Community Risk Assessment and Standards of Cover
Community Risk Assessment and Standards of Cover
Community Risk Assessment and Standards of Cover
2022
Community Risk Assessment and Standards of Cover
www.fitchassoc.com
CCFEMS Standards of Cover 2022 Introduction
INTRODUCTION
The following document functions as Charlotte County Fire and Emergency Medical Services (CCFEMS) All-
Hazard Community Risk Assessment and Standards of Cover statement. The Commission on Fire Accreditation
International (CFAI) defines the process, known as “deployment analysis,” as a written procedure which
determines the distribution and concentration of fixed and mobile resources of an organization. The purpose of
completing such a document is to assist the Department in ensuring a safe and effective response force for fire
suppression, emergency medical services (EMS), hazardous materials incidents, and technical rescues, and in
facilitating activities for domestic preparedness, emergency planning, and disaster response.
Creating a Standards of Cover (SOC) document requires the research, study, and evaluation of a considerable
array of community features. The following report will begin with a descriptive overview of CCFEMS and the
area that it serves. Following this overview, an all-hazards risk assessment provides an analysis of potential risks
and describes activities the Department employs to mitigate those risks. Current deployment and performance
were assessed to determine the capabilities and capacities that are available. Benchmark statements and baseline
performance support CCFEMS ability to meet distribution and concentration metrics. The report concludes with
plans for maintaining and improving capabilities, as well as policy recommendations to address gaps in
performance or desired outcomes.
Charlotte County Fire and Emergency Medical Services would like to thank all members for their continued
dedication to the citizens, visitors and for the commitment to continuous improvement embodied by the
accreditation process.
TABLE OF CONTENTS
Introduction ................................................................................................................................................. 2
Section F - Current Deployment and Performance at the First Due Station Area ............................ 134
First Due Station Area Analysis ...................................................................................................... 135
EXECUTIVE SUMMARY
Standards of Cover Process
A Fire Departments Standards of Cover (SOC) document is defined by the Commission on Fire Accreditation
International (CFAI) as the “adopted written policies and procedures that determine the distribution,
concentration, and reliability of fixed and mobile response forces for fire, emergency medical services, hazardous
materials and other technical types of responses.” For the elected body and department administrators to have
confidence that their department is meeting the needs of the community, a complete assessment of the risks must
be honestly undertaken. Only after the application of a proven and consistent risk assessment model is made can
a Fire/EMS Department develop a SOC performance contract.
It is the responsibility of the Department's decision makers to provide an educated calculation of the expected risk,
what resources are available to respond to that risk, and what outcomes can be expected. All of these factors play
a role in providing the community’s emergency services. It is best practice that communities set response
standards based on the identified risks within their jurisdictions. Departments that do not apply a valid risk
assessment model to their community are not able to adequately educate their community leaders on their true
needs. The application of a tested risk assessment model allows the Department and elected officials to make
educated decisions about the level of emergency service they desire.
Section A- Documentation of Area Characteristics
Charlotte County Fire and Emergency Medical Services operates from 19 stations across the 693 square miles of
the county, which has a population of nearly 200,000 residents. Charlotte County is ideally situated on Southwest
Florida’s Gulf Coast.
Charlotte County’s 693 square miles include 165 miles of canals, 219 miles of shoreline, 70 parks and recreation
areas, and 12.5 miles of Gulf Coast beaches. Amenities include shopping/dining in downtown Punta Gorda or
Port Charlotte, spring baseball at Charlotte Sports Park (Tampa Rays), and multiple shopping venues throughout
the county. Punta Gorda Airport is located centrally within the county allowing for travel versatility. Outdoor
activities include over 4,000 acres of environmental parks and preserves to explore, kayak, and enjoy.
Section B- Description of Agency Programs and Services
Charlotte County comprises the Punta Gorda, FL, Metropolitan Statistical Area, which is included in the North
Port-Sarasota, FL, Combined Statistical Area. Charlotte County Fire and EMS (CCFEMS) is a combined fire and
ALS transport agency. CCFEMS serves a full-time population of nearly 200,000 and protects an area of 693 sq.
miles of land and 129 sq. miles of water from 14 Fire Rescue stations and 5 EMS only stations. CCFEMS ran
over 35,000 calls for service in 2021.
CCFEMS is a growing department and offers many opportunities for professional development and career
advancement. Along with fire suppression and ALS transport, CCFEMS offers multiple specialties to better serve
the community. Specialties include Marine Operations, Special Operations (hazmat, confined space, high angle
rescue, trench rescue, and structural collapse), ARFF (Airport Rescue Firefighting), SWAT Medic, and Paramedic
Field Trainer. Charlotte County Fire & Rescue is a part of Charlotte County Public Safety. Other public safety
departments include Emergency Management, Animal Control, and Radio Management.
Legal Basis
Charlotte County Population Density by Response Zone Charlotte County Fire and EMS Population Density by Sq. Mile
1
https://www.census.gov/quickfacts/charlottecountyflorida
Geography
Florida is a geologically young, low-lying
plain, mostly less than 100 feet (30 meters)
above sea level. The highest point is near the
Alabama border in Walton County, a mere
345 feet (105 meters) above sea level.
Sedimentary deposits of sand and limestone
cover most of the state, with areas of peat and
muck marking locations where freshwater
bodies once stood. The contemporary
topography has been largely molded by
running water, waves, ocean currents,
winds, changes in sea level, and the wearing
away of limestone rocks by solution.
Topography
Performance Indicator 2A.6
The topography is coastal lowlands which occupy roughly three- The agency utilizes its adopted planning zone
fourths of the surface and vary in width from about 10 to 100 miles (16 methodology to identify response area
to 160 km). Generally, the region is exceedingly flat and is often less characteristics such as population, transportation
systems, area land use, topography, geography,
than 25 feet (8 meters) above sea level. geology, physiography, climate, hazards, risks,
and service provision capability demands.
Florida Topography
Charlotte County is prone to thunderstorms during the summer and flooding amid heavy rainfall. August is the
month that typically brings the most rainfall, averaging 7.8 inches, while November is the driest month, averaging
6.6 inches of precipitation. The average annual rainfall per year is 25.98 inches.
Physiography/Disaster Potentials
Charlotte County is vulnerable to natural hazards of fires, thunderstorms, floods, droughts, tornadoes, hurricanes,
and various weather events. The county-wide risk index is a useful guide but cannot predict the probability of all
events with 100% accuracy, as evidenced by Hurricane Charlie that occurred in 2004 along the length of the
county. A snapshot of the overall hazard probability is referenced in the table below. These specific hazards are
discussed in detail in the Community Characteristics of Risk section.
Potential
Growth by
Response Zone
Household Size
Household size is another socioeconomic factor, with more densely populated and inhabited areas often posing
more life safety risks during certain types of emergencies.
7
U.S. Census. (2020). Quick Facts for Charlotte County, Fl. Retrieved from https://www.census.gov/quickfacts/charlottecountyflorida
Human-Made Characteristics
Development
Charlotte County’s general policy plan has established several goals for land use through the 2050 Comprehensive
Plan because it coordinates the central themes and information found in all of the plan's elements. Also, the Future
Land Use (FLU) Data and Analysis outlines the citizens' vision for the County's future and how we intend to get
there. The goals, objectives, and policies of all of the elements are meant to support the vision.
The purpose of the FLU Element is to define areas within Charlotte County that are suitable for various land use
activities up to the year 2030. The FLU Element decrees where, when, and at what intensity development will
occur, thereby indicating where infrastructure and services are needed.
The FLU Element establishes all the types and locations of land uses allowed in the County and the policies to
guide those land uses. "Future land use" is different from "zoning." Future land use designations establish general
ranges of uses that are permitted in each district, while zoning districts include a specific list of permitted uses.
Future land use designations also establish a range of densities (amount of residential
development per acre) and intensities (amount of non-residential development per acre) for each land use
category, but do not guarantee that the maximum amount of development allowed within the district will be
permitted on a specific site.
Map of Charlotte County, FL Future Land Use
Future Land Use | Charlotte County, FL (charlottecountyfl.gov) cc-future-land-use-2050.pdf (charlottecountyfl.gov)
Infrastructure
Mission
The mission of Charlotte County Transit Division (CCT) is to provide safe, high quality, convenient, efficient,
and affordable transportation to the public in Charlotte County.
Service Hours
Monday-Friday: 6:30 a.m.-5 p.m.
Saturday: 9 a.m.- 5 p.m. *restricted to a limited-service area.
https://www.charlottecountyfl.gov/core/fileparse.php/376/urlt/09-TRA-GOP.pdf
Organizational Overview
Service Delivery Programs
Organizational Overview
Charlotte County Fire and Emergency Medical Services provides high quality fire suppression, emergency
medical, technical rescue, and hazardous materials services from 19 fire stations. Additionally, the organization
delivers a full spectrum of fire and life safety services supported by administrative staff and training officers to
ensure the first responders are well prepared for any hazard or situation they may face.
Human Resources
The Department’s organizational structure reflects a fairly typical, paramilitary organization. The Administrative
Staff is comprised of 9 senior personnel, including the Director of Public Safety, 3 Deputy Chiefs, a Fire Marshal,
Emergency Management Director, Vehicle Equipment Coordinator, Division Manager of Animal Control, and a
Radio Communication Manager.
Organizational Overview
Station 1
3631 Tamiami Trail,
Port Charlotte, FL 33952
Station 2
1493 Collingswood Blvd.
Port Charlotte, FL 33948
Station 3
4322 El Jobean Road
Port Charlotte, FL 33953
Station 4
13600 Marathon Blvd.
Gulf Cove, FL 33981
Station 5
26287 Notre Dame Blvd.
Punta Gorda, FL 33955
Station 6
27589 Disston Ave.
Punta Gorda, FL 33982
Station 7
27437 Mooney St.
Punta Gorda, FL 33982
Station 8
21500 Clinton Ave.,
Port Charlotte, FL 33954
Station 9
42915 Lake Babcock Dr,
Punta Gorda, FL.
Station 10
71 Gasparilla Way
Englewood, FL 34224
Station 11
27055 Rushmore Ave., Punta
Gorda, FL 33983
Station 12
2001 Luther Road
Punta Gorda, FL 33983
Station 13
6868 San Casa Road,
Englewood, FL 34224
Station 14
9495 Placida Road
Placida, FL 33946
Station 15
13190 Eisenhower Drive
Port Charlotte, FL 33953
Station 16
29400 Palm Shores Blvd.
Punta Gorda, FL 33982
Rescue 31
City of Punta Gorda Station 3
1623 Aqui Esta Drive,
Punta Gorda, FL 33950
Rescue 32
City of Punta Gorda Station 1
1410 Tamiami Trail
Punta Gorda, FL 33950
Physical Resources-Apparatus
Battalion Chief
There is a Battalion Chief on duty each shift. In
addition to emergency responses and personnel
management, they also supervise many non-
emergency programs.
Engine
A piece of fire apparatus that carries water, medical
equipment and tools to the scene of an emergency.
The primary function of this crew at fires is to
establish a water supply, search for people in the
interior of a structure and apply water with hose lines
to extinguish the fire.
Squad
This apparatus carries various tools and accessories
needed for Special Operations. The apparatus
responds from Station 12.
Ambulance
Ambulances contain the equipment needed to stabilize
and provide ALS services to someone who is ill or
injured and to get them to hospital. The equipment
includes stretchers, defibrillators, spine boards,
oxygen and oxygen masks, cervical (neck) collars,
splints, bandages and a range of drugs and intravenous
fluids.
Tanker
A piece of fire apparatus that carries water, medical
equipment and tools to the scene of an emergency. The
primary function of this crew at fires is to provide a
mobile water supply.
Special Operations Command (SOCOM) works closely with Operations and Training to coordinate the oversight
of 78 specialty trained personnel within CCFEMS Medicine, Airport Rescue Firefighting (ARFF) and all
associated disciplines that fall within those functions.
In addition to these day-to-day operational activities, SOCOM is also responsible for the management and
coordination of the state supported Regional TRT Type II Team (II-634) and Regional Hazardous Materials Team
(HM6-D). The Department also provides support to other regional agencies by way of mutual and automatic aid.
Further, we are available to assist the state through outside of region deployments and support for the Type II
Urban Search and Rescue Team Florida Task Force 6 (FL-TF-6).
SOCOM also assists in coordinating and managing special events by acting as a liaison for public safety with all
agencies the county may work with on special projects and events.
The amount of training that SOCOM teams engage in is quite impressive. The teams stay prepared through
continuous intensive training and drills. The teams also stay proficient by training the rest of the department on
vital skills that will prepare others in the event they arrive on scene before the specialty team. Furthermore, the
team participates in drills with other local agencies and specialized teams. All while still performing the training,
duties, and emergency response of a standard fire station.
There are five fire stations within Charlotte County that are responsible for not only daily fire and EMS response
but also specialty response and mitigation of technical/specialty rescue situations for the entire county. These
stations are supported by an array of apparatus, including ARFF Trucks, Engines, Rescues, Specialty Trucks,
Marine Nautical Units, Command Units, and a Ladder Truck.
Charlotte County Fire and Emergency Medical Services holds its employees to high standards. These standards
lead to exceptionally well-trained professionals responding to specialized rescue incidents throughout the county.
Special Operations
The CCFEMS Special Operations Team was established in 1999 to respond to and mitigate hazardous material
and specialty rescue incidents. The team is trained in many disciplines to provide specialty responses to those
incidents outside of normal day-to-day fire and medical incidents. These specialty functions include hazardous
materials response, rope rescue, confined space rescue, trench rescue, structural collapse/emergency shoring, and
heavy vehicle/machinery extrication. There are 25 full-time members across all three shifts who continually train
to keep Charlotte County safe in the most ominous of circumstances.
Human-made Hazards
matrix. Where these risks are located on the matrix has a direct impact The agency has a documented and adopted
on how resources are located around the jurisdiction (distribution) and methodology for identifying, assessing,
categorizing and classifying all risks (fire and
the overall number of resources required to mitigate the incident non-fire) throughout the community or area of
(concentration) effectively through the use of the staffing and responsibility.
deployment model.
Each of the major natural and human-made risks evaluated received a
clearly defined probability and consequence ranking. Service areas that Core Competency 2B.4
either had little quantitative data or did not require that level of analysis
The agency’s risk identification, analysis,
were evaluated through both retrospective analysis as well as structured categorization, and classification method-
interviews with Department staff members. ology has been utilized to determine and
document the different categories and
“Call Type” variable entries from the 2017-2021 data file from classes of risks within each planning
zone.
CCFEMS were classified into the program areas of EMS, fire, hazmat,
rescue, and aviation based on departmental leadership decisions, and records were additionally assigned a risk
classification based on departmental leadership criteria depending upon available data. Risk classifications were
assigned based on the determinant, when available, and based on critical tasking when the determinant was not
the primary filter.
MPDS Determinant Risk Classification
Determinant Risk
Classification
A Low
B Moderate
C Moderate
D High
E High
Below is the first due zone ratings for CCFEMS, indicating the stations that have low, moderate, high and
maximum risk based on the following factors:
• Population density
• Median household income
• Unemployment rate
• Square miles
• Median age
• Percentage of homes greater than 50 years old
• Number of moderate/high-risk occupancies
• Community demand
• Call concurrency rate
Natural Hazards
• Coastal Erosion Hazard Events for Charlotte County
• Flood
• Severe Weather
• Contagious
Diseases
• Wildfire
Human-made Risk
Hazards
• Airport
• Passenger and
Freight Rail Lines
• Road Networks
• Fires
• EMS
• Hazardous
Materials
• Technical
Rescue
The County boundaries are not expected to change significantly other than through mergers or regional
consolidation efforts. From this perspective, increases in population density may only serve to eventually require
a greater concentration of resources to meet the demand rather than expanding the distribution model. In other
words, if the County does not anticipate creating a larger geographic coverage area through annexations, the likely
result of population growth will require additional resources within the existing distribution model rather than by
expanding the number of stations.
Low Risk
Low Probability Construction Limitations
Low Consequence
The future land use map demonstrates that limitations have been accounted for, and that generally new growth is
occurring at a moderate rate within the County.
High Risk
High Probability Topography – Response Barriers
High Consequence
Primarily response barriers are associated with interaction with coastal areas, water ways, and barrier islands that
may be inhibited during secondary events such as severe weather, flooding, and storm surge. Much of the County
is low-lying coastal area with an elevation ranging from 3-10 feet above sea level.
Moderate Risk
Low Probability
Critical Infrastructure and Facilities
High Consequence
Failure of critical public or private utility infrastructure can result in a temporary loss of essential functions and/or
services that last from just a few minutes to days or more at a time. Public and private utility infrastructure
provides essential life supporting services such as electric power, natural gas, heating and air conditioning, water,
sewage disposal and treatment, storm drainage, communications, and transportation.
Moderate Risk
Low Probability Electrical Power Grid
High Consequence
The County falls within the Florida Power and Light (FPL) Service area but could be impacted by surrounding
electrical services provided by the Lee County Electric Cooperative. FPL maintains a better than 99% service
electrical service reliability. Charlotte County, FL: 2 Electric Providers (findenergy.com)
FPL Service Area
Moderate Risk
Low Probability Water Systems
High Consequence
Charlotte County Water Distribution and Treatment Plants
Low Risk
Low Probability
Rural Interface
Low Consequence
Wild, or undeveloped, lands and any surrounding urban areas (WUI - wildland urban interface) are most at risk
of fires. Potential risks include the destruction of land, property, and structures as well as injuries and loss of life.
Although rare, deaths and injuries usually occur at the beginning stages of wildfires when sudden flare-ups occur
from high wind conditions. In most situations, however, people have the opportunity to evacuate the area and
avoid bodily harm. Financial losses related to wildfires include destroyed or damaged houses, private facilities
and equipment, loss of commercial timber supplies, and local and state costs for response and recovery. An
assessment of the rural interface risk is provided below.
High Risk
High Probability Flooding Event
High Consequence
Floods are the most common natural disaster, damaging public health and safety, as well as economic prosperity.
Between 1980 and 2013, the United States suffered more than $260 billion in flood-related damages, according
to FEMA. Storm surges, heavy downpours, extensive development, and even sea-level rise in coastal areas can
increase the risk of flooding.
Charlotte is a coastal county making it more vulnerable to the storms that come from the Gulf. This includes
tropical cyclones and high-wind events. Damage from high winds, storm surge, and rain-induced flooding can
impact all structures and utilities. The structures most susceptible to damage are older buildings, dilapidated
housing, and other less hardened properties such as mobile homes. Widespread electrical outage is probable, as
well as water and sewage backup in flooded areas. Depending on the intensity of the event, economic and
environmental impacts can be severe. All populations may be impacted by these events, but those at highest risk
are the elderly, the disabled, lower income, and the homeless. Charlotte County has 47,961 homes built before the
code change in 1992 and 11,848 mobile homes. This would make 60% of the homes in Charlotte County
vulnerable to tropical cyclones.
Figure 9: Charlotte County Flood Zone Map5
https://www.charlottecountyfl.gov/core/fileparse.php/152/urlt/evacuation-zones.pdf
High Risk
High Probability Severe Weather
High Consequence
Moderate Risk
High Probability Lightning/Thunderstorms
Low Consequence
Lightning
Lightning occurs with every thunderstorm, and, on average, Florida sees around 70-100 days a year with at least
one thunderstorm in the state. Because of Florida's vulnerability to thunderstorms and lightning, lightning is one
of the deadliest weather hazards in the Sunshine State. In the United States, there are an estimated 25 million
lightning flashes each year. In an average year, Florida sees around 1.4 million lightning strikes. This makes
Florida the "Lightning Capital of the United States."
Thunderstorms
Of the estimated
100,000 thunderstorms
that occur each year in
the United States,
about 10% are
classified as severe.
The National Weather
Service considers a
thunderstorm severe if
it produces hail the size
of a U.S. quarter or
larger or winds of 58
mph or stronger.
Severe thunderstorms
are known to cause
significant damage to
well-built structures or
cause bodily harm.
These strong storms
can also produce frequent and dangerous lightning, flooding, and tornadoes. On average, the interior sections of
central Florida receive the most thunderstorms, with nearly 100 plus days per year. However, thunderstorms are
also frequent along coastal areas, which average 80 to 90 days per year.
High Risk
High Probability Hurricanes
High Consequence
Hurricanes are among nature's most powerful and destructive phenomena. On average, 12 tropical storms, 6 of
which become hurricanes, form over the Atlantic Ocean, Caribbean Sea, or Gulf of Mexico during the hurricane
season which runs from June 1 to November 30 each year. Over a typical 2-year period, the U.S. coastline is struck
by an average of three (3) hurricanes, one of which is classified as a major hurricane (winds of 111 mph or greater).
The dangers associated with hurricanes are vast and listed below:
• STORM SURGE - A hurricane can produce a destructive storm surge, which is water that is pushed toward
the shore by the force of the winds. This advancing surge combines with the normal tides to inundate normally
dry land in feet of water. The stronger the storm, the higher the storm surge.
• INLAND FLOODING - In the last 30 years, inland flooding has been responsible for more than half the deaths
associated with tropical cyclones in the United States.
• HIGH WINDS - Hurricane-force winds can destroy poorly constructed buildings and mobile homes.
Debris such as signs, roofing material, and small items left outside, become flying missiles in hurricanes.
• TORNADOES - Hurricanes can produce tornadoes that add to the storm's destructive power. Tornadoes are
most likely to occur in the right-front quadrant of the hurricane.
Based on historical data from the NCEI Storm Events Database, 9 events were reported between 04/01/2021 and
04/30/2022 (395 days)
High Risk
High Probability Storm Surges
High Consequence
Coastal flooding associated with tropical storms and hurricanes is the result of storm surge, water (not waves)
that is pushed toward the shore by the force of the storm winds. Storm surge inundation zone data is available
from two sources: (1) SLOSH surge maps are developed in conjunction with the preparation of regional hurricane
evacuation studies, and (2) TAOS surge maps are provided to Florida counties.
These 2 sources use different models for predicting storm surge flooding.
The regional hurricane evacuation study maps are based on the Sea, Lake, and Overland Surges from Hurricanes
(SLOSH) model developed by the National Weather Service. The boundaries of the evacuation zones are based
on the surge zones but modified to facilitate ready identification of zone boundaries.
High Risk
High Probability Tornadoes
High Consequence
Tornadoes in Florida can form in a variety of ways and in all seasons. However, many of Florida's tornadoes occur
in the Spring and Summer months. Summer season tornadoes (June-September) typically occur along strong sea
breeze boundary collisions, as well as from tropical cyclones. Spring season tornadoes (February-May) can be
more powerful and deadly as they are spawned from severe supercells along a squall line ahead of a cold front.
These types of tornadoes are also possible in the Fall and Winter months (October-January). Florida tornado
climatology shows us that strong to violent tornadoes are just as likely to occur after midnight as they are in the
afternoon.
There is no recorded history of a tornado with a classification greater than F2 striking in Charlotte County. Of the
tornado events that have occurred in Charlotte County, 80% of them were F0 tornadoes, and 12% of them were
classified as F1 tornadoes. This means that the majority of the tornado events that occur in Charlotte County are
events that cause only moderate damage. Since tornadoes are unpredictable, this makes Charlotte County
vulnerable to all 6 categories of tornadoes.
https://www.mysuncoast.com/2022/01/16/nws-confirms-tornado-touchdown-charlotte-county/
Maximum Risk
Low Probability Contagious and Communicable Diseases
High Consequence
Contagious Disease
The Florida Department of Health in Charlotte County (DOH-Charlotte) is one of 67 Public Health Departments
under the governance of the integrated Florida Department of Health (DOH). Although DOH- Charlotte is a state
agency, it maintains a very strong partnership with Charlotte County Government. DOH- Charlotte is organized
into a number of program areas that focus on the surveillance, prevention, detection and treatment of the most
significant health and environmental issues within the county. The major services provided by DOH-Charlotte
include Infectious Disease Services, which provides for HIV/AIDS Surveillance, Prevention and Patient Care,
Sexually Transmitted Diseases (STD), Tuberculosis Control (TB), Epidemiology and Disease Control, Rabies
Control and Hepatitis. Most notably, these efforts have included the surveillance and response to the COVID-19
pandemic.
To ensure the health and safety of the community, when a contagious disease is confirmed in a place where people
are in close contact (such as schools, daycares, and nursing homes), DOH-Charlotte follows up with the people
who might be exposed to the disease as a result.
Thanks to vaccines, medical COVID-19 Cases and Deaths in Charlotte County
care, clean water, and safe
food sources and handling,
deadly diseases are rarer in the
County than ever before.
However, the County has not
avoided the impact of the
COVID-19 pandemic. As of
August 2022, Charlotte
County had recorded more
than 397 cases of COVID-19
and 11 deaths. New diseases
also pose a threat, as they can
develop and spread rapidly.
Chronic Disease
Chronic diseases, including
heart disease, stroke, cancer,
and diabetes, rank among the
most common, costly, and
preventable of all health
problems throughout the
United States. In 2021,
High Risk
Moderate Probability Wildfires
Moderate Consequence
Each year, thousands of acres of wildland and many homes are destroyed by fires that can erupt at any time of the
year from a variety of causes, including arson, lightning, and debris burning. Adding to the fire hazard is the
growing number of people living in new communities built in areas that were once wildland. This growth places
even greater pressure on the state's wildland firefighters. As a result of this growth, fire protection becomes
everyone's responsibility. Drought conditions and other natural disasters increase the probability of wildfires by
producing fuel in both urban and rural settings.
Wildfires are nature’s way of managing wild plant life and regenerating growth, but they also can be the result of
other factors. Wildfires can be caused by lightning, campfires, uncontrolled burns, smoking, vehicles, trains,
equipment use, and arsonists. People start more than four out of every five wildfires, usually as debris burns,
arson, or carelessness. Lightning strikes are the next leading cause of wildfires (FEMA).
Wildfire behavior is based on three primary factors: fuel, topography, and weather. The type and amount of fuel,
as well as its burning qualities and level of moisture affect wildfire potential and behavior. The continuity of fuels,
expressed in both horizontal and vertical components, is also a factor in that it expresses the pattern of vegetative
growth and open areas. Topography is important because it affects the movement of air (and thus the fire) over
the ground surface. The slope and terrain can change the rate of speed at which fire travels. Weather affects the
probability of wildfire and has a significant effect on its behavior. Temperature, humidity, and wind (both short
and long-term) affect the severity and duration of wildfires (FEMA guidebook).
According to the Florida Forest Service, there has been a total of 8 wild/forest fire events officially reported in
Charlotte County since 2019. These events resulted in no deaths and 1 injury. However, they did burn over 2,500
acres with over $250,000 in property damage.
Charlotte County Wildfire 2022
FFS
Myakka on Twitter: "130 acres 30%, Wildfire is now on the ##MyakkaRiverForest. Will update https://t.co/lQ9UwkIAv8" / Twitter
Moderate Risk
High Probability Population Growth
Low Consequence
Population Density by
Jurisdictional Zones
Population Density by
Square Mile
Population Density by
Jurisdictional Zones with
Growth Rate
The majority of census block areas in the district have population densities of up to 3,000 people per square
mile, a critical factor to watch as population numbers continue to rise.
These meetings are also used to assess whether the current effective A critical task analysis of each risk
category and risk class has been conducted to
response force (ERF) can perform the critical tasking necessary to
determine first due and effective response
mitigate the hazards associated with each hazard and risk level. The force capabilities and a process is
department uses after-action reviews for structure fires, technical in place to validate and document the
results.
rescues, and hazardous material incidents to evaluate the effectiveness
of first due and initial assignments in achieving incident goals.
The EMS program evaluates hands-on training activities for critical tasking and monitors metrics such as return
of spontaneous circulation (ROSC) to assess the effectiveness of initial assignments for cardiac arrest incidents.
Changes to critical tasking and ERFs are documented in annual updates to the Standards of Cover.
High Risk
High Probability Fire Suppression
High Consequence
Fire suppression is one of the most visible response services that a fire department provides, and at the very core
of our existence. As evidenced by the flashover curve and exacerbated by modern furnishings and construction
methods, fires are an extremely time sensitive emergency.
The agency has classified the risk of fires into 4 main categories: low, moderate, high, and maximum. These
rankings are applied to individual occupancies and to areas of like-type buildings.
Recent studies by Underwriter’s Laboratories (UL) have found that in compartment fires such as structure fires,
flashover occurs within four minutes in modern fire environment. In addition, the UL research has identified an
updated time temperature curve due to fires being ventilation-controlled rather than fuel- controlled as represented
in the traditional time temperature curve. While this ventilation-controlled environment continues to provide a
high risk to unprotected occupants to smoke and high heat, it does provide some advantage to property
conservation efforts, as water may be applied to the fire prior to ventilation and the subsequent flashover.
The distribution and concentration of fire related incidents are provided in the heat map presented below.
Command 2 1 1 1
Driver/Pump 2 1 1 0.5
Safety 1 1 1
Ventilation 1 0.5
Search 4 2
Ladders 2 1
Medical 1 1
ERF Personnel 20 12 5 2
Moderate Risk
High Probability Emergency Medical Services
Low Consequence
Time is a critical element when responding to true medical emergencies, with the chance of survival for a cardiac
arrest dropping precipitously with every passing minute.
The potential survival rate for cardiac arrests, which is one of the most serious medical emergencies an individual
can experience, is only about 50% by the time a fire apparatus leaves the station, making prevention efforts a
crucial piece of achieving positive patient outcomes.
When evaluating the steady rise in emergency medical calls over the last few decades, it is readily apparent that
the workload demand for these calls will continue to rise. The agency is actively collaborating with community
partners to reduce or eliminate many of the lower risk/severity calls for help by channeling the patient into a more
appropriate method of care.
The distribution and concentration of EMS related incidents are provided in the heat map presented below.
Triage/Treatment 2 2 2 1
Transport 1 1 1 1
Command 1 1
Medical Branch 1
Leader
RTF 3
ERF Personnel 8 4 3 2
Critical tasks that are shared by a single person, or transient, are identified as half positions.
Maximum Risk
Low Probability Hazardous Materials
High Consequence
The potential release of hazardous materials exists wherever that material may be located. A higher potential for
release coincides with storage sites at fixed facilities and along transportation routes, such as major roadways and
rail lines. Hazardous materials are chemical substances which, if released or misused, can pose a threat to people,
property, or the environment. These chemicals are used in industry, agriculture, medicine, research, and consumer
goods.
As many as 500,000 products pose physical or health hazards and can be defined as "hazardous chemicals." Each
year, over 1,000 new synthetic chemicals are introduced. Hazardous materials come in the form of explosives,
flammable and combustible substances, poisons, and radioactive materials. These substances are most often
released as a result of transportation accidents or because of chemical accidents in manufacturing plants.
Hazardous materials are contained and used at fixed sites and are shipped by all modes of transportation, including
transmission pipelines.
Maximum Risk
Technical Rescue
Low Probability
Collapse, Confined Space, High Angle, Trench, Water Rescue
High Consequence
Technical rescue is a relatively broad term and includes responses to a wide variety of incidents such as water
rescue, confined space rescue, high angle rescues, and structural collapse. Similar to the analyses for hazardous
materials, the demand for technical rescue services is low in relation to fire or EMS calls within the service area.
Command 1 1 1 1
Mitigation Team 6 6 4 2
Suppression Line 1 1 1
Safety 1 1
Operations 1 1
Medical 2 2
Support 4 4
Technician 3
ERF Personnel 19 16 6 3
The distribution and concentration of mutual-aid incidents are provided in the heat map presented below.
Maximum Risk
Low Probability Aviation
High Consequence
The Charlotte County Airport Authority (CCAA), governed by five elected commissioners, owns and operates the
Punta Gorda Airport (PGD), located at 28000 Airport Road, five minutes off I-75, exits 161 and 164. PGD
provides quick and easy access to Southwest Florida and is home to commercial air service, air charters, medical
transport services, aircraft maintenance and avionics repair, as well as flight schools, distributors, and
manufacturers.
A 2018 economic impact study by the FDOT estimated that PGD is responsible for 12,392 jobs and $1.275 billion
in total economic output. In 2021, nearly 1,600,000 passengers utilized the Punta Gorda Airport.
Between January 1, 2022, and October 31, 2022, the overall passenger utilization has seen a greater than 40%
increase in patrons.
Strategic Plan
A strategic plan, on paper, is a commitment to action. A commitment to action
requires an execution strategy. CCFEMS does this by including the
development of specific, measurable, attainable, relevant, and time-bound
goals in the strategic plan. The goals are grouped into five functional areas
including Community Risk Reduction, Administration, Training, Operations,
Logistics. Included are Desired Outcomes, and yearly strategies to accomplish.
Projected Growth
Number Call
Program Calls per Day Performance Indicator 2B.2
of Calls Percentage
The historical emergency and nonemergency
EMS 31,214 85.5 88.6 service demands frequency for a minimum of
three immediately
Fire 3,851 10.6 10.9 previous years and the future probability of
emergency and nonemergency service
Airport 66 0.2 0.2 demands, by service type, have been
Hazmat 30 0.1 0.1 identified and documented by planning zone.
Community Response
History Discussion
CCFEMS answers approximately
35,224 emergency calls per year,
with a fairly even dispersion with
regards to type of call and month or
year. Sundays are the lowest call
volume day for fires, EMS, and
other calls.
Distribution –
Rank Station Travel Time Station Capture Total Capture Percent Capture
Percent of Incidents 1 S01 6 6,711 6,711 19.05%
Captured by Station 2 R32 6 3,230 9,941 28.22%
3 S12 6 2,673 12,614 35.81%
4 S02 6 2,588 15,202 43.16%
5 S13 6 1,544 16,746 47.54%
6 S08 6 1,517 18,263 51.85%
7 S07 6 794 19,057 54.10%
8 S05 6 718 19,775 56.14%
9 S04 6 710 20,485 58.16%
10 S06 6 421 20,906 59.35%
11 R31 6 403 21,309 60.50%
12 S11 6 394 21,703 61.61%
13 S03 6 363 22,066 62.64%
14 S14 6 234 22,300 63.31%
15 S16 6 208 22,508 63.90%
16 S09 6 129 22,637 64.27%
17 S15 6 111 22,748 64.58%
18 S10 6 6 22,754 64.60%
Overlapped calls are defined as the rate at which another call was received for the same first due zone while there
were one or more ongoing calls in the same first due zone. For example, if there is one call in station 1’s zone,
before the call was cleared, another request in station 1’s zone occurred, then the second call would be captured
as an overlapped call. If there is a long structure fire call ongoing, all calls occurred after the structure fire started,
but before the structure fire call was cleared would be counted as overlapped calls. Understanding the probability
of overlapped calls occurring will help to determine the number of units to staff for each station. In general, the
larger the call volume a first due zone has, it is more likely to have overlapped or simultaneous calls. The
distribution of the demand throughout the day will impact the chance of having overlapped or simultaneous calls.
The duration of a call will also have major influence, since the longer time it takes to clear a request, the more
likely to have an overlapped request.
Station 1 has the most demand, and the duration of calls lasted at 35 minutes, thus it has the highest probability of
having overlapped calls at 48.9%. This means that during the period of an active station 1 call, there is a 48.9%
chance that another incident in station 1 will occur. Calls in EFD and ST02 had the second and third highest
probability of overlapped calls occurring since they had the 2nd and 3rd most call volume. Results are presented
below.
Probability of Duration
First Due Overlapped Total Overlapped Calls
Calls (Minutes)
Station Calls Occurring
ST01 4,117 8,413 48.9% 35.0
EFD 1,598 4,524 35.3% 43.0
ST02 1,346 4,243 31.7% 36.9
PGFD 937 3,320 28.2% 38.4
ST12 769 3,093 24.9% 40.4
ST08 433 2,362 18.3% 35.6
ST05 272 1,596 17.0% 47.3
ST07 336 2,221 15.1% 31.8
ST04 171 1,278 13.4% 44.0
ST11 85 971 8.8% 41.4
ST03 74 850 8.7% 43.0
ST09 37 523 7.1% 53.2
ST06 57 854 6.7% 39.1
ST15 28 462 6.1% 41.1
ST10 2 51 3.9% 45.7
ST16 14 401 3.5% 44.2
Grand 10,276 35,162 29.2% 38.7
Total
Another method of assessing the effectiveness of the distribution model is to analyze the demand for services
across the distribution model. Workload is assessed at the station demand zone level and at the individual unit
level.
Analyses illustrate that Station Demand Zones ST01, ST02 and ST12 each accounted for 25.5%, 13.7% and 9.4%
of the total requests for services. Collectively these three demand zones accounted for 48.5% of the department’s
total workload.
Airport 1 4 1 12 32 15 1 0 0 66
Hazmat 0 4 11 2 1 5 5 1 1 30
Rescue 2 6 24 1 2 11 9 5 3 63
Percentage 52.0% 33.5% 0.6% 10.2% 2.4% 0.7% 0.2% 0.2% 0.1%
100%
Avg Busy
Station Minutes per Total Busy Number of
Run Hours Runs
10 26.2 25 58
16 90.9 35 23
15 44.5 5 7
recommends that 24-hour units do not surpass 2 EN02 682 0.08 0.30
Event Outcomes
Outcome measures tell us if our ultimate goals of public safety have Performance Indicator 2B.3
been reached by documenting changes in fire, EMS, hazmat, Event outputs and outcomes are assessed
technical rescue, or community risk reduction efforts. As this is for three (initial accrediting agencies) to
five (currently accredited agencies)
CCFEMS’s first formal immediately previous years.
EMS
Many factors contribute to the survival of out-of-hospital
cardiac arrest including EMS response time, experience/
case volume of the paramedic, layperson CPR, age/health
Technical Rescue
of patient, type of rhythm encountered, etc. However, one
outcome has generally been accepted as a positive Much like hazardous materials incidents,
fortunately, technical rescue incidents are rare as
marker of EMS system performance; Return of Sponta-
neous Circulation (ROSC). Global rates of ROSC for out of compared to EMS or Fire calls, but usually
hospital arrests hover just under 30%. people’s lives are on the line during these low
frequency, high-risk events.
Hazmat
Fortunately, hazardous materials incidents are generally a Community Risk Reduction
relatively rare occurrence, although when they do occur, There is not a single CRR measure that defines
the impacts can be devastating to not only the people program success, but the number and severity of
involved but the environment as well. CCFEMS re- fires (including dollar loss as measured above in
sponded to 778 hazardous materials events over the last the Fire outcome area), and injuries or deaths are
year. CCFEMS is currently analyzing the gallons of the ultimate outcomes of a program. CCFEMS is
product that were successfully stopped from exiting their actively analyzing several measures for code
containers or entering storm drains. compliance, FLS Education, plan review, and fire
investigation programs from page 8-9 from the
Outcome guide.
Baseline Statements
For low-risk fires, the
90th percentile of total
response time for the
arrival of the first due
unit, staffed with a
minimum of two
firefighters, was 13
minutes and 35 seconds
(urban) and 17 minutes
and 23 seconds (rural).
The first due unit is
capable of establishing
command, sizing up the
incident, utilizing
appropriate tactics in accordance with standard operating guidelines, developing an initial action plan, extending
an appropriate hose line, and beginning an initial fire attack or rescue.
Baseline Statements
For high-risk fires, the
90th percentile of total
response time for the
arrival of the effective
response force, consisting
of 12 personnel (6 units),
was 44 minutes and 1
seconds (Urban) and 81
minutes and 54 seconds
(Rural) where the ERF
was assembled. ERF has
the capability to establish
command, provide an
uninterrupted water
supply, advance an attack
line and backup line for fire control, place elevated streams into service, establish a rapid intervention crew,
complete forcible entry and ventilation, conduct primary and secondary searches, control utilities, and perform
salvage and overhaul operations. These critical tasks are done in a safe manner in accordance with department
standard operating guidelines.
For maximum-risk fires,
the 90th percentile of total
response time for the
arrival of the Effective
Response Force,
consisting of 20 personnel
(11 units), was not
statistically relevant due a
sample size of less than 10
where the ERF was
assembled. The ERF has
the capability to establish
command, provide an
uninterrupted water
supply, advance multiple
attack lines and backup lines for fire control, place elevated streams into service, establish a rapid intervention
crew, complete multiple forcible entry and ventilation procedures, and conduct primary and secondary searches.
These critical tasks are done in a safe manner in accordance with department standard operating guidelines.
Baseline Statements
For low-risk emergency
medical services (EMS)
incidents, the 90th percentile of
total response time for the
arrival of the first due unit,
staffed with a minimum of two
firefighters, was 12 minutes
and 3 seconds. (urban) and 16
minutes and 46 seconds (rural).
The first due unit shall be
capable of establishing
command, sizing up the
incident, conducting an initial
patient assessment, obtaining
vitals and patient medical
history, initiating basic life support measures in accordance with standard operating guidelines and transport to an
appropriate health care facility.
For moderate-risk
hazardous materials
incidents, the 90th
percentile of total response
time for the arrival of the
Effective Response Force,
consisting of nine
personnel (5 units), was 17
minutes and 16 seconds
(urban) and rural was not
statistically measurable.
The units are capable of
establishing command,
sizing up the incident,
developing an incident
action plan in accordance
with standard operating guidelines, isolating the hazard, initiating mitigation efforts - including containment
and/or offloading of common hydrocarbon materials, and calling for additional resources if needed.
For maximum-risk
hazardous materials
incidents, the 90th
percentile of total response
time for the arrival of the
Effective Response Force,
consisting of 19 personnel
(7 units), was 15 minutes
and 8 seconds, but was not
statistically relevant due to
the fact that there was only
one incident occurred
where the ERF was
assembled. The units are
capable of establishing
command, sizing up the incident, developing an incident action plan in accordance with standard operating
guidelines, researching the hazard -including initial monitoring, and calling for appropriate assistance from
both the CCFEMS and outside agencies if needed.
Projected Growth
The available data set included five reporting periods of data, representing FY 2017 - 2021. From FY 2017 to FY
2021, calls for CCFEMS services increased from 30,801 to 35,224, with an average growth rate of 3.6% per year.
The figure below depicts observed call volume during the last five-year reporting periods and various hypothetical
growth scenarios for the next 20 years. These projections should be used with caution due to the variability in
growth observed across prior calendar years. In all cases, data should be reviewed annually to ensure timely
updates to projections and utilize a five-year rolling average.
First Due Station Area - This page contains a basic overview of the first due area
and contains a map which shows the stations in relation to the organization’s
boundaries, units based out of the station with full or cross staffing, and an overall
station risk rating based upon risk, demand, and call concurrency.
3D Risk Assessment - Risk for each first due station area was evaluated by
incident type (fire, EMS, hazmat, and technical rescue) and by demand, call
concurrency, and risk; providing a comprehensive and visual way to ascertain the
risk of certain incident types within the first due station areas. The 3D model
graphically shows the event probability, the consequences to the community, and
the impact on the department.
Response Data - This heat map of incidents shows the historical incident
volume across the first due station area. Five distinct heat maps show
elative frequency and geospatial intensity of the incidents for all calls,
fire, EMS, hazmat, and other (which includes technical rescue).
E1 Engine 3
Station 1 R1 Rescue 2
R10 Rescue 2
BN2 Battalion 1
Station 1 is a high-risk station and staffs four primary units; Engine, two Rescues, plus a Battalion Chief.
Risk Analysis
The risk of individual building locations is represented by the small circles and shaded to indicate risk level.
There are high-risk buildings located throughout the first due station area.
Call Category 2017 2018 2019 2020 2021 Historical Data Analysis
EMS 6,998 7,229 7,251 6,843 7,352 Station 1’s profile
Cardiac and stroke 574 633 604 524 599 demonstrates a predominance
Seizure and unconsciousness 394 356 352 391 444 of EMS responses followed by
Breathing difficulty 509 452 453 306 465 fire suppression.
Overdose and psychiatric 97 38 25 48 58
Specialty teams such as
Accident 252 277 262 231 317
hazardous materials, technical
Fall and injury 1247 1395 1464 1291 1439
Illness and other 1426 1466 1456 1653 1596
rescue, and aviation occur with
Medical No ProQA 791 722 756 784 707
much less frequency.
Interfacility transfer 1708 1890 1879 1615 1727 The year-over-year growth has
Fire 940 948 798 870 1040 varied between a 5% decrease
Structure fire 57 42 51 60 59 and a 9% increase.
Outside fire 31 23 19 30 19
Vehicle fire 15 20 13 13 14
Alarm 211 210 183 212 211
Public service 362 424 366 342 448
Fire other 264 229 166 213 289
Hazmat 2 2 4 8 8
Hazmat 2 2 4 8 8
Rescue 11 11 11 9 13
Rescue 11 11 11 9 13
Airport 0 2 0 1 0
Airport 0 2 0 1 0
Total 7,951 8,192 8,064 7,731 8,413
Average Calls per Day2 21.8 22.4 22.1 21.1 23.0
YoY Growth N/A 3.03% -1.56% -4.39% 9.12%
Reporting Period1
Assigned Station
Unit ID
2017 2018 2019 2020 2021
Alarm Handling 4:09 4:18 4:04 4:03 4:19 4:00 3:37 83.2
Turnout Time 2:18 2:10 2:13 2:19 2:26 2:20 2:13 88.6
Travel Urban 6:06 6:05 6:00 5:45 6:14 6:25 6:41 92.7
Time
Rural 8:15 11:08 6:28 7:01 7:53 9:27 10:43 96.6
10:48 10:49 10:30 10:28 11:04 11:02
Total Urban 10:50 90.1
n= n= n= n= n=
Response n = 38,693
Time 7,526 7,814 7,831 7,419 8,103
Other related calls appear in close proximity to Station 1. Several calls occur in the area of the first due station
area.
Station 1’s area is analyzed by the number of personnel that can assemble within 15 minutes.
E2 Engine 3
Station 2
R2 Rescue 2
TK2 Ladder 2
Station 2 is a high-risk station and is adjacent to Station 1. Station 2 staffs three primary vehicles. The
occupancy level risk analysis below shows the highest concentrations of risk is located in the central part
of Station 2’s first due station area. The buildings are predominantly of moderate risk.
Reporting Period1
Hazmat 1 4 2 6 6
Hazmat 1 4 2 6 6
Rescue 8 7 5 10 14
Rescue 8 7 5 10 14
Airport 0 0 0 0 0
Airport 0 0 0 0 0
Alarm Handling 3:59 4:07 3:49 4:07 4:05 3:47 3:37 85.2
Turnout Time 2:09 2:11 2:07 2:04 2:15 2:09 2:13 91.3
Travel Urban 7:23 7:22 7:22 7:06 7:17 7:49 6:41 84.4
Time Rural 7:44 7:33 7:53 7:34 8:00 7:45 10:43 97.8
11:44 11:50 11:30 11:30 11:52 11:59
Total Urban 10:50 84.0
Response n= n= n= n= n=
n = 17,863
Time 3,454 3,554 3,487 3,477 3,891
12:16 12:00 12:03 11:42 12:39 12:34
Rural 15:14 97.2
n = 1,377 n = 248 n = 294 n = 325 n = 286 n = 224
Station 3 E3 Engine 2
R3 Rescue 2
Risk Analysis
The risk of individual building locations is represented by the small circles and shaded to indicate risk level.
Risk is also evaluated by geographic planning zone using the same shading criteria. The majority of Station
3’s first due area is low risk, with a concentration of buildings adjacent of the station.
Reporting Period1
Alarm Handling 3:54 3:57 3:48 3:55 4:10 3:43 3:37 86.3
Turnout Time 2:24 2:27 2:20 2:24 2:23 2:26 2:13 86.7
Travel Urban 7:16 7:30 6:55 7:04 6:58 7:37 6:41 85.1
Time
Rural 9:39 9:38 8:58 9:26 10:13 9:41 10:43 95.1
11:43 12:13 11:11 11:30 11:49 12:05
Total Urban 10:50 82.8
n = 2,577 n = 471 n = 502 n = 445 n = 541 n = 618
Response
Time 14:20 14:23 13:54 14:22 14:54 13:55
Rural 15:14 94.3
n = 945 n = 173 n = 180 n = 156 n = 223 n = 213
Risk Analysis
The risk of individual building locations is represented by the small circles and shaded to indicate risk
level. There is a concentration of lower to moderate risk buildings along the major travel corridor of the
station area that warrants additional attention. Station 4’s first due area is low to moderate risk.
Reporting Period1
Assigned
Station Unit ID
2017 2018 2019 2020 2021
MR03 51 29 27 37 44
4
Total 2,571 2,278 2,455 2,781 3,028
2017 -- -- -- -- --
2021 -- -- -- -- --
Travel Urban 7:25 7:33 6:59 6:46 7:14 8:02 6:41 84.6
Time
Rural 9:01 9:39 9:12 8:54 9:11 8:43 10:43 94.4
E5 Engine 2
Station 5 R5 Rescue 2
BR5 Brush
Station 5 is a moderate risk station and staffs two primary units and cross
staffs a brush truck when needed.
Risk Analysis
The risk of individual building locations is represented by the small circles and shaded to indicate risk level.
There is a concentration of lower to moderate risk buildings located directly East of the station. The majority
of Station 5’s first due area is low to moderate risk.
Reporting Period1
Assigned Unit ID
Station 2017 2018 2019 2020 2021
BR05 27 12 11 22 23
) ) ) )
2017 -- -- -- -- --
2018 -- -- -- -- --
2019 -- -- -- -- --
BR05
2020 0.9 0.0 0.0 0.9 1
2021 -- -- -- -- --
Alarm Handling 4:03 4:07 3:55 4:08 4:16 3:53 3:37 84.7
Turnout Time 2:48 2:36 2:35 2:42 2:56 3:01 2:13 76.5
Travel Urban 7:58 8:08 7:51 7:09 8:03 8:21 6:41 81.5
Time
Rural 13:17 12:50 13:12 12:42 13:35 14:09 10:43 72.1
Station 6 staffs two primary units, and houses one of the two marine
operations teams. Station 6 has a lower overall jurisdictional risk level.
Risk Analysis
The risk of individual building locations is represented by the small circles and shaded to indicate risk
level. Most buildings that warrant special attention are located along a major travel corridor in the station
first due area. Most of the Station 6’s first due area is of a lower risk, with the area immediately adjacent
to the station being high risk.
Reporting Period1
Assigned
Station Unit ID 2017 2018 2019 2020 2021
MR02 84 59 62 62 72
TA06 35 28 23 47 51
6 MR04 -- -- -- 1 41
2021 -- -- -- -- --
Alarm Handling 4:08 4:11 4:31 4:00 4:13 3:51 3:37 83.7
Turnout Time 2:48 2:40 3:00 2:50 2:57 2:39 2:13 77.9
Travel Urban 6:15 6:30 6:21 5:52 6:00 6:19 6:41 91.8
Time
Rural 11:00 11:11 10:54 10:50 10:56 11:13 10:43 89.1
Station 7 staffs three units and has a moderate overall jurisdictional risk
level.
Risk Analysis
The risk of individual building locations is represented by the small circles and shaded to indicate risk
level. There is a concentration of lower to moderate risk buildings located throughout the Station’s area.
With higher risk in the immediate vicinity of the Station.
Reporting Period1
Assigned
Station Unit ID
2017 2018 2019 2020 2021
ARF70 26 19 -- -- --
2017 0 0 0 0 1
First Due Reporting Peri- Number of Over- Total Number Percentage of Over-
Station od lapped Calls of Calls lapped Calls
Station 8 E8 Engine 2
R8 Rescue 2
BR8 Brush
Station 8 staffs two primary units and has a moderate overall jurisdictional
risk profile. A brush unit is cross staffed when needed.
Risk Analysis
The risk of individual building locations is represented by the small circles and shaded to indicate risk
level.
There is a concentration of lower to moderate risk buildings located West of the Station’s area.
Hazmat 0 0 1 2 1
Rescue 1 2 2 2 3
Rescue 1 2 2 2 3
Airport 0 0 0 0 0
Airport 0 0 0 0 0
Total 2,171 2,016 2,240 2,171 2,362
2
Average Calls per Day 5.9 5.5 6.1 5.9 6.5
Reporting
Period1
Assigned Unit ID
Station 2017 2018 2019 2020 2021
BR08 28 19 11 27 6
2017 -- -- -- -- --
2018 -- -- -- -- --
2021 -- -- -- -- --
Travel Urban 6:39 6:31 6:36 6:31 6:32 6:58 6:41 90.4
Time
Rural 7:41 8:32 8:11 6:49 6:10 8:44 10:43 98.7
R9 Rescue 2
Station 9 staffs two units and has a low overall jurisdictional risk
profile.
Risk Analysis
The risk of individual building locations is represented by the small circles and shaded to indicate risk level.
There is a concentration of lower to moderate risk buildings located in close proximity to the station, with
a few outlying buildings with risk profiles. The vast majority of Station 9’s first due area is of lower risk.
Call Category 2017 2018 2019 2020 2021 Historical Data Analysis
EMS 169 174 210 238 372 Station 9’s profile demon- states
Cardiac and stroke 7 15 16 25 42 a predominance of EMS
Seizure and unconsciousness 11 15 12 17 21 responses followed by fire
Breathing difficulty 7 3 6 11 28 suppression.
Overdose and psychiatric 1 0 2 2 1
Specialty teams such as
Accident 48 46 40 39 56
Fall and injury 30 31 46 40 69 hazardous materials, technical
Illness and other 14 16 33 47 67 rescue had few incidents during
Medical No ProQA 51 47 46 54 82 the 5-year rating period.
Interfacility transfer 0 1 9 3 6
The year-over-year growth has
Fire 86 78 61 89 143
varied between a 1% decrease
Structure fire 3 5 3 4 6
and a 57% increase.
Outside fire 36 31 15 29 31
Vehicle fire 8 5 9 8 10
Alarm 11 16 16 25 44
Public service 3 0 3 3 11
Fire other 25 21 15 20 41
Hazmat 0 0 0 4 2
Hazmat 0 0 0 4 2
Rescue 0 1 2 4 5
Rescue 0 1 2 4 5
Airport 0 0 1 0 1
Airport 0 0 1 0 1
Total 255 253 274 335 523
Average Calls per Day2 0.7 0.7 0.8 0.9 1.4
YoY Growth N/A -0.78% 8.30% 21.93% 56.55%
Reporting Period1
Assigned Unit ID
Station 2017 2018 2019 2020 2021
2017 -- -- -- -- --
2018 -- -- -- -- --
2019 -- -- -- -- --
First Due Reporting Peri- Number of Over- Total Number Percentage of Over-
Station od lapped Calls of Calls lapped Calls
Alarm Handling 4:13 4:26 4:22 4:23 4:13 4:02 3:37 83.6
Turnout Time 3:36 3:39 3:50 3:57 3:31 3:13 2:13 57.8
Travel Urban 7:59 7:54 10:33 7:45 8:47 7:00 6:41 77.2
Time
Rural 20:32 23:07 0:10 19:26 19:23 17:22 10:43 51.4
TK 10 Tanker
Risk Analysis
The risk of individual building locations is represented by the small circles and shaded to indicate risk
level. There is no concentration of lower or moderate risk buildings located in the station area. The vast
majority of Station 10’s first due area is lower risk.
EMS 41 42 42 52 43
Cardiac and stroke 6 3 6 6 7
Seizure and unconsciousness 3 6 4 7 5
Breathing difficulty 0 6 1 2 1
Overdose and psychiatric 0 0 0 0 0
Accident 0 1 1 0 0
Fall and injury 10 9 15 10 13
Historical Data Analysis
Illness and other 13 9 9 18 12
Medical No ProQA 9 8 6 9 Station
5 10’s profile
Interfacility transfer 0 0 0 0 demonstrates a predominance of
0
Fire 21 22 13 21 8 EMS responses followed by fire
Structure fire 1 0 1 1 0 suppression.
Outside fire 1 1 2 7 0
Specialty teams such as
Vehicle fire 2 0 1 1 0
hazardous materials and
Alarm 7 5 0 2 2
technical rescue had zero-
Public service 2 3 3 0 0
Fire other 8 13 6 10 6
incidents during the 5-year rating
Hazmat 0 0 0 0 0 period.
Hazmat 0 0 0 0 0 The year-over-year growth has
Rescue 0 0 0 0 0 varied between a 29% decrease
Rescue 0 0 0 0 0 and a 32% increase.
Airport 0 0 0 0 0
Reporting Period1
Assigned
Station Unit ID
2017 2018 2019 2020 2021
EN10 51 46 60 47 11
PU10 21 26 16 42 47
TA10 5 3 2 3 --
10 Total 77 75 78 92 58
2021 -- -- -- -- --
2017 1 62 1.6
2018 0 64 0.0
2019 0 55 0.0
ST10
2020 2 73 2.7
2021 2 51 3.9
Alarm Handling 6:00 6:32 4:54 7:53 6:00 5:38 3:37 72.8
Turnout Time 4:37 3:48 4:40 4:02 6:30 2:55 2:13 54.9
Travel Urban 2:28 N/A 2:28 N/A 1:34 N/A 6:41 100.0
Time
Rural 12:12 17:38 13:34 12:59 10:46 7:28 10:43 84.6
R11 Rescue 2
Station 11 staffs 2 units and has a lower overall jurisdictional risk level.
Risk Analysis
The risk of individual building locations is represented by the small circles and shaded to indicate risk
level. There is a sparse amount of moderate risk buildings spread throughout the station's first due area.
The vast majority of Station 11’s first due area is low in regard to risk.
Reporting
Assigned Period1
Station Unit ID
2017 2018 2019 2020 2021
1st Arriving Baseline 2017-2021 2017 2018 2019 2020 2021 2017-2021 2017-2021
Performance Benchmark Compliance
Alarm Handling 4:02 4:17 4:03 3:50 4:01 3:56 3:37 84.
5
Turnout Time 2:48 2:44 2:59 2:46 2:40 2:51 2:13 78.
8
Travel Time Urban 8:23 8:37 7:54 8:12 8:23 8:30 6:41 72.
2
TECH 12 Hazmat
HZM 12 Hazmat
Station 12 staffs three primary units, has a high overall jurisdictional risk
level, and is adjacent to Station 11.
Risk Analysis
The risk of individual building locations is represented by the small circles and shaded to indicate risk level.
There is a large concentration of lower to moderate risk buildings located in close proximity to the station.
The vast majority of Station 12’s first due area is a higher risk due to call concurrency and demand.
Reporting Period1
Assigned
Station
Unit ID
2017 2018 2019 2020 2021
TECH12 13 4 6 11 10
12
HZM12 6 9 6 4 0
First Due Reporting Peri- Number of Over- Total Number of Percentage of Over-
Station od lapped Calls Calls lapped Calls
E 15 Engine 2
Station 15 BR 15 Brush
Risk Analysis
The risk of individual building locations is represented by the small circles and shaded to indicate risk level.
There is a small concentration of lower to moderate risk buildings located to the Northeast of the station.
Reporting Period1
Assigned
Station 2017 2018 2019 2020 2021
Unit ID
BR15 24 6 2 9 1
BR03 0 0 0 0 6
Total 24 6 2 9 7
15
Average Responses per Day2 17.3 18.6 17.4 16.7 17.9
E 16 Engine 3
Station 16 BR 16 Brush
Station 16 cross staffs two units and has a lower overall jurisdictional risk
level.
Risk Analysis
The risk of individual building locations is represented by the small circles and shaded to indicate risk
level.
There is a lower risk of buildings located in the station’s area.
Reporting Period1
Assigned
Station 2017 2018 2019 2020 2021
Unit ID
BR16 64 29 25 50 23
Total 64 29 25 50 23
16
Average Responses per Day2 0.2 0.1 0.1 0.1 0.1
2018 -- -- -- -- --
1st Arriving Baseline 2017-2021 2017 2018 2019 2020 2021 2017-2021 2017-2021
Alarm Handling 4:11 4:26 4:09 4:16 4:26 3:56 3:37 82.5
Turnout Time 3:09 3:10 2:46 2:52 3:05 3:27 2:13 74.4
R14 Rescue 2
EFD
EFD area is staffed by R13 and R14 and has a high overall jurisdictional risk
level. Englewood Engine 76 is collocated at Station 14.
Risk Analysis
The risk of individual building locations is represented by the small circles and shaded to indicate risk level.
There are lower risk buildings located in the EFD area.
Reporting Period1
Assigned Unit ID
Station 2017 2018 2019 2020 2021
EFD Average Responses per Day2 2.7 3.0 3.0 2.9 3.2
Alarm Handling 4:01 4:11 3:56 3:59 4:07 3:50 3:37 84.9
Turnout Time 2:21 2:27 2:24 2:24 2:21 2:09 2:13 87.7
Travel Time Urban 9:23 10:09 9:19 9:04 9:14 9:24 6:41 63.5
R32 Rescue 2
Punta Gorda jurisdiction is high risk. CCFEMS provides two Rescues for
primarily EMS services since the City of Punta Gorda.
Risk Analysis
Risk of individual building locations is represented by the small circles and shaded to indicate risk level.
Since the City of Punta Gorda is not the County’s responsibility for fire protection, there are few rated oc-
cupancies within the jurisdiction.
Reporting Period1
Dispatch Response
Unit Reporting Peri- Time Turnout Time Travel Time Time Sample
ID od Size1
(Minutes) (Minutes) (Minutes) (Minutes)
Turnout Time 2:06 2:07 2:05 1:59 2:10 2:10 2:13 91.5
Travel Time Urban 6:53 6:57 6:55 6:19 6:43 7:22 6:41 88.8
Total Urban n = 13,640 n = 2,680 n = 2,599 n = 2,798 n = 2,544 n = 3,019 10:50 87.8
Response
Time
12:05 12:43 11:42 12:41 12:05 12:05
Rural n = 571 n = 118 n = 138 n = 119 n = 86 n = 110 15:14 95.8
Planning Team
Continuous Improvement Plan
Annual Appraisal Process
Administration
Training
Operations
Logistics
Emergency Response
CCFEMS’s mission as an all-hazards emergency services agency is to save
live, protect property, safeguard the environment, and take care of people.
The organization understands, even with the best efforts of community risk
reduction personnel, that emergencies can and do occur. The strategic plan
identified gaps in current performance (at least three years) and serves as a
guidepost for improvement.
Business Practices
Operate sustainably and responsibly while maintaining transparency by
strengthening established business practices.
General Observations
Total Response Time
The department has established baseline and benchmark performance objectives during the development of this
SOC. While it is up to the department to establish policy related to meeting or exceeding community expectations,
there are opportunities to better align goals and baseline objectives.
Internal Performance Objectives
Historically, the department did not utilize formally adopted performance objectives, but rather these were
adopted as part of the standards of response coverage process. A gap analysis between baseline and benchmark
performance is fully evaluated in Section G of the SOC. In addition, a per-station comparison is provided below
in Section F – Station Analyses.
Dispatch Time
Throughout the development of the SOC, the Department understands the relative opportunity to improve the
citizen’s experience by improving dispatch time. NFPA 1710, NFPA 1221/1225 recommend a 60 and 64 second
dispatch time.
Currently, the performance is 3.9 minutes. In an environment that utilizes a call triage or prioritization process
could be better aligned with national recommendations of approximately 1.5 to 2 minutes. Following the Medical
Priority Dispatch System (MPDS), the delta and echo calls should have the shortest dispatch intervals than lower
acuity calls such as alpha calls.
Turnout Time
Throughout the development of the SOC, the Department understands the relative opportunity to improve the
citizen’s experience by improving turnout time. The CFAI and NFPA 1710 recommend a 60-second turnout time
for EMS events and either 90 seconds or 80 seconds for non-EMS events, respectively.
Currently, EMS performance is 2.4 minutes, and Fire is 3.0 minutes, both approximately twice the recommended
best-practice performance.
Observation:
A one-minute improvement between the dispatch and turnout times, at little to no cost, would have a fiscal
equivalency of a multi-million-dollar investment in response capability.
Travel Time
Utilizing the department or jurisdiction level analysis, the travel time is 8.4 minutes. The travel time for EMS
incidents was 8.2 minutes and fire-related events was 9.5 minutes. While the NFPA 1710 recommendations
suggest a 4-minute travel time at the 90th percentile, Fitch’s experience is that most jurisdictions perform between
5- and 9 minutes. Therefore, the County’s current performance is well aligned with the national experience.
Observation:
The County’s current performance is well aligned with the national experience. Any changes would solely
remain a local policy choice.
Recommendation:
It is recommended that the County consider an 8-minute travel time to guide planning and investment
strategies.
Additionally, the individual stations were evaluated to provide insight into the relative ability to provide a
commensurate level of service across each of the station areas. Focusing on the travel time, the overall
countywide performance is 8.3 minutes at the 90th percentile. Station 1 has the best performance at 6.4 minutes,
and Station 9 has the longest travel time at 16.6 minutes, both at the 90th percentile. However, the majority of
stations provide a travel time between 7 and 10 minutes. Only stations 5, 9, and 16 have travel times greater than
10 minutes and are all located on the eastern side of the developed areas. Therefore, these stations have a greater
rural demand that proves more challenging for response time.
Figure 3: 90th Percentile Travel Time Performance by Station FDZ in the Ascending Order
In other words, the department’s deployment strategies follow a commensurate risk model as most stations only
vary approximately 3 minutes in travel time at the 90th percentile. Following a system of measures, the department
will be well-positioned to adjust the deployment models to meet changes in development, workload, and risks.
Observation:
The department’s deployment strategies follow a commensurate risk model as the majority of stations only
vary approximately 3 minutes in travel time at the 90th percentile.
Observation:
Following a system of measures, the department will be well-positioned to adjust the deployment models to
meet changes in development, workload, and risks.
Figure 4: Average and 90th Percentile Response Times by Number of Available Units
We also investigated whether response time performance deteriorated when there were fewer 24-hour per day
rescues available to respond to calls. A maximum of 14 Rescues were available. For 94.8% of the calls, the
department has a minimum of 8 Rescue units available to respond. The average and 90th percentile response time
increases when there were less than 5 Rescue units available, driven by the large jurisdiction of the department.
Figure 5: Average and 90th Percentile Response Times by Number of Available Rescue Units
System Reliability
Percentage of First Due Compliance
The reliability of the distribution model is a factor of how often the response model is available and able to
respond to the call within the assigned demand zone. If at least one unit from the first due zone is able to respond
to a call, we consider the station is able to respond to the call within the assigned demand zone. Utilizing the
department’s Fire Station Demand Zones (FDZ), analyses reveal that stations 10, 5, 9, and 3 are capable of
meeting their demand for services at the 90th percentile. In other words, when a request for service is received
FDZ 10, 5, 9, and 3 are available to answer the call nine out of 10 times. Stations 07 and 11 had the lowest
reliability. It is considered both best practice and the most reliable measure to perform at the 90th percentile, as
indicated by the “blue” line in the Figure below. This analysis utilized all dispatched calls within the jurisdiction,
and the performance included all assigned units to the specific FDZ. Please note we assumed unit stations 13 and
14 were assigned to calls in first-due stations 15 and 16.
Station 1 has the most demand, and the duration of calls lasted at 35 minutes, thus it has the highest probability
of having overlapped calls at 48.9%. This means that during the period of an active station 1 call, there is a 48.9%
chance that another incident in station 1 will occur. Calls in EFD and ST02 had the second and third highest
probability of overlapped calls occurring since they had the 2nd and 3rd most call volume. Results are presented
below.
Observation:
Station 1 has the highest call concurrency of all of the deployed stations at 49%.
≥1 FF/PM
Minimum Medic Staffing All Responses Daily
≥1 FF/EMT
Recommendation:
It is recommended that the department adopt a system of measures or triggers to best manage changes in the
environment.
Rank Station Travel Time Station Capture Total Capture Percent Capture
1 S01 8 9,734 9,734 27.63%
2 R32 8 4,121 13,855 39.33%
3 S12 8 3,844 17,699 50.25%
4 S02 8 3,402 21,101 59.91%
5 S13 8 2,664 23,765 67.47%
6 S04 8 1,496 25,261 71.72%
7 S08 8 997 26,258 74.55%
8 S07 8 658 26,916 76.41%
9 S14 8 517 27,433 77.88%
10 S16 8 419 27,852 79.07%
11 R31 8 407 28,259 80.23%
12 S05 8 379 28,638 81.30%
13 S15 8 220 28,858 81.93%
14 S09 8 214 29,072 82.53%
15 S11 8 155 29,227 82.97%
16 S03 8 147 29,374 83.39%
17 S06 8 78 29,452 83.61%
18 S10 8 6 29,458 83.63%
Reconsidering the marginal utility analysis provided in the table below, a 10-station solution can achieve
approximately 91% of the call capture within 10-minutes. Therefore, following the findings of the marginal
utility analysis, when the department is resource constrained down to the last 10 units, they should be temporarily
moved up or accordingly. This progressive move-up policy will provide a more efficient capture and success in
a commensurate delivery approach across the city. The mapping below demonstrates the 10-minute coverage of
the six stations only. The difference between this 10-station move-up model and the 18-station delivery is
approximately 3% call capture. This analysis and strategy may also serve to redistribute workload across the
Rescue units to introduce some cost avoidance strategies within the system.
Table 5: Marginal Station Contribution for 10-Minute Travel Time – All Calls – All Fire and EMS Stations
Rank Station Travel Time Station Capture Total Capture Percent Capture
1 S01 10 13,698 13,698 38.89%
2 R32 10 4,539 18,237 51.77%
3 S12 10 4,026 22,263 63.20%
4 S13 10 3,403 25,666 72.87%
5 S02 10 2,735 28,401 80.63%
6 S04 10 1,666 30,067 85.36%
7 S16 10 567 30,634 86.97%
8 S14 10 491 31,125 88.36%
9 S05 10 460 31,585 89.67%
10 R31 10 344 31,929 90.65%
11 S09 10 307 32,236 91.52%
12 S03 10 131 32,367 91.89%
13 S07 10 115 32,482 92.22%
14 S15 10 100 32,582 92.50%
15 S08 10 82 32,664 92.73%
16 S11 10 64 32,728 92.91%
17 S06 10 60 32,788 93.08%
18 S10 10 6 32,794 93.10%
Additional analyses evaluated a move up plan specifically for EMS incidents. Understandably, since EMS
accounts for 88% of the call volume, no substantive differences were evidenced between the All calls and EMS
calls.
Rank Station Travel Time Station Capture Total Capture Percent Capture
1 S01 8 8,526 8,526 27.44%
2 R32 8 3,903 12,429 40.01%
3 S12 8 3,354 15,783 50.80%
4 S02 8 2,899 18,682 60.13%
5 S13 8 2,615 21,297 68.55%
6 S04 8 1,279 22,576 72.67%
7 S08 8 848 23,424 75.40%
8 S06 8 538 23,962 77.13%
9 S14 8 505 24,467 78.75%
10 R31 8 402 24,869 80.05%
11 S05 8 318 25,187 81.07%
12 S07 8 223 25,410 81.79%
13 S15 8 182 25,592 82.37%
14 S16 8 164 25,756 82.90%
15 S09 8 148 25,904 83.38%
16 S03 8 126 26,030 83.78%
17 S11 8 108 26,138 84.13%
18 S10 8 4 26,142 84.14%
Rank Station Travel Time Station Capture Total Capture Percent Capture
1 S01 10 12,070 12,070 38.85%
2 R32 10 4,144 16,214 52.19%
3 S12 10 3,481 19,695 63.39%
4 S13 10 3,327 23,022 74.10%
5 S02 10 2,296 25,318 81.49%
6 S04 10 1,419 26,737 86.06%
7 S16 10 476 27,213 87.59%
8 S14 10 474 27,687 89.12%
9 S05 10 385 28,072 90.36%
10 R31 10 340 28,412 91.45%
11 S09 10 209 28,621 92.12%
12 S15 10 103 28,724 92.46%
13 S07 10 91 28,815 92.75%
14 S03 10 84 28,899 93.02%
15 S08 10 71 28,970 93.25%
16 S06 10 47 29,017 93.40%
17 S11 10 38 29,055 93.52%
18 S10 10 4 29,059 93.53%
The following analyses specifically evaluated NFPA 1710 response with 16 personnel for each scenario within
the city boundaries. These analyses utilized the current deployment configuration, units, and staffing. The GIS
simulation suggests that a 16-person ERF can be assembled to only a fraction of the county’s jurisdiction within
8 minutes, and only 25% at 20 minutes.
Overall, the ERF coverage is more robust in parts of the jurisdiction where the greatest historical demand exists.
The areas of the county that are more challenged are areas that do not benefit from concentric response zones
such as the eastern portions of the county. The mapping outputs are more informative of the capabilities in the
developed areas.
Transport
We analyzed outcomes of EMS calls through an examination of the “Begin to Transport Time” and “Transport
to Destination Time” variables available in the data file. EMS calls were transport calls if at least one unit
responding to the call had a reported either “Begin to Transport Time” or “Transport to Destination Time” value.
The number of EMS transports totaled 21,397, averaging 58.6 transports per day. Approximately 68.9% of EMS
calls have patients being transported to the hospital. Alpha, Charlie, and Delta had the highest transport rates.
Duration of a call is defined as the difference between the first unit dispatch time and the last unit clear time. On
average, the duration of a non-transport EMS call was 18.7 minutes. The duration of a transport call is 2.8 times
that of a non-transport call, averaging 50.6 minutes per call.
We analyzed variation of total EMS requests and transport requests by the hour of the day and the average hourly
rate of requests. The variation of total EMS requests and EMS transport reports followed a similar pattern. The
busiest period for EMS and EMS transport requests was between 0900 and 1800. Requests by hour of the day
are presented below.
Figure 16: Average EMS Calls and EMS Transports per Day by Hour of Day
Observation:
The department Rescue Unit workload is approaching the upper recommended threshold.
Recommendation:
It is recommended that the department adopt a UHU planning threshold of 0.25, or 25%.
Projected Growth
The available data set included five reporting periods of data, representing FY 2017 - 2021. From FY 2017 to
FY 2021, calls for CCFEMS services increased from 30,801 to 35,224, with an average growth rate of 3.6% per
year. The figure below depicts observed call volume during the last five-year reporting periods and various
hypothetical growth scenarios for the next 20 years. These projections should be used with caution due to the
variability in growth observed across prior calendar years. In all cases, data should be reviewed annually to
ensure timely updates to projections and utilize a five-year rolling average.
Figure 18: Observed and Hypothetical Growth in Call Volume
Projected Growth
450,000
400,000
350,000
No. of Incidents
300,000
250,000
200,000
150,000
100,000
50,000
0
Observation:
Optimal EMS deployment would require a minimum of 18 Rescues during the peak of the day, while
reducing the reliance on large apparatus responding to lower acuity EMS incidents.
Similarly, when attempting to maintain an 8-minute travel time, all 18 stations would be required to approximate
the 8-minute travel time that is consistent with current performance. The resource allocation of 14 rescues and
18 locations is significantly under-resourced.
Figure 20: All Stations - 8-Minute Travel Time and 18 Stations
Observation:
Rescue resources are not sufficiently allocated to meet an 8-minute travel time and control for workload.
Observation:
Considering an 8-minute travel time, an optimized rescue staffing would require a total of 24 24-hour
resources, if only considering the application of 24-hour resources.
25
20 Geo - Demand
Demand - Below Standard Staffing
15
Demand - Needs Attention Staffing
10 Demand - Optimal Staffing
Staffing
5
0
0
300
600
900
1200
1500
1800
2100
0
300
600
900
1200
1500
1800
2100
0
300
600
900
1200
1500
1800
2100
0
300
600
900
1200
1500
1800
2100
0
300
600
900
1200
1500
1800
2100
0
300
600
900
1200
1500
1800
2100
0
300
600
900
1200
1500
1800
2100
Observation:
Considering an 8-minute travel time, an optimized rescue staffing would require a total of 21 24-hour
resources and 3 12-hour peak load units.
Recommendation:
The peak load unit strategy is recommended as the most operationally and fiscally efficient staffing strategy.
2
Stiell, I.G., et al. (1998) The Ontario Prehospital Advanced Life Support (OPALS) Study: Rationale and methodology for cardiac
arrest patients. Annals of Emergency Medicine. 32(2), 180-90. doi: 10.1016/s0196-0644(98)70135-0.
3
Stiell, I.G., et al. (1999) The Ontario Prehospital Advanced Life Support (OPALS) study Part II: Rationale and methodology for trauma
and respiratory distress patients. OPALS Study Group. Annals of Emergency Medicine. 34(2), 256-62. doi: 10.1016/s0196-
0644(99)70241-6.
(GCS). The study found that survival rates did not differ overall between patients receiving ALS care or BLS
care. In fact, among patients with a GCS <9, survival was lower among the ALS group. The study showed that,
for major trauma patients, system-wide implementation of full ALS did not decrease mortality or morbidity.4
For out-of-hospital cardiac arrest, OPALS focused on the rate of survival to hospital discharge. Their study found
no improvement in the rate of survival with the use of ALS in any subgroup. In other words, ALS did not improve
the rate of survival for out-or-hospital cardiac arrest in systems that had already optimized rapid defibrillation.5
The study highlighted the life-saving value of bystander CPR and rapid-defibrillation which can be easily
delivered by Automated External Defibrillators (AEDs).
For respiratory distress, the primary outcome measure was mortality, defined as the rate of death before hospital
discharge, regardless of the duration of admission. Additional outcome measures considered emergency
department intubation rates, aspiration, hospitalization, length of stay, and functional status after discharge. The
study included patients whose primary symptom was shortness of breath related to respiratory illness. The study
did show that specific ALS interventions had a positive impact on the rate of death--a change from 14.3% for
BLS and 12.4% for ALS. However, endotracheal intubation was only performed in 1.4% of patients, and
intravenous drugs were administered to 15% of patients. The use of medications for symptom relief increased
from 15.7 % at the BLS level to 59.4% at the ALS level.6 Thus, ALS interventions were rarely used. Other
research seems to indicate that the addition of CPAP to the BLS scope of practice can reduce the need for an ALS
level of care in patients facing acute respiratory failure.7
The OPALS project, the largest to date at its time, provided valuable insight into the efficacy of ALS in EMS.
However, the OPALS research does not stand alone. For example, another study of patients suffering out-of-
hospital cardiac arrest showed that those who received BLS care had a higher survival rate at hospital discharge
than those who received ALS. These patients were also less likely to experience poor neurological functioning.8
The research indicates that ALS-level care in the EMS environment has a very limited positive impact on clinical
outcomes. While some incidents may benefit by a measure of ALS care, the vast majority of EMS responses can
be effectively answered with a highly functioning and proficient BLS level of care, potentially improving patient
outcomes.
When evaluating the clinical differences between ALS and BLS models, we also consider the levels of paramedic
staffing within ALS models. Research has consistently suggested clinical improvement with fewer paramedics
4
Stiell, I.G., et al. (2008) The OPALS major trauma study: Impact of advanced life-support on survival and morbidity. OPALS Study
Group. Canadian Medical Association Journal. 178(9), 1141-1152. doi: 10.1503/cmaj.071154
5
Stiell, I.G., et al. (2004) Advanced cardiac life support for in out-of-hospital cardiac arrest. OPALS Study Group. New England Journal
of Medicine. 351(7), 647-56. doi: 10.1056/NEJMoa040325.
6
Stiell, I.G., at al. (2007) Advanced life support for out-of-hospital respiratory distress. The New England Journal of Medicine. 356(21),
2156-64. doi: http://dx.doi.org.libproxy.troy.edu/10.1056/NEJMoa060334
7
Williams, T. A., Finn, J., Perkins, G. D., & Jacobs, I. G. (2013). Prehospital continuous positive airway pressure for acute respiratory
failure: A systematic review and meta-analysis. Prehospital Emergency Care, 17(2), 261-273. doi: 10.3109/10903127.2012.749967
8
Sanghavi, P., et al. (November 2014). Outcomes after out-of-hospital cardiac arrest treated by basic vs. advanced life support. JAMA
Internal Medicine, E1-E9. Available at http://www.jamainternalmedicine.com
per capita. Several studies show better survival rates for SCA with fewer paramedics per capita. Other research
has shown that the successful execution of advanced procedures, such as endotracheal intubation, is directly
correlated with the first-hand experience level of the clinician. 9 Advanced ALS level skills are inherently rare,
as the research shows. Thus, the limited opportunities to perform these skills and remain proficient with them are
directly influenced by the concentration of paramedics within the system. Simply put, the limited opportunities
to perform ALS skills are diluted with each paramedic added to the system. Therefore, the ALS staffing strategy
of one paramedic and one EMT per ALS unit is firmly supported by the research.
The research indicates that EMS systems can over-staff paramedic-level providers, negatively impacting patient
outcomes. The ALS staffing strategy of one paramedic and one EMT per ALS unit is firmly supported by the
research.
While there is no question regarding the clinical efficacy of a tiered ALS-BLS system, there are considerations
for the efficiency and effectiveness of the model. Several policy considerations must be addressed.
It is understood that other considerations, such as challenges in recruitment and retention for paramedics, could
influence the ultimate policy decisions.
At this time, it is recommended that the department continues with a single tier all ALS system as the highest
level of care and the most fiscally efficient model. It is understood that other considerations, such as challenges
in recruitment and retention for paramedics, could influence the ultimate policy decisions.
Recommendation:
It is recommended that the department utilizes a single tier all ALS system as the highest level of care and
the most fiscally efficient model.
9
Wang, H.E., Balasubramani, G.K., et al. (2010). Out-of-hospital endotracheal intubation experience and patient outcomes. Annals of
Emergency Medicine, 52(3): 256-262.
10
Scott, G., Et. Al. (2016). Characteristics of call prioritization time in a Medical Priority Dispatch System. Annals of Emergency
Dispatch & Response. 2016; 4(1): pp.27-33.
Department Facilities
Department facilities are acceptable in their condition and repair. However, the department is encouraged to
continue to monitor station facilities for best practices in health, design, protection, and other federal regulations
such as gender and the Americans with Disabilities Act (ADA).
Overall, the greater challenge is in ensuring that there is sufficient capacity to address future demands. Currently,
adopting the right number and location of stations is of greater need than the incremental improvements for
existing facilities.
Department Organization
Charlotte County Fire and EMS provides high-quality fire suppression, emergency medical, technical rescue,
and hazardous materials services from 16 fire stations. Additionally, the organization delivers a full spectrum of
fire and life safety services supported by administrative staff and training officers to ensure the first responders
are well prepared for any hazard or situation they may face.
The Department’s organizational structure reflects a typical, paramilitary organization. The Administrative. Staff
is comprised of nine senior personnel, including the Director of Public Safety, 3 Deputy Chief’s, a Fire Marshall,
Emergency Management Director, Vehicle Equipment Coordinator, Division Manager of Animal Control, and a
Radio Communication Manager.
While the Director/Chief has approximately 7 to 9 direct reports, it is recommended that the Chief only has 5
direct reports / program areas. Therefore, a valid case is made for creating a second management layer between
the Chief and the Deputy Chiefs and their direct reports.
• Outputs or process measures may include number of calls received and number of responses made by a
department, station, or unit; unit dispatch, turnout, travel, on-scene, and response times; percentage of
patient transports; percentage of post-seizure patients receiving a blood glucose check;11 percentage of
STEMI patients transported to a designated cardiac receiving center;12 and number of community
outreach or education events; and
• Impact or outcome measures may include reduced financial loss with structure fires; reduced number of
forest or wildland fires originating from people; improved patient outcomes; and increased survival
rates.
In addition to setting goals or benchmarks related to impact or outcome measures, systems typically set goals or
benchmarks related to outputs or process measures due to the presumed or evidence-based relationship between
the two measures. For example, research indicates that transport of Step 1 and Step 2 trauma patients to a
designated trauma center (process measure) can reduce mortality (outcome measure).13 As such, the Washington
State Department of Health has set a process-related goal that ≥ 90% of Step 1 and Step 2 trauma patients be
transported by EMS to a designated trauma center.
Outputs or process measures are typically more easily evaluated, as the system exerts direct influence over their
outputs and processes, and can oversee related data collection and management. Impact or outcome measures
11
Washington State Department of Health. (2017, January 18). EMS System Key Performance Indicators / Clinical Measures. State of
Washington: Author, KPI 4.1. (Available: http://ncecc.net/wp-content/uploads/2012/03/WA-State-EMS-KPI-Spreadsheet-Update-
20170126.pdf).
12
Ibid, KPI 5.6.
13
Ibid, KPI 1.2.
become more difficult to evaluate when data collection and management are outside the purview of the system,
and interpretation of data must account for other intervening factors.
Nevertheless, systems are encouraged to move beyond goal setting or benchmarking and evaluation related to
outputs or process measures, and consider ways that impact or outcome measures can be evaluated. Establishing
effective partnerships with medical facilities to access data related to patient outcomes is essential for EMS related
outcomes. Internally, the department may benefit from a refined training and quality assurance/quality
improvement effort on fire reporting, estimating fire spread, and estimating fire losses.
14
Friedman, M. (2011). Adapted from Fire department performance measures. Santa Fe, New Mexico: Fiscal Policy Studies Institute
(FPSI).
Act of nature
Cause under investigation
Cause undetermined after investigation
Cause, other (Only used for additional exposures)
Failure of equipment or heat source
Intentional
Unintentional
Grand Total
Therefore, the department is encouraged to utilize and/or create a data point that provides insight into preventable
and unpreventable fires. For example, it would be reasonable to suggest that a large percentage of “Unintentional
Fires” would be preventable. This category typically accounts for a large percentage of building fires. Similarly,
a smaller portion of “Failure of Equipment or Heat Source” may be associated with behavioral influences that
serve as proximal or inception events.
Finally, what percentage of the fires were logged with an undetermined cause? The Department is encouraged to
ensure that as longer duration investigations are completed, the original fire reporting is updated and captured for
analysis, where applicable. Conversely, fires where a cause may not be readily available, the department may
evaluate the process for an appropriate return on investment for a more detailed investigation.
Building Fires in Commercial Occupancies
The differentiation by occupancy type can be accomplished in the fire reporting. The Department is encouraged
to begin to measure the degree of confinement by residential fires and commercial occupancies separately and as
the aggregate data described previously. In addition, this section of outcomes contemplates capturing fire loss as
a percentage of the total property value both with and without fire protection systems.
15
National Fire Protection Agency. (2016). Community risk reduction doing more with more. Quincy, MA: NFPA Urban Fire and Life
Safety Task Force.
Therefore, it is recommended that a structured system be developed internally that incorporates strategies for
estimating fire losses, defining, and capturing original value, and legitimately estimating the portion of the
building that would have burned without intervention.
First, estimating fire losses has been a difficult proposition for most fire agencies. There is often a lack of
structured methodology to estimate the actual loss experienced by insurers may be three-fold the local fire
officer’s estimates. The fire department may estimate the damage to the room of origin but underappreciate the
value to the remainder of the house and contents. Therefore, a system should be developed, and the personnel
should be educated in the system accompanied by a quality assurance / quality improvement process.
Second, it will be important to define the source material for the value of the property. For example, is it market
value or assessed value? Some agencies have incorporated the tax collector’s office link to the address so that
completion of the fire report, personnel can have ready access to the buildings value. It is recommended to use
assessed value for consistency.
Third, the estimate of property saved has to be moderated by the realistic probability of further damage. In other
words, it would not be appropriate for the fire department to put out a small trash can fire in a bathroom of a mall
and assume the entire mall would have been a loss without the intervention. In this example, if the bathroom
were non-combustible or sprinklered, then the opportunity for fire spread would be greatly reduced. Therefore,
it is recommended that a process is adopted that appropriately suggests the impact if there were no intervention
similar to the following:
The probability or likelihood of loss to the remaining structure is:
• 10% • 60%
• 20% • 70%
• 30% • 80%
• 40% • 90%
• 50% • 100%
If the building is sprinklered, then the probability may be reduced to less than 10%.
The property value can be multiplied by the percentage of estimated fire spread to determine the amount of
property saved. Since the number of incidents is relatively low, each postfire report should be reviewed for
accuracy and justification. When specifically contemplating fire loss as a percentage of total protected property
value, the department can measure this annually.
Finally, understanding that number of fires is relatively low in frequency, there may be merit in having a few
department members or less conduct investigations and/or cost estimates to ensure a high degree of consistency
and accuracy in
Cardiac Arrest Patient Management
When contemplating EMS services, there are few better outcome measures than that of understanding the number
and percentage of patients that survived cardiac arrest through hospital discharge. The Washington State
Department of Health created the “System of Key Performance Indicators and Clinical Measures” that provides
a framework for clinical performance and outcomes.16
The Washington Key Performance Indicators (KPI) suggests that greater than or equal to 50% of the patients that
present in cardiac arrest prior to EMS arrival, with a witnessed collapse, and found in a shockable rhythm will
survive to hospital discharge. Similarly, with none of the previous restrictions, it is suggested that greater than or
equal to 10% of all cardiac arrest patients will survive discharge from the hospital.
The recommended outcome measures are provided below for the Department’s consideration. Benchmark
performances are only a recommendation and items left blank will need to be developed and adopted internally.
It is fully expected that the Department will continue to refine the outcome measures as well as add new measures
in the future.
Recommendation:
It is recommended that the department consider adopting outcome measures to complement the system of
measures to guide performance management.
Washington State Department of Health. (2017, January 18). EMS System Key Performance Indicators / Clinical Measures. State of
16
Fire Suppression
Benchmark
Current
Measure Performanc
Performance
e
Fire Spread – Degree of Confinement – All Building Fires with Fire Spread
Fire Loss as a Percentage of Total Protected Property Value with Fire Protection System % %
Fire Loss as a Percentage of Total Protected Property Value without Fire Protection System % %
7.3 Percent of patients (in cardiac arrest before EMS arrival) with a witnessed collapse and found in an initially “shockable”
≥ 50% %
rhythm, with survival to discharge from the acute care hospital
7.4 Percent of overall cardiac arrest patients with survival to discharge from hospital ≥ 10% %
Several process measures were identified and are provided here for consideration and/or adoption. These are
presented in the Table below. As with the previous presentation for Outcome Measures, any benchmark
performance elements that are provided are a suggestion and are not intended to be restrictive for the agency.
Table 13: Recommended Process Measures
Current
Process Measure Benchmark Performance
Performance
Performance and Other Objectives to Accomplish Outcomes
Additionally, a more traditional performance-based system of baseline service measures are provided in the Table
below. However, the intended benefit to the County and Department of migrating towards well-defined outcomes
measures is that the Department can be less sensitive to incremental changes in performance as long as the
outcome measures continue to be met. In other words, if the department continues to meet greater than 50%
survivability on sudden cardiac arrests, then the sensitivity to a 30-second increase in response time may receive
a measured response if at all.
Regarding EMS, the Washington State Department of Health’s KPIs clearly articulates process measures that are
desirable. The full KPIs are provided as an Appendix for the reader’s convenience. A condensed version is
provided here for the Department’s consideration. It is understood that some of the data points may not currently
exist and are either in process development or may have to be fully developed.
At a high level the Medical Director is supportive of a migration towards outcome measures and consideration of
the State’s KPI platform. The KPIs are categorized into 8 broad patient management categories:
1. Critical Trauma
2. Heart Failure
3. Asthma
4. Seizures
5. Acute Coronary Syndrome/Chest Pain
6. Stroke/TIA
7. Cardiac Arrest
8. Advanced Airways
Again, it is understood that some of the measures may need to be modified or adjusted based on local medical
direction. In all cases, the process measures presented in this section will require administrative oversight and
capacity and should be accompanied by a robust quality assurance / quality improvement effort. A condensed
version of the process measures and the benchmark performances are provided below.
3.1 . . . who received a beta-agonist or had the beta-agonist administration protocol documented by the first EMS
≥ 90%
crew able to provide such treatment
4. Seizure Patient Management
4.1 . . . and post-seizure patients who received a blood glucose (BG) check ≥ 90%
Percent of patients ≥ 35 years old with suspected cardiac chest pain, discomfort, or other ACS symptoms
5.1 . . . who received aspirin (ASA) from EMS or had the aspirin protocol documented ≥ 90%
Benchmark Current
Process Measure
Performance Performance
5.3 . . . who received a 12-Lead ECG < 10 minutes from time of arrival on scene by first 12-Lead ECG-equipped
≥ 90%
EMS unit
5.4 . . . with an EMS scene time (arrival-to-departure of ambulance) < 20 minutes ≥ 90%
5.5 Percent of suspected STEMI patients in which a Code STEMI alert is activated prior to hospital arrival ≥ 90%
5.6 Percent of patients identified as STEMI by EMS who are taken to a designated cardiac receiving center ≥ 90%
6.1 . . . who have a FAST exam (i.e., neuro screening) completed and documented or documentation of why an
≥ 90%
exam could not be completed
6.3 . . . with an EMS scene time (arrival-to-departure of ambulance) < 20 minutes ≥ 90%
6.4 . . . with Time Last Normal < 6 hours to hospital arrival, in which a Code Stroke alert is activated prior to
≥ 90%
hospital arrival
6.6 . . . who have a FAST exam score who have a LAMS Stroke Scale Assessment completed and documented or
100%
documentation of why an assessment could not be completed
7.1 Percent of non-traumatic cardiac arrest patients who received bystander CPR ≥ 50%
7.2 Percent of patients (in cardiac arrest before EMS arrives) in an initially “shockable” rhythm who received
≥ 90%
first defibrillation in < 8 minutes from time 911 call was received at Fire/EMS dispatch
Percent of patients
Benchmark Current
Process Measure
Performance Performance
8.4 . . . who are successfully intubated or who have an SGA successfully placed ≥ 90%
8.5 . . . and patients with SGAs with documentation of continuous wave-form ETCO2 ≥ 90%
• The Department is staffing to an optimal level concerning the daily minimum staffing of the current
deployment.
• Alternative EMS strategies would increase staffing by approximately 7 personnel per 24-hour rescue
unit and 5 personnel per 12-hour rescue unit.
• It is recommended to prioritize investments toward improving response capacity and delivery before
considering increasing per-unit staffing.
Fiscal Sustainability
• All of the analyses within this study validate, at a minimum, that the current number of stations and
deployment is appropriate to maintain current services and identify needs for further investment.
• The relative distance between stations solidifies the need for the current deployment. In other words,
there is no systematic duplication of efforts.