Written by Matt Cushman, Missouri EMS Connection Editorial Advisor
Photos provided by RFPD
Our service spotlight for this issue is the Raytown Fire Protection District (RFPD). It is a fire-based EMS operation that is located in the heart of Jackson County, Missouri. RFPD is their own political subdivision, independent of the municipal government, and operates under the direction of a three-member elected board of directors. The District services the entire city of Raytown, Mo., which is a first tier suburb of Kansas City, nestled between Kansas City and Independence. The District is a member of Mid-America Regional Council and the West Central (Region A) EMS Advisory Committee.
The City of Raytown is an increasingly diverse community with just over 30,000 residents living in approximately 10 square miles. A major state highway cuts through the city that is highly traveled by commuters from the suburbs into Kansas City.
A Rich History of Service
Since 1947, the city of Raytown has been protected and cared for by RFPD. Over those years, the mission has changed, and now the District oversees and operates the EMS system for the city. Spanning nine decades, Raytown Fire has evolved from a small volunteer service to full-time paid firefighters. In the early 70s, the District expanded the roles of the responders to include EMTs and later at the turn of the century, expanded to include enhanced services by becoming an EMRA agency with paramedics providing ALS care in advance of the municipal ambulance service. In 2018, after nearly a year of negotiating with city officials, the District assumed control of the EMS service and began a fully integrated fire-based EMS model.
Service Make-Up and Call Volume
RFPD operates under the direction of Chief Matt Mace. A paramedic himself, Chief Mace has a long history and experience in the EMS community. He started his career working for the municipal ambulance service in 1996. When the Fire District expanded their capacity to deliver ALS care, he began his career in the fire service where he soon advanced up the ranks through the prevention division and eventually into the chief’s office. From time to time, you can still find Chief Mace on the ambulance keeping his skills up to standard.
Four years ago, the service was charged with not only absorbing ambulance responsibilities, but the district had to create a plan to take to the citizens to fund it and to eventually hold the license to operate EMS. Those measures, including a property tax increase, overwhelmingly passed with the support of the community.
When the District assumed control of the ambulance service in 2018, Chief Mace and the Board of Directors needed an experienced administrator to shepherd the transition into this new frontier. Assistant Chief of EMS Ben Chlapek is an EMS icon in the Kansas City region. There was no better person to get the service through all of the growing pains of operating EMS.
Chief Chlapek has been a paramedic for over 40 years with experience as a flight paramedic, operations manager, EMS director, and firefighter having also earned the rank of deputy chief. Chief Chlapek serves on the Governor’s Advisory Council for EMS and has served on the Board of Directors of the National Association of Emergency Medical Technicians (NAEMT) as well as the National Volunteer Fire Council’s Emergency Rescue Committee. Additionally, Chief Chlapek is a veteran of the U.S. Army.
The Fire District is comprised of two staffed pumper crews and two ambulances called squads. The pumpers are ALS equipped and staffed and the ambulances are staffed with a minimum of one EMT and one paramedic. The squads are equipped with ESO reporting software and utilize the Lifepack 15 cardiac monitor. Additionally, the service enjoys the use of video laryngoscopes and ultrasound dopplers. Being a first-tier suburb of Kansas City, RFPD is about 10 minutes away from its closest level one trauma, stroke, and STEMI destinations.
RFPD is part of an Automatic Aid Agreement with the Kansas City Fire Department (KCFD). As part of that agreement, the District’s Fire and EMS operations are dispatched using KCFD’s Dispatch Center. They graciously provide and receive mutual aid from their Kansas City Fire partners. The ambulance is not included in the Automatic Aid aspect in order to maximize ambulance coverage for citizens based on the inherent intra-city call volume.
Through the years after the acquisition of the EMS service, RFPD has seen significantly increased calls. In 2018, the service had 3,800 EMS calls and in just four years, they are projecting 4,900 EMS calls or more. Since Raytown Fire is in the KC CAD System and have an automatic aid agreement, total calls for service are just over 8,300 with a portion of that number representing requests for service in Kansas City. From the fire operations side of things, they stay very busy assisting Kansas City. Often, they are the closest resources to some areas in the southeastern Kansas City area.
Several EMS education programs are using Raytown Fire and their crews for clinical sites allowing staff to precept their students. Megan Thurston, assistant director of education at Central Jackson County Fire Protection District speaks to the importance of sending students to Raytown Fire. She said, “We are so fortunate to have them as a clinical partner. Raytown Fire sees the value in teaching the next generation of EMS providers and welcomes our EMT and paramedic students. Their high call volume gives the students a lot of opportunities to gain experience and their providers go out of their way to help the students learn.”
Station Life
There are three stations used for operations. Assimilating into the KCFD CAD, RFPD stations follow their numbering and unit numbers. Station 51 is the location of Squad 51 (which for older paramedics and EMTs is pretty cool if you have watched EMERGENCY), and Pumper 51 as well as the chief officers, fire marshal, and assistant fire marshal. Station 52 houses Squad 52 and Pumper 52. Station 53 is the former municipal ambulance service’s base, and is now used for training, storage, and the Raytown Fire HELPS MIH-Community Paramedic operations. Each station has individual living quarters, quality kitchens, and state of the art fitness centers. The crew life at Raytown is attractive for most. “I’ve come to realize, again, the camaraderie between crews is the most important aspect of this job. The people you spend so many days together in a month are really what makes this job great. Everything else that comes along are additional bonuses. I’ve learned so much from different levels of experience here and hope that I can continue that for others in the future,” says Brandon S, NRP, who recently came to Raytown Fire from a private EMS agency.
Focus on Quality Care and Service
The service has many mechanisms in place to create quality in the care of their patients. Through the Quality Improvement (QI) process, the District looks to not only ensure protocol compliance, but also create exceptional patient care and customer service. The district takes a unique approach to this concept by outsourcing the process to an independent contractor. The person responsible for this robust process provides crews with over 30 years of professional EMS experience and expertise in quality management and similar oversight functions.
Community Involvement, Taking the Prevention Model a Step Further
RFPD has long been involved on many fronts to assist the community’s needs. Through prevention programs in the schools, to the standard inspections and smoke detectors given away, the District does all it can to reduce the loss and harm of fires. The District also offers robust opportunities for children to learn fire safety with a Prevention Program lead by Captain Ferguson, FF/EMT.
In 2021 after seeing a significant need within the community, RFPD started a Mobile Integrated Health program and employed its first community paramedic. The program, called Raytown Fire HELPS, is a comprehensive program designed to look at all aspects of the community’s health and safety needs. The community paramedic assists in care coordination and case management, assists with medication compliance, connects people to valuable and necessary resources, performs home safety checks and fall risk assessments, disease mitigation and risk management, post discharge education and coordination, and works closely with police and mental health professionals as a certified CIT trained paramedic. The degree to which the community paramedic has helped those suffering with mental health and substance abuse problems in Raytown is remarkable.
The urgency is now for services that are trying to figure out the best approach to current trends in the area of mental health and substance use. Chief Chlapek reports, “We run twice as many behavioral health calls and more overdose calls than we did when we first started.” Thinking outside the box with these types of calls creates opportunities to reduce the burden on EMS, reduce congestion in the emergency departments, and create better outcomes.
Medical Direction
When Chief Mace and the Fire District assumed control of the ambulance district, they already had a professional working relationship with Dr. Tucker Lienhop, DO, at Research Medical Center. Before the transition, the Fire District and the municipal ambulance service had an existing EMRA agreement that stipulated they both used the same protocols and medical direction. “It was natural to just continue that relationship,” Chief Mace said, understanding that the need to have medical direction from the closest level one trauma center and TCD hospital would be one more way to naturally create a solid working relationship. “It is important for the medical director to see our crews in the emergency department setting,” said Chief Mace.
Future Challenges
Like all EMS and fire agencies today, the post COVID-era has taken a toll and staffing tops the list of concerns most managers and chiefs face. Raytown Fire certainly has felt the continued struggle to find paramedics. Chief Chlapek says that in addition to the standard lack of paramedics and dispatchers the industry is facing, “Educating the public so the community understands when to call an ambulance is an ongoing challenge. Additionally, there needs to be a serious talk about reimbursement from the insurance companies and the government.” Chief Chlapek also sites the NAEMT position paper on the importance of EMS as an “Essential Public Function” as a necessary starting point. The fire and EMS industry is at a significant crossroads in many ways, and it seems that the challenges in the next several years will continue to grow. These include the difficult times in getting even the basic supplies that all agencies need, like medications, but even more alarming is the difficulty in getting truck chassis making an ambulance purchase difficult to plan because of the wait time.
Through all of the concerns and roadblocks, through pandemics and staffing shortages, the mission of the RFPD has not changed. It is simply to help those in need. The service has gone on the offensive to attract quality providers and are doing things that a lot of other fire-based systems have not done. The first is that starting this winter, RFPD is hiring part-time staff to offset full-time shortages and coverage gaps that are not able to be filled by overtime. The second is to significantly increase paramedic pay. Third, the District has been successful with hiring non-firefighter certified paramedics and putting them through an internal Fire Academy. Crissi C. NRP, said that she was attracted to Raytown Fire because “it is a place that offered to put me through the fire academy and give me the opportunity to expand my knowledge and skills and give me future opportunities for advancement.”
For information on RFPD, check out www.raytownfire.com.
To view the article as it appeared in the magazine, click here.
