The 2019-20 Tacoma city budget — approved Tuesday by the City Council — includes two new fines.
The first is a $150 penalty for a false fire alarm at a residence and $250 at a commercial building.
The second imposes up to $850 when a skilled nursing facility or assisted living center calls the Fire Department or its contractors to lift a fallen resident when no other medical service is needed.
The “lift assistance” fine won’t be levied for calls involving people who have fallen in private residences, parks, at the Tacoma Mall or other public spaces.
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The Fire Department notes that each year it responds to 350 to 360 nonemergency calls for falls.
“We don’t want be in the business of lifting patients in nonemergency situations,” Fire Chief James Duggan said at a City Council study session Oct. 23. “We want to make sure that it isn’t less expensive to simply continue to call the Fire Department instead of purchasing the required equipment and having the required staffing.”
The fine for false alarms — the department responds to 1,300 of them each year — focuses on incidents where alarms were accidentally triggered by:
▪ Construction dust or sanding floors.
▪ Maintenance work on detectors not in test mode and when the Fire Department was not given notice.
▪ Lack of proper maintenance.
▪ Smoking outside designated areas.
In considering the lift assistance fine, some City Council members and advocates for individuals getting long-term care said they feared unintended consequences for residents of facilities whose staff might be ill-equipped or fearful of calling for help in the face of the new fine.
“My concern is on the unintended impact of people with disabilities,” David Lord, public policy director with Disability Rights Washington, told the City Council on Tuesday.
“People fall, and when they fall they can be hurt, but they can also be hurt when they are picked up by someone who doesn’t know what they are doing, or insufficient staff. ... Whatever the circumstances, that can have consequences.
“What we’re worried about is this ordinance may have a chilling impact on people calling when they need to be calling to get some help.”
Discouraging caregivers from calling 911 to get assistance lifting residents runs counter to state code, which does not define medical emergencies, said Amy Freeman, attorney for the Washington State Long Term Care Ombudsmen Program, at Tuesday’s meeting.
“Who’s going to pay the true price?” she asked. “It’s the residents who are going to suffer harm and the caregivers put in an untenable position ... forced to make an ad hoc cost benefit analysis of whether to call 911.”
The City Council approved an amended version of the measure that excludes registered adult family homes from the fine, based on staffing concerns and their number of calls compared to those from larger care facilities.
“The motivation behind this ordinance is to make sure we work with these providers to change behaviors,” said City Councilwoman Lillian Hunter during Tuesday’s council session and who offered the amendments to the measure. “It is not our intention for it to be punitive or a revenue generator.
“One of the first things we need to do is exempt people or facilities that are not required by law to have the staff on hand and fully trained with the equipment.”
According to a memo from the Fire Department to the City Council, “26 facilities made up the majority of the lift assistance call volume in 2017. Of those, 17 are assisted living facilities, seven are skilled nursing facilities, and two are adult family homes.”
While state law does not require lift equipment, the state does says care facilities must provide “reasonable accommodations” and that they have a “general responsibility for the safety and well-being of the resident.”
According to the memo to the city, “reasonable accommodations” include having “additional aids and services” for residents.
“General responsibility for the safety and well-being of the resident,” the memo says, can include providing “emergency assistance, monitoring of the resident, and responding appropriately when there are observable or reported changes in the resident’s physical, mental, or emotional functioning.”
The fine would be $350 for the first call, $500 for the second and $850 for the third call and any calls made starting in 2020, regardless of whether it’s a facility’s first call or not.
Officials said they hope the fine corrects how emergency personnel are used.
Also, licensed care facilities covered by the fine are “required by the state to have the correct staffing levels, the right equipment and the right training” to accommodate residents, Duggan said.
The state Department of Social and Health Services has been clear to licensed care facilities that they should call 911 only for emergencies and not to supplement their staffing, Duggan said.
He also noted that residents should not have to wait until firefighters arrive to get help when care facilities should have adequate staff on site.
Plus, Duggan said, firefighters and caregivers are suffering shoulder injuries as a result of ill-equipped facilities.
“There should be very little manual lifting, and what there should be is the right equipment to safely move a patient,” he said.
The Fire Department will meet with caregiver groups to brief them on the new measure and give the city a midyear progress report.
The false fire alarm fine will take effect Jan. 1; the lift assistance fine will go into effect Feb. 1.