Wellness-Fitness Initiative (WFI) Resource

Facility	In-house
Physician	In-house
Additional Staff	RN/Administrator Exercise Physiologist (2) Exercise Physiologist/Sports Medicine Specialist Records Clerk Administrative Assistant
Exam Frequency	Annual <40 submaximal treadmill test 40+ maximal treadmill test with ECG
Exam Details	Full WFI Exam

Facility	In-House
Physician	Occupational Physician General Physician with special interest in sports medicine Family Physician
Additional Staff	Occupational Nurse Kinesiologists (3) Office Administrators (2) Wellness & Fitness Coordinator/FF
Exam Frequency	Annual
Exam Details	Medical Details

Facility	No department facility – Contracted Physician Group
Physician	Contracted Physician Group
Additional Staff	N/A
Exam Frequency	Pre-employment, annual for HAZMAT team
Exam Details	Full WFI exam See document

Fairfax County, VA

Facility	In-house Occupational Health Center
Physician	In-house
Additional Staff	Exercise Physiologist Nurses Physical Therapist
Exam Frequency	Annual comprehensive occupational medical and fitness exams
Exam Details	Full blood panel assessment, hearing and vision exams, chest x-rays and fitness exam

Facility	Contracted – Public Safety Medical Services
Physician	Contracted – Dr. Moffatt
Exam Frequency	Annual
Exam Details	See document

Metropolitan Dade County, FL

Facility	Contracted – 5 medical Clinics
Physician	Contracted
Additional Staff	Full time Wellness Coordinator
Exam Frequency	Annual
Exam Details	All components of the WFI Full max stress test 3% incentive pay for participation Cardiac CT and Angio-program

Facility	MDFF Wellness Center
Physician	Two from the University of Miami
Additional Staff	One Physical Therapist from the University of Miami Three Medical Assistants One Exercise Physiologist One Dietitian Two Front Desk Staff Four Support Staff from Miami-Dade County
Exam Frequency	Annual
Exam Details	MDFF Medical Protocols

Facility	Wellness/Fitness Center at FDNY Headquarters
Physician	In house staff
Additional Staff	Wellness/Fitness Coordinator Nurses Technicians
Exam Frequency	Designed as annual but can only do 90 members/day
Exam Details	Complete, as per IAFF/IAFC WFI design

Facility	In house health center
Physician	Contract with Banner Occupational Health for medical staffing: Doctor of Osteopathic Medicine (D.O.) Medical Director Physicians – (1) full-time; (4)part-time Physician Assistants – (2) full-time; (2) part-time
Additional Staff	Some staffing requirements are fulfilled utilizing fire fighters on an overtime basis or providing injured fire fighters with an alternate duty position. Program Manager Registered nurse – (2) full-time; (1) part-time Xray Technician Medical assistant Infection Control Officer Exposure Control Officer
Exam Frequency	Annual – department requirement
Exam Details	Annual Physical Components

Facility	Department facility under construction, currently contracted hospital
Physician	Currently separate MDs contract for State required Respiratory Clearance and Entry Medicals
Additional Staff	N/A
Exam Frequency	Baseline physical in 2008, planning for annual capability
Exam Details	Full WFI protocol see document

NON-TASK FORCE CITIES

Beckley, WV

Facility	No Department Facility – Contracted Medical Facility
Physician	Occupational Medicine Physician
Additional Staff	N/A
Exam Frequency	Annually considered by city hall for resourcing
Exam Details	Full WFI exam – See document

Facility	No department facility – contracted Occupational Health Facility
Physician	Occupational Medicine Physician
Additional Staff	N/A
Exam Frequency	Annual
Exam Details	Full WFI Exam – See document

Facility	No department facility – contracted Occupational Health Department at local hospital
Physician	Occupational Medicine Physician
Additional Staff	N/A
Exam Frequency	Every three years, annually for HAZMAT teams
Exam Details	Age based exam – see documents

Facility	No department facility – contracted medical facility
Physician	Individual’s primary care physician
Additional Staff	N/A
Exam Frequency	Annual
Exam Details	Routine physical done based on age see document

Facility	Contracted – Banner Occupational Health Clinic for Pre-hire and annual medical exams, industrial injuries, and industrial exposures
Physician	Occupational Health doctors who are familiar with fire fighters’ job responsibilities, NFPA standards and OSHA requirements
Additional Staff	Clinic management, records and accounting staff, PAs, RN’s, and techs
Exam Frequency	Annual as required by department SOPs
Exam Details	WFI exam – see document

Facility	South County Hospital
Physician	Department physician
Additional Staff	1 assistant to the PFT (uncertified)
Exam Frequency	Annually
Exam Details	Medical Exam Survey

Facility	Contracted – UCI Center for Occupational & Environmental Health
Physician	Dr. Leslie Israel, Medical Director
Additional Staff	N/A
Exam Frequency	Every 2 years
Exam Details	see document

Facility	No department facility
Physician	Individual’s Primary Care Physician
Additional Staff	N/A
Exam Frequency	Health insurance provides physical every two years
Exam Details	Physician determined

Facility	No department facility
Physician	General Physician with special interest in fire fighting Family Physician
Additional Staff	N/A
Exam Frequency	Annual
Exam Details	Physician follows WFI medical exam as close as possible. Medical Service Plan (MSP) will cover certain parts of the medical exam if doctors have a reason to test. Currently, working with the City to provide a budget to cover parts of the medical exam for which the doctor feels members should be tested.

Facility	Off site medical clinic – Concentra
Physician	Wellness/Fitness Medical Director
Additional Staff	Wellness and Fitness Coordinator
Exam Frequency	Annual – scheduled by the Risk Management Office (RMO)
Exam Details	Medical Details

Facility	Contracted
Physician	Contracted
Additional Staff	Exercise Physiologists Dietician Athletic Training – provides educational seminars and individual counseling, personal fitness training and group fitness testing for the participants
Exam Frequency	Annual
Exam Details	See document

Facility	In house at administrative headquarters
Physician	Contracted
Additional Staff	Contracted Nurse Practitioner Wellness Coordinator Fit for Fire Committee
Exam Frequency	Annual
Exam Details	Nurse Practitioner performs the medical exams in house and pay on a per exam basis See Section D. – Medical Exam Components of Program Overview document Contract out chest x-ray, stress EKG, electronic bean tomography’s and true Vo2 testing

Facility	Contracted – Cascade Occupational Medicine for physical exams and return to work evaluations http://www.cascadeoccmed.com
Physician	Physician and support staff are utilized on a contract basis
Additional Staff	Wellness Program Coordinator RN Program Assistant
Exam Frequency	Annual
Exam Details	Examination process designed to help identify health problems affecting the individual, as well as problems common to the District. Conduct all pre-physical exams in-house Dedicated space and equipment to conduct evaluations (vitals, vision, cholesterol, blood work, spirometry, hearing, EKG, urinalysis)

FITNESS

Research has demonstrated the need for high levels of aerobic fitness, muscular endurance, muscular strength, muscular power and flexibility in order to perform safely and effectively in the fire service.

While assessing uniformed personnel’s current fitness level is an important part of developing an individualized fitness program, assessment is not, in itself, a fitness program. An effective physical fitness program has several components that must be implemented, including medical clearance and exercise and nutrition programs, to name a few.

The elements necessary for a successful and comprehensive physical fitness program are highlighted in the 3rd Edition of the Fire Service Joint Labor Management Wellness-Fitness Initiative.

This section contains an overview of the various fitness components implemented by all of the participating departments.

To view fitness components by department, click on the links below:

TASK FORCE CITIES

IAFF/IAFC PFT’s	+/- 20
Duties	Physical fitness for recruits CPAT orientation and proctor
Exercise Time	On duty
Exercise Program	Fitness consultation Personal training CrossFit training Yoga training Kettlebell training
Equipment	Treadmills, bikes and weights at each station
Nutrition	Counseling by appointment

IAFF/IAFC PFT’s	30
Duties	Coaching/mentoring Recruit training Program design CPAT proctors
Exercise Time	1.5 hours per shift
Exercise Program	Designed by PFT’s
Equipment	Full compliment
Nutrition	Contract resources through EFAP services and other agencies

IAFF/IAFC PFT’s	One
Duties	Basic exercise counseling Assist and offer feedback to Physical Fitness Coordinator regarding areas of concern and opportunities for improvement Oversight of Job Related Physical Ability Test practice sessions
Exercise Time	Yes
Exercise Program	Fire Fighter determined
Equipment	Exercise equipment at each station including treadmill, Smith machine, free weights and bench, dumbbells, stability balls, pulley system, exercise mats
Nutrition	None

Fairfax County, VA

IAFF/IAFC PFT’s	Yes
Duties	Work performance evaluation Exercise programming Proctor CPAT
WelFit Program Staff	Health Programs Manager WelFit Program Manager – oversees the PFT Program, CPAT, Work Performance Evaluation and satellite fitness facilities and equipment needs Strength Conditioning & Exercise Specialist
Exercise Time	2 Hours/Day On duty – Can use recreation centers; 5 satellite gyms; deals with local gyms
Exercise Program	Wellness Fitness Center – training and education are provided to support fitness program
Equipment	Every station has cardio and weight equipment

IAFF/IAFC PFTs	28
Duties	Recruit Fitness CPAT Mentoring/Proctor Incumbent Work Performance Evaluations Incumbent fitness programming
Exercise Time	SOG being updated
Exercise Program	Crossfit preparation program/Crossfit on-ramp
Equipment	Cardiovascular/Strength training/Functional training equipment
Nutrition	Contracted – Public Safety Medical Services Dietician

Metropolitan Dade County, FL

IAFF/IAFC PFTs	Yes
Duties	Fitness Assessments and Exercise Prescriptions Body composition evaluation and weight management counseling Recruit Fitness Training Injury prevention program
Exercise Time	On-duty mandatory 1.5 hours dedicated time
Exercise Program	Recruit fitness program – daily exercises led by PFT’s Post recruit mentor program
Equipment	In every station – weight bench w/dumbbells; recumbent bike and treadmill; stability ball
Nutrition	Meal Plans

IAFF/IAFC PFTs	10
Duties	Post daily Workout of the Day
Exercise Time	On duty if time permits
Exercise Program	“Get Fit” Challenge Crossfit seminar Exercise Challenges FITNESS ZONE intranet – members post monthly circuits, fitness articles, list of PFTs, upcoming fitness events, WFI information Physical Therapy program
Equipment	Treadmills, bikes, ellipticals, weights and Smith Machine at each station
Nutrition	Registered Dietician; Online wellness resource for nutrition and recipes provided to members

IAFF/IAFC PFTs	50
Duties	Assist in annual medical administration Design fitness programs for members Maintain fitness equipment Instructors for Academy recruits Instructors for CPAT mentoring program
Exercise Time	Daily as schedule of duties allows
Exercise Program	Various aerobic training Circuit training (resistance)
Equipment	Every firehouse has a gym Equipment is either bought by members chipping in, donated from private individuals, health clubs, colleges, etc. Example – network with a local sports club; universities for liquidated equipment
Nutrition	Nutritional recommendations are made by PFTs; referred to nutritionist or R.D. if desired

IAFF/IAFC PFTs	Yes
Duties	Fire fighter consults Training Academy CPAT Department classes
Exercise Time	Yes – minimum of 1 hour on-duty
Exercise Program	Health education Tobacco cessation training Individual programs upon request
Equipment	All fire stations are equipped with aerobic equipment and various resistance and weight training equipment depending on station size and number of crew members
Nutrition	Contracted registered dietitian upon health center physicians referral only Nutritional counseling Diet and weight management Brown Bag Lunch Program Healthy Recipes

IAFF/IAFC PFTs	25 Certified PFTs
Duties	Fitness evals One-on-one & group trainings Station visits on wellness issues Fitness equipment checks Fire Fit classes Occupational Health & Fitness Committee meetings Articles for newsletter
Exercise Time	1 hour per shift for operational personnel and 1/2 hour for Admin positions
Exercise Program	Members or crews can request one-on-one with a PFT via a formal request for service process Fire Fit Class of the month (members come off-shift on their own time) led by a PFT with advanced certification in that field Information provided in “Fitness” and “Workouts” sections in the Occupational Health & Fitness In-web
Equipment	1 major piece of cardio (treadmill or stepmill, or elliptical, or concept II), full dumbbell set, medicine ball, stability balls, and exercise mats in stations Larger stations have additional weights (dual pulley, spin bike, Olympic weights, kettlebells) depending on size of space
Nutrition	Information provided in “Cooking on Shift” and “Nutrition” sections of OCC Health & Fitness In-web, as part of a newsletter info., and updates to PFTs

NON-TASK FORCE CITIES

Beckley, WV

IAFF/IAFC PFT’s	1 certified PFT
Duties	In charge of CPAT and all wellness activities
Exercise Time	On duty
Exercise Program	Individual, with PFT
Equipment	In each station and discounted gym memberships
Nutrition	Counseling available

IAFF/IAFC PFT’s	12 Certified PFTs
Duties	Conduct functional movement screenings Fitness assessments Performance assessments Develop exercise prescriptions
Exercise Time	60-90 minute on duty time
Exercise Program	Individual, with PFT
Equipment	In each station – treadmill, elliptical, free weights/bench, dumbbells 5 to 70 pounds Some stations have additional equipment
Nutrition	There are currently no links or files available for dissemination. For more information, see the contact listed above.

IAFF/IAFC PFT’s	6 certified PFTs
Duties	CPAT Wellness activities
Exercise Time	On duty
Exercise Program	Individual, with PFT
Equipment	Exercise equipment at each station, includes treadmill, elliptical, free weights and bench, dumbbells 5 to 70 pounds. Some stations have additional equipment.
Nutrition	Counseling available

IAFF/IAFC PFTs	4
Duties	Develop personalized exercise programs Administer aerobic capacity and flexibility evaluations
Exercise Time	On duty – 60 minutes
Exercise Program	Individual, with PFT
Equipment	In each station
Nutrition	Access to dietician if requested

IAFF/IAFC PFT’s	31 wellness team members with various certifications in wellness and fitness including 17 PFTs
Duties	Promotion of fitness, fitness evaluations, recruit physical training, CPAT administration, fire fighter one-on-one consults, and department wellness training
Exercise Time	Yes – minimum of one and a half hours per shift, on-duty
Exercise Program	Crossfit, Ultimate Frisbee, work hardening circuits, and standard cardiovascular and strength training
Equipment	All fire stations are equipped with aerobic equipment and various resistance and weight training equipment depending on station size and number of crew members. When a station’s fitness facility is not adequate for the crews assigned there the department will purchase gym memberships to a gym in the area that members can use on shift only.
Nutrition	Information provided through video presentations, wellness team interactions, training, medical exams, and our quarterly wellness newsletter

Orange County Fire Authority, CA

IAFF/IAFC PFT’s	1
Duties	Oversee all fitness and rehabilitation programs Collect fitness data for all individuals participating in the program Coordinate behavioral health consultations Facilitate all wellness and nutritional education Organize all fitness/fundraising events and competitions for the department
Exercise Time	On duty (1 hour daily when possible) and off duty time allocated; minimum 3-4 days per week
Exercise Program	Cardiovascular, muscular endurance and strength training programs such as Cross Fit and Kettle bell programs Many cardiovascular exercises such as swimming, cycling, running, rowing and stair climbing encouraged
Equipment	Full Smith machine, Kettlebells, Bosu balls, medicine balls, free weights, treadmills, exercise bikes, rowing machines
Nutrition	Outsourced educational programs through Muni Blue (Blue Cross); diabetes education through Muni Blue

IAFF/IAFC PFTs	40 certified PFTs
Duties	Education Fitness assessments Academy fitness Fitness program design/implementation One-on-one training at stations
Exercise Time	On duty, 60-90 minutes per shift
Exercise Program	Core strength Academy PT Quarterly classes Contract with training and rehab vendor
Equipment	Full compliment or gym memberships
Nutrition	Currently being developed

IAFF/IAFC PFTs	30 certified PFTs
Duties	Provide exercise guidance Remedial exercise programs Rehabilitation exercise programs
Exercise Time	On duty, one hour per shift
Exercise Program
Equipment	In each station Three centralized facilities Discounted gym memberships
Nutrition	Counseling available

IAFF/IAFC PFTs	6
Duties	Basic exercise counseling Fitness assessments Facilitate wellness/fitness education
Exercise Time	1.5 hours per shift
Exercise Program	Personal aerobic and circuit training TWIST Sports Conditioning Series
Equipment	Both stations are equipped with aerobic equipment (treadmill, elliptical and stationary bike) Nautilus machine, dumbbells (10lb – 70lb), Bosu board, balance board, stability balls and medicine balls
Nutrition	Education by PFT’s on their respective shifts

IAFF/IAFC PFTs	6
Duties	Conduct physical fitness appraisals Maintain equipment Facilitate wellness/fitness education and promotion at the station/battalion level Recruit physical fitness appraisals and pre-hiring wellness/fitness mentoring Research and development of new wellness/fitness methods Coordination and communication of information and data to the Risk Mgmt. Office and the Wellness and Fitness Coordinator
Exercise Time	Minimum of 1.5 hours 3 days each week on day work 2 hours every 24 hour work shift Each individual employee’s responsibility to maintain a training log of documented physical fitness training and functional physical training; must be signed by the employee’s supervisors and presented upon request to the Risk Mgmt. Office
Exercise Program	Functional Physical Fitness Training Programs – offer the opportunity to combine physical fitness training with heavy exertion skills and movements required of job tasks that are specific to emergency operations Peer Fitness Trainer Programs Pre-Hire Fitness Preparation Program Recruit Fitness Training Program
Equipment	In house 360-square-foot fitness center includes: treadmills, elliptical trainers, stationary bikes, rowing machines, stair climbers, machine and free weights Use of station equipment, community centers
Nutrition	Wellness and Fitness Director works with a certified nutritionist(s) to develop weight loss and create individualized diet plans to achieve and maintain optimum health, body weight while reducing chances for disease

IAFF/IAFC PFTs	A few at academy
Exercise Time	Yes
Exercise Program	Regional Wellness Program contracted w/San Diego Sports Medicine Center – provide full staffing for wellness exams and education
Equipment	Yes – small gym or discount at local gyms
Nutrition	Yes

IAFF/IAFC PFT’s	15
Duties	Exercise programming Fitness assessment Manage each component of the WFI and responsible for that components training and education
Exercise Time	Two hours – 8:30 am – 10:30 am
Exercise Program	Yes
Equipment	Yes in all eight fire stations – treadmills, step mills, Kettle bells, free weights and exercise mats
Nutrition	Yes – Provide education, nutrition tools and meal plans

IAFF/IAFC PFTs	13
Duties	Assist Wellness Program Coordinator in completing annual fitness assessments Assist HR in administration of CPAT; all PFTs are trained CPAT Proctors Attend and participate in Wellness Committee meetings Develop injury prevention and health promotion programs that are disseminated via station presentation, web or video Develop personalized exercise prescription to staff when requested
Exercise Time	On-duty – 90 minutes per shift for career fire fighters
Exercise Program	Monthly newsletters Activity specific exercise programs In-house wellness presentations
Equipment	Full compliment
Nutrition	Individual appointments, newsletter

INJURY-REHAB

Statistics show that fire fighting is one of the most dangerous occupations in the world. Lower back injuries and other sprains and strains account for more than 50 percent of all injuries. Injury prevention is paramount to reducing injuries in the fire service and improving personnel resistance to injuries. The cost of one worker lost due to preventable injury or illness is at least equivalent to two to four times their impacted salary.

Rehabilitation programs can be in-house or outsourced. Regardless of the type of rehabilitation program that is chosen, several criteria must be met, including: a fire department physician who is familiar with job requirements and for fit-for-duty expectations, as well as current treatment methods for the most frequent job-related injury or illness for uniformed personnel; clinicians who are familiar with fire service job requirements and fit-for-duty expectations; a transitional duty program; periodic re-evaluation prior to returning to full duty; a personalized exercise prescription that considers job requirements and the individual’s past medical history; and a comprehensive injury prevention program.

The elements necessary for a successful injury prevention/rehabilitation program are highlighted in the 3rd Edition of the Fire Service Joint Labor Management Wellness-Fitness Initiative.

This section contains an overview of the various injury/rehabilitation components implemented by all of the participating departments.

Injury Prevention/Rehabilitation Programs
To view individual components that can be exported to an Excel spreadsheet, click the links below:

TASK FORCE CITIES

Method	Injury rehabilitation post medical discharge through wellness clinic as needed and injury prevention program via department-wide functional movement screenings
Modified/Light Duty	Yes

Method	Contracted FMS screening during wellness
Modified/Light Duty	Yes
Injury Prevention Committee	No

Method	An employee out of work for more than thirty (30) days due to injury or illness must receive a medical clearance from their attending physician with no indicated or implied physical restrictions. The employee must obtain a medical clearance from the Department’s Occupational Specialist. The Occupational Specialist will complete the Return to Duty Form.
Modified/Light Duty	Alternate Duty Program

Fairfax County, VA
Support is provided for rehabilitation and remedial support for anyone who needs it through the Wellness Fitness Center.

Method	Contracted – Public Safety Medical Services
Modified/Light Duty	Yes, as needed

Method	Contracted for worker’s comp; minor injury prevention program through PFTs
Modified/Light Duty	Yes
Injury Prevention Committee	No committee

Metropolitan Dade County, FL
MDFR provides a physical therapy program for their fire fighters.

Method	Diagnosis, treatment, rehab, cleared to full duty
Modified/Light Duty	Yes, as per physicians determination
Injury Prevention Committee	Yes, Pass it on Program

Method	Contracted Functional movement mobility screenings offered during annual physical Fire Rehabilitation Program
Modified/Light Duty	Alternate Duty Program Industrial leave management
Injury Prevention Committee	No

Method	Members have the ability to request Work Hardening
Modified/Light Duty	Yes – coordinated by Disability Officer
Injury Prevention Committee	Yes – part of both the Occupational Health Committee and the Safety Committee depending on cause

NON-TASK FORCE CITIES

Beckley, WV
There are currently no links or files available for dissemination. For more information, see the contact listed above.

Method	N/A
Modified/Light Duty	Alternate duty program

Method
Modified/Light Duty	Light duty agreement that allows a member to be released for light duty if he/she is injured while on duty
Injury Prevention Committee	Safety Committee meets once a month to look at all injuries

Method	Contracted Occupational Medicine Facility
Modified/Light Duty	Light duty program for on the job injuries at 100% pay for medically approved rehab Limited hours according to medical direction
Injury Prevention Committee	Labor Management Committee

Method	Banner Occupational Health, specialty doctors and physical therapy offices
Modified/Light Duty	Yes – coordinated by the Emergency Services Captain
Injury Prevention Committee	Each Captain is responsible for the safety of their crew. Each battalion has a Battalion Safety Office that reviews injuries and accidents for training opportunities.

Method	In-house programs designed by Peer Fitness Trainer Outsourced programs such as South County Hospital Cardiopulmonary rehab
Modified/Light Duty	N/A
Injury Prevention Committee	Town Safety Committee meets monthly

Method	Physical therapy contract, Coury & Buehler Physical Therapy Injury Illness Prevention Program (IIPP) – required by CalOsha
Modified/Light Duty	Yes, as needed
Injury Prevention Committee	Safety & Occupational Health Committee – represents Injury Prevention Committee

Method	Provided by Pension and Disability Fund Fire Fighters see board MD then can choose from many providers in the community
Modified/Light Duty	Yes
Injury Prevention Committee	Yes, PFTs, EMS Program Manager, and Safety Office

Method	An employee out of work for more than four days (block) due to injury or illness must receive a medical clearance from their attending physician with no indicated or implied physical restrictions.
Modified/Light Duty	Yes – Coordinated by Operations Chief
Injury Prevention Committee	Health and Safety Committee

Method	Injury/Illness Back to Work Program
Modified/Light Duty	Yes – Risk Mgmt. Office conducts case review meetings on a weekly basis
Injury Prevention Committee	No

Method	Injury Prevention Program Athletic Trainer provides rehabilitation to those that need individual attention
Modified/Light Duty	Yes
Injury Prevention Committee	Yes

Method	Rehab/Injury Prevention Program – contract exercise personnel/medical provider
Modified/Light Duty	Yes
Injury Prevention Committee	Wellness Committee Works

EAP Program
Stress Management

Method	Occupational Health and Wellness Services serve as the treatment coordinator(s), and oversee the implementation of treatment, rehabilitation, and other elements as prescribed to the employee by the District physician
Modified/Light Duty	Yes – return to work program includes light duty program and an occupational return to work evaluation (fit for duty and return to work forms listed in medical section above)
Injury Prevention Committee	Yes – Safety Committee reviews all district injuries and develops strategies to combat negative trends in injuries

BEHAVIORAL HEALTH

Wellness is defined as a balance between the various fitness modalities – medical, physical, emotional and behavioral – and sometimes requires intervention and rehabilitation. Investing in the individual — the fire service’s greatest resource — is an investment in the capability to provide high-quality service to communities while enhancing the quality of life of the individuals who serve. The behavioral health component can only be effective if it is used by both the department and the individual. The most successful programs have proven to be a cooperative effort between labor, management and the individual.

In order to maintain a high level of job performance, uniformed personnel must be able to cope effectively and balance the emotional, physical and mental stresses of work and personal life. If the ability to cope becomes compromised, these stresses may act to unbalance his or her mental and emotional health. A truly comprehensive wellness program must provide continual information, education, support, access to resources and a support network.

The elements necessary for a successful and comprehensive behavioral health program are highlighted in the 3rd Edition of the Fire Service Joint Labor Management Wellness-Fitness Initiative.

This section contains an overview of the various behavioral health components implemented by all of the participating departments. Additional behavioral health resources are available at IAFF Behavioral Health Program

To view individual components that can be exported to an Excel spreadsheet, click the links below:

TASK FORCE CITIES

Method	In-house Psychologist
EAP	Yes
Stress Management	Yes

Method	Contracted Facility and Physician – Dr. of Psychology
EAP	Yes
Stress Management	Yes

Method	There are currently no links or files available for dissemination. For more information, see the contact listed above.
EAP	Yes

Fairfax County, VA
SOP Employee Assistance Program
Stress Management Program

Method
EAP	Contracted – White River Psychology
Stress Management	CISD Team

Method	Fire Fighter on own
EAP	Yes
Stress Management	Yes

Method	In house Counseling Services Unit (CSU)
EAP	Yes
Stress Management	CSU

Method	Family counseling Alcohol and drug abuse counseling Friends helping Friends Program
EAP	Yes
Stress Management	Yes

Method	24-hour access to two SFD Chaplains for emergency support
EAP	Yes – City EAP
Stress Management	4-member Fire Dept. CISM Team, City EAP Programs

NON-TASK FORCE CITIES

Beckley, WV

Method	There are currently no links or files available for dissemination. For more information, see the contact listed above.
EAP	Yes

Method	Department will support a behavioral health plan
EAP	Provided by Workforce Services Employee Assistance Program (EAP)
Stress Management	Dallas Area Crisis Response Team is available for providing CISM coverage for department members CFD and CPD have on-call Chaplains available

Method
EAP	City has an EAP program that members can be referred to or contact on their own
Stress Management

Lewiston, ME

Method	Contracted Mental Health Provider
EAP	Yes

Method	Department Chaplain, CISM team and Employee Assistance Program
EAP	Yes
Stress Management	Yes

Method	Member access to CISD, EAP
EAP	EAP available through the town of Narragansett
Stress Management	See above

Method	On own or referred by Management
EAP	Yes
Stress Management	Yes

Method	Extensive training upon hire and as needed
EAP	Yes
Stress Management	Yes

Method	EAP Program Fire Department Padre available 24 hrs/365 days
EAP	EAP Program managed by Interlock
Stress Management	CISM handled by Fire Department Padre

Method	EAP Program Education in station
EAP	Yes
Stress Management	Health care provider and County program

EAP	Yes
Stress Management	Yes through EAP

Method	Behavioral Health Evaluation
EAP	Yes

Method	(see Behavioral Health Overview)
EAP	EAP program managed by Reliant Behavioral Health
Stress Management	The Behavioral Health Specialist is well-versed in critical incident stress management/debriefing Chaplain program

COST JUSTIFICATION

The Wellness Fitness Initiative (WFI) is designed to improve the quality of life for all fire fighters while simultaneously seeking to prove the value of investing in wellness resources over time. A number of studies have shown that a well-designed and implemented health and wellness program provides a favorable Return on Investment (ROI). One of the major roadblocks preventing fire departments from implementing the WFI is cost and concerns about the economic benefit of such a program.

The Cost Justification chapter in the 3rd Edition of the Fire Service Joint Labor Management Wellness-Fitness Initiative determines the economic impact by calculating occupational claims and costs among the charter fire departments that have adopted and implemented the WFI.

This section below contains an overview of the various tools and ideas that have been used by some of the departments to show cost justification.

TASK FORCE CITIES

Method

Track worker’s comp claims cost/savings and lost time of work hours

Los Angeles County, CA
EBCT Scan Justification
Fitness for Life Program Success
Measurement of Success
Why Wellness Document

Method

Track worker’s comp claims cost/savings and lost time of work hours

Method

Line of duty injury claims

Method

Track worker’s comp claims cost/savings and lost time of work hours through the City of Phoenix Safety Division

Method

Had a specific cost justification report in 2007 by an outside consultant – Final Report

NON TASK FORCE CITIES

Method

Risk Manager tracks work comp claims and lost work hours

Method

Department tracks workers comp claims and expenses

Method

Tracking of on-duty injuries and rehabilitation time by Safety Committee and department PFT
Wellness Program Saves City Money

Method

Yes – program has proven to be cost reducing in terms of worker’s comp claims and lost time of work hours

San Diego, CA
LDL Cholesterol Data
Workers Comp Data

Method

Yes, use data from Oregon Health Science University’s PHLAME study and Pension/Disability Fund stats
Since implementing the WFI in 2000, decreased injuries by 46 percent

Snohomish County, WA
Budget Worksheet

Method

Worker’s comp claims cost/savings tracked by our worker’s compensation providers and reviewed by the Districts safety committee
Conduct pre-physical exams in-house vs. outside contractor; District estimates that approximately $30,000 annually saved in contractor fees

DATA COLLECTION

Management and labor support systems that confidentially collect medical, health and fitness data and provide analysis to improve the wellness of all fire department members. An overarching goal of the Wellness Fitness Initiative (WFI) has been to collect and analyze clinical and health outcome data generated in the 10 member jurisdictions which may be generalized to the wider uniformed personnel populations. Since the inception of the WFI, there have been ongoing efforts to develop a centralized database to serve as a repository for the collected data and information.

The Data Collection chapter in the 3rd Edition of the Fire Service Joint Labor Management Wellness-Fitness Initiative determines the economic impact by calculating occupational claims and costs among the charter fire departments that have adopted and implemented the WFI.

The MDS (Minimum Data Set) project is funded by a grant received by the University of Maryland, Baltimore School of Medicine. The MDS will enable the fire service and health providers to gather health-related data from the fire fighter population and aggregate it in a central database for analysis/research and subsequent use in proactive programs to promote health and wellness.

This section below contains an overview of the data collection process each department has implemented.

TASK FORCE CITIES

Method

None, but have commitment from the fire chief to purchase
Track by hand as needed; medical files maintained by civilians

Method

Electronic Medical Information System (EMIS)
Excel spreadsheet fitness tracking

Fairfax County, VA
The Fairfax County Fire and Rescue Department uses MedGate for its medical database system to collect and analyze clinical and health outcome data. Once the WFI/Cancer and Occupational Disease Database (funded by the University of Maryland, Baltimore School of Medicine) is completed, the Fairfax County Fire and Rescue Department and the Indianapolis Fire Department will transfer data from their Medical Information Systems to the IAFF central database.

Method	Contracted – Public Safety Medical Services Medical Information System
Data Collected	Medical/Fitness data collection since 2000

Method	Currently use Excel and working on getting a grant to implement a new MIS system
Data Collected	Medical Fitness Stats Worker’s Comp

Metropolitan Dade County, FL
Excel document to track fitness assessments but no database.

Method	HRIS System (human resources information system)
Data Collected	All medical testing except x-rays

Method	Electronic Medical Records (EMR)
Data Collected	Medical Database – data collected and entered into system by medical staff during the fire fighter’s annual physical exam Fingerprint recognition check-in used for EMR Exposure Control Database

Method	2008 baseline medicals are in Excel, all others are in chart form
Data Collected	Have a number of data reviews from the 2008 baseline medicals as well as information breakdowns from Workers’ Comp data (since 1979)

NON-TASK FORCE CITIES

Method	Information is entered into a computer database for trend analyses of individual results, as well as comparisons within the department as a whole
Data Collected	Annual performance assessment, fitness assessment and functional movement screening

Data Collected

Only cumulative results based on participation values

Method

Medical files are maintained electronically by the contracted medical provider. Fitness data is maintained by the department using our firehouse records program

Method

Individual fitness data collected by PFT
Chart form and Excel program

Method	Medical Information System
Data Collected	Data Report 2004-2008

Method	Variety of ways to track data
Data Collected	Fitness Data-MicoFit and Excel spreadsheet Immunizations-Stand alone database Medical Charts contain initial medical exam, annual hearing, mask fit, immunization and exposure files

Method

Collect annual performance assessment, fitness assessment, and functional movement screening
Medical information is kept confidential by Physician

Method	(CTX) through medical physicals Cardiac risk factors tracked by Mirosoft Access
Data Collected	N/A

Method	Electronic Medical Record designed for WFI Collect all information at time of visit Give immediate feedback – each fire fighter goes home with results in booklet w/educational material on general health related topics and try to individualize the educational material
Data Collected	4 years of data collected 200 fields of information on all fire fighters