Title
Addition of One Full-Time Equivalent Doctor of Physical Therapy Position for the Sacramento Fire Department Wellness Program
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FileID
File ID: 2026-01217
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Location
Location: Citywide
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Recommendation
Recommendation: Adopt a Resolution: 1) approving the addition of one (1.0) full-time equivalent (FTE) Doctor of Physical Therapy position to the Fire Department’s FY2026/2027 Approved Budget; 2) authorizing the City Manager or designee to implement and administer the position and associated wellness services within the Fire Department’s Health and Wellness Program; 3) authorizing the City Manager or designee to make minor changes or adjustments to correct omissions and errors; and 4) authorizing the City Manager or designee to make any necessary administrative and budget adjustments within the Fire Department's FY2026/27 Approved Budget to implement the Doctor of Physical Therapy position and associated wellness services.
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Contact
Contact: Tilden Billiter, Deputy Chief, (916) 808-2203, jbilliter@sfd.cityofsacramento.org, Fire Department
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Presenter
Presenter: None
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Attachments
Attachments:
1-Description/Analysis
2-Resolution
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Description/Analysis
IssueDetail
Issue Detail: The Sacramento Fire Department continues to experience significant operational and financial impacts From rising workers’ compensation injuries, extended Injury on Duty (IOD) leave usage, increasing modified duty assignments, and escalating overtime backfill costs. Over the past ten fiscal years, the Fire Department has generated the highest number and cost of workers’ compensation claims citywide, totaling approximately $55 million in incurred claim costs and more than 386,000 IOD hours. Current FY2026 projections estimate that IOD-related staffing and backfill costs alone will exceed $9.5 million.
The increasing frequency and duration of work-related injuries have reduced frontline staffing availability and created additional operational strain due to overtime backfill requirements necessary to maintain emergency response deployment. As emergency call volume continues to rise, the Department’s ability to maintain operational readiness while controlling costs has become increasingly difficult.
A significant contributor to these costs is the length of recovery time associated with musculoskeletal injuries commonly sustained by firefighters and emergency responders. Current claims data demonstrates that employees may remain in recovery status for extended periods before reaching Maximum Medical Improvement (MMI), resulting in increased salary continuation costs, medical expenses, overtime expenditures, and operational staffing challenges.
To address these issues, the Fire Department and Risk Management Division are proposing the creation of an in-house/on-site Doctor of Physical Therapy position as part of the Department’s comprehensive Health and Wellness Initiative. The position would provide early intervention treatment, injury prevention services, movement and mobility assessments, return-to-work coordination, rehabilitation support, fitness evaluations, and employee wellness education tailored specifically to the physical demands of fire service personnel.
The proposed position is intended to improve employee recovery outcomes, reduce injury severity and duration, decrease workers’ compensation claim costs, lower overtime backfill expenditures, and improve overall workforce readiness and resiliency.
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PolicyConsiderations
Policy Considerations: The proposed recommendation supports the City’s responsibility to provide a safe and effective workplace for employees while promoting fiscally responsible management of public resources. The recommendation is consistent with the City’s obligations under California workers’ compensation laws and occupational safety requirements to provide appropriate injury management and return-to-work practices for employees injured in the course and scope of employment.
The recommendation and implementation of a proactive wellness and injury prevention program support the City’s objectives of reducing long-term liabilities, reducing costs, improving employee retention, minimizing operational disruptions, and maintaining emergency response readiness for the community.
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EconomicImpacts
Economic Impacts: None.
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EnvironmentalConsiderations
Environmental Considerations: Ongoing administrative maintenance activities, such as purchases of supplies, equipment, or materials which are not made for purposes of a public construction project, do not constitute a “project” and are exempt from the California Environmental Quality Act (CEQA), CEQA Guidelines, Section 15061(b) (3), 15378(b) (2).
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Sustainability
Sustainability: None.
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Commission/Committee Action
Commission/Committee Action: None.
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RationaleforRecommendation
Rationale for Recommendation: The addition of an on-site Doctor of Physical Therapy position is intended to directly address the increasing frequency and severity of firefighter injuries and the associated operational and financial impacts on the organization. By providing immediate access to injury assessment, preventative care, rehabilitation services, and return-to-work support, the position is designed to reduce the duration and severity of work-related injuries, improve employee health outcomes, and minimize time away from work. More specifically, an in-house physical therapist will provide immediate injury rehabilitation for active workers’ compensation claims specifically tailored to the unique physical demands of firefighting. The on-site Doctor of Physical Therapy will also focus on preventative care, including mobility assessments and corrective exercise programs. This model is expected to improve continuity of care, reduce delays in treatment, improve recovery outcomes, and reduce dependency on reactive injury management processes.
The proposed position also supports firefighter health, operational readiness, and long-term workforce sustainability. In doing so, we further reduce the strain placed on remaining personnel required to work overtime for backfill assignments.
Research and comparative analysis of wellness programs implemented by other fire departments demonstrate that early intervention and department-specific rehabilitation programs can significantly reduce injury duration, expedite return-to-work timelines, and decrease overall claim costs.
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FinancialConsiderations
Financial Considerations: This is anticipated to be a zero-cost request to the Sacramento Fire Department budget due to projected reductions in overtime backfill costs, reduced injury-related lost time, and operational staffing impacts. The position is also expected to generate cost savings for the Risk Management Fund by reducing the frequency and severity of workers’ compensation claims, lowering medical treatment costs for workplace injuries, and shortening recovery times.
The estimated annual cost associated with the addition of one (1.0) full-time Doctor of Physical Therapy position includes salary, benefits, equipment, and operational support costs necessary to provide on-site injury prevention, rehabilitation, and return-to-work services for Fire Department personnel. If approved, the Fire Department budget will be reduced by an amount equal to the ongoing and one-time costs of this position, funded through corresponding overtime savings, resulting in no net fiscal impact to the Department.
The salary range identified in this report is being used solely for budgetary planning purposes to allocate funding for the position; the final salary range will be established by the Human Resources Department following a classification and compensation analysis.
Estimated program investment is $392,500. This includes wages, benefits, and associated one time costs.
This cost reduction model is based in part on the successful City of Denver Fire Department wellness program, which demonstrated a reduction in average days to Maximum Medical Improvement (MMI) from 209 days utilizing external physical therapy providers to 164 days utilizing internal physical therapy services, representing a 27% reduction in claim duration.
Should the City of Sacramento achieve similar results, the Department expects significant reductions in workers’ compensation costs, overtime expenditure, time spent on modified duty assignments, and staffing disruptions, resulting in improved operational readiness and long-term savings to the Sacramento Fire Department Budget and Risk Management Fund.
Program effectiveness and true cost savings will be evaluated through measurable reductions in:
• Injury on Duty (IOD) hours;
• Overtime backfill expenditures;
• Average workers’ compensation claim duration;
• Days to Maximum Medical Improvement (MMI);
• Modified duty duration;
• Musculoskeletal injury frequency and severity; and
• Total incurred workers’ compensation claim costs.
Baseline performance measurements will be established using historical FY2021-FY2025 workers’ compensation and overtime data. Post-implementation outcomes will be measured annually to evaluate operational and financial return on investment associated with the position.
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LocalBusinessEnterprise
Local Business Enterprise (LBE): Not applicable.
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Background
Background: The Sacramento Fire Department continues to experience increasing operational and financial impacts associated with workers’ compensation injuries, Injury on Duty (IOD) leave usage, modified duty assignments, and overtime backfill staffing requirements. Over the past ten fiscal years, the Fire Department has generated the highest number and cost of workers’ compensation claims citywide, totaling approximately $55 million in incurred claim costs and more than 386,000 Injury on Duty hours.
Current FY2026 projections indicate approximately 123,454 combined IOD and modified duty hours, resulting in an estimated workers’ compensation-related staffing impact exceeding $9.56 million annually. These staffing shortages have contributed to increased overtime utilization, employee fatigue, operational strain, and challenges in maintaining frontline emergency response readiness.
In response to these growing concerns, the Fire Department and Risk Management Division jointly developed the Sacramento Fire Department Health and Wellness Initiative. The initiative is designed to reduce injury frequency and severity, improve recovery outcomes, reduce workers’ compensation costs, and enhance workforce sustainability through proactive injury prevention and wellness strategies.
One of the primary recommendations identified within the Health and Wellness Initiative is to add an on-site Doctor of Physical Therapy position dedicated to supporting Fire Department personnel. The position would provide injury-prevention services, mobility and movement assessments, rehabilitation support, return-to-work coordination, physical readiness evaluations, and employee wellness education tailored specifically to the physical demands of firefighting and emergency response operations as part of the department’s Health and Wellness Program implemented around the Health and Wellness Initiative as its framework.
The proposed position is intended to provide early intervention and preventative care designed to reduce injury duration, decrease overtime backfill costs, improve workforce readiness, and support the long-term health and resilience of Fire Department personnel.
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