David Fraley always hated going to the doctor, but because of what was discovered in the physical examination he underwent last year as a volunteer firefighter, he now knows checkups are crucial.
Fraley, chief of Funkstown Volunteer Fire Co., and other local fire chiefs want physicals provided regularly for their volunteers so that they know the fitness of the people they are sending to emergency scenes.
"We want to make sure health is there and make sure we're not going to have to go to a funeral or something, for lack of caring," said Jason Eckstine, chief of the Longmeadow Volunteer Fire Co.
The fire chiefs and others are pushing to keep the so-called "3-2-1 system" of physical exams based on age that the Washington County Volunteer Fire and Rescue Association currently provides to volunteers.
But the system might become too expensive for the association now that Washington County is requiring physicals for all front-line volunteers and the association's use of county gaming funds is under attack, association President Glenn Fishack said.
"We can keep paying them as long as the gaming commission or the state (legislative) delegation doesn't change the gaming fund the way we do it," Fishack said.
The association is to meet with county government leaders and local state lawmakers Thursday night in their first joint meeting since late September when officials slammed the association's financial practices.
Rather than distribute all of its share of the county gaming fund to local fire and rescue companies, the association had cash and investments totaling more than $600,000, The Herald-Mail found in a yearlong investigation.
If the association is allowed to keep receiving and distributing the gaming money, it will be able to afford the physical exams for a while, Fishack said.
Even so, the county government will either have to work with the association to reduce the costs of physicals or the association's member fire and rescue companies will have to shoulder the expense themselves, Fishack said.
Under the 3-2-1 system, front-line volunteers — those who fight fires and treat accident victims — take a physical exam according to an age-based system.
Volunteers age 29 and younger get an exam every three years; those 30 to 39 get one every two years; and those age 40 and older get one every year.
Of the estimated 1,056 front-line volunteers throughout the county, 198 are 29 or younger; 300 are 30 to 39; and 558 are 40 or older, association Treasurer Richard C. Blair said.
Until late last year, all of them were encouraged but not required to get the physicals.
But then the premium for workers' compensation insurance that the county government pays for the volunteers more than doubled to $555,000 a year. Part of the reason was that their claim history was about 2 1/2 times the national average.
More exams, higher costs
As a result, the county told the association to require the exams in an effort to rein in the claims. As word spread to the county's 27 volunteer fire and rescue companies, the number of volunteers getting physicals rose, and the association's costs increased.
Before the crackdown, about 175 to 230 volunteers were taking the exams each year, Blair said.
All of their exams were covered under the annual $60,000 contract the association had with Health@Work, an affiliate of Meritus Health that provides occupational health services, he said.
By this past summer, when the association's fiscal 2011 year ended, so many more volunteers had taken the exams or gotten Health@Work's approval for physicals they'd taken elsewhere, the association's bills for physicals reached $114,000, he said.
He said the association was facing even higher bills — as much as $491,000 — in all for fiscal 2012, 2013 and 2014 because more than half of its emergency volunteers are in the upper age bracket, requiring physicals every year.
Although the number of physicals varies each year, the bills would have averaged $163,666 a year.
Association leaders then learned that the insurance company that provides the county's workers comp coverage would accept a lesser standard than 3-2-1. The company is willing to let every volunteer, regardless of age, take a physical just every three years.
Changing to that system would have substantially reduced the association's cost to a much more affordable $237,000 total for fiscal 2012, 2013 and 2014, Blair said.
And, it wouldn't have risked the volunteers' health because the doctors giving the exam work closely with other doctors in the county, he said.
"If the Health@Work doctors see there might be a problem, they're going to refer the volunteer to his or her private physician so, you know, it's pretty safe," Blair said.
So the association's leaders recommended changing the system to one exam every three years, regardless of a member's age. But late last month, representatives of the association's 27 companies voted overwhelmingly to keep the 3-2-1 system.
"This is a stressful job," said Ronnie Gray, who is deputy chief of the Potomac Valley Fire Co. in southern Washington County. "I'm 61, and the older you get, the more stressful it gets."
National standard changed
The 3-2-1 system is commonly championed by local emergency officers as being the national standard, as recommended by the National Fire Protection Association. NFPA is recognized throughout the world for its safety standards.
"More firefighters die from heart attacks than from being injured in fires or (while) fighting fires," said Sam Murray, who, at 75, is active as a fire policeman and was active as a firefighter with his home Longmeadow company through the 1970s and 1980s.
"I think (the heart attack rate) is one of the important things that NFPA is looking at," Murray said.
But the 3-2-1 system is NFPA's old national standard.
NFPA stopped recommending 3-2-1 in 2003, when it changed the standard to recommending that all front-line volunteer and career firefighters, and ambulance workers get a physical every year, according to Larry Stewart, a spokesman at NFPA headquarters in Quincy, Mass.
The annual physical for all is the standard now because less frequent exams might allow medical problems to arise in the meantime, NFPA spokesman Ken Holland said.
"There's a lot can happen within a one-year time, let alone a three-year time," Holland said.
'Keep ... what we have'
News of the change surprised local association leaders Blair and Fishack, and some other local fire officers. Some of them said the changes are hard to keep up with because NFPA issues so many standards and revises them often.
But Longmeadow's Chief Eckstine said he and at least some other chiefs have been aware of the change. Eckstine said they also realize that it would be even more expensive for the county to upgrade to require annual physicals for everyone.
That's why they have been pushing 3-2-1, knowing it is costly but more affordable.
"We didn't want to fall backwards from where we were" with 3-2-1, Eckstine said.
The fire chiefs have discussed it and decided that backing 3-2-1 will be their effort "to keep at least what we have. We don't even meet the (current) NFPA requirements, as we are doing it. So we didn't want to go backwards from what we have," Eckstine said.
Kirk Mongan, chief of the Leitersburg Volunteer Fire Co., said it's "really important" that NFPA standards be followed, even if they're the older standards.
Mongan and the three other fire chiefs interviewed for this story said they would prefer that the county switch to the newer standards, requiring annual physicals for all. They said they know that would be more expensive, but not how much more.
But even just the expense of 3-2-1 worries them.
"I'm wondering how long we'll be able to afford it without the county (government) getting into it," Clear Spring Fire Chief Mike Reid said.
Funkstown's Chief Fraley, who will be 48 next week, said he especially understands the importance of the physicals because of the high sugar and cholesterol levels that tests at Health@Work showed during his annual exam there last November.
"I was drinking eight Big Slam Pepsis a day and a Big Boss at night, so I stopped drinking soda," Fraley said. "I'm getting my health back together. And, if I hadn't taken a county physical, I wouldn't have known" about those problems.