According to San Diego State University’s Watchdog Institute, more than 82% of the San Diego Fire-Rescue Department’s calls are for medical emergencies. Indeed, the medical calls in the city have increased from about 65,000 in 2004 to more than 78,000 out of 110,000 total calls in 2009, said Chief Javier Mainar. At the same time, Mainar said the department’s operating budget was reduced this year from about $199 million to $187 million, leading to fire-station brownouts throughout the 342-square-mile service area.

The last thing any chief wants to do is cut operation services, so Mainar first cut administrative staff and community-education programs, then fire station and lifeguard services. To address additional budget shortfalls without cutting from his staff of 850 firefighters, he currently is browning out between one and eight engine companies daily from the city’s 13 fire stations. The move saved jobs and money, as firefighters displaced by the brownouts are used to fill in for sick-leave or vacation absences, saving $11.5 million worth of overtime costs, he said.

There have been consequences with increased fire and EMS response times “so it is taking us longer to get there,” Mainar said. The department luckily has the support of a private ambulance company, Rural Metro, to provide EMS. Rural provides patient transport and patient billing services while the fire department supplements transport by having at least one certified firefighter/paramedic on each response unit. However, the department doesn’t recoup all transport fees charge, since ultimately the patient is responsible for payment if insurance providers don’t cover all charges.

“So, only a portion of the fees are recovered,” he said.

Mainar advised chiefs under similar budget pressures to engage stakeholders, including elected officials, fire department management and the community to discuss options. If major cuts are made, it’s important to inform the public so they know what they are in for, he said.

“We made it clear [to the community] there would be service impacts,” he said. “If you cut [fire] resources back and conversely something bad happens, tell the community. They deserve to know.”