Fire Prevention and Safety Project: Smoke Alarm Installation

The Kentucky Injury Prevention and Research Center (KIPRC) proposes a project to install smoke alarms powered by sealed, long-life, lithium batteries in low income, high risk homes in Kentucky that lack smoke alarms. This project is modeled on our previous, highly successful, CDC-funded smoke alarm installation and fire safety education projects as well as upon our four prior FEMA FP&S-funded projects. This application is endorsed by the Kentucky Firefighters�f Association (KFA), the Kentucky Fire Marshal�fs office, the Kentucky Commission on Fire Protection, Personnel, Standards and Education (fire commission), the Kentucky Department for Public Health (KDPH), the Kentucky Safety and Prevention Alignment Network, and several fire departments. KIPRC staff will partner with local fire departments and other organizations (e.g., local public health departments, senior citizens�f service programs, home health visiting programs, etc.) to make direct contact with residents of low income, high risk households. Individuals who need and will accept smoke alarms will have alarms installed by a project team member. 2 Goals and Objectives: The project goal is to install long life smoke alarms in at least 900 lowincome homes in Kentucky that lack working smoke alarms, with at least 600 of those homes also being high-risk homes. �gLow income�h will be defined as annual household incomes not exceeding 150% of the US Department of Health and Human Services (DHHS) poverty guidelines for a family of the applicable size. Because this is a community-based project, mean household income within the target area (e.g., neighborhood, census district, etc.) will be used to determine eligibility. This eliminates the need to collect individual family income figures from households that may already be distrustful of interactions with public officials (e.g., firefighters). �gHigh risk�h is defined as having one or more of the following characteristics: (a) any resident who is a smoker; (b) any resident who is . 12 years of age or . 65 years of age; (c) any resident with a physical or mental disability; (d) heating with a wood- or coal-burning stove; (e) residential structure . 30 years old; and/or (f) residential structure is a mobile home. Our objectives for this project are to: (1) Purchase 2,500 smoke alarms along with printed fire safety educational materials for all homes where alarms are installed; (2) Partner with at least one local organization in each selected community and provide training and technical support for each of the local organizations participating in the project; (3) Conduct door-to-door canvassing, supplemented by self-nomination and nomination through community services organizations, to identify at least 900 low income homes in need of smoke alarm installation; (4) Install an adequate number of smoke alarms, as defined by National Fire Protection Association (NFPA) standards, in each home identified, with a total installation of 2,500 smoke alarms; (5) Provide home safety inspections to each of the 900 households while visiting the homes for smoke alarm installation, and provide a record of any safety issues identified to the resident(s); (6) Provide fire prevention and exit drill education to the residents of those homes; and (7) Collect and analyze process data (collected via an installation and education record form) to insure that alarms are being installed, to provide an overview of the homes and population served, and to evaluate the effectiveness of the project by comparing the number of homes served to project objectives. Evaluation: We will evaluate the effectiveness of this plan based upon the number of smoke alarms installed, the number of homes in which those alarms are installed, and the number of residents that receive fire safety education. Local partners will re-contact a sample of recipients approximately 90 days after the education intervention to measure learning retention. We will also work with our local partner organizations to identify any fires that occur in project homes for at least three years following alarm installation, to determine if the alarms worked properly. Need for Financial Assistance: Kentucky contains four of the ten poorest counties in the US; only one other state has more than one of the ten. Kentucky ranks 47th in the nation in median household income. While the state budget for FY 2016-17 has not been finalized, the governor has recommended a nine percent budget reduction for almost all state agencies, including public health, the fire marshal�fs office, and the state fire commission. There is no funding available at the state level to support a smoke alarm installation and fire safety education project. The communities that will be served by this project are, as noted above, low income. Residents in these communities lack the resources, and in many cases the knowledge, to purchase and properly install smoke alarms for themselves. They also lack access to resources (e.g., ready access to the Internet) that would allow them to obtain fire safety and prevention information. We will be focusing on low income communities that are served by volunteer fire departments 3 that lack funding or resources for locally developed fire safety programs. There simply is no other source of funding and resources available to support a program to increase working smoke alarms, residential fire prevention knowledge, and home safety awareness in these communities. Vulnerability: According to 2012 data from the US Fire Administration, Kentucky�fs fire death rate of 16 per million is the thirteenth highest among the fifty states and the District of Columbia. This is an improvement from our eighteenth place ranking in 2010, but still 1.5 times the national rate (11/m). The relative risk of dying in a fire in Kentucky is 1.5 (assuming the overall national risk is the reference risk of 1.0.) An National Fire Protection Association (NFPA) report1 from 2012 shows Kentucky�fs five year average fire fatality rate to be the seventh highest in the nation. This report indicates that the percentage of the population below the poverty line, percentage of adults with less than 12 years of formal education, the percentage of teens and adults who smoke, and the percentage of the population living in rural areas are all significant risk factors for fire related death. Kentucky has one of the highest poverty rates in the nation (see below), ranks 46 out of the 50 states in the percentage of adults with a high school diploma or greater2, has the highest rate of smoking in the nation3, and ranks eighth among the states in terms of the percentage of its population living in rural areas.2 Kentucky�fs average fire fatality rate is described as being �gsignificantly higher than the overall U.S. rate�h by the US Centers for Disease Control and Prevention in October, 2014.4 The relative risk of fire related death for Kentuckians, compared to the national average risk of 1.0, is 1.6. State data for 2012 show that 74 Kentuckians died in residential fires during the year, while 76 were hospitalized. The total hospital charges for these individuals were $5,141,050 with a mean charge per hospital admission of $67,645. Structural fires led to 528 emergency department visits in 2012, resulting in total charges of $765,697. (Hospitalization data for 2013 are not yet available.) In 2013, the death toll climbed to 75, for a rate of 17.2/m. In prior projects we have found the percentage of homes with working smoke alarms to be as low as 23 percent in some communities, while 21 of 27 communities surveyed had residential smoke alarm usage rates below 70 percent. Many Kentuckians live in wood-frame housing or manufactured housing that is highly flammable. Many also heat with wood or coal and the use of space heaters is common. These heating sources increase relative fire risk. The poor, the elderly, people with disabilities, and young children have been found by NFPA to be at greatest risk from residential fires. Implementation Plan (Methods): Smoke alarms are a highly effective strategy for preventing deaths and serious injuries due to residential fires. KIPRC has documented 97 individuals who were warned of fires in their homes by smoke alarms installed during our previous programs. Smoke alarms are most effective when they are combined with education and escape planning. Thus, we will provide fire safety education for the residents of homes where alarms are installed. KIPRC will partner with the fire departments and/or other local agencies (e.g., public health departments) in the project communities. The KIPRC project manager will coordinate the project at the state level, assist local agencies with project planning, provide initial training for alarm installers, assist in door-to-door canvassing and smoke alarm installations, provide technical assistance to our local partners, coordinate and assist with the collection of evaluation data, analyze the data to ensure that project goals are being met, and submit required reports. Local partner organizations will provide the majority of the door-to-door canvassing, household recruitment, and smoke alarm installation / home safety inspection / fire safety education. This 4 methodology will make essential resources (training, smoke alarms, home safety surveys, fire safety education materials, and technical support) available to fire departments and other service agencies working in low income communities while reducing the federal cost for the project. This method has been used with great success in Kentucky in previous, similar projects that have resulted in over 30,000 smoke alarms installed over two decades, with almost 100 individuals who have escaped from residential fires after being notified by project-installed smoke alarms. Door-to-door canvassing, supplemented by self-nomination and nominations by local social services and community service agencies, will be used to identify low income, high risk households that lack working smoke alarms. Firefighters and/or other trained personnel will install residential smoke alarms in such households in accordance with NFPA guidelines, conduct a home safety inspection and notify an adult resident of the results of the inspection, and provide fire safety education to at least one adult resident of the household. (All residents present at the time of the installation will be included in the education portion of the intervention.) The intervention activity will be documented on an alarm installation / safety education record form and a home safety inspection form. Experience and Expertise: The PI/project manager conducted similar statewide smoke alarm installation and fire safety education projects for 15 years. He is an are experienced, certified firefighter and fire service officer as well as a trained fire and life safety inspector. He is also a state public safety instructor with extensive experience in delivering training and technical support to local fire prevention project personnel. Technical support and assistance will also be provided by the Kentucky fire commission, KFA, and the state fire marshal�fs office as needed. Cost-Benefit: The precise value of prevention efforts is difficult to quantify because it is very hard to demonstrate events that did not occur due to the prevention program. We do have data, however, that indicate that our proposed project is cost effective. KIPRC has previously worked with local partners to install 38,000 smoke alarms. In that period at least 99 people have been warned of fires in their homes by our smoke alarms. If we assume that half of those individuals would have escaped alive even without an alarm in their home, we are left with 49 lives saved, or one life saved for every 776 alarms installed. If we install 2,500 alarms during this project, we can reasonably expect to see 6 people warned . and 3 lives saved . by those alarms. Kentuckians who died in residential fires in 2013 suffered an average of 38.2 years of potential life lost, based upon current US life expectancies. The average years of lost productivity was 24.9, assuming retirement at 65. At $20,000 per year ($10/hour), without assuming any future raises, and leaving aside all other costs, lost wages average $498,000 for a single fatality. That alone is over five times the amount of federal funding for this program. The federal cost per alarm installed for this project is $39.12. The cost of the alarm and supporting educational materials is approximately 45% of the total cost per alarm installed, while costs for labor, travel and indirect compose a bit over half of the total cost per alarm. Given the other intervention components (door-to-door canvassing, home safety inspection, fire safety education) that are labor intensive, plus the need to collect documentation and data for evaluation and to complete necessary evaluation and reporting tasks, this is a reasonable breakdown of project costs. The federal costs are easily offset by the labor provided �gin kind�h by the local partners (but not included in the project budget). These agencies are strong supporters of the project. 5