How We Got Here: A Decade of Mission Creep
Lift assists weren’t always the Fire Department’s problem.
Historically, the Department of Emergency Medical Services handled these calls. The logic was simple: if someone’s down, it could be medical. But as EMS faced mounting call volumes and resource constraints, they began requesting Fire Department backup—first occasionally, then routinely.
What started as interdepartmental cooperation hardened into operational policy. The Fire Department absorbed lift assists entirely, despite no legal requirement to do so. It was framed as improving service reliability. In reality, it became a textbook case of “mission creep.”
Past Attempts: Good Ideas, Wrong Agency
2017 – The McIvor Study: Research distinguished between legitimate “lift assists” (moving someone from an unsafe location) and “comfort moves” (repositioning someone already safe). The study found that 92% of Fire personnel believed emergency apparatus shouldn’t respond to comfort moves. McIvor explicitly recommended “using two people in a small passenger vehicle instead of a one-million-dollar ladder truck.”
2021 – The Rock Analysis: Battalion Chief Joseph M. Rock produced an analysis and PowerPoint presentation arguing for a specialized lift assist program. The analysis, which focused on the “demand side” (call volume), estimated operational cost savings of $200,000–$400,000 annually. However, the proposal “saw no action.” This document is currently being used as a foundational “proof of concept” for current efforts.
2023 – Aging in Place: A fall-prevention referral program launched to reduce 911 dependency. While successful for enrolled participants, it doesn’t solve the broader response issue.
The numbers tell the story:
- 2012: 704 lift assist calls (1.91% of total incidents)
- 2016: 2,248 calls (tripled in four years)
- 2024: 3,095 calls (7.02% of total incidents)
- 2025: 3,184 calls
The Financial Reality: A Force Mismatch
Consider the math:
- To operate a 4 person engine the cost is roughly $352.72 per hour
- The price per 20-minute call is approximately $117.57
Given the 3,184 lift assist calls for 2025, the estimated annual cost to the Fire Department was:
- Total Annual Cost (Equipment + Labor): $374,374.08
Every lift assist call ties up a million-dollar fire engine for 20–45 minutes. During that window, the city’s most expensive emergency asset is unavailable for structure fires, vehicle accidents, and cardiac arrests. Distant units must cover, increasing response times and risk.
Optimizing this single call type could save $200,000–$400,000 annually—savings desperately needed to support funding the transition to a 24/72 work schedule that would improve firefighter mental health and retention.
The above numbers were calculated using FEMA’s 2025 schedule of equipment rates plus the average salaries of a firefighter, master firefighter, DPO and captain. Variables that alter these numbers are the type of apparatus, the number of personnel, and the duration of the call.
The Case for EMS: Follow the Money (and the Mission)
Returning lift assists to EMS isn’t about passing the buck. It’s about operational efficiency, revenue recovery, and mission alignment.
- The Revenue Argument: EMS Can Charge, Fire Cannot
Starting July 1, 2025, Virginia Beach EMS implemented “Compassionate Billing”—charging insurance carriers for transports while protecting hardship cases. This creates billing infrastructure that Fire simply doesn’t have. Because EMS already has the clearinghouses, billing software, and administrative framework, they can implement a commercial lift assist fee tomorrow. Fire would need to build this infrastructure from scratch—an expensive, redundant effort.
Other cities have already proven the model works:
- Decatur, Illinois implemented a $500 fee for lift assists at commercial facilities. Result: 60% reduction in call volume, significant cost recovery
Source: https://www.ems1.com/ems-management/a-500-fee-and-a-60-drop-how-one-department-tackled-its-lift-assist-crisis
- The Labor Argument: Right People, Right Cost
Fire crews are specialized professionals trained for high-risk, complex emergencies. Sending a $352.75/per hour crew in a $1,094,607 apparatus to help someone off the floor is like hiring a neurosurgeon to apply a Band-Aid.
EMS has access to different staffing models:
- Basic Life Support (BLS) ambulances with two EMTs
- Community Safety divisions with civilian responders
- Volunteer rescue squads with Virginia Beach’s “storied history of volunteerism”
A volunteer-staffed lift team would reduce labor costs to near zero for 3,000+ annual calls—an efficiency Fire’s all-career workforce can’t match.
- The Asset Argument: Stop Burning Million-Dollar Trucks
Every lift assist call accelerates the depreciation of Fire’s most expensive assets. Diverting 3,000 calls annually to lighter EMS vehicles extends the lifespan of fire engines and ladders, avoiding premature replacement costs in the millions. With new pumper trucks costing over $1 million and new aerial ladders up to $2.04 million (according to recent requisitions), this isn’t just about operating expenses, it’s capital preservation strategy.
- The Mission Argument: Core vs. Courtesy
The core of this issue lies in mission alignment. The Virginia Beach Fire Department is mandated as an All-Hazards Emergency Response Agency. Its operational scope is intentionally broad, encompassing:
- Fire Suppression (including fire alarms)
- Hazardous Materials Mitigation
- Technical Rescues
- Water and Marine Emergencies
- Motor Vehicle Accident Response
- Infrastructure Maintenance (e.g., maintaining hydrants, conducting pre-incident plans)
- EMS (including medical alarms)
Every lift assist pulls a unit trained and equipped for these high-risk, low-frequency events. The Fire Department’s role is to manage complex emergencies that no other department can. This is a capacity that must not be degraded by routine, increasing, low-acuity non emergency calls.
The Path Forward
The Virginia Beach Fire Department didn’t create the lift assist crisis. For a decade, we’ve subsidized a service that was never our statutory responsibility, absorbing costs that generate zero revenue while degrading our core emergency readiness as well as morale.
It’s time to correct the mission creep.
By returning lift assists to EMS, Virginia Beach can:
- Generate revenue through commercial billing
- Reduce costs with appropriate staffing and vehicles
- Preserve capital by protecting million-dollar apparatus
- Improve readiness by keeping fire units available for high-acuity emergencies
- Fund priorities by redirecting savings to the 24/72 schedule transition
EMS already has the infrastructure. They have the mission alignment. And starting last summer, they now have the billing capability.
The question isn’t whether Fire can keep doing lift assists more efficiently. The question is whether they should—when another department is better positioned to do it smarter, cheaper, and sustainably.
It’s time to let EMS do what EMS does best, and let Fire get back to fighting fires.
*A. Captain (Officer)
- Grade: Y28, Step 6
- Annual Salary: $91,189.84
- Hourly Rate: $91,189.84÷2,912=$31.32
- Driver/Pump Operator (DPO)
- Grade: Y26, Step 6
- Annual Salary: $82,711.86
- Hourly Rate: $82,711.86÷2,912=$28.40
- Master Firefighter (Estimated)
- Grade: Y24, Step 6 (Assumed progression step between FF and DPO)
- Annual Salary: $75,022.11
- Hourly Rate: $75,022.11÷2,912=$25.76
- Firefighter (FF)
- Grade: Y22, Step 6
- Annual Salary: $68,047.27
- Hourly Rate: $68,047.27÷2,912=$23.37
Total Labor Cost of 4 person crew: $108.85/HR
Fringe benefits included: $163.28/HR (labor cost 108.85 *1.50)
Apparatus Cost (per FEMA) $162.44/HR
Total Cost to operate a 4 person engine: ($162.44 + 163.28) = $352.72
