HomeMy WebLinkAboutORD-2012-057 Approval of Budget Amendment #4-c Implementation Strategy from the Emergency Services Workgroup ORD-2012-057
ORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: November 20, 2012
Action Agenda
Item No. 7-b
SUBJECT: Implementation Strategy from the Emergency Services Workgroup on
Recommendations from the Comprehensive Assessment of Emergency
Medical Services & 911/Communications Center Operations Study, and
Approval of Budget Amendment#4-C
DEPARTMENT: Emergency Services PUBLIC HEARING: (Y/N) No
ATTACHMENT(S): INFORMATION CONTACT:
F. R. Mantes de Oca, 245-6100
Michael Talbert, 245-2308
PURPOSE: To receive an implementation strategy from the Emergency Services Workgroup
regarding recommendations included in the Comprehensive Assessment of Emergency Medical
Services & 911/Communications Center Operations Study, approve Budget Amendment #4-C
for $414,500 in the current fiscal year, and incorporate the recommendations into the Budget &
Capital Investment Plan (CIP) process for Fiscal Year 2013-14.
BACKGROUND: The Orange County Emergency Medical Services (EMS) provides pre-
hospital care and transport to residents and visitors throughout the County. Originated from
volunteer services, Orange County EMS began providing advanced life support ambulances in
the 1980's. EMS 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 10,700 calls
annually, EMS must be able to address extraordinary events such as multi-casualty incidents,
large sporting events, 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 Sheriff's 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.
On December 13, 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 Charge for the ESW included reviewing
alternatives and making recommendations for the following,
2
System improvements for EMS Ambulance response times including but not limited to
equipment, staffing, facility's and/or a strategic plan, to define data elements for
meaningful analytical data as related to ambulance response time and to discuss and
review that data.
Improvements for the E911 Communications Center including but not limited to
technology, equipment, staffing, training and/or a strategic plan.
On March 22, 2012 the Board approved a contract with Solutions for Local Government, Inc. to
develop a multi-year strategic plan addressing Emergency Medical Services System and E911
Communications Center needs.
At the August 30, 2012 Board Work Session, Mr. Steve Allan presented the final draft of the
Comprehensive Assessment of Emergency Medical Services & 911/Communications Center
Operations Study. Mr. Allan held meetings with stakeholders, presented and discussed his
report, answered questions and solicited input. This included one meeting for the general public
that was held on September 27, 2012.
Emergency Services Workgroup is recommending the following implementation strategy from
the recommendations included in Comprehensive Assessment of Emergency Medical Services
& 911/Communications Center Operations Study.
R-1. OCEMS should adjust Medic 5 and Medic 8 coverage hours.
The Workgroup recommends keeping 5 ambulances operational around the clock and add new
12 hour peak load ambulances as new ambulances are staffed and placed in service.
R-2. OCEMS should add an additional ALS Ambulance 9:00 am-9:00 pm, 12 hours/day, 7
days/week.
The Workgroup recommends a new 9am — 9-pm peak load ambulance and evaluate after 6
months to verify that the new ambulance has helped bring down the average number of move
ups. This ambulance was approved in Fiscal 2012/2013 and will be placed in service as soon
as new staff is trained and the new unit is available.
R-3a. Utilize available SORS/BLS ambulance for non-emergency patient transports.
R-3b. OCEMS should bring on line and staff a BLS ambulance to provide non-emergency
patient transports.
The Workgroup recommends combining R-3 & R-3b. into one recommendation. County staff
and SORS are directed to collect & analyze additional call volume data bring back a
recommendation to the Emergency Services Workgroup by January, 2013.
3
R-4. Assess Fire Department capabilities to meet BLS First Responder response time
objectives.
R-5a. Schedule and implement Fire Department, Medical First Responder initiative which
includes performance objectives.
R-5b. Staff and equip four (4) EMS Quick Response Vehicles (QRV's) for assignment,
initially, 12hours/day, 7 days/week with shift startlend times to be determined by EMS.
The Workgroup recommends combining R-4, R-5a, and 5b into one recommendation. A
working group, comprise of Emergency Services staff, representatives from Chief's Council,
representatives from South Orange Rescue Squad and the County Medical Director is directed
to discuss these issues and bring back a recommendation to the Emergency Services
Workgroup by January, 2013.
R-6. Staff & equip six (3) 12 hour/7 day ALS ambulances at appropriate staging/base
facility locations within (1) Zones 1 & 2, (2) Zones 7 & 5, and (3) Zones 6 & 8.
The Workgroup recommends that EMS staff and the County's Medical Director prepare a
detailed 5 year implementation schedule for recommendation R-6 and brings back a
recommendation to the Emergency Services Workgroup by December 11, 2012.
R-7. Hire a Paramedic Level Shift Supervisor a@ 24/7.
The Workgroup recommends hiring 4 new Paramedic Level Shift Supervisor positions
immediately. The Study recommends 5.1 position for a 24/7 Shift Supervisor, but Emergency
Services staff recommended only 4 position. This is recommended to be funded in the current
fiscal year, at an estimated annual cost of$267,500.
R-8. Prepare a detailed Space Needs Assessment that addresses the essential building
and site requirements to accommodate a stand-alone, functional, code compliant EMS
base facility that can serve as a prototype for all future facilities.
R-9. Identify a minimum of nine (9) strategic locations, preferably no less than one (1)
location within each major zone previously identified, for the potential location in each of
a future EMS base.
R 10. The County should purchase/obtain identified sites (and/or buildings) for
development.
R 11. Procure EMS base planning and design services.
R 12. Advertise, bid, and commence construction on designated EMS base facilities.
The Workgroup recommends tabling recommendations R-8, R-9, R-10, R-11 and R-12. EMS
staff is directed to proceed with a space needs assessment while simultaneously exploring the
4
option of co-locating EMS Ambulances at fire departments. Staff is to bring back a
recommendation to the Emergency Services Workgroup by January, 2013.
R-13. Hire a full-time, dedicated Data System Manager to be located as close as possible,
preferably adjacent to the Communications Center, and answerable first to the
Communications Center Operations Manager.
The Workgroup recommends hiring a dedicated full-time Data System Manager immediately in
the current fiscal year, at an estimated annual cost of$74,250.
R-14. Hire a full-time, dedicated Training/Quality Assurance Officer to be located as close
as possible, preferably adjacent to the Communications Center, and answerable first to
the Communications center Operations Manager.
The Workgroup recommends hiring a dedicated full-time Train ing/Quality Assurance Officer
immediately in the current fiscal year, at an estimated annual cost of$72,800.
R-15. Anticipating increasing responsibilities due to the number of new personnel
forthcoming, hire an additional full-time Training/Quality Assurance Officer no later than
the end of year-3.
The Workgroup recommends hiring an additional dedicated full-time Train ing/Quality Assurance
Officer during year-2 or Fiscal 2014/2015, at an estimated annual cost of$72,800.
R-16. Prepare a schedule for the hiring and training of the identified Telecommunicator
positions and identify the date to begin solicitation and acceptance of applications.
R-17. Hire 17 new, full-time Telecommunicators.
The Workgroup recommends combining R-16 and R-17 into one recommendation. The Fiscal
2012/13 Budget includes 4 new full-time Telecommunicators, which are included with the total
of 17 recommended by the Study. The Workgroup recommends combining R-16 & R-17 to hire
and train 13 new full-time Telecommunicators over 3 Fiscal Years. Recommending that 4 full-
time Telecommunicators be added in Fiscal 2013/14, 4 additional Telecommunicators in Fiscal
2014/15, and 5 Telecommunicators in added in Fiscal 2015/16. The total position added over 3
years will be 13 Telecommunicators, with the estimated total cost of$585,000.
R-18. Purchase necessary AVL vehicle hardware for each new EMS vehicle purchased to
enable compatibility with newly purchased CAD software and existing AVL system
hardware.
Necessary AVL vehicle hardware already in place, no action needed.
5
R 19. Following the installation of recently purchased Communications Center software
and the training of in-house personnel; organize and provide informational meetings to
emergency service system members, particularly Fire Departments and Law
Enforcement, with regards to the system's capabilities and the information that will be
available to them for their use.
OSSI Software has been purchased and the 12 month installation process has started. The
Workgroup recommends that the 911 Users Group be resurrected to meet at least 6 times per
year and provide input for the 911 Communications installation and setup of the OSSI system.
R 20. From the Workgroup:
The Workgroup recommends that Page Track software, currently in use by the Fire
Departments, be incorporated into the OSSI system if possible and utilized by 911
Communications. If Page Track remains a standalone system, it is recommended that 911
Communications use the system to support OSSI when possible.
FINANCIAL IMPACT: The Workgroup recommends funding $414,500 as outlined in the
recommendations background in the current fiscal year and incorporate the remaining
recommendations into the Fiscal Year 2013-14 Annual Budget & CIP process.
RECOMMENDATION(S): The Manager recommends that the Board receive the
implementation strategy from the Emergency Services Workgroup regarding recommendations
included in the Comprehensive Assessment of Emergency Medical Services &
911/Communications Center Operations Study, approve Budget Amendment#4-C for $414,500
in the current fiscal year, and incorporate the recommendations into the Budget & Capital
Investment Plan (CIP) process for Fiscal Year 2013-14.
a ILO - -2a1 ? - a,57
'Y b
A motion was made by Commissioner McKee, seconded by Commissioner Foushee to
accept the report.
VOTE: UNANIMOUS
Commissioner McKee said that it has been brought to his attention that since the work
group has worked on these, the Board may want to hold R-7 for now. There have been some
questions related to this recommendation.
b. Implementation Strategy from the Emergency Services Workaroup on
Recommendations from the Comprehensive Assessment of Emergency Medical Services
& 911/Communications Center Operations Study, and Approval of Budget Amendment
#4-C
The Board received an implementation strategy from the Emergency Services
Workgroup regarding recommendations included in the Comprehensive Assessment of
Emergency Medical Services & 911/Communications Center Operations Study, considered
approving Budget Amendment#4-C for$414,500 in the current fiscal year, and incorporating
the recommendations into the Budget & Capital Investment Plan (CIP) process for Fiscal Year
2013-14.
Michael Talbert reviewed these recommendations and said that the work group agreed
with these but wanted to move faster on some.
Emergency Services Workgroup is recommending the following implementation strategy from
the recommendations included in Comprehensive Assessment of Emergency Medical Services
& 911/Communications Center Operations Study.
R-1. OCEMS should adjust Medic 5 and Medic 8 coverage hours.
The Workgroup recommends keeping 5 ambulances operational around the clock and add
new
12 hour peak load ambulances as new ambulances are staffed and placed in service.
R-2. OCEMS should add an additional AILS Ambulance 9:00 am-9:00 pm, 12 hours/day, 7
days/week.
The Workgroup recommends a new 9am — 9-pm peak load ambulance and evaluate after 6
months to verify that the new ambulance has helped bring down the average number of move-
ups. This ambulance was approved in Fiscal 2012/2013 and will be placed in service as soon
as new staff is trained and the new unit is available.
R-3a. Utilize available SORS/BLS ambulance for non-emergency patient transports.
R-3b. OCEMS should bring on line and staff a BLS ambulance to provide non-emergency
patient transports.
The Workgroup recommends combining R-3 & R-3b into one recommendation. County staff
and SORS are directed to collect& analyze additional call volume data bring back a
recommendation to the Emergency Services Workgroup by January, 2013.
R-4. Assess Fire Department capabilities to meet BLS First Responder response time
objectives.
R-5a. Schedule and implement Fire Department, Medical First Responder initiative which
includes performance objectives.
R-5b. Staff and equip four(4) EMS Quick Response Vehicles (ORV's) for assignment,
initially, 12hours/day, 7 days/week with shift start/end times to be determined by EMS.
The Workgroup recommends combining R-4, R-5a, and 5b into one recommendation. A
working group, comprise of Emergency Services staff, representatives from Chief's Council,
representatives from South Orange Rescue Squad and the County Medical Director is directed
to discuss these issues and bring back a recommendation to the Emergency Services
Workgroup by January, 2013.
R-6. Staff& equip six (3) 12 hour/7 day ALS ambulances at appropriate staging/base
facility locations within (1) Zones I &2, (2) Zones 5 & 7 and (3) Zones 6 & 8.
The Workgroup recommends that EMS staff and the County's Medical Director prepare a
detailed 5-year implementation schedule for recommendation R-6 and brings back a
recommendation to the Emergency Services Workgroup by December 11, 2012.
R-7.DEFER --Hire a Paramedic Level Shift Supervisor @ 24/7.
The Workgroup recommends hiring 4 new Paramedic Level Shift Supervisor positions
immediately. The Study recommends 5.1 position for a 24/7 Shift Supervisor, but Emergency
Services staff recommended only 4 positions. This is recommended to be funded in the current
fiscal year, at an estimated annual cost of$267,500.
R-8. Prepare a detailed Space Needs Assessment that addresses the essential building
and site requirements to accommodate a stand-alone, functional, code compliant EMS
base facility that can serve as a prototype for all future facilities.
R-9. Identify a minimum of nine (9) strategic locations, preferably no less than one (1)
location within each major zone previously identified, for the potential location in each of
a future EMS base.
R 10. The County should purchase/obtain identified sites (and/or buildings)for
development.
R 11. Procure EMS base planning and design services.
R 12. Advertise, bid, and commence construction on designated EMS base facilities.
The Workgroup recommends tabling recommendations R-8, R-9, R-10, R-91 and R-12. EMS
staff is directed to proceed with a space needs assessment while simultaneously exploring the
option of co-locating,EMS Ambulances at fire departments. Staff is to bring back a
recommendation to the Emergency Services Workgroup by January, 2013.
R-13. Hire a full-time, dedicated Data System Manager to be located as close as possible,
preferably adjacent to the Communications Center, and answerable first to the
Communications Center Operations Manager.
The Workgroup recommends hiring a dedicated full-time Data System Manager immediately in
the current fiscal year, at an estimated annual cost of$74,250.
R-14. Hire a full-time, dedicated Training/Quality Assurance Officer to be located as close
as possible, preferably adjacent to the Communications Center, and answerable first to
the Communications Center Operations Manager.
The Workgroup recommends hiring a dedicated full-time Training/Quality Assurance Officer
immediately in the current fiscal year, at an estimated annual cost of$72,800.
R-15. Anticipating increasing responsibilities due to the number of new personnel
forthcoming, hire an additional full-time Training/Quality Assurance Officer no later than
the end of year-3.
The Workgroup recommends hiring an additional dedicated full-time Training/Quality
Assurance
Officer during year-2 or Fiscal 201412015, at an estimated annual cost of$72,800.
R-16. Prepare a schedule for the hiring and training of the identified Telecommunicator
positions and identify the date to begin solicitation and acceptance of applications.
R-17. Hire 17 new, full-time Telecommunicators.
The Workgroup recommends combining R-16 and R-17 into one recommendation. The Fiscal
2012/13 Budget includes 4 new full-time Telecommunicators, which are included with the total
of 17 recommended by the Study. The Workgroup recommends combining R-16 & R-17 to hire
and train 13 new full-time Telecommunicators over 3 Fiscal Years. Recommending that 4
fulltime Telecommunicators be added in Fiscal 2013/14, 4 additional Telecommunicators in
Fiscal 2014/15, and 5 Telecommunicators in added in Fiscal 2015/16. The total position added
over 3 years will be 13 Telecommunicators, with the estimated total cost of$585,000.
R-18. Purchase necessary AVL vehicle hardware for each new EMS vehicle purchased to
enable compatibility with newly purchased CAD software and existing AVL system
hardware.
Necessary AVL vehicle hardware already in place, no action needed.
R 19. Following the installation of recently purchased Communications Center software
and the training of in-house personnel; organize and provide informational meetings to
emergency service system members, particularly Fire Departments and Law
Enforcement, with regards to the system's capabilities and the information that will be
available to them for their use.
OSSI Software has been purchased and the 12 month installation process has started. The
Workgroup recommends that the 911 Users Group be resurrected to meet at least 6 times per
year and provide input for the 911 Communications installation and setup of the OSSI system.
R 20. From the Workgroup:
The Workgroup recommends that Page Track software, currently in use by the Fire
Departments, be incorporated into the OSSI system if possible and utilized by 911
Communications, If Page Track remains a standalone system, it is recommended that 911
Communications use the system to support OSSI when possible.
The Workgroup recommends funding $414,500 as outlined in the recommendations
background in the current fiscal year and incorporate the remaining recommendations into the
Fiscal Year 2013-14 Annual Budget& CIP process.
Chair Pelissier took a poll to see if Board of County Commissioners wanted to continue past
10:30pm. The Board all agreed.
A motion was made by Commissioner McKee, seconded by Commissioner Foushee to
receive the implementation strategy from the Emergency Services Workgroup regarding
recommendations included in the Comprehensive Assessment of Emergency Medical Services
& 911/Communications Center Operations Study; approve Budget Amendment#4-C for
$414,500 in the current fiscal year; and incorporate the recommendations into the Budget &
Capital Investment Plan (CIP) process for Fiscal Year 2013-14.
VOTE: UNANIMOUS
The Board thanked Steve Allen for working on this report for Orange County.
c. Establishment of a Community Loan Fund for the Water and Sewer Connections
for Efland and Rogers Roads Residents, and Approval of Budaet Amendment#4-D
The Board considered approving the establishment of a Community Loan Fund for
water and sewer connections for residents of the Efland and Rogers Road areas of Orange
County, and approving Budget Amendment#4-D.
Clarence Grier introduced this item. He said that in previous discussions with the
Board, it was decided to start a small loan fund for this purpose. The recommendation is to
start a Community Loan Fund with a $100,000 appropriation from the General Fund available
fund balance. All loans would range from $3,500 to a max of$10,000, and carry a low interest
rate of 1-2% over a maximum period of 10 years. A 0.25% administrative fee would be added
to each loan to cover the administration of the loan.
Frank Clifton said that this loan is to assist people from running water and sewer lines
from the street to their homes.
Commissioner Jacobs said that he thought the County had developed a loan fund
through OCIM for people in Efland. Clarence Grier said that this is part of that discussion
instead of going through OCIM.
A motion was made by Commissioner Foushee, seconded by Commissioner
Hemminger to approve the establishment of a Community Loan Fund for water and sewer for
residents of the Efland and Rogers Road areas of Orange County, and approve Budget
Amendment#4-D an appropriation of General Fund available fund balance of$100,000.
VOTE: UNANIMOUS
d. Recommended Uses of General Fund Unassigned Fund Balance, as of June 30,
2012 -
The Board considered recommendations for the use of the General Fund unassigned
Fund Balance in excess of the BOCC's fund balance policy.
Clarence Grier introduced this item.
On April 5, 2011, the BOCC adopted a fund balance policy that states:
The County will strive to maintain an unassigned fund balance in the General Fund of
17% percent of budgeted general fund operating expenditures each fiscal year. The
amount of unassigned fund balance maintained during each fiscal year should not fall
below 8%percent of budgeted general fund operating expenditures, as recommended
bythe North Carolina Local Government Commission (Attachment 1).
Over time, the County's financial reserves grew. On June 30, 2012, the general fund's
unassigned fund balance totaled $39.6 million (Attachment 2). Of this amount, $3.2 million was
appropriated, prior to the end of the fiscal year. After these appropriations, the general fund's