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  • #16
    Originally posted by randsc
    ..."that" being break away doors. Would you believe that in NH the Bureau of Health Facilities and Fire Marsh. want to mandate them, but the Bureau of Elderly and Adult Services wants to forbid them (they're a "wander" hazard)? And naturally, none of these agencies actually has written their requirements into their administrative rules, they are informal (but strictly enforced). So what the hell is the provider supposed to do?

    What makes this sort of bureaucratic crap especially irritating is that state agencies are operating outside the scope of their powers as defined by statute and administrative rules. The Bureau of Health Facilities admin rules expired 5 years ago. So why don't they just write these things into the rules? Because in NH, unfunded mandates are prohibited by the state constitution, and state law requires a cost-benefit analysis before new admin rules are enacted. So by keeping it on the QT, they hope to do whatever they like.

    This is the sort of thing that causes providers and property owners to cringe when they see the FD coming.
    I can't really remember the issue in Ca exactly but I think the same sort of beauracratic bs happened here as well.
    I think it took multiple MCIs at these places within the span of a year or two to finally force the issue.
    Hopefully New Hampshire shows more passion than Ca. and expidites the process.

    Comment


    • #17
      Originally posted by FlyingKiwi
      ALL care hospices, elderly homes etc were required to do this a few years back down here after a spate of death fires.

      Did some bleat, did some go out of business, yes.

      Should they have been in the business if their facilities were not adequate?

      Should they have been allowed to care for elderly and or infirm without adequate protection in the first place?

      Did some of them have below minimum night time staff to cope with an emergency?

      Was there a settling period where adjustments were made, yes.

      Have we had any deaths to fire since. NO.

      Answer is obvious really.
      How is this level or care funded in NZ? Here, it is almost entirely Medicaid. The state and feds decide what level the reimbursement is at. So the provider has no control over revenue. Aggressive regulatory actions remove much of the provider's control over expenses. Staying solvent is a challenge to say the least.

      I asked my fried if this was really a business he wanted to be in. He said he would literally make more money by selling the real estate to be broken up into apartments, and parking his money in something like T-bills. So I asked him why the hell he didn't do that, and quit working 90 hours a week and dealing with the hassles from the state. His reply? "These people have no where else to go"

      Many of the providers approach sainthood. I hate to see them run down because they are stuck between a rock and a hard place, neither of their own making. I repeat, this is NOT a no-brainer.

      Comment


      • #18
        We have a mix of government pension that is paid for out of tax during your working life, and state benefits that are paid out of everyone elses tax. Along with personal contributions, weighted against value etc.

        Sometimes it gets tricky even for us to work the damn system out.

        I agree where someone is providing a "Social Service" for the state/city that the state/city should then be accountable for funding sprinklers, protection etc. This would be more of a homeless shelter style of arrangement as opposed to a Retirement Home / care facility.


        Long term care facilities that provide medical care should NOT even have been allowed to open their doors without adequate protection in the first place.

        If you are going to run a BUSINESS looking after the infirm or mentally ill, then having adequate protection for these people is part of the price of running the business.

        Whatever charity you provide to other cases is irrelevant. And yes he may be a "saint" but that does NOT negate his primary responsibilities to those in his care.
        Psychiatrists state 1 in 4 people has a mental illness.
        Look at three of your friends, if they are ok, your it.

        Comment


        • #19
          this isn't a simple solution.

          If you mandate sprinklers, it will be more expensive to stay in business. Ergo, some care centers will go out of business, and some that would open will not.

          This will leave the marginal patients, namely the poor, without a care center. They will likely be forced to stay with their families, if they have any, who will not provide 24h care (they have to work), and are not likely to live in a sprinklered building.

          So, yes, you can, with a rule change, drastically reduce the likelihood of a senior citizen dying in a fire at a senior home. However, you will have likely increased the likelihood of senior citizen's dying in private homes. It is likely to be a net loss, because at least in a non sprinklered group home, you've got people awake and on duty 24/7.

          Comment


          • #20
            Originally posted by SBrooks
            this isn't a simple solution.

            If you mandate sprinklers, it will be more expensive to stay in business. Ergo, some care centers will go out of business, and some that would open will not.

            This will leave the marginal patients, namely the poor, without a care center. They will likely be forced to stay with their families, if they have any, who will not provide 24h care (they have to work), and are not likely to live in a sprinklered building.

            So, yes, you can, with a rule change, drastically reduce the likelihood of a senior citizen dying in a fire at a senior home. However, you will have likely increased the likelihood of senior citizen's dying in private homes. It is likely to be a net loss, because at least in a non sprinklered group home, you've got people awake and on duty 24/7.
            Exactly right, thank you.

            Comment


            • #21
              Its to bad that everyone needs to politic their case: safety vs. cost effectiveness. I'm sorry to say that I don't beluieve the majority of these facilities are in existance for the good of the elderly, yet the good of some peoples wallets. Yeah, yeah, non-profit! with the top offices earning large salaries. As Fire Service professionals we are charged with providing a minimum level of safety to the public.

              It is a No Brainer! I guess by a few arguements poor people don't deserve to live in safe facilities? Why do we have any codes at all? Most of these low-income homeless-elderly housing facilities take State and Federal funds; this should require minimum safety requirements. What's stopping someone from converting an old farmhouse in a rural area miles from the nearest vollie firehouse and no water? Nothing! We have many around our area. So a fire occurs in a facility where there are too few providers, no sprinklers, a long FD response with a water supply issue. Great! I hope I can afford to retire to an upscale nursing home.

              For those who say it isn't as easy as requiring sprinklers: What would you suggest the minimum safety standards be for an facility that houses people incapable of self-preservation?

              Comment


              • #22
                With all due respect...

                [QUOTE=FlyingKiwi]

                Long term care facilities that provide medical care should NOT even have been allowed to open their doors without adequate protection in the first place.

                If you are going to run a BUSINESS looking after the infirm or mentally ill, then having adequate protection for these people is part of the price of running the business.

                [QUOTE]

                This is BS. Facilities open with adequate protection as defined by applicable law. In this case, the issue is whether changes can be made to that law AFTER the fact, without adjusting reimbursement levels.

                My analogy would be this. A municipality contracts with a fire district for a particular level of protection, for example, that a firehouse will be staffed with an engine company and a truck company, and in exchange the municipality will kick in a million dollars to the fire district budget. (am quite common arrangement in the States) There is then a bad fire, and the municipality decides it would feel more comfortable with TWO engine companies and a truck company. Should the municipalty be able to mandate that staffing level without adjusting its payment to the fire district?

                Look, like I said above, sprinkler everything if you want. Just be sure that the legislation mandating sprinklers includes a funding mechanism.

                To pretend that these things are cost-free is just silly.

                Comment


                • #23
                  SBrooks this isn't a simple solution. If you mandate sprinklers, it will be more expensive to stay in business. Ergo, some care centers will go out of business, and some that would open will not.
                  Which is why legislation with tax incentives and grants is important.

                  Insurance premiums would be effected, too. Companies offer discounts for fire sprinklers. Better to pay out for a little water damage then for death. Wouldn't you rather put a family member in a safe environment?

                  We kill between 3500 - 4000 people in this country each year due to fires (yes, not all of them are in places that would be sprinklered) and no one seems to bat an eye! If they're dumb enough to not have a working smoke alarm, then maybe a mandate is needed!? Obviously public education isn't working.

                  There are also other options that may prove to be less expensive and use less water -- ever hear of Marrioff? http://www.marioff.com/

                  Other sources of info:

                  http://www.homefiresprinkler.org/hfsc.html

                  http://www.nfsa.org/
                  "When I was young, my ambition was to be one of the people who made a difference in this world. My hope is to leave the world a little better for my having been there."
                  -- Jim Henson (1936 - 1990)

                  Comment


                  • #24
                    If you would actually read the thread...

                    Originally posted by RFDACM02
                    Its to bad that everyone needs to politic their case: safety vs. cost effectiveness. I'm sorry to say that I don't beluieve the majority of these facilities are in existance for the good of the elderly, yet the good of some peoples wallets. Yeah, yeah, non-profit! with the top offices earning large salaries. As Fire Service professionals we are charged with providing a minimum level of safety to the public.

                    It is a No Brainer! I guess by a few arguements poor people don't deserve to live in safe facilities? Why do we have any codes at all? Most of these low-income homeless-elderly housing facilities take State and Federal funds; this should require minimum safety requirements. What's stopping someone from converting an old farmhouse in a rural area miles from the nearest vollie firehouse and no water? Nothing! We have many around our area. So a fire occurs in a facility where there are too few providers, no sprinklers, a long FD response with a water supply issue. Great! I hope I can afford to retire to an upscale nursing home.

                    For those who say it isn't as easy as requiring sprinklers: What would you suggest the minimum safety standards be for an facility that houses people incapable of self-preservation?
                    ...you would see that no one is suggesting that sprinklers not be mandated. What we (mostly me, I guess) suggest is that the reimbursement rates paid to providers need to reflect the cost of complying with the mandate.

                    Otherwise, as SBrooks points out, what you will have is a dearth of providers, leading to people living in separate apartments with no attendents or fire safety equipment at all.

                    As for the idea that cost-benefit analysis has no place in public safety discussions: Grow Up. If cost-benefit doesn't apply, I want all construction to be masonary. I want steel roofing, laid over full rafters. I want truss constrction banned. I want all interior flooring to be ceramic tile or poured concrete. I want a firehouse on every corner, manned 24/7 with two companies of 5 men each. It's a NO BRAINER! Every one of these things would prevent fire deaths and injuries!

                    Comment


                    • #25
                      DianeC

                      Originally posted by DianeC
                      Which is why legislation with tax incentives and grants is important.

                      Insurance premiums would be effected, too. Companies offer discounts for fire sprinklers. Better to pay out for a little water damage then for death. Wouldn't you rather put a family member in a safe environment?

                      We kill between 3500 - 4000 people in this country each year due to fires (yes, not all of them are in places that would be sprinklered) and no one seems to bat an eye! If they're dumb enough to not have a working smoke alarm, then maybe a mandate is needed!? Obviously public education isn't working.

                      There are also other options that may prove to be less expensive and use less water -- ever hear of Marrioff? http://www.marioff.com/

                      Other sources of info:

                      http://www.homefiresprinkler.org/hfsc.html

                      http://www.nfsa.org/
                      I agree with everything in your post. This is the sort of reasonable and responsible approach that is needed. Therefore, it stands no chance at all of ever happening.

                      Comment


                      • #26
                        OK

                        Try having a look at http://homesprinklers.fire.org.nz/
                        One initiative that is being well recieved.

                        Is it the "dearth of providers" you are worried about, or the logic behind providing an acceptable level of protection?

                        Here is a quick lesson in changing attitudes.

                        -----------

                        Start with a cage containing five apes.

                        In the cage, hang a banana on a string and put stairs under it. Before
                        long, an ape will go to the stairs and start to climb towards the
                        banana. As soon as he touches the stairs, spray all of the apes with
                        cold water.

                        After a while, another ape makes an attempt with the same result - all
                        the apes are sprayed with cold water. This continues through several
                        more attempts. Pretty soon, when another ape tries to climb the stairs,
                        the other apes all try to prevent it.

                        Now, turn off the cold water. Remove one ape from the cage and replace
                        it with a new one. The new ape sees the banana and wants to climb the
                        stairs. To his horror, all of the other apes attack him. After another
                        attempt and attack, he knows that if he tries to climb the stairs, he
                        will be assaulted.

                        Next, remove another of the original five apes and replace it with a new
                        one. The newcomer goes to the stairs and is attacked. The previous
                        newcomer takes part in the punishment with enthusiasm. Again, replace a
                        third original ape with a new one. The new one makes it to the stairs
                        and is attacked as well. Two of the four apes that beat him have no
                        idea why they were not permitted to climb the stairs, or why they are
                        participating in the beating of the newest ape.

                        After replacing the fourth and fifth original apes, all the apes, which
                        have been sprayed with cold water, have been replaced. Nevertheless, no
                        ape ever again approaches the stairs. Why not?

                        Because that's the way they've always done it around here.

                        (Sometimes you have to move mountains to change an attitude.)
                        Psychiatrists state 1 in 4 people has a mental illness.
                        Look at three of your friends, if they are ok, your it.

                        Comment


                        • #27
                          Hmmm...All long term care homes here are required to have sprinklers. Hasnt had any of the drastic effects mentioned in the thread. And belive me, we have TONS of them. They all appear to be doing quite well.
                          Fire Marshal/Safety Officer

                          IAAI-NFPA-IAFC/VCOS-Retired IAFF

                          "No his mind is not for rent, to any god or government"
                          RUSH-Tom Sawyer

                          Success is when skill meets opportunity
                          Failure is when fantasy meets reality

                          Comment


                          • #28
                            Hmmmm...

                            Originally posted by Dave1983
                            Hmmm...All long term care homes here are required to have sprinklers. Hasnt had any of the drastic effects mentioned in the thread. And belive me, we have TONS of them. They all appear to be doing quite well.
                            ...maybe the reimbursement rate in Florida reflects the cost of sprinklers. Hmmm.

                            Comment


                            • #29
                              Again, what is so hard about this?

                              Originally posted by FlyingKiwi
                              OK

                              Try having a look at http://homesprinklers.fire.org.nz/
                              One initiative that is being well recieved.

                              Is it the "dearth of providers" you are worried about, or the logic behind providing an acceptable level of protection?

                              Here is a quick lesson in changing attitudes.

                              -----------

                              Start with a cage containing five apes.

                              In the cage, hang a banana on a string and put stairs under it. Before
                              long, an ape will go to the stairs and start to climb towards the
                              banana. As soon as he touches the stairs, spray all of the apes with
                              cold water.

                              After a while, another ape makes an attempt with the same result - all
                              the apes are sprayed with cold water. This continues through several
                              more attempts. Pretty soon, when another ape tries to climb the stairs,
                              the other apes all try to prevent it.

                              Now, turn off the cold water. Remove one ape from the cage and replace
                              it with a new one. The new ape sees the banana and wants to climb the
                              stairs. To his horror, all of the other apes attack him. After another
                              attempt and attack, he knows that if he tries to climb the stairs, he
                              will be assaulted.

                              Next, remove another of the original five apes and replace it with a new
                              one. The newcomer goes to the stairs and is attacked. The previous
                              newcomer takes part in the punishment with enthusiasm. Again, replace a
                              third original ape with a new one. The new one makes it to the stairs
                              and is attacked as well. Two of the four apes that beat him have no
                              idea why they were not permitted to climb the stairs, or why they are
                              participating in the beating of the newest ape.

                              After replacing the fourth and fifth original apes, all the apes, which
                              have been sprayed with cold water, have been replaced. Nevertheless, no
                              ape ever again approaches the stairs. Why not?

                              Because that's the way they've always done it around here.

                              (Sometimes you have to move mountains to change an attitude.)
                              It's not about changing attitudes, it is about adjusting reimbursement rates to make sprinklers financially feasible.

                              The home has a deal with the state. "We will shelter 20 people, at X degree of safety, for $100,000" The state agrees, and things are fine for several years. Then the state says, "We want you to shelter 20 people, at X plus 10 degrees of safety" What the HELL is wrong with the home saying, "Fine, but we can't do that for the same $100,000, you will need to kick in some more money?" What? Is anyone going to make any attempt to engage the real issues here, or will we just continue to post fire-safety platitudes as if they were arguments, even though no one is opposed to fire safety.

                              I repeat, sprinkler the world if you want. But pay for it.

                              Comment


                              • #30
                                And, by the way...

                                Originally posted by Dave1983
                                Hmmm...All long term care homes here are required to have sprinklers. Hasnt had any of the drastic effects mentioned in the thread. And belive me, we have TONS of them. They all appear to be doing quite well.
                                ...this is an incorrect statement of Flordia law. The requirement for sprinklers is only for facilities licensed since 1996. Facilities licensed before 1996 do not need to be sprinklered, nor do facilities licensed since 1996 that house fewer than eight residents. Gotta love google.

                                Comment

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