having to do with Communications Center workload and performance based on established "best practices" (i.e. APCO, NFPA, NC 911 Board); minimum-annual report/CAD data for calendar year 2011; preferred, annual report/CAD data for calendar years 2007-2011. 2.1. Calls received ^ Emergency ^ Non-emergency/administrative 2.2. Calls dispatched ^ By type; police, fire, rescue, medical, etc. ^ Calls received & forwarded 2.3. Call rate(s) ^ Average total calls per hour, day, month, year ^ Per hour/year ^ Average call duration 2.4 Emergency (911) call interval times ^ First Ring-to-Call Answer ^ Call Answer-to-Call Dispatch 2.5 Identify annual costs ^ The total annual cost of the Communications Center - Personnel - Operations -Capital/equipment 2.6 Identify significant staff and/or task-to-cost ratios 2.7 Compare recent year data calculated for trends 2.8 Review, analyze, and collate data; i.e., findings and observations 3. Study Findings Present study findings and recommendations for management review 3.1 Process Map; i.e., process documentation 3.2 Performance & workload data ^ Call Volume ^ Call handling ^ Staffing 3.3 Costs 2 Solutions for Local Government, Inc. 25 Orange County, North Carolina Communications Center Operations Assessment 3.4 Performance expectations/criteria 4. Management Review Meet w/principal personnel individually to receive input/comment/critique~with regards to study findings ^ County Manager and/or his designated representative ^ Communications Center Supervisor(s) 4.1 Address questions raised 4.2 Pursue follow-up data review/analysis and/or research as required 4.3 Include findings and/or edits in draft report if/as appropriate 5. Final Report Prepare final report document ^ Narrative w/accompanying diagrams and graphics ^ Print and bind all copies ^ Deliver report documents to County 6. Formal Presentation At such time as requested by the County, will be available to the Board of Commissioners to provide formal presentation of report findings & recommendations Deliverables 1. On-site time, as required, to collect and assess the information necessary to address the study tasks identified; estimate minimum of 3-4 days. 2. Coordination and facilitation of all project related meetings and interviews as referenced in the Work Plan Outline. 3. Participation in and presentation of draft report information for management level review, with principal County, and Communications Center personnel. 4. Formal presentation of findings and recommendations to the Board of County Commissioners, at such time as determined by the County. 5. Development, production, and delivery of eight (8) copies of the completed study document to Orange County. 6. Final report, including copies of all presentation materials will also be provided to the County in electronic (CD) format. Fees The costs that make up the proposed fee are based on: ^ Man-hours; both on-site and "in-office", and ^ Project related expenses for travel, per diem, communications, materials preparation, and document production. Solutions for Local Government, Inc. 3 26 Orange County, North Carolina Communications Center Operations Assessment At this time it is estimated that the tasks and activities necessary to complete this project will require between 50-55 man-hours. Therefore, based on the stated project requirements and the major tasks and project deliverables identified in the Scope of Services Work Plan Outline provided, our fee, including all related project expenses for travel, per diem; document production and printing, are estimated at, and will not exceed; $5,500.00. Our practice is to bill monthly (typically on or about the 15t) based on the percentage of the work completed during the previous month. Once the fee is agreed upon, we do not add service or administrative fees, or any form of miscellaneous overhead charges to our billing at any time during the project. In addition, we will withhold billing the final 10 percent of our fee until you have received the agreed upon copies of the report document and are satisfied with the work that has been done. Schedule Based upon the Scope of Services outline presented here, a schedule of 4-5 weeks is suggested to accomplish Tasks 1-4. The formal presentation to the Board of County Commissioners would of course occur at such time as requested by the Manager. The delivery of the final report document, pending any additional work requested, would occur within ten (10) days of the formal presentation to the Board or within two (2) weeks of the referenced Final Management Review (Task 4) should the County wish that the final document be complete and printed prior to the Commissioners meeting, whichever the preference of the County. Additional Firm Information Solutions for Local Government, Inc. is a legal, Sub-Chopter'S' Corporation, authorized and registered with the North Carolina Secretary of State; SOSID: 0624915. Federal IRS Employer Identification Number: 81-0546253 Our business location is; 2301 Valencia Terrace Charlotte, NC 28226 Telephone: 704.366.9719 Toll free: 1.866.300.3545 4 Solutions for Local Government, Inc. j~!}Gd„~,~- 5 Solutions for Local Govemment, Inc. PROJECT LIST-PUBLIC SAFETY [Not Including Law Enforcement Projects] Client Project/RepoK Title Year Allegheny County Public Safety Capital Needs Assessment Study; Fire, Rescue, EMS, Sherdf, 911, Em. Mgt. 2008 Anson County Public Safety Operations & Space Needs Study; Em. Management, EMS, 911/Communications 2008 Bettie County EMS & Rescue Operations Assessment 2010 Burke County Communications Center Consolidation Study 2004 Catawba County Regional Public Safety Education & Training Center feasibility Study 2005 Strategic Plan for Emergency Services; Fire, Rescue, EMS, Communications, Em. Management 1999 Cramerton, NC Fire Services Needs Assessment Study 2007 Davidson County Communications Center Space Needs Study 2004 Henderson County EMS Operations Assessment & Planning Study 2007 Communications Center Operations Study 2006 Hertford County EMS & Rescue Operations Assessment 2008 Johnston County Emergency Services/EMS Summit-Facilitation 1999 Kernersville, NC Fire Station Location Study 2008 Lincoln County Strategic Plan for Fire & Emergency Services -2006 Maiden, NC Fire Department Needs Analysis & Site Assessment 2002 Moore County Comprehensive Strategic Plan for Fire, Rescue, EMS, 911, and Emergency Management 2004 Onslow County Volunteer Fire Study 2009 Pitt County EMS Study Phase II-Planning Options 2003 EMS Advisory Commission-Facilitation-Work Plan 2001 EMS/Rescue Study 2001 Robeson County Communications Center Operations Study 2010 Rockingham County EMS/Rescue Services Operations Assessment & Cost Study 2011 Shelby, NC Government Facilities Space Needs Assessment & Fire Station Location Study 2009 Vance County Comprehensive Strategic Plan for Fire & Emergency Medical Services 2007 Wake County Communications Center Operations & Cost Study 2004 Whispering Pines, NC Fire Services Needs Assessment Study 2008 Wilkesboro, NC Fire Services Needs Assessment Study 2009 27