Increasing Population and Decreased Funding Puts Strain on Emergency Services

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Correction: In the original post of this article, 911 Center Director Barry Furey’s name was misspelled. 

As Raleigh and Wake County grow, the increasing population puts pressure on the area’s emergency service system. While the system is no where near a crisis point, departments are preparing for and anticipating challenges that come with an expanding community.

According to recent Census numbers, Raleigh’s population has grown by almost 70 percent in the past 10 years – from 276,093 to 403,892. In Wake County, the population stands at about 901,000. That’s 43 percent growth since 2000.

While the state doesn’t regulate how many firefighters, 911 operators or emergency medical technicians are needed per a specific amount of people, there are industry standards each department aims to meet.

The Raleigh-Wake Emergency Communications Center, which fields all 911 calls for 40 agencies in Raleigh and Wake County, strives to answer 90 percent of its calls in 10 seconds or less.

More Calls
Like all departments, the call center has seen a dramatic increase in the number of calls as population boomed during the past decade. According to the 2011 Emergency Communications annual report, the center received 509,171 calls — about 9,000 more calls than in 2010.

According to the 2010 annual report, from 2000 to 2010, when the area saw significant growth, the total amount of public safety dispatches – including fire, EMS and police – increased 33 percent. The biggest change was seen in EMS dispatches, which increased 94 percent from about 40,450 to about 78,600.

Today, the 911 center has 102 employees, 81 of whom work on the call center floor.

The call center has not increased its employee base in recent years, but does hire people twice a year as employees leave.

Twelve-year veteran telecommunicater Robert Heckler responds to emergency calls placed during lunchtime Thursday afternoon. The Call Center is located in the Raleigh Fire Department, Station 26. Photo by Hide Terada.

The city’s proposed budget for next year includes hiring seven more call takers. Center Director Barry Fuery said it is the first time he has been able to increase his staff since 2008.

More Ambulance Rides
To put the increase in EMS dispatches into perspective, Wake County EMS Chief Skip Kirkwood said that for every 1,000 people that move into Wake County per year, his departments typically see an increase of 88 EMS calls.

As the call volume grows, the system’s performance is monitored and more ambulance hours are added to meet the demand.

“Most recently, we have added ambulances in 12-hour increments during daylight hours, because ambulance calls are not distributed linearly throughout the day. They happen more often during working and evening hours, when more of the population is up, out and about,” Kirkwood said in an email.

While the call volume has increased, the number of trained medical professionals has not. Kirkland said the county initiated an advanced practice paramedic program about three years ago, which added 14 full -time employees. Otherwise growth has remained level.

Despite that, Kirkland said the department isn’t in crisis mode. Even at its current level the staff is able to keep up with the demand.

Rather than trying to grow the EMS program, Kirkland said the department’s focus is looking to change how it handles each call so emergencies can be handled more efficiently. He said in the past, people would only call for an ambulance when there was a life-threatening emergency.

Today, people are quick to call for help even when they are capable of driving themselves to the hospital. Changes have been made to treat the patient on site or transport him or her to an urgent care facility rather than a hospital.

Raleigh’s Fire Department
Unlike the EMS system, Raleigh’s 27 fire stations only handle calls within the city, unless a nearby department needs assistance.

Construction will begin this summer on Raleigh’s 28th station and with that will come 15 new firefighters. It is slated to open next spring.

Map Credit: Mike Legeros - http://legeros.com/

Assistant Chief Peter Brock said within the past decade the city has opened at least five new stations to keep up with the increasing population. With 575 firefighters, the total is double what it was 27 years ago when he joined the force, Brock said.

The city will add about 30 firefighters at the end of June when they graduate from the academy. The city’s proposed budget has 12 vacant positions, which will be filled if the budget is adopted as written.

Brock said that there will be some challenges as Raleigh starts to encourage more urban development instead of suburban sprawl.

“The taller the buildings, the more challenging it is for the fire department in the sense of response,” he said. “To get to the 30th floor of a building takes us a couple of extra minutes.”

Brock said there are already plans in place to deal with taller and larger buildings and they are ready to meet that challenge.

Hide Terada / Raleigh Public Record

Kelly Junker, of Raleigh, handles incoming 911 calls Thursday afternoon. Junker has been working at the center for the past two years. Photo by Hide Terada.

Tight Budgets
Just because the county is in a recession doesn’t mean the volume of emergency calls has gone down. In fact, 911 Center Director Barry Furey said he suspects that the recession, and the subsequent loss in many residents’ health insurance, may have played a role in the upswing, adding that in a better economy, residents may have handled things differently.

But the recession has meant flat budgets.

On the county side, Kirkwood said the EMS budget has only increased slightly during the past few years.

“Although it’s not great and it’s certainly not a crisis or anything,” Kirkwood said, “the population has grown, the demand has grown and the size of the emergency medical services has not grown.”

But Kirkwood doesn’t see it becoming a problem any time soon, because the department continues to receive increased funding when it’s needed.

One of the major challenges for the emergency call center, Furey said, isn’t the budget, but the need for more space. The call center has been located in city hall since the 1970s and it is quickly outgrowing its cramped quarters.

“It was not designed to be a 911 center,” he said.

In February, city officials approved going forward with a plan to build a new emergency services headquarters that will house, among other things, a new emergency call center.

This booklet, The National Academy – EMD (Emergency Medical Dispatch), is given to every emergency operator at the Call Center. It guides operators on how to get more information from callers and how to handle situations as crews arrive on scene. Photo by Hide Terada.

The emergency call center is also highly dependent on technology. With that dependency comes an added cost.

Furey said a lot of the center’s equipment is reaching the end of its lifecycle and is due for an upgrade. 911 systems are also changing to include video and text messaging. New system upgrades would be required to handle those kinds of calls.

As for the fire department, Brock said that doing more with less is a common theme around the country these days and they are no different. Departments have been trying to save money by keeping the air conditioners higher in the summer and the heat lower in the winter, along with collecting rain water for washing trucks and other emergency vehicles.

This year’s city budget included $4.2 million for a new ladder truck and fire station maintenance.

Overall, Brock said he is happy with the money the city is setting aside for fire services.

“A lot of fire departments have closed,” Brock said of the recession’s effects. “We are very fortunate that we don’t have to do that.”

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