Firefighter Matt Brozovich looks down from a ladder truck in August. (Saphara Harrell/Salem Reporter)
The firefighters at Salem’s Station 3 in east Salem were alerted by a familiar tone that sounds like an elevator ding.
An automated voice then announced the address of an emergency.
Three firefighters climbed aboard a fire engine for the drive to a shopping plaza. There they found a 30-something man rocking back and forth, huffing a can of air duster and yelling at passing cars.
Pulling on gloves, the firefighters gather around the man, trying to determine if he needs medical attention. The man believes they are police officers and repeatedly puts his hands behind his back, waiting to be handcuffed.
Eventually, he refuses medical attention and walks away. The firefighters return to their engine and head back to the station.
The event lasted around 15 minutes, another in an ever-increasing number of calls that are taxing Salem fire services, putting lives at risk, and with no letup expected.
Officials say the Salem Fire Department already has handled 754 more calls so far this year compared to last year. Crews are stretched thin, response times are suffering, and agency officials say they are understaffed.
“That’s really our challenge, is how do we best cover the calls that we have,” said Mike Niblock, Salem fire chief.
Data provided to Salem Reporter shows that last year Salem firefighters repeatedly missed their goal of reaching an emergency within 5 ½ minutes – 3,500 calls or about one-third of their emergency calls. That’s an average of 10 a day where firefighters say the substandard response time can leave lives in the balance.
In the case of a cardiac arrest, a delay could prove deadly.
“The brain begins to die at six minutes,” Niblock said. “When your heart stops beating, the clock starts running and for every minute that goes by, you slide down the recoverability scale by 10%. So, at six minutes, you’re down to 40% chance of recovering.”
The 5 ½-minute goal set by the city includes dispatch time that takes on average 22 seconds and a minute for the crew to get to the truck.
The crews are supposed to achieve this 85% of the time for emergency calls, like fires or heart attacks.
National standards are more stringent. The National Fire Protection Association said that for 90% of calls, the first engine company should arrive within four minutes, measured from the time the truck leaves the station.
Salem’s response times are partly a victim of geography. In the Mill Creek industrial area, Niblock said, the closest station is eight minutes away.
Niblock said the department doesn’t have the resources to track what happens if crews don’t arrive within the standard.
The fire chief acknowledged that the department has been falling farther behind. He said his agency needs three more engines and 36 more firefighters – roughly another $3 million in annual cost.
“When I say we need three more, that’s to try to meet the 85th percentile today. It doesn’t count the growth in the next three years,” Niblock said.
Firefighters Daniel Steffen and Matt Brozovich talk while washing a UTV. (Saphara Harrell/Salem Reporter)
Last year the city spent $1.5 million to reopen Station 11 in west Salem to reduce call loads on other stations and boost response times.
The station was expected to handle 2,500 emergencies, Niblock said.
But then the calls for emergency help increased, and instead of spreading around the workload, the agency had to find a way to add on even more calls to firefighters.
Last year, the department responded to 25,431 calls, up more than 2,000 calls from 2017.
The majority -18,797 – were medical calls. Service calls accounted for 2,666, good intent calls where responding firefighters found no emergency numbered 1,808 and false alarms numbered 1,022. The department responded to 564 fire calls last year.
Number of calls for service the Salem Fire Department responded to from 2008 to 2018. (Graphic by Saphara Harrell)
“That’s the problem,” Niblock said. “We catch up just a little, we open a station then we add 2,500 calls on top of it.”
Niblock said aging population and homeless individuals in the community contribute to the increase as well as calls from those who don’t have a regular doctor. They count on emergency room treatment for their ailments.
“You’ve got insurance, but how do you get medical care? You call an ambulance,” Niblock said.
Kyle McMann, chief of Marion County Fire District 1, said call volumes also reflect the larger healthcare problem the country is experiencing.
He gave an example of someone who’s sick or has cut a toe and needs a doctor’s care, but can’t get an appointment.
That person calls for an ambulance to take them to the emergency room.
“You call, we haul,” McMann said. “We can’t really refuse to take you.”
That ambulance bill can be anywhere from $1,100 to $1,500.
McMann said since 2008, his district has had a 40% increase in call volume but has only added one medic unit.
From January to July of this year, call volume is up 6% from last year. McMann said historically the increase is around 4%.
“We’re feeling the strain of the increasing call volumes,” McMann said.
In the district that covers rural territory, the goal is to respond in 7 minutes 30 seconds 90% of the time. In July, the district on average took one minute longer to get to those needing help.
Firefighter Daniel Steffen loads into a Salem Fire Department truck. (Saphara Harrell/Salem Reporter)
LOOKING AT OTHER OPTIONS
In the Portland area, one agency took a new approach to contain costs while still responding to all calls.
Tualatin Valley Fire and Rescue handles about 50,000 calls a year but no longer dispatches an engine with four firefighters to each one.
Instead, it dispatches one firefighter-medic in a Toyota Cruiser to non-emergency calls such as headaches, smoke alarms, and minor abdominal pain.
The one person, one rig arrangement has been billed as cost-effective and quicker to respond to certain situations.
“We are very good at looking at statistics and data and science in determining how we respond to incidents,” said Les Hallman, assistant chief of Tualatin Valley Fire.
The program was so successful, the agency increased to six one-person rigs in 2016.
Niblock said his agency evaluated Tualatin’s program last year but concluded that Salem was better off adding an engine crew instead of one-person system.
He said instead the agency is considering more actively following up on those treated for medical needs to help keep them at home and out of an ambulance.
Niblock said the program would likely pair a nurse practitioner and a paramedic to handle five to seven calls a day during the week, visiting with those who have returned home after medical treatment. He estimates that could spare the fire department about 1,300 calls a year.
He said he is considering a year-long trial to test the concept.
Firefighter Tyler Hordichok looks through a bag of medical supplies at Fire Station 1. (Saphara Harrell/Salem Reporter)
Have a tip? Contact reporter Saphara Harrell at 503-549-6250, firstname.lastname@example.org or @daisysaphara.