HomeMy Public PortalAboutReport presented on June 2003.tifReport of the
VILLAGE OF KEY BISCAYNE
FIRE RESCUE DEPARTMENT
June 2003
Prepared by:
Carlos A Gimenez and Associates
Executive Summary
This is a Report of the study requested by Village of Key Biscayne (hereafter referred
to as the Village ) officials to review certain aspects of the organizational structure
management practices emergency response resources communications capabilities and
contractual agreements of the Village of Key Biscayne Fire Rescue Department (hereafter
referred to as the `Department )
This Report lists recommendations in 6 areas The various observations and
recommendations of this Report are designed to assist Village officials as they formulate a
new long range plan for the Department and to augment their own local experience with an
external consultant s view
The Report is orgarn7ed into 6 subject areas with corresponding observations and
recommendations in each of the areas Recommendations which are critical and should be
considered high priority are marked with an asterisk (*)
List of Recommendations from Report
Section 1 Organizational Structure
Recommendation The Fire and Police Departments, which constitute over 73% of
the personnel and close to 60% of all expenditures should be direct reports to the
Village Manager The reasons for this recommendation are twofold
1)
2)
The size of Village government is not to the scale where an Emergency
Services Director is needed
The inherent bias of an Emergency Services Director to his or
her field of expertise to the detriment of the other field
Recommendation No changes are recommended to the Fire Rescue Department
organizational structure
1
Section 2 Fire Response System
Recommendations
• *Add an additional full time position per shift This will elevate the Fire
response and fully utilize both Village suppression units COST $63,655 x 4
$254,623 84
• *First evaluate and if needed, improve the turnout time of firefighters to
alarms Turnout time is the tame from the receipt of the alarm at the station to
the exit from the station by the apparatus This should lead to a reduction in the
total response time to incidents COST $0
• Consider establishment of a penalty (fines) system for abuse of Automatic
Alarms Look at similar ordinances in neighboring jurisdictions This is not to
be considered a revenue enhancement as much as a deterrent for abuse of the
system COST $0
• Formalize in writmg, all Mutual Aid Agreements This will improve relations
with surrounding jurisdictions and give the region additional resources to deal
with worst case scenarios Remember that Mutual Aid goes both ways COST
SO
Section 3
Emergency Medical Service System
Recommendations
• *Strengthen SWAP program with ancillary services provider and look to expand
program through interlocal agreements with neighboring jurisdictions COST
$0
• *Develop agreements with local hospitals, such as JMH, for advanced paramedic
training of Department paramedics COST $0
2
" * F u l l y u t i l i z e n e w E M S T r a m m g O f f i c e r b y p e r f o r m i n g m o r e i n h o u s e a n d o n -
d u t y t r a i n i n g C O S T $ 0
" * A s s u r e a d e q u a t e f u n d s i n F i r e R e s c u e b u d g e t f o r t h e a c q u i s i t i o n o f E M S
t r a i n i n g e q u i p m e n t C O S T $ 1 0 , 0 0 0 p e r y e a r
" A s s u r e D e p a r t m e n t p e r s o n n e l a t t e n d W e a p o n s o f M a s s D e s t r u c t i o n a n d t e r r o r i s t
i n c i d e n t m i t i g a t i o n t r a i n i n g , w h e n a v a i l a b l e C O S T V a r i e s , d e p e n d i n g o n
c o u r s e
" L o o k a t o b t a i n i n g a n e w E M S r e p o r t i n g p r o d u c t C u r r e n t s y s t e m i n u s e i s
I n a d e q u a t e ( I t i s p o s s i b l e t o w o r k w i t h t h e a n c i l l a r y s e r v i c e p r o v i d e r t o h e l p
o f f s e t t h e c o s t o f t h i s r e c o m m e n d a t i o n ) C O S T U n k n o w n , v a r i e s w i t h p r o d u c t
C o u l d b e m i t i g a t e d i f b o u g h t i n c o n j u n c t i o n w i t h a n o t h e r j u r i s d i c t i o n
" I n c r e a s e K e y B i s c a y n e r e p r e s e n t a t i o n a t r e g i o n a l a n d s t a t e E M S f o r u m s
A t t e n d a n c e w i l l k e e p t h e D e p a r t m e n t a b r e a s t o f l a t e s t d e v e l o p m e n t a n d c a n a l s o
s h a p e t h e c o u r s e o f E M S i n t h e S t a t e C O S T $ 2 , 0 0 0 - 3 , 0 0 0
" W i t h t h e a d d i t i o n o f t h e n e w E M S T r a i n i n g O f f i c e r , t h e D e p a r t m e n t s h o u l d t a k e
a l e a d e r s h i p p o s i t i o n i n d e v e l o p i n g a d v a n c e d m e d i c a l p r o c e d u r e s a n d
a d m i n i s t e r i n g n e w m e d i c a t i o n s i n t h e f i e l d
S e c t i o n 4 D i s p a t c h ( 9 1 1 ) a n d C o m m u n i c a t i o n s
P r e l i m i n a r y R e c o m m e n d a t i o n s
" C o n t i n u e t o h a v e a n c i l l a r y s e r v i c e p r o v i d e r f u r n i s h 9 1 1 d i s p a t c h s e r v i c e s
C O S T $ 0
" * E v a l u a t e t h e p o s s i b i l i t y o f s e r v i c e e n h a n c e m e n t s d u e t o c o n v e r s i o n t o n e w C A D
s y s t e m b y t h e C i t y o f M i a m i a n d M i a m i - D a d e C o u n t y C O S T T o b e
d e t e r m i n e d
3
" * E v a l u a t e t h e c r e a t i o n o f i n t e r n a l 9 1 1 c e n t e r b y u t i l i z i n g c u r r e n t r e s o u r c e s i n t h e
P o l i c e D e p a r t m e n t , o n c e c o n v e r s i o n s t o n e w C A D o c c u r i n t h e C i t y o f M i a m i o r
M i a m i D a d e C o u n t y C O S T T o b e d e t e r m i n e d
" * P u r c h a s e a n a d d i t i o n a l F i r e H a n d l e T a l k i e a n d p l a c e i t m t h e P o l i c e d i s p a t c h
c e n t e r C o s t A p p r o x i m a t e l y $ 2 , 0 0 0 0 0
S e c t i o n 5
E v a l u a t i o n o f S e r v i c e C o n t r a c t w i t h C i t y o f M i a m i
R e c o m m e n d a t i o n s
" C o n t r a c t l a n g u a g e o n t h e p r o v i s i o n s o f a u t o m a t i c a i d e s p e c i a l l y " m o v e u p "
s h o u l d b e c l a n f i e d .
" T h e M D F D s h o u l d b e c o n t a c t e d f o r p o s s i b l e c o o p e r a t i v e a r r a n g e m e n t s T h e
p r o v i s i o n o f s e r v i c e t o t h e u n i n c o r p o r a t e d a r e a s o f K e y B i s c a y n e c o u l d p r o v i d e
a n o p p o r t u n i t y f o r n e g o t i a t i o n s
" C l e a r l y d e l i n e a t e i n t h e c o n t r a c t w h i c h t y p e s o f t r a i n i n g a r e t h e r e s p o n s i b i l i t y o f
t h e V i l l a g e a n d w h i c h a r e t h e r e s p o n s i b i l i t y o f t h e s e r v i c e p r o v i d e r
" A s s u r e t h a t t h e n e w E M S t r a i n i n g o f f i c e r i s u s e d t o k e e p V i l l a g e u n i t s i n s e r v i c e
a s l o n g a s p o s s i b l e w h i l e c o n d u c t i n g t r a i n i n g
" * A s s u r e t h a t c o n t r a c t l a n g u a g e w i t h m a i n t e n a n c e p r o v i d e r i s c l e a r a n d
u n a m b i g u o u s a s t o t h e " q u e u i n g " o f a p p a r a t u s i n s y s t e m ( T h e V i l l a g e s '
a p p a r a t u s w i l l b e t r e a t e d e q u a l l y w i t h p r o v i d e r ' s a p p a r a t u s )
" N e w c o n t r a c t n e e d s t o r e f l e c t t o d a y ' s r e a l i t y N e w p r o v i d e r n o l o n g e r n e e d s t o
p e r f o r m E M S t r a i n i n g f u n c t i o n
4
Section 6 General Observations and Recommendations
Recommendations
• Continue dedicating an individual to perform detailed fire prevention
inspections on a regularly scheduled basis It is noted that the Department was
awarded a grant from the United States Fire Administration for Fire Prevention
Look at this and other innovative ways to fund the position
• The Village should consider the establishment of a Fire Inspection Fee, similar to
fees charged by all other county fire departments and look to their enabling
ordinances for guidance The revenues from this fee can offset the expense of a
dedicated inspector
• The Department should continue it's voluntary home inspection survey to help
citizens identify hazards around the home
• The Department should consider developing a training program for hotel and
condominium security personnel to assist whenever an alarm is activated
• The Department should frequently and clearly articulate the importance of fire
prevention as the primary fire mission of the Department to it's members
• The Department should continue participation in Risk Watch program
• The Department should continue participation in the CERT program
• The Village should consider the purchase of AED's for it's Police patrol vehicles
• The Village should encourage hotels and condominiums to purchase AED's for
use by their secunty personneL The Department should provide training on the
use of the device
• The Village should not institute an EMS transport fee
5
Village of Key Biscayne Fire Rescue
Study Purposes
This comprehensive study of the Village of Key Biscayne Fire Rescue Department
(Department) was requested by the Village Council to provide a general review of the
Department and to provide specific recommendations when required The Department was
formed over 10 years ago and the Council felt a need to conduct an independent analysis of
the Department and it s overall effectiveness
This current study was requested to review and analyze the following areas of the
Department
• The Department s service capabilities including it s support services and programs
• The performance of the Department relating to the safety and effectiveness of the
service to the citizens of the Village and Department personnel
• Review the practices and performance of the Department to nationally recognized
standards
• The current contract between the Village and the City of Miami for provision of
ancillary services and a financial analysis of the cost effectiveness of the current
structure and an operational analysis of the quality of services rendered
• A review of the 911 process and recommendations for improvement
The study is helped by the fact that the Department is accredited through the
Commission on Fire Accreditation International and therefore the study did not need to deal
with problems of an extremely serious nature which is sometimes the case in some small
departments and in departments that have suffered through tough budgetary times The fact
that the Department has an existing contract with a competent major department like the City
of Miami also reduces the negative aspects of some smaller departments in that the Village is
able to take advantage of the significant capabilities that a major department usually
possesses The study then dealt with reviewing the operational aspects of the Department
with an eye toward improving the effectiveness of the Department It was quite evident from
discussions with the Village Mayor the Village Manager the Village Fire Chief and the
6
Village of Key Biscayne Fire Rescue
firefighters themselves that everyone is committed to providing the best fire service possible
to the residents of the Village This indicates a keen awareness from all of the importance
that a well staffed and well equipped fire department is to the quality of life of a community
Study Methodology
The Study was conducted over a 75 day period with multiple site visits and analysis
of documentation Numerous separate topics were reviewed analyzed and considered for
recommendations Interviews were conducted with the Village Mayor the Village Manager
the Village Fire Chief and various Village firefighters A site visit was made to the station
the communications centers of Miami Dade County and the City of Miami plus the
headquarters of the Miami Dade and Coral Gables Fire Departments
Meetings where also held with the Fire Chiefs of the City of Miami Miami Dade
County and the City of Coral Gables Additional meetmgs where held with the
communications staffs of the City of Miami and Miami Dade County In addition L R
Kimball and Associates was contracted to perform more detailed work on the subject of
identifying different alternatives to the current 911 structure in the Village
The Medical Director for the Department s emergency medical services was
mterviewed
I wish to thank everyone who was interviewed or who provided information for their
willingness to spend their time and effort towards the conclusion of the study Everyone
involved provided the author with their unedited and honest opinions on the subject at hand
The Village of Key Biscayne
The Village of Key Biscayne occupies the middle one third of the southernmost
barrier island in the United States It encompasses an area of 1 25 square miles and has a
7
Village of Key Biscayne Fire Rescue
population of approximately 10 500 according to the 2000 census The Village is a short
drive away from the City of Miami and the greater Miami metropolitan area which is the
11Th largest metropolitan area in the United States
The Village has a Council Manager form of government compnsed of six (6)
Council members and a mayor all elected at large The Council selects a Manager who m
turn runs the day to day operations of the Village The annual budget for all funds for FY
2003 is approximately $26 9 million The Village is comprised of 6 500 housing units of
which roughly 80% are multi family units and the remainder single family homes There is
a commercial corridor in the center of the Village with close to 250 000 square feet of mainly
retail establishments Close to 20% of the Village population are over the age of 62 This
represents a significant number of persons who will probably require the services of the
Department s Emergency Medical Services The Village enjoys a very high Average
Household Median Income of $92 604 significantly higher than the Flonda average of
$38 819 per household This tends to reduce incidents requiring public safety
The Village has pockets of higher density mainly on the east side of the island where
numerous high rise condominiums and hotels are situated All of these structures comply
with the appropriate fire code and are mspected yearly by the Department Being fairly
modern structures they pose a threat only to the extent that a high number of persons inhabit
these structures especially at night The central portion of the Village is dominated by retail
establishments and the Village Green There is a potential for high dollar loss in these
structures mainly during late night hours But conversely life hazard is low because for the
most part these structures are vacant during late night hours The western portion of the
Village has several schools and churches but is mainly comprised of single family homes
The vast majority of these homes were built between 1950 and the present The average price
per square foot of these residences are some of the highest in the County Many of these
homes are either on the bay or have ocean access canals directly in the rear which house
expensive boats and yachts These boats and yachts constitute a hazard m that they typically
are filled with hundreds of gallons of gasoline or diesel fuel Traffic in the Village is well
8
Village of Key Biscayne Fire Rescue
controlled by the Village Police Department with speeds regulated to no more than 30 miles
per hour anywhere in the Village This tends to reduce the number of accidents and their
severity
The Village is subject to a very high nsk exposure to humcanes Being a barrier
island Key Biscayne (hereinafter referred to as Island) is usually completely inundated
whenever hit by a major hurricane The Island is normally evacuated whenever a hurricane
warning is issued for the area Unfortunately after the events of September 11 2001 the
threat to all junsdictions from terronst attack needs to be seriously considered The Village
while not a particularly high target area is m close proximity to Downtown Miami and the
Port of Miami This makes the Village susceptible to the collateral damage inflicted by a
weapon of mass destruction The seventy of exposure to chemical and biological agents will
depend on the size and type of agent as well as environmental factors such as wind
direction These two factors and the relatively large number of high density residential high
rises and the large number of visitors to the Village require a high level of fire and EMS
protection for the protection of life and property m the Village
The Village needs the following basic service items from its Fire Rescue Department
Emergency Medical Services at the Advanced Life Support -transport level
Comprehensive prevention inspection and public safety education
Fire suppression
Hazardous materials mitigation
Marine firefighting and rescue capabilities
Technical rescue
Disaster response and
Comprehensive emergency management
Most of these services are being provided either through the Department or by
contract with the City of Miami The noticeable exception is marine firefighting and rescue
9
Village of Key Biscayne Fire Rescue
capabilities The Department does have an inflatable boat for in water rescue but neither the
Department or the City of Miami has the ability to fight a fire on the water away from shore
History and current status of the Department
The Department was born m October of 1993 2 years after the Village was
incorporated The Village was looking at ways to improve services to it s citizens while at
the same time reduce costs Prior to this time all of Key Biscayne s fire and EMS services
had been provided by the Miami Dade (then known as Metro Dade) Fire Department
(MDFD) since all of unincorporated Miami Dade County plus a number of smaller cities
were part of the Miami Dade County Fire District The District would impose a uniform tax
on property on all properties within the District The theory being that this would assure a
uniform level of service throughout the District This funding mechanism however gave the
newly formed Village of Key Biscayne the opportunity to evaluate alternative delivery
systems since the high property values in the Village contributed millions of dollars to the
District There was considerable debate over whether the Village would form it s own
Department contract with another department or retain the services of the Miami Dade Fire
Department After much debate the Village decided to form it s own Department and
contract with the City of Miami for ancillary services This solution provided the Village
with improved services as the secondary units responding to emergency calls were coming
from a much closer location and saved the citizens of the Village millions of dollars (over
$26 million since 1995) This has enabled the property owners of the Village to enjoy the
lowest combined millage rate in Miami Dade County The Department itself mirrored the
resources dedicated to the island by the MDFD A fully staffed Fire unit along with a fully
staffed transport capable Advanced Life Support Rescue unit where placed in service With
some very minor modifications these are the basis of the service delivery to the Village to
this day Recently the Department moved into a state of the art facility in the heart of the
Village It also recently purchased but has yet to receive two (2) new fire apparatus which
should reduce the out of service time that plagued it s first fire apparatus
10
Village of Key Biscayne Fire Rescue
The Department is staffed by what is essentially a hand picked group of men and
women who responded to advertisements requesting firefighters in the Village Most of the
members are experienced firefighters who had served previously in other fire departments in
the State of Florida. They are a group of highly motivated people who have served the
Village well The Department has modem up to -date equipment to deal with most of the
incidents that it may encounter Those incidents outside of it s capabilities are handled
through it s ancillary services contract with the City of Miami Department of Fire Rescue
The City of Miami Department of Fire Rescue is a Class One department and one of the
largest departments m the State of Florida It is a full service department which can handle
all types of fire and EMS calls plus it is equipped to handle Haz Mat incidents with the one
of the largest on duty Haz Mat teams in the State It also staffs Dive Rescue and Confined
Space Rescue teams on a full time basis
While the Department functions m some ways very similarly to the City of Miami s
it differs in several key ways that tend to increase the out of service time for its units For
one the Department responds to a very high number of automatic alarm calls
Additionally the Department transports Basic Life Support (BLS) patients on a much greater
percentage basis than the City department ( The City of Miami and all other departments in
the County for that matter usually transport BLS patients through contract with a private
ambulance company) These and other additional services provided by the Department are
understandable given the small town atmosphere of the Village However Village
officials need to understand that these additional tasks reduce the availability and
effectiveness of the Department to respond to true emergencies In reality bigger
departments and their inherently greater resources would allow for more of those types of
activities since the loss of a umt denigrates their ability to a much lesser extent than the
Village The Study also found much to be proud of in the Department For one the
Department seems to enjoy a very good level of commitment from it s elected officials
Village Manager and of course the Fire Chief The firefighters employed by the Village
have the best interest of the safety of the Village and it s citizens at heart and are willing to
provide the best service that they can The size of the Department also helps to increase the
11
Village -of Key Biscayne Fire Rescue
competency level and the ability to provide innovative services easier than in larger
departments The Department is also able to react to changing circumstances easier
Section 1 Organizational Structure
Current Status
Current Organizational Chart of the Village of Key Biscayne
Observation The current Village structure of Department of Emergency Services
with the Police and Fire Chiefs reporting through an Emergency Services Director should be
streamlined Usually this type of organizational structure is utilized by large organizations
in which the Manager has a large span of control The individual in this position is usually an
Assistant Manager level person which reduces the number of direct reports to the Manager
12
Village of Key Biscayne Fire Rescue
The Village structure is not overly complex and the Manager appears to have a
manageable span of control The Police and Fire Chiefs should have direct reporting
responsibilities to the Manager who in turn will determine the allocation of the Village s
resources Another problem with an Emergency Services Director is the inherent bias
towards one department or the other depending on the individuals field of expertise
Recommendation The Fire and Police departments, which constitute over 73% of
personnel and close to 60% of all expenditures should be direct reports to the Village
Manager The reasons for this recommendation are twofold
1) The size of Village government is not to the scale where an
Emergency Services Director is needed
2) The inherent bias of an Emergency Services Director to his or
her field of expertise to the detriment of the other field
Current Organizational Structure of the Village of Key Biscayne Fire Rescue
Department
13
Village of Key Biscayne Fire Rescue
Observation The current Departmental orgamzational structure seems to work
well There is a clear second in command which can handle day to day operational issues
thereby leaving the Fire Chief with time to work on non operational issues and planning
Recommendation No changes are recommended to the Fire Rescue Department
organizational structure
Section 2 Fire Response System
Observations The Department currently has on order 2 new suppression apparatus
that will be delivered shortly to the Village While the addition of these 2 apparatus is a great
addition to the Department the apparatus will only be as good as the staffing that is provided
to operate the vehicles
First we must concede the fact that the Village will not pass the test many fire
departments use to calculate the adequacy of their fire suppression capability This test
usually determines the capability of the department to simultaneously respond to and control
2 multiple alarm building fires This would necessitate 8 engines 4 aerials 8 rescue units and
4 Chief Fire Officers This is obviously beyond the capability of the Village to provide This
is one of the reason why the Village maintains an automatic aid contract with a major
department
The Depai liuent now operates with 7 personnel on duty per day to respond to EMS
and Fire emergencies in the Village The Department operates a Quint apparatus and also
maintains an Engine An engine or pumper is a vehicle with hose a water tank and a pump
hence the term `pumper Different diameter hose is earned on board to perform various
functions The larger diameter hose is usually used to supply the fire pump with water
usually from a hydrant An Engine can also have rigid large diameter hoses to draft water
from static sources such as a lake ocean or even a swimming pool when necessary Smaller
diameter hose is used by the individual firefighters to actually combat the fire Even in
14
Village of Key Biscayne Fire Rescue
today s high tech world water is still the most efficient extinguishing agents in terms of
availability and cost However in order to move vast quantities of water from point A to
point B a lot of people are needed A distribution network has to be established and water is
relatively heavy (A gallon of water weighs 8 34 pounds Considering that a typical hand line
can move up to 250 gallons per minute one can see why it takes so many people to fight a
fire) An Engine will also carry it s own limited supply of water usually 500 gallons The
pump will usually have a capacity of 1000 gallons per minute or more An Engine will also
carry a light compliment of ground ladders tools and equipment and medical gear A Quint
has the 3 basic components of an Engine but will also carry a full compliment of ground
ladders and a mechanical aerial device of usually of 55 feet or more
While the type and number of apparatus is important to a department it is more
important to have a well trained adequately staffed group of professionals who can respond
quickly and effectively to fire and emergency medical emergencies The fire propagation
curve demonstrates the importance of a rapid attack m case of fire The fire propagation
curve is used to calculate the percentage of destruction once a fire starts It is vitally
important to get to the scene of a fire as quickly as possible since the rate of destruction for
the first 6 minutes is moderate and fairly constant However the rate of destruction
accelerates dramatically past the six to seven minute mark In the first 6 minutes of a fire the
percentage of destruction rises to around 30% however if allowed to bum the fire will
destroy 90% of the contents in the next 6 minutes This phenomena is known as flashover
and is the point at which a fire becomes extremely difficult to control A 4 minute response
time from the station is important in that it usually takes 90 seconds or more for the fire to be
communicated to an alarm center and the center to process the call and notify the appropriate
fire station
Staffing NFPA 1710 the standard of the industry states that for every building fire
the following number of personnel are recommended for initial assignment
1 person for incident command
15
Village of Key Biscayne Fire Rescue
1 person for establishment of an uninterrupted water supply
4 persons to effectuate water application 2 hand lures with 2 operators each
2 persons to provide support for the 2 hand lines
2 persons for Rapid Intervention Team (For rescue of trapped or injured firefighters )
2 persons for a victim search and rescue team
2 persons for establishment of ventilation team
1 Aenal operator
As can be seen from the above a minimum of 15 personnel are required for response
to any building fire Since the Village only employs 7 personnel per day the missing
components are dispatched through the ancillary services contract
Response Crztena NFPA 1710 also has response criteria which mandates a
maximum response time for a certain percentage of calls Unfortunately time records are not
kept in accordance with the definitions as outlined in NFPA 1710 NFPA 1710 states that
response time is the time from when the umit(s) is en route to arrival at the scene Turnout
time is the time from the receipt of the alarm at the station to the beginning of response time
The system today does not measure turnout tune NFPA 1710 calls for the first arriving fire
apparatus response time to be within 4 minutes and/or the amval of the entire fire response
(15 mdividuals and their apparatus ) within 8 minutes for 90% of all calls
The greatest challenge to meeting the criteria for the entire compliment of personnel
and apparatus is the distance from the Village to the closest responding units from the City
of Miami An analysis of the run data shows that because of distance Miami units can not
respond mto the Village within the 8 minutes allocated by the standard Therefore the
Village can not meet NFPA 1710 standards unless it employs 15 full time firefighters on
duty per day This would mean an additional recurring personnel expenses to the Village of
$2 5 million The run data however does not support the maintenance of such a large force
of firefighters This will be discussed later in the report
16
Village of Key Biscayne Fire Rescue
While it is understandable why the 8 minute response of the full compliment is not
attainable a 4 minute initial response from within the Village by the Department is certainly
not only attainable but to be expected If you allow 1 minute for turnout time the
Department meets the standard for nutial response However I believe the Department can
and should do better with regards to total turnout and response time The Village
encompasses an area of 1 25 square miles and is serviced by a single fire station A study of
initial arrival times for the Department for 2001 and 2002 shows that turnout and response
times exceeded a 4 minute time frame 19 6% and 25 26% respectively In other words the
Department units arrived within 4 mmutes 80 4% of the time in 2001 and 74 74% in 2002 A
study of the City of Miami which encompasses some 34 square miles and is serviced by 14
fire stations or roughly 1 station per 2 4 square miles discovered that the City had initial
unit turnout and arrival times m the 4 minute range to 90% of fire calls The City also met the
1710 standard on the response of the recommended full compliment of firefighters ( All
apparatus on the scene within 8 minutes) It should be noted that the Department has an
excellent AVERAGE response tune of approximately 3 minutes The issues raised above are
that on a certain percentage of calls response time is greater than 4 minutes
Run Data A study of the run data for 2001 and 2002 indicates that non EMS calls
account for 55% and 57% respectively of calls This is somewhat surprising in that in the
majonty of departments that handle both Fire and EMS alarms those departments usually see
a rate of roughly 80% EMS calls to 20% Fire or non EMS calls One explanation for this
phenomenon is the very high number of automatic alarms that the Department responds to
In 2001 the number was 644 out of 1197 alarms or 53% of all fire or non -EMS calls In
2002 it was even greater with 725 out of 1150 or 63% of all fire or non -EMS calls This is
an exceedingly high number on a percentage basis of automatic alarms The vast majority of
these calls seem to be non fire m nature
Operational Considerations The Department will usually respond to a building
fire by placing 2 of it s firefighters on the Engine and 2 on the Quint The other 3 firefighters
will respond on a Rescue ambulance Although recognized in 1710 as an acceptable response
17
Village of Key Biscayne Fire Rescue
configuration when both units are dispatched and arrive simultaneously a 2 person crew is
not viewed by this author to be a functional firefighting unit It would make more sense to
place the 4 firefighters in 1 fire unit and have the other 3 respond in the rescue ambulance In
this fashion the 4 person crew could work together much better under the unified command
of a single company officer The addition of 1 position to the daily table of organization will
also have significant operational advantages For one in case of a building fire both
suppression units of the Village can be utilized to their fullest potential One unit can arrive
at the scene and investigate while the other unit can if needed secure and supply water
With these resources the Department can operate and back up a single attack line provide for
a search and rescue team and also staff an Initial Rapid Intervention Crew ( IRIC )
Currently on significant fire incidents the City of Miami Fire Department will supply a
Safety Officer initiate personnel accountability procedures augment rapid intervention
crews for rescue of firefighters and provide for firefighter rehabilitation These measures are
employed to assure to the greatest extent possible firefighter safety
Availability Availability is the percentage of time that one would expect that a
particular unit is available to respond and not responding on another call Departments try to
maintain an availability factor of 95% for their fire apparatus Based on data obtained fox the
first 4 months of this year the availability factor for Quint 1 was 96%
Recommendations
• *Add an additional full time position per shift. This will elevate the Fire
response and fully utilize both Village suppression units COST $63,655 x 4
$254,623 84
• *First evaluate and if needed, improve the turnout time of firefighters to
alarms Turnout time is the time from the receipt of the alarm at the station to
the exit from the station by the apparatus This should lead to a reduction in the
total response time to incidents COST $0
18
Village of Key Biscayne Fire Rescue
• Consider establishment of a penalty ( fines) system for abuse of Automatic
Alarms Look at similar ordinances in neighboring Jurisdictions This is not to
be considered a revenue enhancement as much as a deterrent for abuse of the
system COST $0
• Formalize m writing, all mutual aid agreements This will improve relations with
surrounding Jurisdictions and give the region additional resources to deal with
worst case scenarios Remember that Mutual Aid goes both ways COST $0
19
Village of Key Biscayne Fire Rescue
Section 3 Emergency Medical Service System
Observations Currently the Village operates with a full time on duty force of 7
firefighters These firefighters are all cross trained paramedic/firefighters who can respond
to both fire and medical emergencies This capability gives the Department flexibility to
maximize it s resources by allocating personnel and equipment in a number of different ways
that respond to the need
The Department s operations center on 7 full time on duty positions Depending on
the call the on duty members can utilize one of 4 apparatus that are housed m the
Department s station The Department maintains 1 Engine 1 Quint and 2 fully equipped
Rescue ambulance vehicles The on duty force is capable of responding in various
configurations depending on the nature of the call For example if a fire call is received the
usual response at this time would be for 2 firefighters to staff the Engine 2 for the Quint and
3 for one of the Rescue vehicles In cases of medical emergencies 3 firefighters would
normally respond in one of the Rescue vehicles This would leave 4 firefighters to staff
either the Engine Quint or if another medical call where to be received the 2nd Rescue
vehicle
The medical capabilities of the Department are closely aligned to those of the City of
Miami in that the equipment and medications earned on the vehicles are similar if not
identical In addition the Village and City share the same Medical Director and work under
the same medical protocol
The recent addition of a full time EMS Training and Quality Control Officer is a great
step forward and will allow the Department to move ahead with new and innovative
procedures and medications to put the Department at the forefront of EMS in Miami Dade
County This is significant in that the EMS system in Miami Dade County is recognized as
one of the finest regional systems in the country
-20-
Village of Key Biscayne Fire Rescue
Staffing NFPA 1710 calls for different staffing requirements depending on the
seriousness of the call The standard calls for the members responding to Basic Life Support
(BLS) incidents be trained to the first responder /Automatic External Defibrillator level
(AED) It states that there should be a sufficient number to adequately treat the patient and
provide for personnel safety The Department exceeds these requirements when responding
to BLS level calls
The standard for Advanced Life Support (ALS) differs significantly It states that for
ALS calls a minimum of 2 members trained to the Paramedic level and 2 trained at least to
the Emergency Medical Technician (EMT) level One needs to understand that the standard
is a NATIONAL one and that when written, most departments around the country would
respond to ALS incidents with a single paramedic and an EMT on initial response As stated
previously we are fortunate to live in a county in which EMS service is second to none As
such all departments in Miami Dade County have responded with 3 paramedics on their
Rescue vehicles for a number of years Therefore the Department exceeds the minimum In
that on all EMS calls the department at a minimum responds with 3 paramedics On those
calls where additional resources are needed the Department can respond with up to 7
paramedics within a short time
Response Criteria As with fire response time is a critical factor in determining
the survivability of a patient who is seriously ill or injured A person who has suffered a
cardiac arrest will suffer irreversible brain damage unless Basic Life Support is not initiated
within 4 to 6 minutes Even with available BLS within that time frame definitive treatment
which consists of a defibrillator needs to be administered in the shortest amount of time
possible in order to increase the likelihood of survival This is why NFPA 1710 calls for the
arrival of BLS level care within 4 minutes to all and when needed, for the arrival of ALS
level care within 8 minutes to 90% of calls An analysis of selected run data from 2001 and
2002 indicates the Depai fluent met the arrival of ALS within 8 minutes to 98 2% of all calls
However another sampling of over 420 calls over 2 years indicates that initial response times
for medical calls exceeded 4 minutes in close to 20% of calls These findings are similar to
-21--
Village of Key Biscayne Fire Rescue
those found for fire responses and again need to be explored Also remember that response
time as defined in 1710 is not measured in this system
Run Data Over the past 2 years there are close to 1000 EMS calls responded to by
units of the Department This is an average of 3 calls per day Most departments will look to
add additional units when the call volume of a unit begins to approach 4000 calls per year
Since the Village unit responds significantly fewer times than this there is no need to add
additional units at this time Also in terms of experience a good rule of thumb is that in
order to keep your skill level up a daily run volume of around 10 calls per day is desired As
you can see the Department s paramedics do not attain this level of activity In order to
offset the lack of expenence obtained by Department personnel it is necessary to invest
additional resources in on going training and to develop a viable SWAP ( Switch With
Another Paramedic ) program with systems that generate the number and type of calls that
will keep Village paramedics sharp and up to date Fortunately the addition recently of a
dedicated Training and Quality Assurance Officer will help greatly with additional training
The SWAP component needs to be dealt with through the ancillary services contract and
through interlocal agreements with neighboring fire departments and possibly medical
institutions
Operational Considerations The previously recommended addition of 1 full time
position to the daily on duty force will have additional benefits for EMS services in the
Village The additional position will give the Department the ability to respond to 3
simultaneous EMS incidents as opposed to today s ability to respond to 2 Assuming that 6
paramedics are dispatched on the 2 Rescue units to separate calls the remaining 2 individuals
can be dispatched on an ALS equipped fire vehicle while simultaneously dispatching a unit
provided by the ancillary services provider The 2 Village firefighters can immediately begin
treatment while awaiting the arrival of a mainland Rescue unit
Availability Data from the first 4 months of this year indicates that Key Rescue 1
has an availability factor of 94% Even if Key Rescue 1 is on emergency call or otherwise
-22-
Village of Key Biscayne Fire Rescue
occupied Key Rescue 2 is usually available for use by the remaining 4 firefighters at the
station In the event all Department personnel and units are unavailable the ancillary
contract calls for automatic move up into the Village by mainland units to provide coverage
Recommendations
• *Strengthen SWAP program with ancillary services provider and look to expand
program through interlocal agreements with neighboring jurisdictions COST
$0
• *Develop agreements with local hospitals, such as JMII, for advanced paramedic
training of Department paramedics COST - $0
• *Fully utilize new EMS Training Officer by performing more in-house and on
duty training COST $0
• *Assure adequate funds in Fire Rescue budget for the acquisition of EMS
training equipment COST $10,000 per year
• Assure Department personnel attend Weapons of Mass Destruction and terrorist
mcident mitigation training, when available COST Vanes, depending on
course
• Look at obtaining a new EMS reporting product Current system in use is
inadequate (It is possible to work with the ancillary service provider to help
offset the cost of this recommendation) COST Unknown, varies with product
Could be mitigated if bought no conjunction with another jurisdiction
• Increase Key Biscayne representation at regional and state EMS forums
Attendance will keep the Department abreast of latest development and can also
shape the course of EMS in the state COST $2 3,000
-23-
Village of Key Biscayne Fire Rescue
• With the addition of the new EMS Training Officer, the Department should take
a leadership position in developing advanced medical procedures and
administering new medications in the field
Section 4 Dispatch ( 911 ) and Communications
Observations The City currently dispatches and provides radio communications to
the Department The engineering firm of L R Kimball and Associates was contracted to
evaluate the current structure and make recommendations for improvement While the
report is not due until mid June there are a number of observations and recommendations
that could be discussed at this time
Current Status 911 As stated above the City of Miami Fire Department currently
dispatches the Department on all it s calls for service The City also provides the Department
with it s 800 MHz radio system The system currently is configured with all 911
calls being routed to the Miami Dade Communications center located on SW 87 Ave and
Miller Road ( SW 56 St ) If the call is for a Police emergency the Miami Dade call taker
takes down the information which is then routed to a Miami Dade dispatcher Depending
on the nature of the call the Miami Dade dispatcher then will contact the Village Police
dispatcher who will in turn then dispatch the Village Police Officer A fire or EMS call is
also initially routed to a Miami Dade call taker who once it is determined to be a Village
incident will one button transfer the call to a City of Miami Fire call taker Once the
information is transferred the City of Miami will then take over the call and dispatch the
appropriate Village apparatus It appears that there is room for considerable improvement in
the delivery of 911 services While there are no tune records kept on the delay m causing
Police and Fire dispatches to be handled in this manner it appears that there is a delay of 30
seconds or more for Police dispatches and 45 to 60 seconds or more for fire dispatches
The good news is that both the City of Miami and Miami Dade will acquire the same
dispatch system sometime next year The consultants are determining whether there is an
-24-
Village of Key Biscayne Fire Rescue
opportunity for the City and County to link their systems and thereby reduce any lag time
currently in the Village dispatch system Also the possibihty of the Village to serve as an
arm of either the City or the County dispatch system can result in the Village operating it s
own 911 center This would eliminate all time delays m the dispatch of public safety
services Another added plus is the fact that this may be able to be accomplished with a
reduced puce tag as currently the Police Department has 4 dispatchers on it s payroll
Current Status of Radio Communication Currently the Village Fire and Police
Departments operate on 2 separate 800 MHz radio systems The Village Police utilize the
Miami Dade system and the Village Fire Department uses the City s system The 2
Departments do not as far as we could tell have each others radios m event of emergency
This is an unacceptable condition Even though there are operational reasons to maintain
separate systems there is no excuse for the lack of conimumcation among the Departments
A more detailed look at this issue could lead to simple solutions to this problem
Preliminary Recommendations
• Continue to have ancillary service provider furnish 911 dispatch services
COST $0
• *Evaluate the possibility of service enhancements due to conversion to new CAD
system by the City of Miami and Miami Dade County COST To be
determined
• *Evaluate the creation of internal 911 center by utilizing current resources in the
Police Department, once conversions to new CAD occur in Miami or Miami
Dade COST To be determined
• *Purchase an additional Fire Handle Talkie and place it in the Police dispatch
center Cost Approximately $2000 00
—25—
Village of Key Biscayne Fire Rescue
Section 5 Evaluation of Service Contract with City of Miami
Current Status The Village currently has in effect a contract with the City of
Miami (City) for ancillary services The provision of these services are crucial to the
effectiveness of the Department These services are
1) Automatic aid
2) Initial and on going training for all firefighters
3) Apparatus and equipment repair due to normal wear and tear
4) Inspection services to the Village when requested
5) EMS quality assurance
6) Maintenance of all communications and dispatch equipment
7) Replacement of all expendable EMS and firefighting supplies and
8) Personnel for command and control of incidents in accordance with the
provisions of the contract
Automatic Aid The City provides fire and EMS equipment material and personnel
to augment Department resources An example of this would be a call to a house fire where
the initial response would require at least 15 firefighters and their equipment Since the
Village only employs seven full time firefighters per shift the City augments these resources
automatically on dispatch to assure that the appropnate number of personnel and apparatus
are dispatched Without a doubt while the provision of automatic aid is the most difficult to
quantify m terms of cost it is the most important aspect of the contract Records indicate that
the City of Miami responded to 139 alarms in 2001 with 538 units responding In 2002 the
number of alarms responded to was 138 with 476 total Miami units responding
When evaluating this portion of the contract the most overnding aspect of the
provisions of this section of the contract is the response time that the service provider will
arrive on the Village in order to augment Village umts The followmg list outlines the
anticipated response tunes from stations from the City of Miami Fire Department and from
stations of the Miami Dade County Fire Department
-26-
Village of Key Biscayne Fire Rescue
City of Mianu F D stations that respond to the Key and response times
Station 4 1105 SW 2nd Ave 8 miles 12 minutes @ 40 MPH
Station 8 — 2975 Oak Ave 9 6 miles 14 4 minutes @ 40 MPH
Station 1-144 NE 5th St 9 miles 13 5 minutes @ 40 MPH
Miami Dade County F D stations that respond to the Key and response times
Station 14 — 5860 SW 70 St —12 2 miles 18 3 minutes @ 40 MPH
Station 2 — 6460 N W 27 Ave — 14 8 miles 22 2 minutes @ 40 MPH
Station 30 — 9500 N E 2 Ave —15 3 miles 23 minutes @ 40 MPH
As can be seen the anticipated response times are shorter for the City than the
County This is to be expected since the County units responding to the Key have to traverse
the City in order to get there
The second most important aspect of the current contract is the automatic move up
provision This mandates that a mainland unit moves into the Village whenever a Village
unit is out of service for a period of time This is an added safety feature to the citizens of the
Village m that it assures as much as possible a rapid initial response to emergency incidents
There appears not to be a clear policy on when a move up is requested There also appears to
be a resentment on the part of some City of Miami firefighters for having to make the trip to
the island Any new contract with a service provider should clearly state when a move up
will be needed and expected
The elected and administrative heads of the Village should take the above into
consideration when negotiating with an ancillary services or automatic aid provider While
on the face it appears that the City of Miami is the natural choice due to geography there are
opportunities to develop a relationship with Miami Dade County and the fire station that hes
just outside of the Village boundaries In the event that the City of Miami is negotiated with
-27-
Village of Key Biscayne Fire Rescue
on the provision of automatic aid a fee for response arrangement, rather than a flat fee
should be considered
Recommendations
• Contract language on the provisions of automatic aid especially "move up"
should be clarified
• The MDFD should be contacted for possible cooperative arrangements The
provision of service to the unincorporated areas of Key Biscayne could provide
an opportunity for negotiations
Trammg The City is obligated to deliver recruit and on going fire and EMS training
to Village firefighters The Village utilizes the provisions of the contract to a certain extent
When the City is conducting a recruit firefighter class the Village will take advantage of the
fact and send one or more of it's newly hired firefighters to the framing However sometimes
this service is required by the Village and the City has no recruit classes scheduled In the
times that this circumstance has occurred the Village has been able to place the newly hired
firefighter through another departments recruit class The provisions of this part of the
contract are not being adhered to for operational reasons It would be inefficient for either
the City or the Village to conduct a recruit class for one or two individuals Apparently
there has developed an understanding between the City and the Village on this provision
On the issue of on going training the Village has taken advantage of the provisions of the
contract to a large extent The Village routinely sends it s firefighters to numerous courses
offered by the City on a wide range of topics In addition the City is responsible for
payment for courses required by Village firefighters for EMS recertification Some of these
courses are conducted by the University of Miami for a fee which the City pays Recently
with the addition by the Department of an EMS training position it is anticipated that the
need for the resources of the City will diminish in this area This will have the effect also of
keeping Village firefighters on the Key for a greater percentage of the time
—28—
Village of Key Biscayne Fire Rescue
Recommendations
• Clearly delineate in the contract which types of training are the responsibility of
the Village and which are the responsibility of the service provider
• Assure that the new EMS training officer is used to keep Village units in service
as long as possible while conducting training
Maintenance The contract calls for the City to maintam all apparatus and
equipment of the Village with routme maintenance and maintenance due to normal wear and
tear Also the City will provide apparatus and equipment to the Village in case the repair will
take an extended amount of time It appears that many of the aspects of this provision are
working well One area of discontent by the Village is the perception real or not that
Village apparatus are taking too long to repair It appears that part of the problem lay with
the fact that the original apparatus purchased by the Village contained non industry standard
components such as the fire pump The apparatus would be out of service for months
waiting for parts to be manufactured an extremely slow process This problem will be
resolved by the purchase of new apparatus by the Village Not only the fact that they are new
will help the situation but also the Village has purchased apparatus which have a very good
reputation in the industry and the component parts such as the pump and engine are industry
standard
The following is an estimation of the cost of providing these services The estimates
are derived from data received by the Miami Dade Fire Department It should be anticipated
that the maintenance costs for fire apparatus will be significantly reduced with the addition of
the newly purchased vehicles to be delivered shortly
Apparatus * Parts Labor Consumables Fuel Total
Rescue $8,505 83 $9,998 00 $6,689 36 $2,2352 00 $27,54519
Pumper $15,647 93 $20,427 13 $10,374 62 $2,622 93 $49,072 61
Quint $15,933 46 $20,405 46 $10,839 09 $4,583 31 $51,761 32
-29-
Village of Key Biscayne Fire Rescue
* These figures are for units with higher run rates than those m Key Biscayne
It is also important to note that the ancillary contract also performs many of the safety
functions outlined in NFPA 1500 the Standard on Fire Department Safety Functions such
as the proper maintenance of breathing apparatus air tanks and personal alerting devices are
performed by the MFD as part of the contract
Recommendations
• *Assure that contract language with maintenance provider is clear and
unambiguous as to the "queumg" of apparatus in system ( The Villages'
apparatus will be treated equally with provider's apparatus )
Inspection Services The contract allows for service provider to perform
inspections in the Village This service is currently either not utilized or utilized very httle
In the early and mid 90 s the services where utilized much more frequently as new projects
were being constructed Since then however with little to no new construction of major
projects the expertise of the provider has not been required The Village performs most if
not all of it s inspections at this time
EMS Quality Assurance The Village has taken over responsibility for this function
with the addition of it s own EMS training officer This officer will perform all EMS Quality
Assurance for the Village
Recommendation
• New contract needs to reflect today's reality New provider no longer needs to
perform this function
Maintenance of all Communications and Dispatch Equipment The City has
maintained all radios and Dispatch equipment for the Village The Village fire station for
-30-
Village of Key Biscayne Fire Rescue
these issues is treated as an additional City station There have been few if any complaints
on this issue
Radios Maintenance Cost $250 00
Replacement of expendable EMS and firefighting supplies The City replaces all
expendable supplies utilized by the Department Again the Village is treated like any other
City station
Small Equipment Repair and Maintenance
EMS Equipment
Approximately $13,000 00
$1458 00
Personnel for Control and Command The City provides the Village with Chief
Fire Officer level fire personnel to perform incident command duties at the scene of multiple
unit responses The Village is well served by this provision for it provides to the Village
with a cadre of experienced officers to handle complicated incidents The contract clearly
delineates the chain of command to any incident in the Village
Recommendation
• It is recommended that no changes be made m this section of the contract
Conclusion The ancillary services contract is cntical to the safety of Village
citizens and firefighters alike It provides the necessary resources to the Village whenever
Village units respond to routine and major incident The contract also eliminates the need for
the Department to invest in some potentially very costly infrastructure improvements such as
a radio system maintenance shop Self Contained Breathing Apparatus maintenance facility
quartermasters office and framing facility Also the Village is spared the recurring cost of
-31-
Village of Key Biscayne Fire Rescue
staffing these facilities and functions The current contract cost gives the Village access to
over $70 000 000 00 worth of resources from the Miami Fire Department ( MFD )
That being said there are opportunities for the Village to explore the possibility of
establishing alternative sources for some or all of it s ancillary services needs Conversations
with the leadership of the Miami Dade Fire Department (MDFD ) where productive but not
conclusive Unfortunately current events at the MDFD have precluded further
conversations until the leadership situation is clarified Once this situation is resolved then
the Village should enter into serous discussions with the MDFD
The City of Coral Gables Fire Department ( CGFD )was also contacted While the
initial discussions where promising on some issues later discussions revealed the reluctance
of the CGFD to provide automatic aid response Subsequently no proposal from the CGFD
has been received for the other components of ancillary services
Finally discussions and renegotiations should also continue with the MFD
Geographically they are the closest department to the Village and will respond in significant
numbers in the quickest time
-32-
Village of Key Biscayne Fire Rescue
Section 6 General Observations and Recommendations
Fire Prevention The most efficient way to fight a fire is to prevent the fire from
happening in the first place While this may seem like common sense the facts are that easy
and relatively inexpensive fire prevention efforts are some times difficult to implement
Most people do not personalize the possibility fire affecting their lives Let s face it how
many of you really think a fire is going to happen to YOU?
Regardless of the attitudes of the people about fire prevention, since the Village is on
an island and relatively distant from help It becomes mcreasingly important for the Village
and the Department to undertake extensive fire prevention efforts First a dedicated
individual is needed to perform detailed inspections on a regularly scheduled basis The
Department has recently added a position to do this work and they are to be commended
The line firefighters should be involved in inspections also but their emphasis should be in
conducting tactical inspections to draw up emergency operational plans and be totally
famihar with all major buildings in the Village Currently the Department conducts
numerous inspections in commercial establishments without a corresponding fire inspection
fee A fee should be established to offset the cost of these inspections In addition the
Department should look to develop programs to tram condominium and hotel security
personnel to assist whenever an alarm is activated
The Department should also continue it s voluntary home inspection for homeowners
who wish to reduce hazards in the home Unfortunately there appears te• be a reduction in
the number of these types of inspections over the last couple of years Renewed emphasis on
this program should see a rise in the number of inspections performed Finally the
Department is to be commended for it s continued commitment to fire prevention
Recommendations
• Continue dedicating an individual to perform detailed fire prevention
inspections on a regularly scheduled basis It is noted that the Department was
-33-
Village of Key Biscayne Fire Rescue
awarded a grant from the United States Fire Administration for Fire Prevention
Look this and other innovative ways to fund the position
• The Village should consider the establishment of a Fire Inspection Fee, similar to
fees charged by all other county fire departments and look to their enabling
ordinances for guidance The revenues from this fee can offset the expense of a
dedicated mspector
• The Department should continue it's voluntary home inspection survey to help
citizens identify hazards around the home
• The Department should consider developing a trammg program for hotel and
condominium security personnel to assist whenever an alarm is activated
• The Department should frequently and clearly articulate the importance of fire
prevention as the primary fire mission of the Department to it's members
Risk Watch The Department currently participates in the NFPA Risk Watch
program This program is taught to 3''d and 5th graders with a curriculum dedicated to
personal safety The program is worthwhile and should be continued
Recommendation Continue participation in Risk Watch program
CERT The Department also is an active participant and supports the Community
Emergency Response Team (CERT) program set up by the Miami Dade County Emergency
Management Department This program develops a cadre of citizens to assist the Village in
case of emergency in a number of vital areas such as First Aid light firefighting and rapid
disaster evaluation
Recommendation Continue participation in the CERT program
-34-
Village of Key Biscayne Fire Rescue
EMS On the subject of improving EMS as stated earlier in the report time is of the
essence to persons suffering from a cardiac arrest The definitive treatment for cardiac arrest
is defibrillation There is a direct correlation with the rapidity of the application of
defibnllation and patient survivability Since Police personnel are constantly in the street on
patrol and often amve at medical emergencies before the Fire Department the Village
should consider purchasing and equipping it s Police Department patrol vehicles with
Automatic External Defibnllators (AED s) Training for all Police personnel should also be
conducted on the use of the devices In addition hotels and condominiums in the Village
should be encouraged to purchase these devices for use by their security personnel Security
personnel should be trained by the Department as a community service on their use
An additional EMS issue discussed was the subject of charging a fee for transports
performed by the Village Rescue units After conversations with departments who currently
charge the fee it appears that Medicare and Medicaid are refusing payment to a large number
of transports which they consider could have been transported by much more economical
means Departments have found themselves in audits in which a repayment is demanded for
hundreds of thousands and even millions of dollars In light of this the establishment of this
fee at this time is not recommended
Recommendations
• The Village should consider the purchase of AED's for it's Police patrol vehicles
• The Village should encourage hotels and condominiums to purchase AED's for
use by their security personnel The Department should provide training on the
use of the device
• The Village should not institute an EMS transport fee
-35-