April 3, 2011

USA: Agencies adjust to older citizens

PORT HURON, MI /  The Times Herald / News / April 3, 2011

Fire departments face tight budgets, increasing number of medical calls

EMERGENCY:                         Fort Gratiot firefighters and paramedics load a patient into an ambulance after responding to a medical call at the Sanctuary at Mercy Village. The increasing number of senior citizens here and nationwide creates additional demands on first responders and health care workers.  Melissa  Wawzysko, Times Herald

Times Herald

Virginia MacDonald likes being independent. But, at 95 years old, the Port Huron Township woman said there are times she needs a little help.

A few years ago, MacDonald fell and wasn't able to get up. She called 911 and said firefighters and paramedics were at her side in no time.

"You couldn't ask for better service than what we get from them," MacDonald said. "They put me in a chair and stayed with me to make sure I was alright.

"Because she can depend on getting that kind of help, MacDonald has been able to continue living on her own.

"It gives you a wonderful feeling to know they respond so quickly and they are so courteous to you," she said.

GETTING READY: Carl Stosik, a battalion chief for the Kimball Township Fire Department, checks the automated external defibrillator at the start of his shift. His department has added a regular shift to save money on the township's rising number of emergency medical calls.  WENDY TORELLO, Times Herald
With the number of Blue Water Area residents 65 and older expected to double by 2035, fire departments -- already battling tight budgets -- are beginning to feel the strain. It's a concern statewide and one that's easy to boil down, said Fred Timpner, executive director of the Michigan Association of Fire Fighters.

"As people get older ... they have increased medical needs on things, which is understandable," he said. "As a result, they are heavy utilizers of medical providers, whether they be first-responders or doctors or hospitals. ... This is part of our society that is vulnerable and needs help."

While the ranks of senior citizens are just starting to see an uptick in some places, Fort Gratiot has had a high concentration of seniors for years, thanks partially to the many assisted-living facilities and nursing homes there.

That means the department is used to responding to medical calls -- 753 in 2010, which was 67% of all runs -- and has built its staff around the demand.

But for many departments, figuring out how to handle the extra load without breaking the bank is becoming a challenge. Fire departments increasingly are grappling with how they can respond to more medical calls without going broke on fuel costs and paychecks.

The problem is bigger for smaller, rural fire departments than those in cities like Port Huron. Larger departments generally keep firefighters in the hall around the clock and pay a set hourly wage. But, most local agencies are the modern version of volunteer departments. In those places, most firefighters are paid for each call. So, more medical runs means a larger payroll.

"We're kind of caught (between) a rock and a hard place," Port Huron Township Fire Chief Craig Miller said. "We're seeing an increase in demand for service, but at the same time ... the pressure is on us to be more cost-effective."

Officials have said changing the way fire departments operate is one way to handle the problem.

Kimball and Port Huron townships have taken what some said is likely to become a common approach: Sending fewer firefighters to medical emergencies.

About three months ago, Kimball Township started staffing a fire hall every afternoon with a firefighter who is paid hourly. That firefighter handles minor medical emergencies and other firefighters -- the ones paid for each run they make -- are called on if more help is needed. Before, all available on-call firefighters answered calls, adding to the cost of each emergency.

Port Huron Township's call logs help paint the picture of how things are changing. The fire department, which traditionally has handled more medical emergencies than fires, responded to 534 medicals last year compared to 477 in 2009. Miller said falls and medical emergencies aren't the only concerns. Seniors also have more risks associated with fires. Because of that, the department has stepped up fire-prevention education aimed at people 65 and older.

"When you look at the age of people who die in fires, they're very young or very old," he said.

While cost is a concern nearly everywhere, manpower also is an issue for some departments.

The Memphis Fire Department handles about 300 calls a year, and is on track to hit 400 this year, Chief W. Tim Franz said.

"We've seen a lot more medical incidents and things of that nature," he said.

As training requirements stiffen and people commute farther for work, it's becoming increasingly difficult to make sure enough firefighters are available to respond, he said.

"For us, being a small community, it's always a concern."

Liz Shepard
E-mail: lshepard@gannett.com

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