Orange County Cuts Costs, Saves Lives with Mobile Wellness Program

In August 2007, the Orange County (Fla.) Fire Rescue Department (OCFRD) had the distinct honor of receiving the International Association of Fire Chiefs’ (IAFC) Fire Service Award for Excellence for the unique spin we put on our wellness program, a product of many years of dedication and hard work from all members of our department. The dividends our department now receives from a healthy and fit workforce are immense.

A Dangerous Tradition

It goes without saying that the fire service is steeped in traditions, which range from the uniforms we wear, to how we respond to calls, to our day-to-day activities at the station. One of the traditions we pride ourselves on most is how we maintain our equipment. Daily, weekly or monthly, we pull each piece of equipment off the trucks, run it, clean it and/or polish it. Everything is impeccable and ready for the next call. Sadly, the one piece of “equipment” we’ve rarely maintained is our personnel.

We all know that poorly maintained equipment can have a significant financial impact on a department if not attended to quickly. Remember the old mechanics’ commercial: “You can pay me now or pay me later”? The same is true for injured personnel. One injured employee affects the whole department: Someone will need to work overtime to backfill the position; the employee must file a workers’ compensation claim, which may increase insurance premiums; and a unit may be taken out of service.

In 2001, the OCFRD was faced with this same scenario when our risk management department published a report indicating that the fire department was responsible for 63 percent of the workers’ compensation claims in the entire county. Costs levied against the department were in excess of $1.8 million. The majority of these claims involved heart and lung ailments and/or lower back injuries, with recurring expenditures year after year. The financial drain to the department was immense.

It was obvious something had to be done quickly, but we weren’t the first to realize the seriousness of the situation. The IAFF/IAFC’s Fire Service Joint Labor Management Wellness-Fitness Initiative had already been published, proclaiming the need for the fire service as a whole to improve the health and fitness of its members. The time had come to make some major changes.

Going Mobile

As a result of the risk-management department’s findings, OCFRD Chief Carl L. Plaugher met with then Lt. Rick Segrest to begin discussions on developing a department-wide wellness program. Segrest had initially come up with the idea, but it wasn’t until Plaugher was hired as fire chief that the idea became a reality.

Both men knew that for the program to succeed, buy-in from all levels of the department was crucial, especially at the top, so Plaugher and Segrest ran the idea by senior staff members first, then took it to the rest of the department.

Program success took a few years to realize, but by 2006, significant gains had been made. In 2001, we ran 71,026 calls for service. During those calls we incurred 295 claims for injuries, with a direct cost to the department of more than $1.8 million. Five years after implementing our wellness program, our claims dropped to 167 for 87,264 calls for service and only $672,000 in incurred costs. This was a 43 percent drop in the number of claims and a 63 percent reduction in cost. What made these numbers even more significant was that the number of employees had grown by 20 percent during this same period. The wellness program paid off!

This was by no means an easy task. The logistics proved to be huge. Orange County covers more than 1,000 square miles, and in 2001 there were more than 750 employees and 30 fire stations. Taking units out of service to bring crews in for evaluations was out of the question. We couldn’t afford to leave areas uncovered, and to have off-duty crews come in was cost prohibitive due to overtime. There had to be a better way.

Many ideas were tossed around until we decided to take the program to the troops. All we had to do was find a vehicle big enough to carry the needed equipment to each station. But like any other department, funds were tight and often spoken for years in advance. Simply going out and purchasing a truck wasn’t possible, so we looked to the Assistance to Firefighters Grant. What we got in return was a step van large enough to carry the fitness and medical monitoring equipment. Thus, the Mobile Fitness Evaluation Unit, or Fit Van, was born.

As a result, our department enjoys regularly scheduled fitness evaluations. Every other year, the Fit Van travels to each station and tests firefighters on site. This creates minimal disruption to operations as a unit can quickly be put back into service if/when the need arises. During opposing years, firefighters participate in a task-related physical evaluation held at our training center.

The Right Staff

Grant funds also helped us purchase exercise equipment, which we placed in every station that could accommodate it. For stations that could not, we made arrangements with local fitness centers for crews to use the facilities while on duty and at reduced rates. For those employees who wanted their own memberships, reduced rates were negotiated for them as well as their families.

The proper equipment was crucial to the success of the program, as were the people who ran the program. The initial tests were, and still are, administered by 38 firefighters cross-trained and certified as peer fitness trainers by the IAFF/IAFC/ACE Peer Fitness Training Certification Program. The trainers also serve as group fitness activity leaders and assist with nutritional planning. Today the program has its own bureau within the department and is overseen by a battalion chief and lieutenant.

Outside guidance was sought from The Seventh Day Adventist’s Florida Hospital Industrial Care Unit, which worked very closely with the OCFRD to help set up the program. As the primary provider for our annual physicals, Florida Hospital has access to every firefighter’s health records and is therefore able to track fitness-related trends throughout the department by entering acquired data into a program that identifies each employee’s strengths and deficiencies. The data is then used to develop individualized fitness programs and goals for those employees in need of help. Note: Testing is confidential, with only gross statistics being used for the department’s rehabilitation program.

Florida Hospital physicians also attend a bi-annual recommendations symposium where they address industrial health issues and return with suggestions on ways to improve the program. One good example of how their input has improved our program: Our annual respiratory fit tests for our SCBAs and filter masks are now performed during the employee’s annual physical instead of on a separate day. This is especially helpful because employees no longer have to travel to a separate facility to complete the evaluation. Should any concerns arise during the testing, medical staff is on hand to help diagnose and/or correct the issue. This “one-stop shopping” brings our department one step closer to having a wellness center as it further streamlines the program.

For ill and/or injured employees in need of rehabilitation, local clinics were contacted to provide guidance for job-specific rehabilitation. These focused efforts have reduced employee recovery time and, subsequently, the amount of overtime logged by those filling in for ill/injured personnel.

Inside the Program

The OCFRD Wellness Program begins with each applicant completing the required Candidate Physical Ability Test (CPAT) prior to being hired. Those who fail on their first attempt are offered a second opportunity and are enrolled in a pre-employment mentoring program. The mentoring program lasts for several weeks and assists the candidate in preparing for a final opportunity to pass.

In addition to the CPAT, each candidate must pass a psychological evaluation and pre-employment physical. Since 1993, our department’s pre-employment and annual physicals have met all required standards, however, 3 years ago, we added Hepatitis A vaccinations to the program because it was financially possible and many members had expressed an interest in this service.

With the CPAT’s success in selecting physically fit new hires, we decided to routinely test our employees’ physical abilities via a skills-related test. On a rotating basis, employees complete the skills test in even- numbered years and complete their fitness evaluations via the Mobile Fitness Unit in odd-numbered years. This has become a great system by which to measure each employee’s wellness and fitness levels.

The program doesn’t stop at the physical. Evaluating employees’ mental health is just as important, so the OCFRD established a Critical Incident Stress Management team along with chaplain services designed to provide peer counseling and support to everyone after a significant incident. Today, several confidential counseling programs are available for employees and their families that deal with everything from alcohol and substance abuse to family and mental health issues.

On a Roll

The momentum of our wellness program grows every year. We have now merged wellness training with the annual National Safety Stand Down now known as the Fire/EMS Safety, Health and Survival Week, taking the time to discuss situational awareness and respiratory and exposure protection programs.

Realizing that not all fire department employees are firefighters, and that good health and wellness shouldn’t stop when an employee’s career is over, the program was made available to all department employees, regardless of their job function, and to our retired members. It is expected that through the program’s nutritional guidance and exercise opportunities, the department can help many of its former employees enjoy a long and healthy retirement.

Today, the program also acts as an educational resource for each employee. Wellness tips and information are frequently made available via the department intranet, e-mails and printed bulletins. In addition, employees have access to our library of books and videos in our headquarters’ Safety and Wellness office.

Branching Out

The success of the program has not gone unnoticed throughout our community. When asked, our Mobile Fitness Unit and peer fitness trainers provide evaluations and testing to other local departments.

We also regularly conduct a 6-week Citizen’s Fire Academy that teaches our local citizens what firefighters do for a living. Incorporated into this class is the OCFRD wellness program where participants learn which exercises most benefit a firefighter and receive tips and directions for improving their own fitness.

Many local health-related organizations have recognized our achievements and frequently invite the department to participate in and speak at health fairs. We also participate in several local 5K charity runs where we are frequently featured as a success story.

More importantly, as a government agency, we must be good stewards for the citizens of Orange County. The OCFRD Wellness and Fitness Program is a shining example of how we accomplish this, because it promotes a healthy, productive employee and decreases injury claims and associated costs, which caught the attention of our insurance carrier, who subsequently reduced the yearly cost of our insurance premiums by $950,000. Above all, it helps us provide the residents of Orange County with efficient and effective responses to emergencies. The bottom line: We have a healthier workforce that equates to fewer injuries and dollars saved.

Most importantly, our employees have succeeded in achieving the following:

  • Greater strength and stamina;
  • Weight reduction and/or control;
  • Lower cholesterol and blood pressure levels;
  • Decreased risk of death, injury or disability from disease;
  • Heightened job performance and enjoyment from work;
  • Improved performance in physical activities;
  • Better posture and joint functioning;
  • Reduced anxiety, stress, tension and depression;
  • Increased energy, general vitality and mental sharpness;
  • Enhanced self-esteem and self image;
  • More restful and refreshing sleep;
  • Enhanced capacity to recover from strenuous and exhaustive work;
  • Increased tolerance for heat stress and more effective body cooling; and
  • Improved mobility, balance and coordination.

The OCFRD’s Wellness Program has been so successful, wellness is now listed as one of our seven core values, and our county officials are now implementing several components of our plan into their own wellness program available to every county employee.

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