Fire Rescue
EMS/Fire History
Emergency Medical Services
The Emergency Medical Services component of Alachua County Fire Rescue has evolved over the years as an essential service. Changes were brought about as a result of State-mandated programs, and in response to public appeal. Williams-Thomas Funeral Home provided the first recorded ambulance service that was delivered to the citizens of Alachua County.
According to Dick Williams, his family entered the Funeral Home business in 1890, and shortly thereafter, ran their first call for help using a horse drawn funeral carriage. For many years, Funeral Homes provided the transportation to the hospital. The requirement to work for the Funeral Home in those days, was "a warm body that didn't mind blood and death". As Mr. Williams explained, "an Ambulance run was called an accommodation", meaning that they were providing a service to people whom would use their Funeral Home in the future. This was true with all of the area Funeral Homes at that time. A trip to Jacksonville, for example, cost $24.50 in 1960, and calls within Alachua County were free-of-charge.
The demand for service increased, and so did the budget for running calls. Because of this, the Funeral Homes of the area supported Mr. Walt Wilson's proposal to start a private Ambulance Service. Alachua Ambulance Service, Inc. (AAS) was born and AAS continued to provide ambulance service until 1974.
The concept of Emergency Medical Services was first discussed in the early 1960's, but gained more credence from techniques learned and personnel trained in Viet Nam. In the middle 1960's, President Lyndon Johnson commissioned a survivability study of trauma patients who were involved in motor vehicle accidents in the United States. The National Academy of Sciences and the National Research Council published a landmark study in 1966 entitled Accidental Death and Disability: The Neglected Disease of Modern Society. This study demonstrated that a soldier injured on the battlefields of Viet Nam had a better survival rate than a motorist injured on the highways of the U.S. The study also brought the idea of pre-hospital treatment of trauma victims to the attention of the public. The National Highway Safety Act of 1966 offered an 80-hour training program, developed by the Department of Transportation (DOT) to firemen and ambulance attendants. This relied heavily on instruction by area physicians and clinical experience that was gained by on-the-job training. In 1968, the first textbook was published by The National Academy of Sciences and the National Research Council and had the extended title: Training of Ambulance Personnel and Others Responsible for Emergency Medical Care of the Sick and Injured at the Scene and During Transport. In 1971, the American Academy of Orthopedic Surgeons publish the text: Emergency Care and Transportation of the Sick and Injured, which became the text for the DOT's national curriculum for Emergency Medical Technicians (EMT's).
Alachua County became involved in funding EMS after Beazy Stephens purchased the local ambulance service in 1970. Mr. Stephens asked for (and received) financial assistance in 1972 due to the increased costs resulting from the need to expand services to the growing area of greater Gainesville and Alachua County. In addition to the increased volume of calls, personnel were now being trained at the higher level of EMT and Mr. Stephens' costs of $20.00 per transport and $1.00 per mile were going up. Included, as part of the agreement to subsidize AAS with $30.000.00, was the establishment of an Emergency Medical Advisory Council to insure that AAS continued to meet the State's requirements. Various Legislative Acts governing the provision of ambulance services increased training requirements, and, increased the County's involvement in the operations of AAS.
At this time, the provision of EMS, in general, varied greatly from one jurisdiction to another based on local variations of a common theme. Also at this time, several areas of the country were distinguished as progressive and worthy of imitation. Along with EMS Providers in San Diego, Seattle and Baltimore, Jacksonville emerged as one of the more progressive areas. In January of 1973, the United States Department of Health, Education and Welfare (HEW) undertook the most important project of its kind. The Department of HEW established EMS "demonstration projects" in five regions of the country (Arkansas, Illinois, Florida, California and Ohio) to show how a cooperative effort between government, the medical community and the community-at-large could offer the public an effective Emergency Medical System on a regional basis. Northeast Florida, and Jacksonville, was chosen because of the area's reputation as a front-runner in EMS. Seven other Northeast Florida counties (including Alachua County) were included in what became known as the "Eight County Project", with Jacksonville providing guidance and training to the local responders. The Department of HEW allocated $3.1 million dollars in Grants to the Eight County Project out of the $16 million that was available nationwide. Though the individual jurisdictions continued to utilize different types of EMS Providers (volunteer, "third service", or fire departments), this was still considered a regional approach and a standardization of training and equipment. Modular type ambulances, with identical configurations and equipment inventories, were purchased under the Eight County Project and deployed across the region to replace the varied vehicles and equipment that were in service at the time. Personnel from Jacksonville coordinated and provided training to responders across the region.
In November 1973, the EMS Systems Act was signed into law. This Act provided $170 million dollars to enhance EMS over a 3-year period. Similar to the demonstration project, the EMS Systems Act provided assistance and encouraged the development of comprehensive EMS throughout the rest of the country. The EMS Systems Act was later extended by Congress through 1979, and authorized $200 million for system development, $15 million for research, $30 million for training and $22.5 million for burns.
On October 1, 1974, AAS disappeared as an employer, and was replaced by the Alachua County Department of Public Safety. Concurrently, the Alachua County Volunteer Fire Chiefs Association negotiated an arrangement with the Alachua County Board of County Commissioners to provide first response Basic Life Support (BLS) EMS service in the rural areas. This arrangement enhanced the system's response posture and improved efficiency by augmenting the transport vehicles operating in the Gainesville urban area by stationing quick response vehicles in the County. The Board of County Commissioners established a Municipal Services Taxing Unit (MSTU) to be applied to the property values in the un-incorporated areas of the County. MSTU funds were, and still are intended to pay the costs of providing fire and law enforcement services in unincorporated Alachua County. Municipalities such as the Gainesville, Alachua and Hawthorne, and FireBoards qualifying as non-profit corporations were now able to hire EMT's, and purchase vehicles. Alachua County coordinated the acquisition of grants to train personnel and purchase equipment.
The late 1960's and early 1970's also saw the return of highly trained and experience Medics and Corpsmen from Military Service in Viet Nam. As the first conception of EMS in the country was born of a study involving the success of these individuals in enhancing the survivability of soldiers, it was inevitable that their expertise would be sought after in EMS. The capability of EMS to provide pre-hospital Advanced Life Support became an inevitable extension on what was proving to be a successful, nationwide effort to improve survivability of a variety of illnesses and injuries. Of particular interest was a study conducted in Seattle, Washington that showed an increase in survival rates of persons suffering heart attacks. An aggressive Public Education campaign teaching CPR to the lay public was undertaken in Seattle. This, along with the early application of advanced intervention techniques by the EMS Provider demonstrated that survivability of sudden cardiac arrest was more than twice as high in Seattle as anywhere else in the country. In 1975, EMS Providers began to train EMT's in advanced techniques. These individuals were then authorized to practice advanced skills within their areas of operations. The first practitioners of Advanced Life Support in Florida were called EMT II's, due to Los Angeles holding the copyright for the term "Paramedic" (the term was being used in the production of a television show featuring "Johnny and Roy" and L.A.F.D. Squad 51). In 1976, Florida conducted the first pilot offering of a standardized exam for EMT II's in Jacksonville and Miami, and in 1977, the term Paramedic was included to the EMS Act of 1973. This was also the first year that a standardized, State of Florida recognized exam was given to certify pre-hospital care workers as Paramedics, and in 1978, the first Paramedics were registered by the State.
In 1977, the Department of Public Safety became the Department of Emergency Services and encompassed Emergency Medical Services, Communications, Civil Defense and County Fire. By now, the funding for the EMS System was over $500,000.00 annually.
The rapidly changing standard of care being mandated by the State was leading to increasing costs for personnel and equipment. The Board of County Commissioners explored the possibility of divesting the County of EMS. The costs to continue providing EMS was not addressed in the County Manager's proposed budgets and Requests for Proposals where advertised. Performance criteria were developed based on the 1976 service levels of the Department of Public Safety and this became the standard that the prospective provider would be required to meet, or exceed. Proposals were received from the private sector, but none from the City of Gainesville. The County continued to provide EMS when the entities that submitted proposals could not meet the objectives outlined in the RFP's for less subsidy than what the County was already providing.
In the 1980's, the Department became a full Advanced Life Support system in order to comply with State and County requirements. This enhancement involved relocating the quick response units that had provided a BLS first response capability in the small municipalities to areas where they could respond quickly to a wider area, and staffing them with Paramedics. These quick response units were later replaced with ALS ambulances, which are still stationed in those locations. Alachua County continued to provide funding to the municipalities and independent FireBoards from the MSTU collected in the unincorporated areas of the County, including the area immediately surrounding corporate limits of Gainesville. EMS response involved a fire apparatus, capable of providing BLS and leaving from the fire stations dispatched simultaneously with the County's ALS ambulances.
Fire Rescue Services
Prior to 1985, Alachua County contracted for fire suppression services. However, during that year quickly transpiring events meant that the Department of Emergency Services would be called on to begin providing fire suppression services directly. Contract negotiations with the City of Newberry broke down and the Newberry Fire Department would not provide a response outside their corporate limits. The Department deployed a fire apparatus, to share the station with the quick response unit, at the Half Moon Station. This fire apparatus was staffed by Department personnel and provided a response to fire calls in that area, without relying on a contracted provider. Beginning with the deployment of the fire apparatus in Half Moon, EMS and Fire Suppression could be delivered from the same location, however this required two vehicles to adequately deliver both services. Dual role apparatus were determined to be the most cost- effective manner of providing both services. Recognizing that 75, or more, percent of a fire rescue department's responses involved medical response, staffing fire apparatus with Paramedics meant that ALS could be provided from fire-based units for non-fire related response. These units would initiate treatments when arriving before the ALS ambulance, that could now be stationed elsewhere. The dual role capability meant that EMS would be even more accessible to the community than ever before. The provision of EMS and fire suppression was now integrated, and this integration would be considered the norm for the future.
The increase in residential and commercial development in the Jonesville area during the early to mid 1980's created an increase in the call load for both fire and medical response in that area. In 1987, the Department deployed an ALS fire apparatus to the Jonesville area. Also in 1986, the City of Alachua annexed large portions of the County and was faced with providing fire and EMS to its growing corporate area, as well as the unincorporated areas under contract. Citing increased costs and demand for a higher level of service from its citizens, the City of Alachua approached the County to enter into a partnership to provide service. Simply, the County would provide trained and certified personnel, the City of Alachua would provide the station, and the cost for providing service in the area would be divided based on call location - by percentage.
Also, at this time the City of Gainesville was seeking more money in a new contract to provide fire suppression services to the rapidly urbanizing area of Alachua County. Along with the prospect of increasing costs in a new contract, the City of Gainesville closed a fire station located in the northwest urban "fringe" in 1988. Alachua County, recognizing that area's need for continued fire protection, responded by purchasing and deploying a fire apparatus, staffed with Paramedics to provide dual role service in that area.
With Alachua County now demonstrating an ability to directly provide fire protection, the need arose for a standardization of equipment and personnel. Joint negotiations between Alachua County and the City of Gainesville produced a 7-year strategic plan and agreement that that included criteria for apparatus, and the locations and types of construction for new stations in the urban fringe. The Agreement set performance standards and established the location/s of new stations based on the assumed increase in call loads in the urban fringe areas surrounding Gainesville that were projected to experience a continued growth.
According to the Agreement, Alachua County was to build and operate fire stations at specified times outlined in the Plan. In 1989, ACFR Station 19 opened at 1800 SW 43 St, at the corner of SW 20th Avenue and 43rd Street. Station 19 would house an ALS Engine and crew to provide dual role response. In 1993, ACFR Station 16 opened at 1600 Fort Clark Boulevard. Station 16 would be a multiple company station with a tower-ladder truck company and heavy rescue vehicle sharing the station with an ALS Engine. In 1994, ACFR Station 12 opened at 1200 SE 43 Street. As with Station 19, Station 12 would also house an ALS Engine and crew to provide dual role response. The Agreement "expired" in 1995, however the Department has continued to enhance its service capability in the urban fringe by opening Station 15 at 8900 SW Archer Road.
Numerous improvements with regard to staffing, training, vehicle purchase and more rapid delivery of EMS to a County of 902 square miles and a population of over 180,000 have been made during the late 1980's, and throughout the 1990's. All of these enhancements have relied heavily on the Department's dual role capability of providing ALS first response from fire apparatus and ALS transport with ambulances that are not necessarily sharing the same station with the fire apparatus. The result is that more units, each with the capability of provide Advanced Life Support are deployed to more locations which assures better coverage of the service area.
Annual call loads have risen steadily placing greater demands on the number of ambulances available to the service area. The provision of ALS first response from fire apparatus assures timely arrival, and initiation of care. However, the increased demand for transport vehicles could have lead to patients waiting on scene, and under the care of a Paramedic, for an available ambulance to arrive and take them to the hospital. In the early 1990's, the Department sought ways of better deploying its ambulances to assure that vehicles would be available during the times of greatest need. The Department reviewed ambulance deployment plans from around the country. EMS Providers in the private sector had developed a deployment plan called System Status Management (SSM). Basically, when the call load (and the need) was higher, more ambulances would be deployed. Then, when the call load (and the need) was lower, fewer ambulances would be deployed. By monitoring the need and adjusting the number of ambulances deployed, the System could still maintain the same level of service without have ambulances sitting idle for long periods of time. Among other criteria, SSM relied on determining the Unit Hour Utilization of each ambulance, and the Unit Hour Utilization of the System. Unit Hour Utilization is expressed in percentage and indicates the percentage of time that an ambulance is actually utilized for its intended purpose - transporting a patient and is based on the demand for service. Achieving a balance between demand for service and Unit Hour Utilization required a System Status Manager to constantly monitor the performance of the system. The Manger will put ambulances in service, and remove ambulances from service virtually on a quarter hour basis.
Based on the success of the SSM model, the Department assessed the call load for one year, identifying the times of the year, days of the week and the times of day and night that call demand stressed the availability of the ambulances. With that information, in 1996 the Department began to deploy 1, 2 or 3 ambulances during the times of heaviest call loads. These units came to be known as the Peak Load Units and their locations can be shifted to place them in areas where calls can be anticipated based on history.
In 1975, 3 ambulances delivered Emergency Medical Services to all of Alachua County and the medical call load averaged 4,500 to 5,000 annually. In some areas of the County, a patient might wait 30, or more, minutes for the arrival of the first caregiver. In 1998, the Department responded to more than 25,000 calls utilizing between 8 and 11 ambulances, depending on the day of the week and the time of the day. This System response was enhanced by dual role ALS fire apparatus responding from 6 stations in the urbanized area surrounding the City of Gainesville, and the BLS first response from the Contract Departments. Along with the response from the City of Gainesville fire apparatus leaving from their 6 stations, today, the first arrival of ALS anywhere in the urban area is less than 8 minutes, with 4.5 minutes being the average. The first arrival of EMS in the rural area is less than 15 minutes for 80% of calls.
Training
The Department's commitment to training has increased from one Training Captain in the late 1980's to a Training Bureau supervised by a Chief Officer, two Training Captains, and the Department's Health and Safety Officer. Qualified and nationally certified Instructors provide training to the Department's Reserve and Career Service personnel, as well as to the personnel of the contract fire departments. The Department's Training Bureau also works in conjunction with the Training Division of Gainesville Fire Rescue to conduct joint inservice training programs. Training Bureau personnel are Affiliate Faculty for Basic and Advanced Cardiac Life Support; Basic Trauma Life Support; Pediatric Advanced Life Support; Pediatric Pre-Hospital Care Instructor; Hazardous Materials Response and Incident Management; and Incident Safety Officer. Additionally, the Training Bureau coordinates additional training programs by qualified Department personnel in Basic, Intermediate and Advanced Incident Management; Incident Commander; Water Rescue Technician; Trench and Confined Space Rescue; and Rope Rescue Technician.
Inservice Training is provided on a monthly basis, giving personnel the necessary Continuing Education Units to maintain certification. A comprehensive Quality Assurance program conducted by Training Bureau Captains and the System's Medical Directors reviews run reports to assure that individual and Department performance complies with State mandates and standards. Field personnel receive valuable feedback on their performance and the need for remedial training can be identified and provided.
Physician oversight of the EMS System began with a single Medical Director providing indirect supervision of personnel of ambulance personnel. EMS is now is made up the Alachua County as the primary provider, Gainesville Fire Rescue and ShandsCair Helicopter Service as secondary providers along with the Emergency Departments of each hospital. Medical Direction now involves a board of Physicians who have oversight of the entire system and its components. This Medical Directors Board is designed to assure that all Paramedics and EMT's working in the EMS System do so under identical protocols and maintain identical standards. The Operations Medical Director devotes 10 hours a week to riding on ACFR Medical Units, and additional time for administrative tasks.
Fire Prevention
As a Fire Rescue Department, Alachua County adopted the National Fire Protection Association (NFPA) guidelines as the standard for training and equipment. Included in the NFPA guidelines are the Life Safety Code and Fire Prevention Standards. In order to meet those requirements of the guidelines, in the late 1988 the Department hired a Fire Inspector, who later completed Criminal Justice Standards for Law Enforcement and became the County's Fire Marshal. Fire Prevention involves construction plans review of commercial structures, and on-site inspections during construction and before occupancy. The County's Fire Marshal investigates all incidents when company officers are not able to immediately determine a cause and origin of the fire. Additionally, the Fire Marshal investigates any incident when a fire fighter has been injured. When reports of possible codes violations are reported by units in the field, the Fire Marshal will investigate and inspect the area to provide a follow-up. In 1991, a Fire Inspector was hired for plans review and on-site inspections.
Each of the Department's fire companies participates in fire prevention through a comprehensive Pre-Fire Plan Program. All commercial buildings and areas are first identified and categorized as a "Target Hazard" or a "Special Hazard". A Target Hazard is defined by the Insurance Services Organization (ISO) as a facility which could produce or stimulate a fire that could cause a large loss of life or property (i.e. hazardous materials storage, etc.) A Special Hazard is defined by the ISO as a hazard that arises from the operations or processes that are peculiar to the individual occupancy (i.e. painting, welding, etc.). Each Target, or Special Hazard receives a site visit by a fire company during the months of September and October to identify structural hazards, ingress and egress routes, identify hazardous materials and assess for "fire load" (fuel types and/or volatility). This information is filed and available should the fire station respond to that location. Each Target or Special Hazard receives a telephone call during March and April to determine if a significant change has occurred and to assess the need for a follow up site visit.
Included with adoption the NFPA Guidelines as the standard for fire services in Alachua County, the Department is required to maintain all equipment related to fire suppression at a high standard of readiness. All hydrants in the service area are tested at least twice annually and cataloged by the Department listing locations and water flow rates. Additionally, each pumper is inspected and each undergoes a two-hour NFPA "Service Pump Test" at least twice annually.
Combined with the continual preparation for response in Alachua County, the Department prepares to assist others during times of disaster. In 1994, Alachua County was included in the first group of signatories to the Statewide Catastrophic Mutual Aid Agreement, which pledges resources support between signatories during declared states of emergency. The Department's Command Staff is active in the Florida Fire Chiefs Association (FFCA) and is available to state and local agencies for planning and response by participating on the Board of Directors and Disaster Response Committees. The FFCA's Disaster Response Plan provides all fire and most EMS resources to areas that have been impacted by natural or technological disasters.
ACFR has adopted the National Interagency Incident Management System (NIIMS), and in 1998 began training all Department personnel in the progression from Introduction to Incident Management to Incident Commander. Department personnel participate on one of four State of Florida Interagency Incident Management Teams and serve in several capacities. This training and experience proved invaluable throughout 1998 when the frequency of disasters was unprecedented. Beginning in February 5 events transpired that would call on virtually all responders across the State. The State experienced the no-warn event of tornadoes in Central Florida, escalating events of flooding and wildfire brought about by the same phenomenon - El Nino, and two pre-warn events of Hurricane Georges making landfall in both the Florida Keys and the Florida Panhandle. The worst campaign fire in the history of the State began in May and June of 1998, and burned across North Florida. In Alachua County a small reported fire north of the Gainesville Racetrack rapidly grew to involve 7,500 acres within three days. ACFR joined with the Division of Forestry in a Unified Command and jointly coordinated the effort of more than 250 firefighters from across the State. The fire was extinguished within 10 days. When the "Racetrack Fire" was declared out, ACFR personnel were deployed to Putnam, Flagler, Volusia, St. Johns and Broward Counties to assist with wildfires in those areas. Later that year, the Department sent its Water Rescue Team to the Florida Keys to assist with search and rescue in Marathon after Hurricane Georges made landfall.
1999 will see the Department continuing to maintain its preparations for responding to the EMS and Fire Suppression needs of the citizens of Alachua County. The Department will also be prepared to assist as needed, and when called upon, to any area affected by catastrophic events.
