- The Washington Times - Monday, August 19, 2002

D.C. officials say a dire shortage of emergency medical service technicians to staff ambulances does not present a crisis in public safety they'll just order the trained emergency workers they do have to work longer hours, with no overtime pay.
This solution will only make things worse by creating an exhausted group of lifesaving technicians, firefighters warn.
"Bad care is not better than no care," said Paul Maniscalco, a board member and past president of the National Association of Emergency Medical Technicians.
The shortage of EMS personnel has driven staffing levels below half of what is needed to operate the city's fleet of ambulances, The Washington Times first reported last week.
An internal fire and EMS department report distributed earlier this month said 335 personnel are needed to staff the 36 ambulances the city operates on a daily basis, but that the EMS department budget allocates only 277 field-provider positions.
The report said 57 medics are detailed elsewhere or out on leave and 46 positions are vacant, leaving 174 personnel only enough to staff 15 ambulances full time.
"I think it's a concern, but I wouldn't call it a crisis," said D.C. Council member Kathy Patterson, who chairs the Judiciary Committee that has oversight of the fire and EMS department. "Trying to come to terms in a financial crunch to do what we have to do to recruit is something the mayor and the fire chief are going to have to address."
Deputy Mayor for Public Safety and Justice Margret Nedelkoff Kellems said interim Chief Adrian Thompson has created a plan that would make staffing the ambulances a top priority rather than putting units out of service if medics aren't available.
"In the short term, we will correct that using overtime," Mrs. Kellems said.
Under the terms of a union firefighters' contract negotiated when the city was in financial trouble, firefighters won't be paid time and a half, however only straight pay.
She said Chief Thompson will use on-duty firefighters, who are trained to provide basic life support as emergency medical technicians, to staff ambulances.
The city will staff the fire engines using overtime personnel from the larger pool of firefighters. While the funds to pay the extra firefighters come from the overtime budget, it will cost less than having medics work overtime because D.C. firefighters don't get paid extra for overtime. D.C. medics earn time and a half for overtime.
Mrs. Patterson said the department's swelling overtime budget has been "a concern for the Judiciary Committee for quite some time now."
Mrs. Kellems agreed.
"They're not staffed as cost-effectively as we want," she said. "The larger issue is we really need to focus on recruiting and retaining more folks."
Fire officials say efforts to recruit medics, who earn between $35,000 and $40,000 a year to start, haven't been very successful.
"My colleagues and I around the country know, anecdotally and intuitively, that we are in the throes of a recruitment and retention problem the proportions of which we have never seen in the history of EMS," Mr. Maniscalco said.
He said jurisdictions are in competition for medics, offering lucrative signing bonuses to lure them away from other departments.
The District's paramedics union, the American Federation of Government Employees Local 3721, says one reason the District has a hard time recruiting medics is that its retirement benefits are inadequate.
In the District, uniformed firefighters have a plan in which they receive a 67 percent pension after 25 years of service. Paramedics, who are civilians represented by a separate union, get a yearly 4 percent contribution from the city to a retirement account, similar to a 401(k) plan.
Arlington County offers its paramedics the same retirement benefits as its police officers and firefighters. County officials say their goal is to keep benefits in the "top quartile" of those offered in the region.
Mrs. Kellems said medics need to have "commensurate benefits," but another aspect of the long-term solution to the paramedic crisis is to cross-train the department's firefighters as paramedics.
Some other regional jurisdictions have already adopted that model.
In Prince George's County, firefighters are hired as "emergency rescue technicians," with a four-year window to attain certification as paramedics.
But in October, the District will adopt the expanded training requirements of the U.S. Department of Transportation's National Standard Curriculum, the federal guideline for emergency medical care.
Mr. Maniscalco said the expanded training is necessary with new medications and techniques that are available in pre-hospital care.
Mrs. Kellems said she realizes the new standard will complicate efforts to train medics internally, but the city doesn't have many options.
"The reality is there's a new standard, and we're going to work by that standard," she said.

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