The independent study found the Philadelphia Fire Department did not meet national standards in response time, is "beset with racial strife," and is resistant to change.
Still the department's brass and city leaders say this document provides a plan to reorganize the department for the future.
The independent study found the Philadelphia Fire Department falls far short of the national standard for response time, arriving within five minutes only 45% of the time.
The standard is 90.
City leader say those numbers can be misleading, considering Philadelphia's age and infrastructure.
"Those standards are for the entire nation. We put our times up against anyone else," said Mayor Nutter's Chief of Staff Everett Gillison. "Over the past three years, we've had the lowest number of deaths in the city's history."
The study also found the relationship between management and labor to be poor. The organization tends to reinforce the status quo and issues of racial and gender equity loom; these are findings that are refuted by Fire Commissioner Lloyd Ayers.
"Racial strife, I don't agree with. We don't experience that. I don't think we are resistant to change. I think that we know we are going to go through some changes and we'll do it together, collaboratively," Ayers said.
But change costs money and the city is strapped.
Among the recommended changes are a reorganization with redefined roles, charging fees and fines for responses to auto accidents, hazardous material spills, false alarms and non-emergency medical responses, and a roughly 10% reduction in staffing.
"We've been cut. We've been gutted," said Union President Bill Gault. "The fire department is not the piggy bank to keep taking from."
Sam Katz is the chair of the Pennsylvania Intergovernmental Cooperation Authority, responsible for financial oversight of the city and the organization which oversaw the study.
He says it was collaborative effort by the city, fire department and union, and offers a blueprint for real change.
"We are going to be looking to see which of these recommendations were implemented and of the one's not - why?" says Katz.
There is no timetable set to implement some of the recommendations, but city leaders say many of them have been in the works.