Philly Fire Department Shifting Focus on Supporting EMS

The Philadelphia Inquirer

Buried deep in a recent bureaucratic city report is a startling statistic: The number of buildings that caught fire in Philadelphia over the last two years nearly doubled.

This was reported at a time when the number of structure fires across the country—in big cities like Chicago and Los Angeles and smaller ones like Camden and Pittsburgh—has been flat or decreased.

The story behind Philadelphia’s troublesome stat lies with a new, by-the-numbers commissioner and the department’s fresh look at a Philadelphia tradition called the “pot of meat” fire.

About a year into his job as Philadelphia Fire Commissioner, Adam Thiel learned through a journalist that firefighters had raced to a blaze that day in early 2017 and spotted a man hanging from a third-floor window as dark smoke billowed above him. Because it took fewer than 20 minutes to both snuff out the flames and rescue the man, the fire wasn’t counted in the department tally of structure fires—and didn’t make its way to the commissioner’s office.

“If this happened anywhere else, they would still be talking about it,” Thiel said of the dramatic rescue.

Firefighters were following the “Ace Jobs” standard. “Ace Jobs,” whose real name is Tom Malia, was the department’s unofficial house fire statistician for two decades until his 2009 retirement. He kept a manual tally of the department’s “real” fires—defined as those that took more than 20 minutes and at least a 1¾-inch-diameter hose to extinguish.

“Back in the day, if a fire wasn’t blowing out the window then ‘Ah, we’re not counting that—‘oh, it’s a pot of meat,’” said Greg Marshall, a firefighter at Ladder 14 at 26th and York. “The fires that didn’t look like something out of Hollywood, they wouldn’t count.”

So Thiel, who had worked at departments around the country, directed that every fire and medical emergency call be counted following national standards, even the “pot of meat” fires. The department issued colorful handouts that instructed: “Using proper incident type coding may result in increased funding for the Philadelphia Fire Department.”

Since then, those small kitchen fires have more than tripled—on paper at least. The rest of the categories that make up the structure fire tally have remained relatively flat, according to an Inquirer analysis of the new data. Fire truck responses to medical emergencies decreased by a few thousand since 2017.

At the same time, however, the department’s ambulance teams have been busier. In 2018, the fire department’s medics responded to 291,545 incidents, up 12,000 from the year before.

Thiel also realigned how fire and EMS response times are measured. They now include the time it takes between a call and the dispatch of apparatus, as well as the times of EMS “cold calls”—those that don’t require lights and sirens. Those changes, which Thiel said are national standards, have led to a surge in response times.

In Philadelphia, firefighters respond to fires an average of a minute and 24 seconds longer than the national standard, while medics takes an average of three minutes more.

It’s unclear if the commissioner’s directive to count everything according to standard has led to more funding. But the department’s budget has grown 28% since 2017 to its highest amount ever: $333 million.

City Council and Mayor Jim Kenney, the son of a Philadelphia firefighter, have added nearly $80 million more to the department’s general fund budget since Thiel arrived. Much of that has been spent on firefighting. The commissioner has hired more than 600 firefighters and 66 paramedics since 2016.

That additional funding, plus $20 million from FEMA, which was in part used to hire 120 firefighters who will also be emergency medical technicians, will allow the department to reopen seven fire companies that were closed during the recession. Thiel also recently reestablished two battalions and one division that had been closed decades ago. (He said the latter decision was based on federal recommendations, following the 2014 death of firefighter Joyce Craig. She suffocated while battling a house fire.)

When just 6% of all calls Philadelphia firefighters respond to are actual fires, and the vast majority of the department’s response is focused on medical emergencies, the question arises: Should the department be focusing more of its resources on the EMS side?

“We have a fire problem and we have huge EMS demand,” Thiel, 47, said in a recent interview. “It’s an ‘and’ proposition. We have to have resources to address all hazards … If we decommissioned a fire engine, it would hurt our response times for EMS because that fire engine is going to EMS calls 24/7/365 and it’s getting there first most of the time.”

Even if firefighters considered a fire to be minor and labeled it as a “pot of meat,” those small fires were supposed to be counted as part of Philadelphia’s structure fire tally under the National Fire Incident Reporting System (NFIRS) that the city moved to in 2009. But Thiel, who worked on the NFIRS system as a consultant 20 years ago, said that the data entry required for even a pot of meat fire is so extensive (the stove’s serial number is one of the prompts), that firefighters might have just put “other” or not counted it at all in order to move to the next call.

Between 2015 and 2017, the city averaged about 2,500 structure fires, of which fewer than 1,000 were confined to cooking containers, or otherwise known as “pot of meat.” There were no “other” fires listed in those years. By 2019, the number of structure fires jumped to 4,889, of which 2,944 were “pot of meat” fires.

Thiel speculated that the increase in cooking fires may have to do with more people living in the city. But population has only increased 0.8% since 2015.

“We don’t know,” he said. “That’s why we are doing the handouts, looking at the data and trying to understand.”

Fire union officials say that firefighters are now more encouraged to count the small fires they used to balk at counting.

“We live in an age that if you don’t have the data to back up the need, you’re not getting anything,” said Marshall, who manages public relations for the union. “You could have people hanging out the third floor window all day long but if you’re not counting them as a fire, you’re not getting anything.”

Thiel, a self-proclaimed data geek, is also a fire-data skeptic—at least when it comes to comparing Philly with other cities and nationally.

“Everywhere in the country, the quality of NFIRS data is very dependent on the users who are inputting the data,” he said. “It’s hard to know the truth.”

But there is no denying that the bread and butter of Philadelphia’s fire department and that of almost every other department around the country are medical calls and not fires.

Nearly half of all incidents fire trucks respond to are medical emergencies and rescues. The second and third most popular incidents are false alarms and “good intent” calls—when a caller thinks there is a fire but firefighters find none. Fire trucks also respond to thousands of car accidents, extractions, elevator rescues and hazardous conditions—such as responding to oil and chemical spills.

“You’re an EMT before you’re a firefighter,” Brian Coughlin, a captain on Ladder 5 on South Broad Street and the fire union treasurer, said. At the fire academy, he added, cadets are first certified as emergency medical technicians before they learn to fight fires. And for good reason.

“You can go a week or two weeks without a fire," he said. "You won’t go a shift without multiple EMS calls.”

Dispatchers will often send fire trucks to stabilize patients having heart attacks or drug overdoses because they are closer to the call—and that’s a result of having more fire trucks than ambulances on the street. Fire trucks outnumber ambulances 83 to 55, with five more ambulances on order.

A firefighter EMT can work on a patient but a fire truck cannot transport a patient to the hospital. And so, firefighters still need to wait for an ambulance.

Two fire dispatchers, who spoke on condition of anonymity because they weren’t authorized to talk to the media, said the volume of medical emergencies has been increasing faster than dispatchers can keep up with—let alone the emergency responders.

“Freaking more medics” is what the department needs, said one dispatcher.

According to national standards, fires should be responded to within 5 minutes and 20 seconds. Philadelphia’s current average fire response time is 6 minutes and 44 seconds.

Medical emergencies should be responded to within 9 minutes. Here the average EMS response time is 12 minutes and 15 seconds.

In the past, response times did not account for the near minute it took for the 911 call center to process the call and dispatch first responders, Thiel noted. The new numbers, while higher, are more accurate.

Another reason for Philadelphia’s below-standard numbers for medical calls is that the department now includes cold calls—incidents that are not life threatening and don’t require lights and sirens, such as a caller complaining about constipation or a head cold. Cold calls make up about 14% of all EMS responses.

“Combined with the opioid problem … resources are severely strained,” another dispatcher said. “Dispatchers and medics are both at the breaking points most days.”

Thiel, along with union leaders, say that the current investments are simply replenishing what was lost during the recession when Mayor Michael Nutter closed seven fire companies and had the controversial brownouts—temporarily closing firehouses and reassigning their firefighters elsewhere on a rotating basis.

Adjusting for inflation and population growth, the department’s prerecession staff size and budgets were lower than now.

The department grew from 2,462 employees in 2007 and a budget of $250 million in today’s dollars to 2,737 employees in 2019. Plans for 2,906 full-time positions and a $333 million budget for the 2020 fiscal year amount to a 33% increase over 2007.

“I can’t speak to what happened before, why those decisions were made,” Thiel said. “I can say that right now, for us to deliver the level of service that I believe our citizens demand, and certainly what’s reflected in our budget, we need a certain set of resources.”

The new firefighters, whose numbers include 68 recent graduates and the 120 hired through the FEMA grant, will help staff the seven fire companies that are reopening. Then every fire house in the city will have an engine truck, which pump water to extinguish fires.

Raymond Vozzelli, a retired firefighter, praised the move to reopen the engine companies. He said that there was a fire recently in his Northeast neighborhood in which the ladder truck arrived first but an engine was delayed. The firefighters who arrived on the ladder evacuated the house where the fire originated, plus ones on either side, and cut a hole in the roof so the kitchen fire wouldn’t spread further. Those efforts failed.

“The firefighters were just looking at the house burning,” he said.

By the time the engine arrived with water, Vozzelli said, all three homes were destroyed.

Despite increases in staffing, the fire department also has been spending record amounts in overtime. Just this past fiscal year, taxpayers paid $49 million in overtime to firefighters and paramedics.

Thiel said the overtime is, in part, a result of supply and demand and not having enough medics to staff the city’s ambulances.

At any given time, he said, 25 to 50% of the city’s ambulances are staffed by firefighters on overtime.