Occupational physical for Great Falls firefighters up for City Commission vote

Commissioners will consider tonight an agreement with Benefis Healthcare Occupational Health for firefighter occupational physicals.

The physicals for operational staff were added as a requirement in the labor agreement between the city and International Association of Firefighters Local 8. During last year’s budget process, commissioners approved $35,000 for the annual occupational physicals.

But finding a provider proved a more complicated process than anticipated with a higher price tag.

Last fall, the city requested proposals and received just one qualified response, provided by Benefis Healthcare Occupational Health.

The estimated cost for each annual occupational physical is $1,222.89 per firefighter. With 65 people in operations at Great Falls Fire Rescue, that’s an estimated $79,487.85 annually. Baselines physicals will also be conducted before hire at an additional cost of $2,103.82 and return to work evaluations are $133.75 per occurrence, according to the staff report.

City budget proposal impacted by legislative actions, cuts [2017]

This year’s budget proposal includes an additional $34,100 for firefighter physicals.

According to the city’s  RFP, the scope of work must include laboratory analysis and review the results with the firefighter during the exam. The lab work must include Chem. 24; complete blood count; total lipid panel; thyroid panel; hemoglobin A1C; glucose; urinalysis; Hepatitis B surface antibody; HCV antibody; heavy metal urine and cholinesterase for Haz-Mat members; PSA prostate cancer marker and testosterone metabolic marker for men; ovarian cancer marker CA-125 for women.

The comprehensive medical exam includes: a detailed medical history; hand-on physical exam; vital signs; occupational hearing and vision screening; TB skin test; and skin cancer screening.

The cardiopulmonary evaluation includes a cardiac treadmill stress test with EKG; an OSHA type respiratory questionnaire and pulmonary function testing.

The ultrasound imaging includes an echocardiogram (heart with function); carotid arteries with CIMT vascular age; aorta and aortic valves; internal organs – liver, pancreas, gall bladder, kidneys, and spleen; testicular and prostate for men; ovaries and uterus for women; bladder and thyroid.

The fitness analysis includes metabolic analysis with body fat; strength, endurance, and flexibility analysis; diet and nutritional recommendations; and personal exercise prescription.

The idea of the physicals is to provide a baseline health analysis to be able to catch any health issues early and also to be able to identify conditions caused by the job.

Montana is one of a few states that does not offer presumptive health coverage for firefighters and some of the conditions they are more prone to because of their exposure to a variety of toxins.

IAFF Local 8 has pushed for years to get a law change through the Montana Legislature to provide presumptive care for Montana firefighters, with little luck so far. Firefighters met with lawmakers in Great Falls earlier this year to discuss plans to continue that push and legislation is expected again in the upcoming session.

Great Falls firefighters continue effort to get presumptive law in Montana

That initial bid was rejected earlier this year and the city continued to negotiate with Benefis to “get the best price while complying with nationally recognized standards for occupational physicals for firefighters working in operations,” according to the staff report.

If commissioners approve the agreement tonight, Benefis will provide the exams and screenings to ensure firefighters are fit for duty.

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“If a condition is discovered in the exams that may compromise the health and safety of an individual or the public, the department’s assigned physician may recommend to the Fire Chief that the member be taken off full duty until corrective action is taken. The physician will work with the firefighter to get them back to full duty, if possible,” according to the city staff report.