I was never a fan of DeKalb’s decision to open a fourth fire station. It’s not financially sustainable. Already we see it in this year’s budget, with $100,000 coming out of the city’s operating reserve to repair fire facilities, and pension liabilities continuing to explode. A more modest expansion would have fit financial realities better.
That being said, DeKalb does earn points for taking action, especially in contrast to Sycamore. Also, there’s still lots we can do to tame the EMS overwhelm and contain costs as well.
Let’s refresh on the issues. In the last fire department/EMS post, I sketched out two challenges that many, if not most, fire departments that provide EMS are facing today: maintaining adequate staffing, and finding ways to manage the growth trend for emergency service calls.
Keep in mind, shortages of healthcare workers and lack of access to primary healthcare are not new, but both were exacerbated by Covid, and many areas have never returned to “normal.” However, responses can vary by quite a lot and by quite a while, depending on a variety of factors including financial resource limitations and the quality of crystal balls. Sycamore expected 2022 to be its bounce-back year for recruitment; this never happened so they’re still struggling. DeKalb hired its first woman firefighter/paramedic in 2021 and has since found additional ways to deal.
Today I’m looking at mitigation strategies from the Bloomington and DeKalb fire departments, because they’re the ones I know the most about.
In terms of innovation, City of Bloomington seems to have pulled out all the stops in addressing personnel recruitment and retention. Bloomington’s only residency requirement is to live in Illinois. They’ve changed the shift schedule from 24 hours on, 48 hours off (24/48) to 24 hours on, 72 hours off (24/72). The city additionally has widened the candidate pool by hiring EMTs and prehospital registered nurses, and they often staff emergency vehicles in tiered deployments instead of employing 100% firefighter/paramedics. The result: Bloomington now has all the applicants it needs.
DeKalb’s recruitment strategy is a bit more conservative than Bloomington’s, but we already enjoy the distinct advantage of proximity to the populous Chicago metro area and are not afraid to use it. Starting pay is adjusted with intent to attract interest from prosperous suburbs east of here. The residency requirement likewise looks generous, the approved area comprising a 40-mile radius from Fire Station One on Pine Street. While DeKalb hasn’t changed its normal shift from 24/48 and doesn’t routinely use tiered deployments, it does employ a handful of nurses and EMTs now, according to DeKalb fire chief Luke Howieson. As of this writing, the department looks like it has the qualified candidates it needs to finish staffing Fire Station Four this year.
Bloomington and DeKalb fire departments both have shifted into more proactive roles in addressing medical emergency call volume. Bloomington prioritizes prevention of falls as well as prevention of fires. For its part, DeKalb has expanded outreach in partnering with social service providers to address mobility, accessibility, and behavioral issues often underlying calls for medical help. These activities reflect the recognition that follow-up to an emergency call often provides that proverbial ounce of prevention — and who’s better positioned to initiate it than people you already trust with your life.
In the next EMS-related post, we’ll spotlight DeKalb’s Community Paramedicine Program.
More:
Ensuring your EMS workforce will dwindle: a cautionary perspective