Copyright 2005 P.G. Publishing Co.
EMS feels budget pressure
Paramedics say staffing cuts, forced overtime resulting in slowed response times
By RICH LORD
Pittsburgh Post-Gazette (Pennsylvania)
PITTSBURGH — Dial 9-1-1 for a life-or-death emergency in the city of Pittsburgh and paramedics will come rushing to your door, usually within eight minutes.
The city’s award-winning Emergency Medical Services Bureau, though, is starting to suffer some maladies of its own that are rooted in Pittsburgh’s budget problems.
In the short term, those problems could result in a strike authorization vote tomorrow and a Jan. 1 walkout.
In the long run, budget cuts could lead to a steady degradation of services, starting with a planned cutback in river rescue, slower response times and worsening wear-and-tear on workers.
“We’re the bastard stepchild of public safety,” said Jeff Vesci, president of the Fraternal Association of Professional Paramedics.
The city EMS workload has remained constant, at around 56,000 service calls a year, including more than 20,000 top-priority medical emergencies, according to city budgets.
Since 2003, though, the work force available to handle those calls has shrunk from 209 paramedics and medical technicians to 162 paramedics and no technicians.
To handle the same volume of calls, the bureau has scheduled mandatory overtime, to the point where premium pay will amount to one-quarter of the $12 million EMS budget this year.
That’s creating what EMS Chief Robert McCaughan called an “enormous domino effect” of overtime, stress, injuries and more overtime to cover for worn out workers.
“We have an aging work force,” Chief McCaughan told City Council on Dec. 8. “We’re asking the same people to work more.”
Many paramedics like the overtime, which allows a few go-getters to make twice their base salaries of $32,000 to $47,000.
Others say it’s just too much. One veteran, who asked not to be named, complained that the paramedics “are forced to work [overtime] day after day, week after week.”
Now they’re being asked to take home less.
The paramedics’ contract runs out at year’s end, and negotiations continue. An 11th-hour bargaining session is set for today.
The city wants the paramedics to pay more for health insurance. They now have one plan that involves no employee contribution and others that entail modest contributions.
Some other city workers now make monthly contributions for health insurance that range from $11 to $229 a month, depending on the plan chosen, the worker’s wages and family size. Police and firefighters pay $30 to $90 monthly, amounts that are scheduled to rise next year.
Mr. Vesci said that if his people were paid as much as police and firefighters that would be one thing. They’ve long fought for parity with their better-paid brethren, but have temporarily set aside that goal.
“The city’s telling us, ‘Oh, we’re broke, now’s not the time, we don’t have the money,’ ” he said. “That’s fine, but we’re not giving anything else back.”
Reduced staffing appears to be affecting response times.
National standards call for paramedics to reach the scene of a life-threatening problem within eight minutes 90 percent of the time, Chief McCaughan told council. City records say crews arrived for such calls within eight minutes 75 percent of the time in 2003, 70 percent of the time in 2004, and only 51 percent of the time this year.
Mr. Vesci said the response time for low-priority calls sometimes reaches two hours.
Last week, he said, he transported an injured teenager. Dispatchers “held that call so long, by the time I got him to Allegheny General Hospital, his mother had already been there looking for him, and left,” he said.
Since the city let go of its less-well-trained medical technicians in 2003, non-emergency calls have increasingly bogged down paramedics, he said.
“You have overtaxed paramedics responding to calls that we shouldn’t be responding to,” he said. “When we respond to calls that we should respond to, we’re tired and overstressed.”
The stress may worsen. The city’s proposed 2006 budget includes $300,000 less in EMS salaries than in 2005, amounting to several fewer paramedics.
The bureau’s contingency plan is to cut back River Rescue Unit operations dramatically during boating season, Chief McCaughan told council. That unit typically responds to 100 calls per year.
The downside: Cuts in river rescue services could jeopardize federal funding the city has been able to get to replace boats, which has totaled around $500,000 in recent years.
“We may in fact be shooting ourselves in the foot,” he told council.
The city depends on the paramedics for $12 million a year in revenue it gets from billing insurance companies for transporting patients. That revenue offsets the bureau’s costs, except for employee benefits.
Hospitals depend on EMS for patients.
“Clearly we would hope that this matter is resolved in a manner that is satisfactory to all parties,” said Tom Chakurda, vice president of communications and marketing for West Penn Allegheny Health System.
A Jan. 1 walkout would start two days before Bob O’Connor is to become mayor. The paramedics have long been political supporters of Mr. O’Connor.
“We’re following pretty closely what’s going on with the situation,” said O’Connor spokesman Dick Skrinjar. “He looks forward to working with the EMS union on these issues.”