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Honolulu EMS nears deal to end 16-hour shifts

A pilot project would convert shifts from 12 to eight hours with the aim to eliminate double shifts

By Honolulu Star-Advertiser

HONOLULU — City officials say they’re close to reaching an agreement with the union representing roughly 200 emergency services workers on a scheduling plan that they hope will curb staff shortage and overtime problems that forced them to shut down shifts at four ambulance stations during Easter weekend last month.

The city hopes the pilot project that converts most of its shifts for paramedics and emergency medical technicians to 12 hours from eight hours will reduce the amount of overtime they are forced to work and keep them happier, said Mark Rigg, director of the Department of Emergency Services.

This would mean the city would pay less in overtime and be able to draw from a larger pool of available workers to substitute for people calling in sick rather than force those already there to work double shifts.

Talks are expected to resume Wednesday with officials from United Public Workers, which represents Emergency Management Services Division workers, Rigg said Tuesday. “We are hopeful we will have an agreement in a couple of weeks,” he said.

About 30, or more than 15 percent, of EMS’ 220 funded positions are unfilled, a situation that has forced EMTs and paramedics to work double shifts of 16 hours.

Staff shortages and overtime have been a chronic concern in recent years for Oahu’s Emergency Medical Services Division.

But the current problem was exacerbated by the recent unanticipated exodus of at least half a dozen emergency workers from EMS to the Honolulu Fire Department, the state or other counties. EMS workers often leave to become firefighters, who typically have more advancement opportunities and step pay increases, Rigg said.

Meanwhile, EMS cleared the way for 15 current EMTs to begin paramedic training classes at Kapiolani Community College in January, putting them out of commission for about 15 months, Rigg said. “It was a tough decision ... but we need paramedics or we’re going to be short.”

The situation reportedly has left some emergency workers so worn down that they have been taking sick days off to recuperate.

Rigg confirmed that four of the island’s 20 ambulance stations each shut down for one eight-hour shift during the April 19-20 Easter weekend. The weekend was slow, and contracted ambulance operator American Medical Response was on standby, Rigg said.

The department is neither seeking out nor punishing anyone who may have purposely taken sick leave to recuperate. “My position is ... if you’re tired and you’ve been working 16-hour shifts for two or three days, if you’re too tired to come in, don’t come in,” Rigg said.

The staffing dilemma has required EMS to spend roughly $5 million in overtime annually, more than a third of the EMS budget.

The city had budgeted $4 million for EMS overtime in the current year and, with just over a month to go in the current fiscal year, is projecting spending $5.19 million in OT, city emergency services spokeswoman Shayne Enright said. The city paid $4.95 million in EMS overtime last year, she said.

State Health Director Linda Rosen said the consistently high EMS overtime costs have troubled officials at the Health Department, which reimburses the city for EMS operations through a contract, for a number of years.

Rosen, who has been the Health Department EMS branch chief since 2006 and has continued in that role even after becoming health director in February, said she has pressed Oahu EMS to convert to 12-hour shifts for several years.

While overtime is often necessary, Rosen said, chronic OT issues like those experienced by EMS leads to employee burnout and then retention issues.

Rosen said the larger fear is that"they’ve really reached the point where if they have more people leaving because of the forced overtime, they’ll just have to shut down stations because they don’t have the personnel.”

Rigg said he agrees with the logic behind moving to a predominantly 12-hour schedule. “It requires less staffing to operate a 12-hour schedule than an eight-hour schedule on a daily basis, so we’d have more personnel available to us,” he said.

The actual number of stations that will convert to 12-hour schedules is still being negotiated. But Rigg said a 90 percent conversion would result in the need for approximately 30 fewer EMS personnel daily.

EMS personnel “will have to be relieved” after 12 hours rather than be forced to stay for additional shifts due to shortages, he said. Most EMS personnel support the 12-hour shift “because they’ll have less days of work and more weekends off,” he said. Tentatively, the plan calls for those on 12-hour shifts to alternate three- and four-day workweeks, he said.

Also expected to help the staffing shortage is the influx of 12 to 15 newly hired EMTs in the coming weeks who are coming onboard after finishing their evaluation period, Rigg said.

Another group of 15 to 20 EMTs who have just graduated from KCC will be ready to join EMS by August, he said.

Meanwhile, starting this year, KCC is increasing the number of EMT classes it offers annually to three, up from two.