Board of Supervisors:

Recommendations 34

• R1

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  Provide the Bayview Hunters Point District With Neighborhood Schools SFUSD should provide the Bayview Hunters Point district with neighborhood schools commensurate to its population of eligible local students. Response Arlene Ackerman Superintendent of Schools San Francisco Unified School District August 30, 2004 This recommendation does not acknowledge the existence of the SFUSD student assignment system mandated by Consent Decree, which provides students with the right to select schools from any neighborhood within the District. Therefore, students are not limited to available seats in the schools within their own neighborhood. This student assignment system may only be changed by agreement of the parties or by an order of the Court. Currently, there is adequate capacity within the schools in BVHP for students who opt to attend those schools. The SFUSD Master Facilities Plan provides objective criteria for planning educational facilities to meet the changing needs of the community, and to provide options in allocating facility resources to achieve the district’s goals and objectives. The Master Plan includes a capacity study for the District, and included the following conclusion: “The 10-year enrollment projections, in 135 conjunction with the Capacity Study, forecast excess capacity at San Francisco Unified School District’s school facilities of nearly 7,600 seats, or more than 12%, on a district-wide basis for the time frame addressed in this Master Plan.” As of August 25, 2004, there remained 363 open spaces across all grades in K-12 schools located in the 94124 zip code area. Only 6 of the 35 grades offered in the 94124 zip code area are at capacity. However, in order to maximize the quality of the schools located within the BVHP area, SFUSD has initiated the Dream Schools Initiative, and has participated in the STAR Intervention Program and the Secondary School Redesign Initiative. Dream Schools The first three Dream Schools are all located in Bayview/Hunters Point. These schools will provide a pre-kindergarten to grade 12 continuum housed on three campuses: Charles Drew, Twenty-First Century, and Gloria R. Davis. The pre-kindergarten to third grade campus at Charles Drew will be focused on early learning and literacy. The fourth to sixth grade campus at Twenty-first Century will focus on academic development in the upper elementary and middle grades, and the seventh to 12th grade campus at Gloria R. Davis will be focused on academic attainment and college and career preparation. These Dream Schools will be based in part on the Frederick Douglass Academy in Central Harlem, New York started by Dr. Lorraine Monroe. Each of the Dream Schools will incorporate seven core components: (1) Academic Achievement, (2) Varied Learning Opportunities, (3) Parent Empowerment and Support, (4) Alternate Learning Models, (5) College Connections, (6) Career Preparation, and (7) Safe and Friendly Learning Environments. In particular, each of these Dream Schools will provide additional assistance and resources to students and parents to improve academic achievement and transform previously under- performing schools into models for other schools in the District. For example, these Dream Schools will use a longer school day, which will run approximately from 8 a.m. to 5 p.m., and will incorporate after-school tutoring and enrichment programs to help students who need mentoring in particular areas and to provide different kinds of learning experiences to students and families who might not otherwise have them. A wide range of extracurricular activities – including several kinds of dance, drama, employment development, chorus, and sports – will be offered to students attending these Dream Schools at all grade levels. In addition, these Dream Schools will offer various personal development programs, including through partnerships with community organizations such as the Career Resource Development Center, Enterprise for High School Students, Job Corps, and others, to assist students with career and college planning. These Dream Schools will provide students experiential learning opportunities as well – such as internships, job shadowing, and other off-site programs. Each of these Dream Schools also will provide additional resources and activities to encourage parental involvement and build parents’ capacity to support student learning. For example, the pre-kindergarten curriculum at Charles Drew will be delivered through home visits and group 136 meetings that facilitate parent education and development. Parents will be trained by means of sample activities and role-playing, and will be paid to deliver services to other parents through weekly home visits or group meetings. In addition, these schools will offer Saturday sessions that will include family programs that emphasize parental empowerment to permit parents to participate actively in their child’s education. Parents at these Dream Schools may also be able to participate in General Educational Development (“GED”) test preparation, computer training, job skills and employment search skills programs. Faculty members and other administrators at these Dream Schools will be held to the highest standards. For example, all faculty members will be required to participate in designated development activities, including the “Dream School Institute” and an intensive academic professional development training program. Each faculty member also will be expected to sponsor or supervise an after-school activity, communicate with parents extensively, including through at least two parent conferences per year, and participate in schoolwide and community activities. STAR Intervention Program The central goal of the STAR Intervention Program is to increase student achievement at currently underperforming schools. SFUSD provides three categories of targeted interventions – site personnel, District support, and additional resources – to improve student achievement. Each school in the STAR program receives additional site personnel, including an instructional reform facilitator, parent liaison, and volunteer tutors/mentors, to support instructional improvement. In addition, the STAR program provides additional resources to establish new parent centers at each school, transportation services to increase the accessibility of after-school programs, and extended learning packets for distribution to parents and families. Several BVHP schools have participated in the STAR Initiative, including schools such as Charles Drew Elementary, 21st Century Elementary, Hillcrest Elementary, Malcolm X Elementary, Gloria R. Davis Middle School, Martin Luther King Middle School, and Thurgood Marshall Academic High School. Secondary School Resdesign Initiative Finally, Gloria R. Davis has been selected to be part of the Secondary School Redesign Initiative next year, which utilizes funding from the Bill and Melinda Gates Foundation in order to provide small, personalized learning communities, rigorous academic curriculum, opportunities for applied learning, and access to qualified teachers. Arlene Ackerman Superintendent of Schools San Francisco Unified School District June 30, 2005 As noted in the District’s original response, the recommendation does not acknowledge the existence of the SFUSD student assignment system mandated by Consent Decree, which provides students with the right to select schools from any neighborhood within the District. Therefore, students are not limited to available seats in the schools within their own neighborhood. This student assignment system may only be changed by agreement of the parties or by an order of the Court. Currently, there is adequate capacity within the schools in BVHP for students who opt to attend those schools. The District continues to be subject to the Consent Decree. The District continues to provide additional support and resources to the Bayview Hunters Point community through the provision of Dream Schools, the STAR Initiative and the Secondary 137 School Redesign Initiative, as described in the original response. Despite severe budget limitations, the District has offered summer school for all elementary students in BVHP Dream Schools, while elementary schools in the rest of the city only had the option to provide summer school for the 5th grade.
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  The Fire Department and the Department of Public Health Should Establish Criteria for Measuring Success of the Merger SFFD and DPH should establish specific criteria for measuring the success of the merger. They should determine the steps necessary to complete the merger. Steps to be taken and the establishment of timelines should be delineated and agreed upon as soon as possible. Responses Tania Bauer Commission Secretary San Francisco Fire Commission August 12, 2004 Agree. The Commission agrees with this recommendation to the extent that it suggests the establishment of specific criteria for measuring the success of the Department’s provision of Emergency Medical Services. This recommendation will be implemented, understanding that the Commission views the merger as having already been “completed”, but with the view that goals and timelines for further improvement should be established and articulated and accomplishment of these goals measured. Joanne Hayes-White Chief of Department Fire Department August 23, 2004 Disagree in part. The Department and this Administration see the ‘merger’ as being complete. However, as the Department moves forward, it constantly searches for more efficient mechanisms to deliver its critical services. Mitchell H. Katz, MD Director of Health Department of Public Health August 24, 2004 Agree. In retrospect, I wish that we had set specific criteria for measuring the success of the merger in the Phase II document. Although we did not do this, I am nonetheless pleased with the successes that we have achieved: 1. Shorter response times to both life-threatening medical emergencies and to urgent calls. 2. Increased number of ambulances on San Francisco streets. 3. Single communication system for coordinating actions during emergencies. 4. Single chain of command for swift response during emergencies. Although we cannot go backward, I agree with the recommendation that we set goals and timelines for improvements to the current system. I will meet with the Chief of the Fire Department to set up goals and timelines as soon as possible. Edward A. Chow, MD President San Francisco Health Commission August 27, 2004 Agree. The Health Commission held extensive hearings on the Health Department, the Fire Department, and the EMS reconfiguration at the time of the merger. We have been monitoring performance of the EMS System including the number of ambulances on the street, the presence of ALS trained personnel on the Fire engine, and the response time. We will work with the Fire Commission to establish new criteria for measuring the success of fire based EMS. Mitchell H. Katz, MD Director of Health Department of Public Health June 24, 2005 Agree. Although we did not set specific criteria during the merger, I am pleased with the successes that we have achieved: 1) Shorter response times to both life-threatening medical emergencies and to urgent calls. 2) Increased number of ambulances on San Francisco streets. 3) Single communication system for coordinating actions during emergencies. 4) Single chain of command for swift response during emergencies. I met with the Fire Department during the Fall of 2004 to jointly modify the EMS configuration plan based on the successes and limitations of the existing model and the recommendations of a stake holders process. The Health Commission held two hearings on the new configuration, the basic elements of which are: • Establishment of 42 ALS engine companies (from 21). • Dynamic deployment of ambulances with higher number of ambulances at peak times. • Use of dedicated paramedics and dedicated EMTs to staff ambulances. The Commission approved the Reconfiguration Proposal for Emergency Medical Services in the Fire Department at its meeting October 26, 2004. Lee Ann Monfredini President San Francisco Health Commission June 28, 2005 Agree. Although specific criteria was not set during the merger, the Health Commission is pleased with the successes that has been achieved: 1. Shorter response times to both life-threatening medical emergencies and to urgent calls. 2. Increased number of ambulances on San Francisco streets. 3. Single communication system for coordinating actions during emergencies. 4. Single chain of command for swift response during emergencies. Dr. Katz, who reports to the Health Commission, met with the Fire Department during the Fall of 2004 to jointly modify the EMS configuration plan based on the successes and limitations of the existing model and the recommendations of a stake holders process. The Health Commission held two hearings on the new configuration, the basic elements of which are: • Establishment of 42 ALS engine companies (from 21). • Dynamic deployment of ambulances with higher number of ambulances at peak times. • Use of dedicated paramedics and dedicated EMTs to staff ambulances The Commission approved the Reconfiguration Proposal for Emergency Medical Services in the Fire Department at its October 26, 2004 meeting. Paul Conroy President San Francisco Fire Commission July 15, 2005 Reference is made to the attached Fire Commission Resolution 05-4, which provides that the EMS Reconfiguration is to be measured as follows: [The resolution is not attached as part of this report. Please contact the commission for a copy of the document.] “Success of the reconfiguration will be monitored and reported on a continual basis and measured by the following factors: maintenance or improvement of current patient outcomes; maintenance or improvement of current response times; achievement of uniform response times among the City’s battalion districts; compliance with accepted and applicable standards for the provision of pre-hospital emergency care; compliance with EMSEO Section and Department agreed upon standards and Continuous Quality Improvement guidelines; reduction in the current level of fatigue experienced by EMS responders and transporters; fiscal accountability; and the effect on the ability of the Department to provide a balanced response to all types of emergencies; “The Chief of Department shall report to the Commission on a quarterly basis, or more often as circumstances warrant, on the progress and success of the reconfiguration, and shall make recommendations to the Commission concerning any proposed changes to the hiring and deployment schedule outlined above;” It should be noted that the EMS Reconfiguration is at the beginning stages, with no new personnel or apparatus deployed as yet. It is anticipated that the first new ten hour shift Paramedic/EMT ambulances will be deployed in January 2006. The Fire Commission continues to receive regular reports from the Chief of Department and her administration concerning the Department’s provision of EMS services, including response times, quality of service, significant events and the progress of the EMS Reconfiguration. Joanne Hayes-White Chief of Department Fire Department August 1, 2005 STATUS AS OF JUNE 2005: Portions of the recommendation have been implemented 15 The Department has worked collaboratively with the Department of Public Health (DPH) and has identified criteria for ongoing assessment of the delivery of Emergency Medical Service (EMS). The Department reasserts its position that the merger is, in many respects, an unparalleled success. The merger is in fact complete; the Fire Department has become wholly responsible for the delivery of pre-hospital care in the City and County of San Francisco. How that service is delivered are operational details of that merger, not its essence. The merger resulted in rapid Paramedic level Advanced Life Support (ALS) becoming available faster to more of our residents and visitors. Emergency medical systems are fluid and dynamic by their nature. As such, our EMS delivery is constantly evolving to meet the needs of the population served including the incorporation of updated technology. Therefore, it is inherently impractical and counter-productive to make efforts to assess the “success” or “completeness” of a merger which has already occurred. It is far more important for an EMS provider to identify and develop criteria that can be used to measure progress and success on an ongoing basis. In retrospect, the absence of ongoing performance evaluation was a glaring omission from the 1996-97 Phase I and II plans. The Department has, in partnership with the Department of Public Health Emergency Medical Services Agency, a number of indices to measure the success of its EMS system. These criteria are used on a daily and monthly basis by Department upper management to facilitate performance review and provided to the public on a monthly basis at both the Fire Commission and the Mayor’s SFStat meetings. These criteria will be used to monitor and prevent degradation in the level of Emergency Medical Service as the Department moves into the implementation phase of its EMS reconfiguration.
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  The Fire Chief and Fire Commission Should Be Accountable for Achieving Success for the Merger Once criteria and timelines are established, the Chief and the Fire Commission should be held accountable by the Mayor for achieving them. Responses Tania Bauer Commission Secretary San Francisco Fire Commission August 12, 2004 Agree, as noted in 1a, above. The Commission is accountable to the Mayor and agrees that it should be accountable for all goals established for the Fire Department. Joanne Hayes-White Chief of Department Fire Department August 23, 2004 Disagree. See Recommendation 1a. Mitchell H. Katz, MD Director of Health Department of Public Health August 24, 2004 Agree. Edward A. Chow, MD President San Francisco Health Commission August 27, 2004 Agree. Mitchell H. Katz, MD Director of Health Department of Public Health June 24, 2005 Agree. The Fire Department now submits a quarterly report with specific indicators to the Health Commission on the progress of the new configuration. Lee Ann Monfredini President San Francisco Health Commission June 28, 2005 Agree. The Fire Department now submits a quarterly report with specific indicators to the Health Commission on the progress of the new configuration. Paul Conroy President San Francisco Fire Commission July 15, 2005 The Commission continues to agree that it should be accountable for all goals established for the Fire Department, and remains accountable for such.
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  The Mayor Should Appoint a Health Professional to the Fire Commission The Mayor should appoint a health professional, preferably one with Emergency Medical Services experience, to the Fire Commission. Responses Tania Bauer Commission Secretary San Francisco Fire Commission August 12, 2004 The Mayor appoints Commissioners, pursuant to the San Francisco Charter, Sections 3.100 and 4.108, and, therefore, the Commission cannot implement this recommendation. Joanne Hayes-White Chief of Department Fire Department August 23, 2004 Sections 3.100 and 4.108 of the San Francisco City Charter confer exclusive Commission appointment privileges to the Mayor of the City and County. The Department would welcome the opportunity to work with the Mayor’s Office to realize this recommendation. Mitchell H. Katz, MD Director of Health Department of Public Health August 24, 2004 Not applicable to the Health Department. Edward A. Chow, MD President San Francisco Health Commission August 27, 2004 Not applicable to the Health Commission. Mitchell H. Katz, MD Director of Health Department of Public Health June 24, 2005 Not applicable to the Health Department. Lee Ann Monfredini President San Francisco Health Commission June 28, 2005 Not applicable to the Health Department. Joanne Hayes-White Chief of Department Fire Department August 1, 2005 STATUS AS OF JUNE 2005: The recommendation has been implemented Since the Civil Grand Jury issued this recommendation, Dr. Douglas Goldman was appointed to the Fire Commission. Dr. Goldman was a non-practicing, board certified emergency physician. Appointed in October 2004, Dr. Goldman’s tenure ended when he resigned from the Fire Commission in May 2005.
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  The Fire Commission and the Health Commission Should Meet Jointly at Least Quarterly The Fire and Health Commissions should meet jointly at least quarterly for better oversight of SFFD EMS. Responses Tania Bauer Commission Secretary San Francisco Fire Commission August 12, 2004 The Commission disagrees with this recommendation. Medical oversight is provided by: The Department of Public Health Director; the Director of the San Francisco County Emergency Medical Services Agency (EMSA); the Department’s two Medical Directors, all in communication with one another. The Department’s Medical Directors and the EMS Division Chief and the EMS Operations Chief report to the Chief of Department and through her, report directly to the Fire Commission at regularly scheduled Commission meetings. Individual Commissioners recommended in November, 2003 that greater communication occur between the Chief of Department and the EMSA Director. There has been significant improvement in this area since the inception of Chief Hayes-White’s administration, to the benefit of the Department’s provision of EMS services. The Commission believes that there may be occasions in the future when both the Fire Commission and the Public Health Commission would find it beneficial to meet jointly with respect to specific policies or procedures, as appropriate. Joanne Hayes-White Chief of Department Fire Department August 23, 2004 Both Commissions receive regular updates and reports. The Chief and the Director of Public Health meet regularly to discuss any issue that might impact the provision of EMS in San Francisco. Mitchell H. Katz, MD Director of Health Department of Public Health August 24, 2004 Agree. The Health Department agrees that joint meetings between the Commissions, as occurred during the pre-merger discussions, would be worthwhile. Edward A. Chow, MD President San Francisco Health Commission August 27, 2004 Partially agree. The Health Commission agrees that joint meetings between the Commissions, as occurred at the time of the merger, would be worthwhile and we intend to work with the Fire Department to schedule them as soon as possible. We believe the interval of the meetings should depend on the need at the time. Mitchell H. Katz, MD Director of Health Department of Public Health June 24, 2005 Agree. The Health Department agrees that joint meetings between the Commissions, as occurred during the pre-merger discussions, would be worthwhile. While no joint meetings have occurred this fiscal year, the Fire Chief has attended three Health Commission meetings to discuss system changes within the Fire Department. Dr. John Brown, EMS Medical Director regularly attends the Fire Commission meetings. Lee Ann Monfredini President San Francisco Health Commission June 28, 2005 Agree. The Health Department agrees that joint meetings between the Commissions, as occurred during the pre-merger discussions, would be worthwhile. While no joint meetings have occurred this fiscal year, the Fire Chief has attended three Health Commission meetings to discuss system changes within the Fire Department. Dr. John Brown, EMS Medical Director regularly attends the Fire Commission meetings. Joanne Hayes-White Chief of Department Fire Department August 1, 2005 STATUS AS OF JUNE 2005: Implementation is independent of the Department 20 The Department feels that it may be beneficial for the Fire and Health Commissions to hold joint meetings, as necessary, for issues that arise requiring input of both entities.
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  Department Leadership Should Communicate the Importance of EMS. Department leadership should define and communicate the values of the department so that EMS is seen to be at least as important as fire suppression, as stated in the SFFD's mission statement. The Fire Commission, the Chief and Department leadership should promote and support EMS by communicating the value of its mission throughout the Department. Responses Tania Bauer Commission Secretary San Francisco Fire Commission August 12, 2004 The Commission agrees with this recommendation, which has already been implemented. The Commission, in its Annual Statement of Purpose posted on the Commission web site, recites that the provision of emergency medical services, together with fire suppression and fire prevention is an integral part of the Department’s mission. The Commission has also communicated the importance of the Department’s EMS mission in public statements during both regular and special Commission meetings. In addition, at a special meeting convened by the Commission on August 12, 2003 specifically for the purpose of considering steps to take to improve the progress of the merger and to respond to complaints from Firefighter/paramedics, the Commission sought and obtained public comment from members. Following this meeting, two Commissioners undertook a series of individual meetings with all stakeholders in regards to the merger and the complaints since reiterated in the Report. These Commissioners publicly announced and repeated the importance of the EMS mission during the November 25, 2004 Commission meeting. (See minutes of August 12, 2003 Special Meeting and November 25, 2003 Regular Meeting.) Additionally, in communications with Department membership and administration, Commissioners have stressed the importance of a team approach of all segments of the Department in carrying out its mission to provide fire prevention, emergency medical services, fire suppression, rescue and hazardous materials response. The Chief of Department has clearly and unequivocally communicated the same message. Joanne Hayes-White Chief of Department Fire Department August 23, 2004 Agree. This Administration communicates its values, and those of the Department, by words and actions, on a daily basis. EMS, suppression, prevention and training are all equally important and valuable to carrying out the Mission of the Department. Mitchell H. Katz, MD Director of Health Department of Public Health August 24, 2004 21 Not applicable to the Health Department. Edward A. Chow, MD President San Francisco Health Commission August 27, 2004 Not applicable to the Health Commission. Mitchell H. Katz, MD Director of Health Department of Public Health June 24, 2005 Not applicable to the Health Department. Lee Ann Monfredini President San Francisco Health Commission June 28, 2005 Not applicable to the Health Commission. Paul Conroy President San Francisco Fire Commission July 15, 2005 The Commission continues to stress the importance of the EMS mission of the Department. This is evidenced by Resolution 05-4 and continues to be publicly stated by individual Commissioners during Commission meetings. The Chief of Department and her administration continue to communicate this message. Joanne Hayes-White Chief of Department Fire Department August 1, 2005 STATUS AS OF JUNE 2005: Completed The provision of Emergency Medical Services is an integral part of our core mission. This administration continues to articulate that both the EMS and suppression missions define our organization. The message is clear and unequivocal; neither EMS nor Fire suppression has to win at the expense of the other. Our Department will only be successful if these two goals are integrated into a cohesive, unified vision for the future of our Department.
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  Respond to Alarms With Appropriate Staff and Equipment Given that most alarms are false and those that are not are medical in nature, SFFD should respond with appropriate staff and equipment. Responses Tania Bauer Commission Secretary San Francisco Fire Commission August 12, 2004 This recommendation has already been implemented. Additionally, the EMS configuration study is currently underway to refine the Department’s delivery of EMS services and ensure that the most effective and efficient combination of resources is brought to bear on medical and other emergencies. The Commission does not agree with the inference that there has been a disproportionate emphasis on fire suppression, but agrees with the recommendation that the Department should respond with appropriate staff and equipment. Joanne Hayes-White Chief of Department Fire Department August 23, 2004 Disagree. Until proven otherwise, every alarm is a true emergency. The Department currently responds, and will continue to respond, with all necessary apparatus and personnel, as determined by the Chief of Department and her Command Staff. Additionally, the Department is working with the Department of Telecommunications and Information Services (DTIS) to reduce false street alarms by installing False Alarm Deterrent Devices (FADD) on all street boxes. This program is being monitored through the Mayor’s SFSTAT Program and has already proven to be successful. The San Francisco Fire Department is a multi-faceted, multi-skilled public safety agency, whose mission of which is to protect the lives and the property of the people of San Francisco from fires, natural disasters, and hazardous materials incidents; to save lives by providing emergency medical services; to prevent fires through prevention and education programs; and to provide a work environment that values cultural diversity and is free of harassment and discrimination. The Department is staffed by 1,734 members: of those, 1,601 are field personnel directly involved in provision of fire protection and prevention, medical assistance, emergency communications and technical rescues. Sixty-five (65) members provide administrative and investigatory support, training and continuing education curriculum for all Department personnel. Sixty-eight (68) members of the Fire Department are civilians. The Civil Grand Jury commissioned a report on the Fire Department in July of 2003, some six months prior to Chief Hayes-White taking office. In 1996, the City and County of San Francisco was faced with what physician and medical groups termed a “public health crisis”. The Paramedic Division of the Department of Public Health was not meeting the County’s mandated response times. The question that faced the Health Commission, the Health Department and the Director of Public Health was how to provide the maximum number of health care resources to the City of San Francisco, using existing equipment, without a significant increase in expenditures. Transfer of EMS into the Fire Department was the natural next-step. Fire Services all over the nation had successfully assumed responsibility for providing Paramedic Services and the San Francisco Fire Department had been providing emergency first response since the late 1950’s. Every front line responder in the Department has been staffed with at least one firefighter trained to the level of Emergency Medical Technician since 1989 and equipped with first aid equipment, oxygen and an automatic external defibrillator. Additionally, the Fire Department was equipped and trained in extrication, confined space rescue and Hazardous Materials mitigation techniques. The addition of Paramedics was a logical progression in the development of the services it provided. The SFFD has had three Chiefs since 1997. Lack of continuity, lack of long range goals and the lack of time and ability for the Department to meet those goals are all factors in the questions that are raised in this report. This Administration has stated unequivocally that the transfer of function of Paramedic Services from the Department of Public Health to the Fire Department is complete. The combination of services and the strengthening of the service provided have created a public safety entity that is orders of magnitude stronger than the sum of its parts. Except for the National Fire Protection Agency (NFPA) standards, the Fire Services of this nation have enjoyed operational autonomy since their inception. Each Fire Department carries equipment and tools unique to its own operational district and no two Fire Departments are exactly alike. In contrast to the Fire Service, the medical profession is very different in regards to oversight and autonomy. There are laws, directives, and governing bodies for every facet of medicine, and EMS is no exception. The State EMS Agency oversees fifty-eight counties in California, each with its own Department of Public Health, and its own Emergency Medical Services Agency. Each county is required by state law to have an EMS Medical Director, who is responsible for the oversight, regulation and efficacy of the pre-hospital medical and trauma care practiced in their jurisdiction. Every provider in those jurisdictions, public or private, maintains a Director of EMS who is responsible for the oversight and efficacy of the medical care being provided by their agency. In San Francisco, the Fire Department is overseen by the civilian governing body of the Fire Commission. Public Health is overseen by the like civilian body of the Health Commission. The perception that there is no contact between the Health Commission and the Fire Commission is incorrect. While the twelve commissioners do not regularly conduct joint meetings or discussions, the Health Commission is keenly aware of the Fire Department’s provision of pre- hospital care. The Fire Department provides ongoing reporting and documentation to the office of the EMS Medical Director of the Department of Public Health. John Brown, MD, presents to the Health Commission in the same manner that the Department presents to the Fire Commission. During his presentation, Doctor Brown reports on the Fire Department activities and response times. In addition, Chief Hayes-White and Doctor Mitch Katz maintain open lines of communication and confer on a regular basis. The Fire Department provides a myriad of services to the public. The perception that fire suppression is valued more highly than EMS services is false. This Department values every 24 component of its mission equally, and every facet of this Department is geared towards the preservation of life and property in San Francisco. The Controller’s Report of 2004 noted that the Fire Department responds to 20,000 street box alarms per year. The audit went on to state that 95% of street box alarms are false. The Fire Department also responds to 1,836 ‘person downs’, 3,256 ‘vehicle crashes’ and 6,128 ‘sick evaluations’ per year. The majority of those incidents are without emergency merit, but many are true life-threatening emergencies. Until a Paramedic is on scene and can determine the extent of the emergency, every person down is considered a cardiac arrest. Until Firefighters can arrive on scene and determine the extent of the emergency, every street box alarm is considered a working fire. In the past, the Department responded to most alarms with a full box assignment. The apparatus dispatched has been pared down to accommodate changes in the nature of service requests. A first response Engine and a Truck are considered to be the absolute minimum response to an initial box alarm. It should be made clear that the Department is constantly evaluating system performance and seeks to deploy the most effective configuration of resources to each call for service. Mitchell H. Katz, MD Director of Health Department of Public Health August 24, 2004 Not applicable to the Health Department. Edward A. Chow, MD President San Francisco Health Commission August 27, 2004 Not applicable to the Health Commission. Mitchell H. Katz, MD Director of Health Department of Public Health June 24, 2005 Not applicable to the Health Department. Thank you again for all the hard work involved in preparing this report. Lee Ann Monfredini President San Francisco Health Commission June 28, 2005 Not applicable to the Health Commission. Thank you again for all the hard work involved in preparing this report. Paul Conroy President San Francisco Fire Commission July 15, 2005 The EMS Reconfiguration has been developed by the Department and approved by the Commission as a means of further enhancing the provision of Fire-based EMS service to the public. The Department continues to respond with appropriate staff and equipment to fire, medical and other emergencies.
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  Confront the Perception that Local 798 Is Running the Department Department leadership should confront the commonly held perception that Local 798, rather than the Chief, is “running the department.” Response Joanne Hayes-White Chief of Department Fire Department August 23, 2004 Disagree. The Department has had three Chiefs over the past seven years. This procession of Department Heads had difficulty in achieving the momentum necessary to effect substantive change. Chief Joanne Hayes-White and the current Command Staff is committed to providing, and has already displayed the strong leadership necessary to facilitate change and promote the accountability and professionalism throughout the ranks of the Department. IAFF Local 798, as the authorized bargaining unit for most members of the Department is involved in any decision that has the potential to impact the wages, hours or working conditions of its members. The Chief, however, is the sole arbiter of decisions that affect the operations and administration of the Department. The current leadership has already displayed its willingness to exercise independent authority, often in opposition to the opinion of the labor union. 28
• R2a

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  Determine and Control the Cost of Its Benefits Plans and Prevent Abuses Management should determine and control the cost of its benefit plans and act to prevent abuses. Response Cleopatra Vaughns Chair Board of Directors Municipal Transportation Agency Michael T. Burns Executive Director of Transportation Municipal Transportation Agency August 25, 2004 Implemented. Muni is controlling the costs of benefit plans and is actively routing out and eliminating abuse. The Municipal Railway is part of the City and County of San Francisco and strictly adheres to its established policies and procedures. The three benefit plans mentioned in the Grand Jury report: Battery Pay, Transitional Work and Workers' Compensation, each have specific components for preventing abuse. All claims for battery pay are investigated by a full-time staff investigator who reviews the incident report and the video tape on-board the vehicle, interviews witnesses, takes a recorded statements from battery pay applicants, reviews all medical evidence and reviews the appropriate City and County laws prior to accepting or denying a claim. As mentioned in section 2.5, there are currently 4 employees who are receiving battery pay at this time A Transitional Work Program Coordinator as well as supervisors and superintendents to whom transitional work employees are assigned monitors the work performed. Workers’ Compensation staff conducts random spot checks. In the event that an abuse of the program is validated, the appropriate steps are taken that may include docked pay, counseling or re-assignment. Benefit rates and increases for the Workers' Compensation program are set by the State of California. Muni’s role is to monitor acceptance and denial of claims, ensure appropriate benefit distribution and insure contract compliance by our Third Party Administrator (TPA). All claims for Workers' Compensation are investigated to determine the validity of the claim. Once the validity has been established, the TPA is contractually required to review each claim every 14, 30, 60 and 90 days, depending on the type of benefit paid or the seriousness of the claim. Workers' Compensation staff reviews claims-related issues with the TPA on a daily basis. Muni investigates allegations of fraud or abuse in cooperation with other city or regional agencies such as the San Francisco Police Department, BART, and the District Attorney. Muni also has a telephone “tip hotline” to encourage the reporting of any abuse.
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  Base Pay for the Light-Duty Plan on Hours Actually Worked Management should consider basing pay under the light-duty plan on hours actually worked. Response Cleopatra Vaughns Chair Board of Directors Municipal Transportation Agency Michael T. Burns Executive Director of Transportation Municipal Transportation Agency August 25, 2004 Implemented. Muni employees in the Transitional Work Program are paid based on hours worked. In 1996, pursuant to Proposition J, the Budget Analyst performed a full management audit of the Public Transportation Department. One of his recommendations was to “discontinue the practice of paying overtime to Special Duty Operators in MUNI Headquarters, for time not actually worked”. A review of the Action Plan prepared by Muni in response to the Audit shows that a policy was established in September 1996, and continues today, that Operators in the Transitional Work Program would be paid on an hourly basis and that staff would monitor compliance with this policy on an ongoing basis. 115 (In 1996, the terms “Special Duty” and “Light Duty” were used interchangeably. Today, the program is called the Transitional Work Program.)
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  Ensure Employees Are Eligible for Light-Duty and That They Actually Perform Assigned Tasks. Management must establish controls to ensure that those employees assigned to light-duty are eligible under the conditions of the plan and are actually performing their assigned tasks. Response Cleopatra Vaughns Chair Board of Directors Municipal Transportation Agency Michael T. Burns Executive Director of Transportation Municipal Transportation Agency August 25, 2004 Implemented. A physician must diagnose all industrially injured employees in writing, before they are eligible for transitional work. A Transitional Work Program Coordinator as well as the supervisors and superintendents to whom transitional work employees are assigned monitors the work performed. In addition, Workers’ Compensation staff conducts random spot checks. Employees assigned to the Transitional Work program are performing their assigned tasks.
• R2d

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  Managers Should Be Responsible for Employees’ Performance of Light-Duty Assignments. The managers of the departments to which light-duty personnel are assigned should be responsible for their presence and performance. Response Cleopatra Vaughns Chair Board of Directors Municipal Transportation Agency Michael T. Burns Executive Director of Transportation Municipal Transportation Agency August 25, 2004 Implemented. Muni agrees with this recommendation and is confident that all transitional work employees are under supervisory control. A Transitional Work Program Coordinator as well as the supervisors 116 and superintendents to whom transitional work employees are assigned monitors the work performed. Worker’s Compensation staff also performs random checks.
• R2e

  Page 125
  The Controller and Budget Analyst Should Audit the Light-Duty and Battery Pay Plans and the Workers’ Compensation Benefit Program. The Office of the Controller and the Budget Analyst's Office should conduct independent audits of the light-duty and battery pay plans and workers’ compensation benefit programs to determine the actual costs of the plans and benefits and the feasibility of determining ways to reduce the overall costs of those programs. Responses Cleopatra Vaughns Chair Board of Directors Municipal Transportation Agency Michael T. Burns Executive Director of Transportation Municipal Transportation Agency August 25, 2004 Not yet Implemented The MTA welcomes audits by any agency. Cleopatra Vaughns Chair Board of Directors Municipal Transportation Agency Michael T. Burns Executive Director of Transportation Municipal Transportation Agency June 30, 2005 We continue to welcome audits by any agency. Ed Harrington Controller Office of the Controller July 29, 2005 The recommendation has not yet been implemented, but will be implemented in the City Services Auditor Division’s audit plan for fiscal year 2005-06. The City Services Auditor Division will work with Muni to determine the priority for conducting audits of the light-duty and battery pay plans and workers’ compensation benefit programs. 117
• R2f

  Page 126
  Examine Plans to Ensure They Do Not Duplicate Benefits. Compensatory plans should be examined to ensure that, although they may provide similar assistance, they do not duplicate the benefits. Response Cleopatra Vaughns Chair Board of Directors Municipal Transportation Agency Michael T. Burns Executive Director of Transportation Municipal Transportation Agency August 25, 2004 Implemented. Muni has examined their plans and we are not aware of any compensatory plans that duplicate benefits to injured employees. Some employees may have obtained individual long-term or short- term disability policies that may be used to supplement Workers’ Compensation benefits. Those plans are entirely outside of Muni’s control.
• R3

  Page 155
  Undertake Greater Outreach to Ensure Eligible Students Are Enrolled in Dream Schools. SFUSD should undertake greater outreach in order to insure that eligible students get enrolled in Dream Schools and that students not eligible are given every opportunity to attend their current school next year with equal or improved resources. Responses Arlene Ackerman Superintendent of Schools San Francisco Unified School District August 30, 2004 This recommendation has already been implemented, as described in Section 3.8, above. Over 280 new students have been assigned to the Dream Schools, and there is a wait list for the entering kindergarten class. The District will continue its efforts to inform families and students about the Dream Schools Initiative. Arlene Ackerman Superintendent of Schools San Francisco Unified School District June 30, 2005 As noted in the District’s original response, the District took detailed and thorough action to ensure that students were aware of their opportunities and choices within the District, including the opportunity to attend a Dream School. Students who were attending a school that was converted to a Dream School were assigned to remain at that site unless they affirmatively chose to transfer to another school. There were no eligibility requirements to enroll in a Dream School.
• R3a

  Page 43
  Allocate Resources According to the Change in Workload From Fire Suppression to EMS. Resource allocation and staffing should reflect the Department's change in workload from fire suppression to EMS. Responses Tania Bauer Commission Secretary San Francisco Fire Commission August 12, 2004 Agree. This recommendation has already been implemented and is also undergoing further evaluation through the EMS Configuration process. It should be pointed out that although the medical dispatches amount to approximately 70% of the current dispatch volume, this medical workload has been layered on top of the Department’s pre-merger fire and emergency response. These additional calls do not obviate the need to respond to suppression and other emergencies. Given the age and density of San Francisco’s predominantly wood frame structures, quick and aggressive response by a sufficient number of personnel and apparatus is necessary to extinguish fires before they spread, which could otherwise result in conflagration. Resources cannot be allocated based solely on the daily series of dispatches, but must also be ready to respond to the regular occurrence of fire and the risk of earthquake, conflagration and other anticipated major events. Joanne Hayes-White Chief of Department Fire Department August 23, 2004 Disagree. The Department’s workload is reflective of the demands that the public places on its resources. Paul Conroy President San Francisco Fire Commission July 15, 2005 As noted in the Commission’s response, above, the recommendation has already been implemented. Since the response, the EMS Reconfiguration has been approved by the Commission as a means of further enhancing the Department’s provision of emergency medical services.
• R3b

  Page 43
  The Fire Chief Should Be Directed to Allocate Resources to Support the EMS Mission The Mayor, Board of Supervisors and the Fire Commission should direct and support the Chief in making resource allocation changes that properly support the EMS mission. Responses Tania Bauer Commission Secretary San Francisco Fire Commission August 12, 2004 Agree. This recommendation has already been implemented and is continuing. The Commission has overseen the deployment of Department resources to carry out the EMS mission of the Department since the inception of the merger as noted in the Introduction to this response. Joanne Hayes-White Chief of Department Fire Department August 23, 2004 The Chief works collaboratively with the Mayor, the Board of Supervisors and the Fire Commission. Paul Conroy President San Francisco Fire Commission July 15, 2005 Since the above response, the Fire Commission has approved the EMS Reconfiguration to further enhance the Department’s provision of emergency medical services to the public. Joanne Hayes-White Chief of Department Fire Department August 1, 2005 STATUS AS OF JUNE 2005: Chief Hayes-White continues to work collaboratively with the Mayor, the Board of Supervisors and the Fire Commission in oversight of the Department operations. They have provided the support and counsel necessary to allow the Department to move forward, including implementation of our EMS reconfiguration plan.
• R3c

  Page 44
  The Board of Supervisors Should Direct the Fire Chief to Implement the Recommendations of the Controller’s Office The Board of Supervisors mandated the review of SFFD recently conducted by the Controller's Office. The Board should now act on and direct the Chief to implement the recommendations. Responses Tania Bauer Commission Secretary San Francisco Fire Commission August 12, 2004 This is a recommendation to the Board of Supervisors. The previous and current Presidents of the Commission have met with the Controller and his staff concerning the Controller’s recommendations. The Department has responded in those meetings and during the public meeting conducted by the Finance Committee of the Board of Supervisors. Under the City Charter, it is the Fire Commission that sets objectives, programs and policies and prescribes and enforces rules and regulations for the Fire Department. Joanne Hayes-White Chief of Department Fire Department August 23, 2004 The Department is committed to implementing any change that promotes efficiency without compromise to operational readiness and ability to deliver service. The Controller’s report, as is any audit or report of an organization, a tool for the management of that agency. The Department is respectful of the recommendations made in that report. Each recommendation was reviewed by the Department for feasibility and to gauge its impact on service. The Department has implemented or is in the process of implementing many of its recommendations. The Department committed to implementing change that promotes efficiency without impinging its ability to safeguard the health and welfare of the public it serves. The Department has been aggressive in maintaining on-going dialogues with all Supervisors, decision makers and community leaders, in its institution of fiscal policies while mitigating any operational impact. Joanne Hayes-White Chief of Department Fire Department August 1, 2005 STATUS AS OF JUNE 2005: Portions of the Controller’s Office recommendations have been implemented. The Department continues to use the review conducted by the Controller’s Office as a valuable management tool, and has already completed implementation of a number of the recommendations in the report. The Controller’s Report made two important recommendations concerning the delivery of EMS services by the Department. The Controller recommended: 1. The use of peak period staffing3 3 A Review of the San Francisco Fire-EMS System, Office of the Controller, April 2004, pg. 12 37 2. The implementation of alternative staffing and shifts4 Both of these recommendations will be implemented as part of the Department’s current EMS Reconfiguration plan. Additionally, after discussions with the Controller’s Office, the Department completed its analysis of data on street box alarms in October of 2004. Rather than reconfigure response and jeopardize the health, safety or property of those legitimate requests for service, the Department partnered with the Emergency Communications Department (ECD) and the Department of Telecommunications and Information Service (DTIS) to install Anti-Tamper Devices on Fire Call Boxes. This action has resulted in a 35% reduction in false alarms.
• R4

  Page 157
  Undertake Greater Outreach to Ensure Eligible Students Receive Free or Low-Cost Lunches. SFUSD should undertake greater outreach in order to insure that students who are eligible for free or low- cost lunches are receiving them. Responses Arlene Ackerman Superintendent of Schools San Francisco Unified School District August 30, 2004 This recommendation has already been implemented, as described in Section 4.3, above. Arlene Ackerman Superintendent of Schools San Francisco Unified School District June 30, 2005 As noted in the District’s original response, the District took detailed and thorough action to ensure that parents and guardians filled out free and reduced lunch applications. Additionally, the District explained that SFUSD does not deny any student a free or reduced price lunch due to their parent’s failure to return the appropriate documentation. If a parent fails to return such documentation, the result is that the District will not be reimbursed for the lunch that is provided to the student. In the fall, the free and reduced cost lunch program application will be included in the August welcome packet sent home to all students. The forms in this packet all must be filled out and returned at the beginning of the school year, and are stapled together to ensure that parents understand that all of the enclosed forms must be filled out and returned. 149
• R4a

  Page 50
  Recruit and Retain Firefighter/Paramedics Recruitment and retention of firefighter/paramedics is a critical problem that needs immediate attention. The Department should hire additional firefighter/paramedics and/or cross-train more existing personnel to be firefighter/paramedics as soon as possible. Responses Joanne Hayes-White Chief of Department Fire Department August 23, 2004 Agree. The number of Firefighter/Paramedics will be determined by any changes in deployment and configuration. Joanne Hayes-White Chief of Department Fire Department August 1, 2005 STATUS AS OF JUNE 2005: The recommendation is in process The Department continues to be committed to recruitment and retention of high quality candidates that reflect the diversity of our City and can serve our community as Firefighters and as Firefighter / Paramedics. The Department considers possession of a valid paramedic license as important secondary criteria for candidates seeking entry into the H2 Firefighter Academy. Additionally, the Department has secured an MOU with the City College Paramedic program to guarantee or current firefighters an opportunity to train to become Paramedics. The report of the SFFD EMS Reconfiguration Committee of October 2005 and the subsequent adoption of its recommendations has compelled a change in focus from the recruitment and retention of currently cross trained Firefighter / Paramedics to the recruitment and retention of currently certified and licensed EMTs and Paramedics. Future cross trained Firefighter Paramedics would be drawn from the ranks of Paramedics serving on the transport tier. The Department anticipates holding the entrance exam for Paramedics in the latter part of this year and the entrance exam for EMTs sometime in early 2006.
• R4b

  Page 51
  Cross-train Both Officers and Firefighters Officers should be cross-trained as well as rank and file firefighters. Officers who are already cross- trained should continue their paramedic licensure and use their paramedic skills in their command positions. Responses Joanne Hayes-White Chief of Department Fire Department August 23, 2004 Agree. Matriculation through the ranks by Firefighter /Paramedics will occur naturally as promotional exams are given. Evidence can be found in all departments (i.e. LA County, San Diego, etc.) where Paramedic level EMS has been a long standing component of operations. Joanne Hayes-White Chief of Department Fire Department August 1, 2005 STATUS AS OF JUNE 2005: The recommendation will be implemented in the future or is in process Diversity in middle-management positions is critical to the long term health of any organization. While the cross-training of officers is a laudable goal, it is somewhat impractical. The Department believes that achieving diversity throughout its ranks is best accomplished by the steady promotion of Firefighter / Paramedics. Departments across the nation that have successfully integrated the EMS component have done so with “bottom-up” promotions and not a “top-down” imposition of policies. Future promotional examinations conducted by the Department will have significant emphasis on the EMS mission of the Department as well as the traditional fire suppression components.
• R4c

  Page 52
  Reduce Ambulance Workloads Alleviation of heavy ambulance workloads should be addressed as soon as possible. The necessity for a 24-hour ambulance shift should be reviewed as well as other options for transporting patients. Responses Joanne Hayes-White Chief of Department Fire Department August 23, 2004 Agree. Formulating an action plan to address ambulance workload is a main component of the Reconfiguration Task Force. These issues are not unknown to the Department, and the leadership is committed to addressing the issues of workload on the ambulances and the inevitable attrition of Firefighter / Paramedics. The number of Paramedics has not increased in proportion to call volume that has increased significantly in recent years. This problem has manifested in increases in unusual occurrences (UOs), a frustrated workforce and a non-retirement attrition rate for Firefighter / Paramedics that is higher than their Firefighter colleagues. The Department is also acutely aware that the problem of high ambulance call volume does not exist independent of greater systemic issues. In order to be successful, any strategy addressing this issue must be part and parcel of an overall direction and vision for the provision of EMS in the Department. The Department has already taken steps to address the larger system-wide issues it currently faces. It is in the process of reviewing the final report of the recent Reconfiguration Task Force and, in conjunction with the Mayor’s Office and Department of Public Health, will select a model for the future. Negotiations with City College of San Francisco have recently been completed that secure spots in the City College Paramedic Training Program for our Firefighters. The current class of forty-eight (48) probationary Firefighter recruits was required to possess current, valid California State Emergency Medical Technician (EMT) certificate as a prerequisite to employment. Twelve (12) members of that class are licensed Paramedics. The current administration has an unprecedented number of Firefighter / Paramedics among the Command Staff. Two (2) Assistant Deputy Chiefs are cross-trained Firefighter/Paramedics, in addition to several Lieutenants and fourteen (14) Rescue Captains already in command or supervisory positions. The Department is committed to promote and continue the advancement of Firefighter/Paramedics through its ranks. Joanne Hayes-White Chief of Department Fire Department August 1, 2005 STATUS AS OF JUNE 2005: The recommendation will be implemented in the future or is in process The new administration of the Department immediately recognized the critical need to address the heavy workload placed on the transportation arm of the Department. Ambulance workload has been the primary focus of the reconfiguration workgroup and the long term solution to this issue is the sweeping, system wide change of the reconfiguration. The Department is moving to implement its new EMS reconfiguration with all haste. Once the remaining labor and human resource hurdles are cleared, the Department anticipates that the first dynamically deployed units will be on our streets in the latter half of FY 2005-2006. In the interim, the Department is considering a number of changes that will provide some relief to our units through the implementation of the new transport tier. The changes being considered include: • Rotation of unassigned Firefighter / Paramedics • Selected use of ALS Engine Responses to a subset of Code 2 calls • Modification of dispatch rules for our units with the highest call volume • More aggressive use of private ambulance resources 45
• R5a

  Page 60
  Identify and Discipline Those Engaging in Harassing Behavior Department leadership should identify the stations where harassment is occurring. Those engaging in harassing behavior should be appropriately disciplined. The range of discipline should include suspension with or without pay and/or firing, depending on the degree of harassment. Harassers who are not fired should be reassigned to different stations. Responses Tania Bauer Commission Secretary San Francisco Fire Commission August 12, 2004 The Commission agrees with, and has already implemented and pursued a policy that harassment of any type, including harassment of Firefighter/paramedics, will not be tolerated. The Department should continue to investigate specific claims of harassment and, if verified, impose appropriate discipline, up to and including potential termination. The Department should take steps to eliminate structural impediments that are perceived as preventing enforcement of the Department policy that harassment will not be tolerated. The Commission recently terminated a member it found guilty of harassment. Joanne Hayes-White Chief of Department Fire Department August 23, 2004 Should evidence become available, and should this finding be substantiated, this Administration will move swiftly and decisively to address the allegations. Paul Conroy President San Francisco Fire Commission July 15, 2005 Since the Commission’s response, the Commission has heard additional disciplinary matters concerning incidents predating the Grand Jury Report and has appropriately disciplined those members found guilty of harassment. The Commission also disciplined an officer who did not take appropriate steps to stop harassment. There are currently no complaints of harassment before the Commission. Neither the Fire Commission, nor individual Commissioners, have received any complaints that harassment of Firefighter Paramedics, Paramedics or women members has occurred since the issuance of the Grand Jury Report to the present date. Joanne Hayes-White Chief of Department Fire Department August 1, 2005 STATUS AS OF JUNE 2005: The recommendation has been implemented 52 Harassment of any kind, and for any reason, is not tolerated by this Department. This administration takes our obligation to provide a safe and supportive workplace, free from harassment of any kind very seriously, and has already demonstrated its commitment in the discipline and termination of members who have committed this infraction.
• R5b

  Page 61
  Hold Officers Accountable for Actions or Inactions Related to Harassment. Ranking officers should be held accountable for their actions or inaction related to harassment. Officers who participate in or allow those under their supervision to participate in harassment should be disciplined. The range of discipline should include suspension without pay, demotion and/or firing, depending on the severity of the offense. Responses Tania Bauer Commission Secretary San Francisco Fire Commission August 12, 2004 The Commission agrees with this recommendation, which has already been implemented. Joanne Hayes-White Chief of Department Fire Department August 23, 2004 See 5a. Paul Conroy President San Francisco Fire Commission July 15, 2005 Since the Commission’s response, the Commission has heard additional disciplinary matters concerning incidents predating the Grand Jury Report and has appropriately disciplined those members found guilty of harassment and an officer who did not take appropriate steps to stop the harassment. There are currently no complaints of harassment before the Commission. Neither the Fire Commission, nor individual Commissioners, have received any complaints that harassment of Firefighter Paramedics, Paramedics or women members has occurred since the issuance of the Grand Jury Report to the present date. Joanne Hayes-White Chief of Department Fire Department August 1, 2005 STATUS AS OF JUNE 2005: The recommendation has been implemented 53 This administration is keenly sensitive to the issue of harassment, and continues to take its obligation to provide a safe and supportive workplace, free from harassment of any kind very seriously, and has already demonstrated its commitment in the discipline and termination of members who have committed this infraction. All members, regardless of rank, are held accountable.
• R5c

  Page 62
  Hold Fire Department Leadership Accountable for Eliminating Harassment The Fire Commission should hold Department leadership accountable for eliminating harassment. Responses Tania Bauer Commission Secretary San Francisco Fire Commission August 12, 2004 The Commission agrees with this recommendation, which has already been implemented. Joanne Hayes-White Chief of Department Fire Department August 23, 2004 Harassment of any kind, and for any reason is not tolerated by this Department. This Administration has zero tolerance for harassment of any kind and is obligated to provide a safe and supportive workplace. The current Administration takes the obligation very seriously, and has already demonstrated its commitment in the discipline and termination of members who have committed this infraction. Any member who feels that he or she is being subjected to harassment or unfair treatment is obligated to speak up, loud and clear. Whoever the offender, whatever his or her rank, position or title, if a member of this Department is harassing another, that person can expect a swift and appropriate response from my office. Paul Conroy President San Francisco Fire Commission July 15, 2005 The Department leadership continues to be vigilant in eliminating harassment, as demonstrated above. Joanne Hayes-White Chief of Department Fire Department August 1, 2005 STATUS AS OF JUNE 2005: The recommendation has been implemented 54 The Fire Commission is unwavering in holding Department leadership responsible for providing a safe and supportive work environment, free from harassment of any kind. The current administration welcomes the accountability required from this Fire Commission.
• R6

  Page 63
  Provide Comprehensive Leadership and Command Training for All Officers The Department should provide comprehensive leadership and command training for all officers prior to their assumption of command. Periodic training should emphasize professionalism, responsibility and accountability and be given on a regular, ongoing basis. Training should include conflict resolution and team building. Responses Joanne Hayes-White Chief of Department Fire Department August 23, 2004 The roles and responsibilities of the officer-as-supervisor have changed dramatically over the years. At one time, a supervisor just needed to be respected by their peers to perform adequately. The role of the supervisor has evolved dramatically. Today, a successful supervisor in the Fire Service must not only understand and know operations and tactics about a broad scope of potential challenges, but be well versed in modern management and personnel theory. Assistant Deputy Chief Tom Siragusa and his training staff are currently researching leadership and command programs for all SFFD Officers. Examples will be drawn from civilian corporations, uniformed public service agencies and even officer training programs from the Armed Forces. In fact, the Department recently completed a comprehensive three-day Battalion Chief Academy training program. Joanne Hayes-White Chief of Department Fire Department August 1, 2005 STATUS AS OF JUNE 2005: The recommendation has been implemented In the last nine months, management and supervisory classes were held for members accepting provisional promotions into the officer ranks. Curriculum included modules in customer service, professional demeanor, conflict resolution and teambuilding, administrative responsibilities, review of fire tactics, dealing with high risk, low frequency operations such as high-rise fires, BART / MUNI responses, management multi-casualty incidents and disaster operations. Accountability is a key element to the success of any organization, and is expected from every member of this Department regardless of rank. This administration continues to hold all its members accountable for performance and behavior. While the administration continues to hold all members accountable for their actions, promotional exams and permanent appointments are crucial to executing this recommendation. The Department looks forward to resolution between the Civil Service Commission and Local 798 regarding the promotional certification rule.
• R7a

  Page 71
  Develop Secondary Promotional Criteria for Submission to the Civil Service Commission Department leadership should develop and submit secondary promotional criteria to the Civil Service Commission for approval as soon as possible. Although there is a legal appeal in process and the Department will not be able to act until this appeal is resolved, it is imperative that the Department be ready to proceed with examinations and selections after the appeal is adjudicated. Responses Joanne Hayes-White Chief of Department Fire Department August 23, 2004 The Chief is working closely with the Civil Service Commission and employee groups to develop meaningful and measurable secondary criteria. Kate Favetti Executive Officer Civil Service Commission August 23, 2004 Agree. There is no legal reason to delay further. The examination for the Captain’s rank is ready to be administered. Joanne Hayes-White Chief of Department Fire Department August 1, 2005 STATUS AS OF JUNE 2005: The recommendation will be implemented in the future or is in process The Department has worked in partnership with the employee groups to develop meaningful, measurable secondary criteria for promotional examinations and is working to assure that approved criteria will be in place after all legal issues are resolved and promotional exams are scheduled.
• R7b

  Page 72
  The Mayor Should Investigate Why the Fire Department Has Not Given Promotional Examinations The Mayor should investigate why promotional examinations have not been given in the SFFD and determine what the financial ramifications are. Responses Joanne Hayes-White Chief of Department Fire Department August 23, 2004 Chief Hayes-White works collaboratively with the Mayor’s Office on all Department related issues. Kate Favetti Executive Officer Civil Service Commission August 23, 2004 Examinations are ready to be administered. The Civil Service Commission is waiting for the Fire Chief to return to the Civil Service Commission with secondary criteria. Joanne Hayes-White Chief of Department Fire Department August 1, 2005 STATUS AS OF JUNE 2005: Implementation is independent of the Department.
• R7c

  Page 73
  The Mayor Should Investigate Why the Civil Service Commission Implemented a Certification Rule Not Supported by Management and Labor The Mayor should investigate why the Civil Service Commission implemented a new certification rule that neither management nor labor want. Responses Joanne Hayes-White Chief of Department Fire Department August 23, 2004 The Department continues to work with the Mayor’s Office in an effort to provide updates related to the development of a timeline for administration of promotional examinations. The Department is eager to hold promotional examinations for all ranks. The appointment of permanent officers is critical to improving accountability and the ability of the Department to move forward at a rapid pace. Serial litigation, lack of funding and protracted development of Civil Service certification rules have delayed the administration of promotional exams for a number of years. The Department is working diligently with the Department of Human Resources and employee groups to develop secondary criteria, and hopes to resolve this issue in the near future. When funding is allocated for promotional exams, the Department intends to administer them without unnecessary delay. It should be noted that the H-30 Captain’s Examination has been developed and will be the first promotional exam to be administered. Kate Favetti Executive Officer Civil Service Commission August 23, 2004 The Civil Service Commission has Charter authority to establish Rules to administer the merit system, including applications, examinations, eligible lists, and certification rules, specifically, the certification rules for promotions. In doing so, the Civil Service Commission takes into account the input from department heads, employee organizations, other interested persons and members of the public. Civil Service Commission Rules require for promotions in the Fire Department that qualified firefighters take a test that is job related and valid. Those who pass the test are placed on a list in 65 order of their scores and only reachable candidates (those in the grouping/band) are referred to the Fire Chief for consideration for selection. The Commission, in considering various certification rules for promotions in the Fire Department, took into account the more than 20 year history of litigation on San Francisco Fire Department examinations resulting in the Consent Decree. With the termination of the Consent Decree and the subsequent Stipulated Order in 1998, the Civil Service Commission adopted updated Rules applicable to the Uniformed Ranks. The challenge facing the Civil Service Commission was to establish a fair and defensible certification Rule for promotions that enables the Fire Chief to select the best-qualified candidates and ensures compliance with Federal, State and local anti-discrimination laws. Statistically valid grouping is a concept that has withstood court challenge in many instances and involves a statistical formula to determine that eligibles have comparable knowledge, skills and abilities and that the difference in their scores is not significant and are included in the “grouping” (the band). Those eligibles are referred to the Fire Chief for consideration for selection. The Fire Chief may only consider the scores in the band. Additional eligibles may only be considered when the top score is exhausted. The Civil Service Commission Rules also require the Fire Chief to develop secondary criteria that are job-related, based on experience, training and employment history, and NOT based on relationship, race, religion, national origin, ethnicity, age, disability, gender, gender identity, political affiliation, sexual orientation, ancestry, marital or domestic partnership status, parental status, color, medical condition, or otherwise prohibited nepotism, or favoritism. Certification Rules authorized by the Civil Service Commission are the Rule-of-Three-Scores, Rule-of-Three-or-More-Scores, Rule-of-List and Statistically Valid Grouping. The Rule-of-Three-Scores requires the Department of Human Resources to refer to the department, the names of eligibles with the three highest scores on the list of eligibles for the position available for appointment. When there are two (2) or more approved personnel requisitions on file, the number of scores certified is equal to the number of positions to be filled plus two scores. The Rule-of-Three-or-More-Scores Certification Rule requires the Department of Human Resources to refer the number of scores equal to the number of positions to be filled plus the number of scores in the certification rule applicable to the eligible list being certified minus one. Simply stated: If the certification rule is Rule-of-Seven-Scores, and there is one position to be filled, then the names of eligibles with the seven highest scores on the list of eligibles for the position available for appointment are referred to the department. If there are two positions to be filled, then the names of the eligibles with the eight highest scores on the list of eligibles for the position available for appointment are referred to the department. The Rule-of-the-List requires that ALL names on the eligible list that are available for appointment be referred to the department for consideration for selection. The Certification Rule, Statistically Valid Grouping (Sliding Band), requires that the names of the eligibles that are within a statistically valid grouping/sliding band of scores (“grouping”) be referred to the department for consideration for selection. The grouping is determined through the 66 standard error of the difference (SED) of the examination multiplied by a confidence factor of 1.96. Eligibles within the grouping are considered to be of comparable knowledge, skills and abilities with respect to the areas tested on the examination. If at any time, the highest score in the grouping is exhausted, the grouping will slide so that its upper limit rests on the highest score remaining on the list. Any additional eligibles whose scores fall within the new grouping shall be certified to available positions. The grouping will also slide if all eligibles at the highest score waive or fail to respond within the time limits provided in this Rule. The Certification Rule for entry level positions in the San Francisco Fire Department is Rule-of- the-List. The Certification Rule for promotions is the Statistically Valid Grouping. In making the decision to adopt the Statistically Valid Grouping, the Civil Service Commission considered input from the department, the recognized bargaining agent – Local 798, employee association representatives, and other interested parties, including experts in selection procedures. The Civil Service Commission also considered the history of litigation and the need to ensure compliance with Federal, State and local anti-discrimination laws. The adopted Rules for promotions in the San Francisco Fire Department, the Statistically Valid Grouping, and the secondary criteria are selection devices that identify those candidates with comparable knowledge, skills and abilities, ensures compliance with Federal, State and local anti- discrimination laws, and enables the Fire Chief to select from among the best-qualified candidates within the grouping. In matters related to the merit system, except for matters of inquiry, the Mayor is subject to San Francisco Charter Section 10.102 non-interference provisions, which state: “…Except for the purpose of inquiry, the Mayor shall deal with the administration of the civil service merit system solely through the Human Resources Director and the Civil Service Commission or their designees. The Mayor shall not dictate, suggest or interfere with the merit system activities of the Civil Service Commission or Human Resources Department. Administrative matters shall be dealt with only in the manner provided by this Charter, and any dictation, suggestion or interference herein prohibited shall constitute official misconduct; provided that nothing herein contained shall restrict the power of hearing and inquiry as provided in this Charter.” Gavin Newsom Mayor Office of the Mayor March 18,2005 The Fire Department is updating its examination components to reflect any recent changes in standard operating procedures. With regard to the method of selecting employees from promotive eligible lists, the Civil Service Commission is currently involved in legal proceedings and settelment discussions with Local 798 to determine a mutually agreed upon certification rule. Joanne Hayes-White Chief of Department Fire Department August 1, 2005 STATUS AS OF JUNE 2005: Implementation is independent of the Department / in process. The Department has worked in partnership with the employee groups to develop meaningful, measurable secondary criteria for promotional examinations and is working to assure that approved criteria will be in place after all legal issues are resolved and promotional exams are scheduled. Promotional exams and permanent appointments are crucial to executing this recommendation. The Department looks forward to resolution between the Civil Service Commission and Local 798 regarding the promotional certification rule.
• R8a

  Page 81
  Determine the extent of on-duty alcohol consumption and substance abuse. The Department needs to determine the extent of on-duty alcohol consumption and substance abuse among Department personnel as soon as possible. Responses Joanne Hayes-White Chief of Department Fire Department August 23, 2004 Agree. Joanne Hayes-White Chief of Department Fire Department August 1, 2005 STATUS AS OF JUNE 2005: The recommendation has been implemented Early in 2004, this administration re-fashioned and developed new polices that allow the Department to effectively address this important issue. This administration has always been unequivocal that there will be no tolerance for substance use while on duty and all members will be held to that unwavering standard. Further, the Department has demonstrated its commitment in its willingness to exercise discipline for, and the termination of, members violating that rule. The Department is close to implementing a complete substance abuse screening policy including screening prior to hire, promotion, post accident, reasonable suspicion, and on a random basis.
• R8b

  Page 81
  Negotiate for expanded and random drug and alcohol testing. The Department should negotiate for expanded and random drug and alcohol testing as soon as possible. Responses Joanne Hayes-White Chief of Department Fire Department August 23, 2004 The current MOU with IAFF Local 798 provides a provision for random drug testing. The testing program will begin in October of this year. Joanne Hayes-White Chief of Department Fire Department August 1, 2005 STATUS AS OF JUNE 2005: The recommendation has been implemented This administration, in last year budget negotiations, secured random drug and alcohol testing for members of Firefighter’s Union Local 798. The Department and Local 798 are currently finalizing the scope and mechanism of testing, and random testing is anticipated to begin September 2005.
• R8c

  Page 82
  Establish and Internal Investigative Unit The Department should establish an Internal Investigative Unit that reports directly to the Chief. Investigators trained in identifying people who are under the influence should staff this Unit. The investigators should have complete authority to make unannounced visits to fire stations and to conduct drug and alcohol tests. They should have access to lockers used by firefighters for storage of personal items. Responses Joanne Hayes-White Chief of Department Fire Department August 23, 2004 The Internal Services Bureau of the Department is the primary investigative authority for internal Department matters. This Administration has already displayed its willingness and resolve to take whatever action necessary and appropriate to address these internal issues, including the appointment of a fully cross-trained Firefighter / Paramedic to serve as the primary Investigative Officer. Joanne Hayes-White Chief of Department Fire Department August 1, 2005 STATUS AS OF JUNE 2005: The recommendation has been implemented The Investigative Services Bureau (ISB) is the internal investigative unit of the Department. Members assigned to the ISB completed training in the identification of people under the influence of substances. The members of the ISB have authority to make unannounced visits to fire stations and conduct drug and alcohol tests. During these visits they have access to lockers used by members for storage of personal items.
• R8d

  Page 83
  Implement a Strong and Clear Drug Policy The Department needs to implement a strong, clear, and effective drug policy. Responses Joanne Hayes-White Chief of Department Fire Department August 23, 2004 Agree. A stronger and clearer alcohol and drug policy has already been implemented. Joanne Hayes-White Chief of Department Fire Department August 1, 2005 STATUS AS OF JUNE 2005: The recommendation has been implemented / in process. The Department is close to implementing a complete substance abuse screening policy including screening prior to hire, promotion, post accident, reasonable suspicion and on a random basis. This administration has been working closing with Local 798 to finalize the scope and mechanism of testing. The Random Drug Testing Policy is anticipated to be implemented in September 2005.
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  Institute and Outreach Program The Department should institute an outreach program to help identify and refer for treatment those members with alcohol and substance abuse problems. Responses Joanne Hayes-White Chief of Department Fire Department August 23, 2004 Agree. Outreach to Department members is a component of the new alcohol and drug policy. The Fire Department is an organization just like any other, and is comprised of individuals that face the same challenges as all other members of our community. While the Department has had to address substance abuse among a few of its members, it is unfair and misleading to impute the guilt of a few onto the 1,734 dedicated members who serve our community each and every day. When infractions do occur, the Department is committed to holding its members accountable. Each and every member of the Department took an oath when they accepted the responsibility of serving the City. Any infraction, particularly one that could jeopardize other members and the public we serve, is handled swiftly and decisively. The Department’s Administration has already taken significant steps in addressing this issue. New alcohol and substance abuse policies, including post-accident testing, are in place and being used. This is the first Administration to successfully negotiate random drug and alcohol testing as part of the MOU with the Firefighter’s Union Local 798. The Mayor, the Fire Commission and the Department all recognize and support that alcoholism and chemical dependency are considered disease processes and require the attention that a disease or illness demands. We are committed to supporting Department members in any way possible to reclaim their lives and independence from substance dependency. Joanne Hayes-White Chief of Department Fire Department August 1, 2005 STATUS AS OF JUNE 2005: The recommendation has been implemented / in process. An important component of the Department’s new and renovated substance abuse polices is an outreach program designed to identify and find treatment programs for members with alcohol and substance abuse problems. Those members coming forth voluntarily will be provided with every resource available. In addition, the Department intends to provide a training module to raise awareness to its members of alcohol and substance abuse issues. General Responses Tania Bauer Commission Secretary San Francisco Fire Commission August 12, 2004