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HomeMy WebLinkAbout12 - Response to Grand Jury ReportSEW Pp,Pr CITY OF NEWPORT BEACH u�9'P Cif Council Staff Re ort 9ClFO+N y p Agenda Item No. 11 September 25, 2012 TO: HONORABLE MAYOR AND MEMBERS OF THE CITY COUNCIL FROM: City Manager's Office Dave Kiff, City Manager 949 - 644 -3001, dkiff @newportbeachca.gov FROM: Dave Kiff, City Manager APPROVED: A TITLE: Response to the Orange County Grand Jury — "Emergency Medical Response in Orange County" ABSTRACT: The City of Newport Beach is obligated to respond to a recent Orange County Grand Jury Report on Emergency Medical Response in Orange County by October 1, 2012. RECOMMENDATION: Authorize the Mayor to send the attached response to the Presiding Judge of the Superior Court. FUNDING REQUIREMENTS: There are no fiscal impacts related to this item. DISCUSSION: Please see the attached proposed draft response for details regarding the study and the City's response to the study's findings /conclusions and recommendation. ENVIRONMENTAL REVIEW: Staff recommends the City Council find this action is not subject to the California Environmental Quality Act ( "CEQA ") pursuant to Sections 15060(c)(2) (the activity will not result in a direct or reasonably foreseeable indirect physical change in the environment) and 15060(c)(3) (the activity is not a project as defined in Section 15378) of the CEQA Guidelines, California Code of Regulations, Title 14, Chapter 3, because it has no potential for resulting in physical change to the environment, directly or indirectly. Response to the Orange County Grand Jury — "Emergency Medical Response in Orange County" September 25, 2012 Page 2 The agenda item has been noticed according to the Brown Act (72 hours in advance of the meeting at which the City Council considers the item). Submitted by: Dave Kiff, City Manager Attachment 1: Proposed draft response to the Grand Jury Attachment 2: Orange County Grand Jury Report "Emergency Medical Response in Orange County' 4 Response to the Orange County Grand Jury — "Emergency Medical Response in Orange County" September 25, 2012 Page 3 September 25, 2012 The Honorable Judge Thomas J. Borris Presiding Judge of the Superior Court 700 Civic Center Drive West, Santa Ana, CA 92701 RE: Report of the Orange County Grand Jury — "Emergency Medical Response in Orange County" Dear Presiding Judge Borris: The City of Newport Beach appreciates the time and effort the Grand Jury spent on the development of their report, "Emergency Medical Response in Orange County." The City Council has reviewed the report and authorized the attached response to the findings, conclusions and recommendations noted in the report. The City values the opportunity to respond to this report, share our perspective, and provide a response to each of the issues requested by the Grand Jury in their report. If the City of Newport Beach can provide additional information or clarification of our response, please do not hesitate to call me. Sincerely, Nancy Gardner Mayor of Newport Beach Encl: Response to Findings /Conclusions & Recommendations Cc: Dave Kiff, City Manager (w /Enc.) City of Newport Beach Council Members (w /Enc.) Fire Chief Scott Poster (w /Enc.) Assistant Chief Kevin Kitch (w /Enc.) K Response to the Orange County Grand Jury — "Emergency Medical Response in Orange County" September 25, 2012 Page 4 ATTACHMENT RE: Report of the 2011 -2012 Orange County Grand Jury — "Emergency Medical Response in Orange County" FROM: City of Newport Beach, California DATE: September 25, 2012 The Report obligates the City to respond no later than October 1, 2012 to: • Findings /Conclusions: F1, F2, and F3; and • Recommendations: R1 and R2. The Newport Beach City Council, the City Manager's Office and the Fire Department have reviewed the Orange County Grand Jury report, Emergency Medical Response in Orange County; published June 5, 2012. City Manager Dave Kiff was instructed to provide the following response, in accordance with California Penal Code Section 933.05 (a) and (b). His comments follow. FINDINGS /CONCLUSIONS Finding F1 - Fire departments that once primarily responded to calls for fire emergencies now have become emergency medical response departments primarily responding to medical emergencies. This evolution has occurred since the onset of "9- 1 -1 "call where all emergency calls are received at one place. Response: The City of Newport Beach disagrees partially with the Finding F1 as it pertains to Newport Beach. Just over a year ago, the Newport Beach Fire Department ( "NBFD ") celebrated its 100th anniversary. Although, branded as the "Fire Department" throughout its existence, the primary mission of the NBFD has always been the preservation of life and property, including emergency medical calls and ocean rescue (lifeguarding). Our partial disagreement noted above is because emergency medical care was a core service even during the early years. Because of its coastal waters and high surf, the City of Newport Beach has always needed to provide rescue and lifesaving services for its residents and visitors. In 1913, the fire department was presented with its first mechanical resuscitation device that was stored on one of its first fire vehicles. In September 1927, the fire department's first rescue squad was placed into service for the sole purpose of providing resuscitation in the case of drowning, smoke inhalation, or a Response to the Orange County Grand Jury — "Emergency Medical Response in Orange County" September 25, 2012 Page 5 other medical emergencies. In 1937, the sign in front of the NBFD headquarters read "Fire and Life Saving Depts. "' It was not until the late 1960s to early 1970s that emergency medical services (EMS) became more formalized (40+ years ago). During this time frame it became obvious that to save lives, patients needed to be treated on scene, which meant prior to arriving at the hospital. This concept came to the forefront in a hallmark document published in 1966 entitled, "Accidental Death and Disability: The Neglected Diseases of Modern Society." The paper concluded that accidental injury was "the neglected epidemic of modern society' and the "the nation's most important environmental health problem." Veteran medical experts returning from the Korean and Vietnam wars felt their chances of survival on the battlefield were far better than on America's streets. The reduction in the death rates of war casualties was directly attributed to how quickly medical care was initiated after injury .2 Congress reacted by charging the Department of Transportation ( "DOT ") with establishing federal funding and standards for regions willing to develop EMS systems between 1966 and 1973. The DOT went on to create national standards for the training of Emergency Medical Technicians and Paramedics as well as defining the required components of an EMS system. The California Legislature, recognizing the value of resources already in existence, such as strategically located fire stations and response vehicles, and fire personnel already trained to respond to emergencies, passed several important statutes. California Health and Safety Code §219, enacted in 1967, mandated minimum first aid training standards for all public safety personnel. NBFD did comply with the mandate and eventually all fire personnel were certified in advanced first aid and all captains became qualified first aid instructors. About the same time, three physicians in Los Angeles County launched a pilot program that trained firefighters as "Mobile Intensive Care Paramedics' ( "Paramedics ") to provide advanced life support to the critically ill and injured. The success of the program led to the California Legislature passing the Wedworth- Townsend Paramedic Act ( "Act ") in 1970. This Act allowed the County of Orange to establish a Mobile Intensive Care Paramedic Pilot Program in January 1973. The Board of Supervisors designated an Emergency Medical Care Committee ( "EMCC "), through which all aspects of planning were to be presented and coordinated. At the direction of their governing boards and councils, the Orange County Fire Service took on a leadership role while working in collaboration with the EMCC to develop a master plan for paramedic services. This document served as a guide for the implementation ' Michael J. Novak, Images of America: Newport Beach Fire Department, (Charleston SC, Chicago IL, Portsmouth NH, San Francisco CA: Arcadia Publisher, 2008), 16, 29, & 95. 3 Prepared by Committee on Trauma, Committee on Shock, Division of Medical Sciences, National Academy of Sciences, & National Research Council, Accidental Death and Disability: The Neglected Diseases of Modern Society, (Washington D.C., September 1966). n Response to the Orange County Grand Jury — "Emergency Medical Response in Orange County" September 25, 2012 Page 6 of a fire - based, EMS delivery system utilizing paramedics.3 Each fire department funded their paramedic program costs with local dollars. On May 30, 1974, the City of Newport Beach approved the implementation of a Paramedic Program, which began with eight firefighters certified as Paramedics on September 26, 1975. 4,5 The first Paramedic van was placed into service on October 8, 1975. The Board of Supervisors eventually adopted the Master Plan as policy in 1976. This historical timeline outlined above illustrates how the delivery of EMS was a primary responsibility of the NBFD since its inception. The evolution of EMS as a formalized system was a direct result of integrative planning that took decades to unfold. Therefore, while we agree that fire departments like ours now respond far more often to emergency medical or other life- saving calls than to fire suppression calls, the delivery of EMS as a primary responsibility of the NBFD has been longstanding (predating 9 -1- 1). Finding F2 - As the fire departments evolved into emergency medical departments, the model for operating the fire departments has not radically changed. The fire departments have simply absorbed the emergency medical responses into their departments under their old "fire response" model. Response: The City of Newport Beach disagrees partially with Finding F2 as it pertains to Newport Beach. While our fire department continues to operate out of fixed stations and crews are assigned to each station, other aspects of the operating model have changed over the years in regards to fire suppression, marine operations, life safety services, and especially emergency medical service delivery. The operating model of the NBFD has been and will continue to be dynamic. The City Council is continually evaluating service delivery and recommending changes based on the needs of the community and the community's demand for high service levels. Since its inception in 1911, the NBFD has developed into a multi- faceted, all -risk public safety department. Changes in the operating model occurred as the NBFD evolved from volunteer firefighters, mostly military veterans with experience in the basic building trades, self- educated, trained to basic fire suppression skills to trained professionals committed to serve the public in many ways. Fire stations have been strategically located to provide short response times to emergency medical calls, fire responses, and requests for other services. The 3 Office of the City Manager, Paramedic Services Report, (City of Newport Beach CA, May 1974). 4 Newport Beach, CA, Regular Council Meeting Minutes, May 28, 1974. 5 Orange County Medical Center, Graduation Program Class 1 -75 (#6), (Orange County Mobile Intensive Care Program Paramedic Training Division, September 26, 1975). n Response to the Orange County Grand Jury — "Emergency Medical Response in Orange County" September 25, 2012 Page 7 expectations of today's Paramedic /Firefighter are significantly different today than yesterday. As stated in the response to Finding F1, legislation enabled firefighters to be trained as paramedics, and the operating model changed from basic to advanced life support. NBFD built a strong relationship with Hoag Hospital and cultivated an advanced life support system to serve the residents and visitors in Newport Beach. Today, the NBFD continues to change its operating model to care for our residents and visitors (examples are in regards to Cerebral Vascular Accidents (Strokes), Myocardial Infarctions (Heart Attacks), and Spinal Injuries). Finding F3 - Economic recessions have forced local fire department boards of directors and city councils to re- evaluate their models for providing fire and emergency medical responses. While this brings to the fore issues of staffing, response times, public safety, training, consolidations, union rules and privatization of their various services, it also spotlights the model used for all emergency responses. Response: The City of Newport Beach disagrees partially with Finding F3 as it pertains to Newport Beach. The items listed in Finding F3 are being evaluated by the City Council and Fire Department on a continual basis, not forced by the economy, but as part of good business and government practices. As described in our response to F2, the City Council is continually evaluating the operating model of the NBFD, regardless of economic conditions. The City of Newport Beach has implemented numerous changes to reduce costs, manage public safety pensions and plan for the future while striving to provide quality services to the community. The fire department, along with other City departments, has experienced organizational changes to maximize staff and incorporate multifunctional personnel to become more efficient. The Operating Model underwent re- evaluation prior to the economic recession where the City Council oversaw changes in emergency service delivery such as the change from using an ambulance service to providing transportation for patients, which is a system that serves Newport Beach well and is cost effective. RECOMMENDATIONS: Recommendation R1 - The city fire departments and the Orange County Fire Authority should engage independent private consultants to re- evaluate their models for providing response for both fire and medical emergencies. These re- evaluations should include the strengths, weaknesses, opportunities and threats of current models and alternative models. This re- evaluation should be accomplished by July 31, 2013. (See F1, F2 & F3) Response: The recommendation will not be implemented, because it is not reasonable. Response to the Orange County Grand Jury — "Emergency Medical Response in Orange County" September 25, 2012 Page 8 As the Grand Jury is aware, respondents are prescribed via the California Penal Code to formally respond to the Grand Jury's findings /conclusions and recommendations with specific text, even if the phrase and tone we might rather respond with is significantly different than the Penal Code's strictures. Therefore, please know that the City of Newport Beach appreciates the Grand Jury's attention to the interesting and timely issue of change in fire departments — indeed, we see the change too. We know that any government service must change with times, as difficult as that can be. And while we might not choose the precise path and timeline that the Grand Jury requested (study done by consultant services, all by July 31, 2013); please know that we acknowledge that similar studies and analysis need to occur soon if local governments and their fire departments are to continue to remain efficient and effective. Recommendation R2 - Suggested alternative models should include forming a unified Emergency Response Department that includes fire and medical response, separating the fire response from the medical response, privatizing the emergency medical response, etc. (See F3) Response: The recommendation has not been implemented, but may be considered in the future. Given that recommendation R2 is subordinate to R1, it may be incorporated as part of the operating model re- evaluation noted in the response to R1. I welcome any views contrary or concerns that the Grand Jury might have about this response. I can be reached at (949) 644 -3001 or dkiff(a)newportbeachca.00v. Sincerely, Dave Kiff City Manager City of Newport Beach I Response to the Orange County Grand Jury — "Emergency Medical Response in Orange County" September 25, 2012 Page 9 (7E Emergency Medical Services EXIERGENCY MIEDICAL RESPONSE M ORAINGE COUN'T'Y iiirere did all the 'fires "go? Long due passing_ Apologies to Pete Seeger SUABLARY During the last forty years, the role of local fire departments has changed The s ntces have changed from fee prevention to medical emergency responses. In earlier days, the fire departments were predominately staffed with fire fighters with their fire trucks, but Dow these departments include paramedics and emergency medical technicians as part of the crews that respond to the calls. Today medical emergency calls account fm at least 70 percent of fee departments emagenry dispatches- The low percentage of fire emergencies, i e., less than two percent in the Orange County Fire Authority (OCFA) atone, is attributed to improved building codes, more alarm dectices, fire suppression systems, stricter code enforcenent, and perhaps greater public awareness. This timmition from fire emergencies to medical emergencies has not generated major changes in the operation model for responding to these emergencies. Each emergency call generally results in both fire trucks and ambulances being dispatched to the site of the emergency regardless of the type of emergency. The emergency response communities have discnssad developing Dew models, Ind little change has been accomplished_ While the Orange County Emergency Medical Services (OCEMS) sets the medical standards and protocols for both nan-emcrgencies and emergencies. The fire departments handle the actual operations_ The 2011 -2012 Orange County Grand Jury concluded that the current emergency response models should be re mluated by independent outside consultants. This reeralvation should consider the strengths, weaknesses, opportunities and threals to the economics and operations of both the OCFA and city fire department's emergency response models. This Grand Jury recommends that these studies be completed and made public by July 31, 2013. PCRPOSE The 1996 -1997 Orange Cormty Grand Jung evaluated the Orange County Fire Authority (OCFA) shortly after the Authority was formed in 1995_ That study compared the effectiveness of the ww agency in relation to other Sue departments within the county. That study addressed inequities in the costs to the various OCFA cites but did not address how the emergency sen-ices were promdedi The 2011 -2012 Orange County Grand Jury agreed that a restudy of the Authority 2011 -8012 Orange County Grand jury Page 1 ATTACHMENT Response to the Orange County Grand Jury — "Emergency Medical Response in Orange County" September 25, 2012 Page 10 OC Emerumcv Medical Services was due. Doug their review of the operations and finances of the OCFA it became apparent that the size of the organization lent itself to concentration on certain items. Consequently this Grand Jury has focused on the emergency response model of the OCFA and the twenty -three cities they serve. The results of this study could also apply to the neighboring eleven non - Authority city fire departments in Orange County. 1111314: (r) oIa/ felft% The 2011 -2012 Orange Canty Grand homy used the following methods to gather m€ormation about the current and future modeling of emergency medical services: • Interviewed fire chiefs of independent city fire depattoimis of Orange County; • Infei-viewed the Chief of the Orange County Fire Authority; • Imenwured Carious. members of the OCFA staff. • Interviewed selected members of the OCFA Board of Directors;. • fid rwwed selected city managers of participating cities and non-participating °toes; • Reviewed OCFA files at their headquarters; • Attended OCFA Board of Directors and Finance Committee meetings; • Interviewed the General Manager of Orange County Medical Emergency Services; • Interviewed afficers of a pinmte artabuhmee cooqamy in Orange County, • Interviewed a former private ambulance company owner; • Famewed past studies regarding emergency medical services; • Ffinewed various sources for statistics related to fire and emergency medical services; • Prepared this report containing the findings, concimous and recommendations. llr4CKGAOUriID During the past 140 years, Orange County has grown from a rural agricultural area of less than 3,000 residents with oe incorporated city into an urban county of mine than 3,000,000 people in 34 cities- Major tabanization began in the 1950's when the population was only 216,000 with I I incorporated cities_ Each city had its own fire department supplemented by the Change County Fire Department- Until the mid- 1970's the fire departments' main responsibilities were foe prevention At that time, emergency calls were handled by the local telephone operator. Calls such as, `I want to report a fire," or `T need an ambulance,' were ttansfeued by the opeaatnr to the fire department or to a pirate ambulance company depending on the type of emergency.I After some machinations, '9 -I -1" became the natiomtide emergency repotting number for all types of emergencies. The combining of fire departments and ambulance companies began as the private ambulance services were gradually replaced by the fire departments. Today, the 2011 -2012 Orange County Grand jury Page 2 10 Response to the Orange County Grand Jury — "Emergency Medical Response in Orange County" September 25, 2012 Page 11 OC Emergency Medical Services NEEN typical emergency response model has both fire and medical emergencies covered by the fire departments. However, not all fire departments follow that model- Some cities contract the medical emerrwn-ies to Im;mte ambulance companies. Some pmiwk both in-house and contacted am .lance service. Today more than 70 percent of all non- police/fire emergency calls are for medical purposes. However,, some city fire departments report more than 80 percent of their calls are for medical �gencies.r of the 180,000 incidents reported in orange County in 2010 by the various fire deparmueuts, approantately 134,000 (76 %) were for medical emewencies and 44,000 (24 %) were for foes and "ocher -' The orange County Fire Authority alone reported less than two percent of their 98,22.7 responses were for "Fm&Ezplosicu. "s The relationship of the various responses of only the {hinge Cody Fite Authority is illustrated m Figure No- 1. The "other" includes `rupdnes," "h� `:service calls," `good intent,:, "false alarms' and `natural disasters-' Figure No. l - Responses of the oCFA for the Past Ten Years Orange County Emergency Response by Type 80.0% b 7a.CN u a, 50.0% ao.n 1[L[Yk'i X0.0% lao� �r,iat 2. -v' 2003 2031 . 2iC- 2006 2007 2Wn 2009 2010 2Vi1 Current Emergency \Sedical Procedures ' C..d raq .raj®. v & w.,. ar.d., wab. af. .0m C .q s. &,.be 20. 0; N.e ml ocrti A..WF.. .dY jj m FT ivaaur —PYR —I %1S —0MVI 2011 -2012 OTauge County Grind fury Page 3 11 Response to the Orange County Grand Jury — "Emergency Medical Response in Orange County" September 25, 2012 Page 12 OC Emergency Medical Services Most fire departments now respond to traffic collisions; hazardous materials spills, remote rescues, medical aid calls and various other emergencies.. The typical emergency responses include a fire truck and an ambulance. The staffing of the OCFA emergency equipment is specified by their MemorandlmmofUnderstanding that states.§ I Each single piece engine company shaft how a minimum ofthree (3)persanneL 2. Each paramedic engine company shall have a minimum of four (4) personnel_. Each truck company or urban search and rescue vehicle shall have a minimum of fora (4) psrsonnel... 3. Each paramedic van shall have a minimum of two (21poramedic personneL The qualifications of the responders depend upon the contract obligations they have with the city and the standards set by the State Emergency Medical Services Authority, the Orange County Emergency Medical Services Agency, and the OCFA. The response time standard used by the OCTA is amviag in 7 minutes 20 seconds occurring 90 percent of the time.° The independent city fire departments have other response time standards. These depend upon the geography and the density of the community- Some city fire chiefs reported that depending on ;enables, the medical emergencies account for 90 to 95 perceEd of their calls with the response times of 5 mumtes 90 percent of the tune.' Emergency medical qualifications and protocols_ not the operations node], are governed and standardized by the Orange County Health Care Agency- These Unctions are assigned to the Orange Coimty Health Disaster Management Department, Emergency Medical Services (OCEMS). This agency is staffed with a medical doctor as the director and a registered muse as the program manager. Emergency Medical Serices is guided by the 17 member Emergency Medical Committee, comprised of appointed members with background in health care. OCEMS prescribes the standards for initial training and certification of emergency medical teclimcians (ENfFs) and paramedics. OCEMS either provides or delegates (in the case of OCFA) oversight of the administration of emergency medicine certification! All fie departments, private ambulance companies. and hospitals are required to meet the same standards. OCEMS does not prescribe the delivery sen •ice, which is left to the fire departments. OCEMS also monitors and validates ail emergency treatment facilities and monitors facilities for special capabilities. All treatment administered by emergency medical persomel- from either private companies or local fire departments use the same Standing Orders and Protocols set forth by the Health Care Agertcy.a A OCPA& OCN& ra!v :_ �]A. ammdM lba X01.20Gti X56, 2190 '�Io>�,�d ins. aemms dept tM.w � ihn [nrheu bade« tvmc.d emuv>bev heath sd �aan�n2:. � O ®pe C ^mtr Cmod Jey m�npma ssh Icml fve rbsE:. ' 4mp Cu�rPmv' 3Sad;cil Sackw;.EiLSPa9ras; 12 -T' -Ll 2011 -2012 OTauge County Grand Jury Page 4 12 Response to the Orange County Grand Jury — "Emergency Medical Response in Orange County" September 25, 2012 Page 13 OC Emergency Medical Services The Orange County Board of Supervisors, upon advice of the Orange County Emergency Medical System (OCEMS), sets maximum rates for Advanced Life Support (ALS) and Basic Life Support (BLS)- Cities take into consideration these sates when putting together Requests for Proposal and Imitation to Bid on ambulance transport services with private providers. Although the process is said to be competitive, meaning the award goes to the "most responsive and responsible bidder." all ambulance providers are under the oversight of OMIS that adrninoterc and certifies the medical protocals (i.e-, licensing). Further, the Orange County Board of Supervisors sets the maximum rates. These requirements limit the number of potential qualified bidders. Several of the cities contract their medical emergenriec to local Private ambulance Con4 - Other cities either havre OCFA or a combination of OCFA and ptrvate ambulance services providing emergency medical response to their citizens - Currently_ private ambulance companies are aaarded long -term service contracts for up to ten yem-" Fees are based on the rates set by Orange County Health Care Agency. which are approved by the Board of Supenuors. Typically, these contracts have pregnahfication dictated by OCFA and at least experience in similar sized cities. Potential private ambulance companies find the contract proposals vague in their billing requirements_" Current Emergency Response Operations Chiefs of the various fire departments of Orange County were interviewed by the 2011 -2012 Orange County Grand Jury. All were relatively new in flieir position, some having been recently appointed, and some sitting m an inter capacity -` All appeared to have been given the challenge of looking at their organization and proposing alternative ways of providing their services. A problem that faces all of these agencies is financial. The labor agrees adopted in good times have become financial burdens during the recent business downhun. These burdens not only affect the current but also &kue budgets. In most departments, the costs of the long -term benefits are not transparent to the boards of directors, city councils, and the public, consequently the challenge that the governing bodies have given to the nee fie chiefs. Personnel from one Orange County private ambulance onmpany and one former ambulance company owner were interviewed by the 2011 -2012 Orange County Grand .buy. The local ambulance company contracts with several Orange County fire departments. to provide emergency medical service. These contracts are a result of naquests for proposals from the cities and are open to competitive bidding_ Some city fire departments provide `home" for these private ambulance companies in the local fire stations_ Other cities allow the ambulances to be a TW"b. .auAma aka. aC fur baps "raa T fiedga�o�ffi�e ®mist 1 1.41 2x11 -2012 Orange County Grand fury Page 5 13 Response to the Orange County Grand Jury — "Emergency Medical Response in Orange County" September 25, 2012 Page 14 OC Emergency Medical Services housed wherever the primate company determines to be a strategic location- In most areas, the fire departments dispatch the fire trucks at the same time that the private ambulances are dispatched Private ambulance serices are now, required to have radio systems on the SDQNH -IZ band for rmiform communications with all surrounding fire departments and ambulances. In the 1960's and 1910's, primate ambulance companies were the predominant prodders of emergency medical smices- This changed at the onset of the `9 -1 -1' phone dial whem emergency medical responses began to be taken over by the fire departmemis.43 Local labor union leaders note that the greatest challenge facing them today is 'an increasing demand for sevices with fewer personnel while competing for limited funding resources. "14 They go on to say `4mscrupulous private vendors" are trying to profit from cement financial diiFrntties. In accordance with California Penal Code §933 and §933.05, the 2011 -2012 Orange County Grand Any requires responses from each agency affected by the FindiagslConchdons presented in this section The responses are to be submitted to the Presiding Judge of the Superior Court The Board of Directors of the OCFA and the City Councils of each city fire department shall respond to these FindingslConelasions. Based on its study of the OCFA, the 2011 -2012 Orange County Grand Jruv makes the following Fi adingslConclasions Fl. Fire departments that once primarily responded to calls for fire emergencies now have become emegency medical response departments Primarily responding to medical enlergMQes, This evolution has occurred since the onset of `9 -1 -1" call where all emergency calls are received at one place. F2. As the fire departments evolved into emergency medical departments, the model for operating the fire departments has not radically changed The fire departments have simply absorbed the emergency medical responses into their departments under their old "fire response" model. F3. Economic recessions have forced local fire department boards of directors and city councils to re- evaluate their models for pramiding foe and emergency medical responses.UUe this brings to the fore issues of staffing, response times, public safety, training, consolidations. union rules and privatization of their various services_ it also spotlights the model used for all emergency responses - RECOMt. ENDASIONS In accordance with Calfornia Penal Code §933 and §933.05, the 2011 -2012 Orange County Grand Jury requires responses from each agency affected by the Recommendations presented �,G� rt raa�timamia �. ym�mr�drea spy. °ate Grad J.,. -yea; 3-M-1: 2011 -2012 Orange County Grand jury Page 6 14 Response to the Orange County Grand Jury — "Emergency Medical Response in Orange County" September 25, 2012 Page 15 OC Emergency Medical Services in this section The responses are to be submitted to the Presiding Judge of the Superior Court. The Board of Directors of the OCFA and the City Councils of each city fire department shall respond to these Recommendations. Based oa its unwfigation of emergency response models in Orange County. the 2011 -2012 Orange County Grand hay makes the fallowing recommendations RI. The city fire departments and the Orange County Fire Authority should engage independent private consultants to re- evaluate their models for providing response for both fire and medical emergaic;,es. These re -evaluations should include the strengths, weaknesses_ opportunities and threats of current models and alternative models. This re- evaluation should be accomplished by July 31, 2013. (See FL F2 rk F3) R?. Suggested ahemative models should include foraying a unified Emergency Response Department that mchides fire and medical response: separating the fire response from the medical response, privatizing the emergency medical response, etc_ (See F3) REAL= RESPONSES The Board of Directors of The OCFA and the City Comcils with city fire departments shall respond to the Fmd[inoConclusions and the Recommendations as specified below. In accordance with California Penal Cade §933 and §933.05; the 2011 -2012 Orange Come Grand Jury requires responses from each agency affected by the Findiags/Conclnsions and Recommendations presented in this section The responses are to be submitted to the Presiding Judge of the Superior Court- "Not Iaw than 90 dacs after the grand jury submits a final report on the operations of any public agency subject to its renewing authority, the governing body of the public agency shall comment to the prasidog judge of the superior court on the findings and recommendations pertaining to matters under the control of the gavmning body, and emery elected county officer or agency head far which the grand ju?y has responsfb0ty pursuant to §914.1 shall comment within 60 day's to fife presiding judge of the superior court; with an information copy sent to the board of supervisors, on the findings and recommendah mr pertaining to matters under the control of that county officer or agency heat and mV agency or agencies which that officer or agency head supervises or controls. In a?W chi and county, the mayor shall also comment on the findings and recommendations_.., The Penal Cade lists the following response choices for a responding entity- Responses to Findings 1. The respondent agrees with the fording_ 2G11 -2012 Orange County Grand fury Page 7 15 Response to the Orange County Grand Jury — "Emergency Medical Response in Orange County" September 25, 2012 Page 16 OC Emergency Medical Services 2. The respondent disagrees wLally or partially with the fording, in which case the response shall specify the portion of the finding in dispute and shall include an eaplanabou of the reason_ Responses to Recommendations 1. The recommendation has been implemented, with a summary regarding the implemented action. 2. The recommendation has not been implemented, but will be implemented in the future, with a timef mite for implementation. 3. The recommendation requires further analysis, with an explanation of the scope and parameters of that analysis and turneframe. This timeframe shall not exceed six months from the date of publication of the Grand Jury report. 4. The recommendation will not be implemented because it is not warranted or is not reasonable, with an espLmatiom All responses should be received no later than October 1 (unless the agency or department has requested in writing an additional extension)- Follow -up is the responsibility of the sitting Grand Jury- rsssssx 2911 -2012 OTauge County cased fury Page 8 16 -"12- 1,73.12_ Response to the Orange County Grand Jury — "Emergency Medical Response in Orange County" September 25, 2012 Page 8 Response: The recommendation will not be implemented, because it is not reasonable. As the Grand Jury is aware, respondents are prescribed via the California Penal Code to formally respond to the Grand Jury's findings /conclusions and recommendations with specific text, even if the phrase and tone we might rather respond with is significantly different than the Penal Code's strictures. Therefore, please know that the City of Newport Beach appreciates the Grand Jury's attention to the interesting and timely issue of change in fire departments — indeed, we see the change too. We know that any government service must change with times, as difficult as that can be. And while we might not choose the precise path and timeline that the Grand Jury requested (study done by consultant services, all by July 31, 2013); please know that we acknowledge that similar studies and analyses need to occur soon if local governments and their fire departments are to continue to remain efficient and effective. Recommendation R2 - Suggested alternative models should include forming a unified Emergency Response Department that includes fire and medical response, separating the fire response from the medical response, privatizing the emergency medical response, etc. (See F3) Response: The recommendation has not been implemented, but may be considered in the future. The City of Newport Beach's Resolution 2010 -04 (Enacting a Fiscal Sustainability Plan) states, among other things, that the City will consider competitive contracting of services and equipment when appropriate and where clear, cost - effective alternatives exist. Consistent with this Resolution and the Grand Jury's report the City will continue to consider competitive contracting within the NBFD and all City departments. The City will continue to re- evaluate all alternative models to create efficiencies for emergency medical service response while maintaining the highest level of service to the community. I welcome any views contrary or concerns that the Grand Jury might have about this response. I can be reached at (949) 644 -3001 or dkiff ,newportbeachca.gov. Sincerely, Dave Kiff City Manager City of Newport Beach