By Anne Snabes
The Detroit News
STERLING HEIGHTS, Mich. ― On a chilly afternoon in early February, Sterling Heights Fire Department emergency medical technicians Nick Willson and Nick Prantera pulled their ambulance into the parking lot of a local dialysis and rehabilitation center and got a patient who needed to be transported to a nearby hospital.
The transport was less than a mile away, a short drive from one facility to another, but six months ago, one of the city’s advanced paramedic units would have been required to do it.
| State of the industry survey: What Paramedics Want in 2026
That’s not the case anymore. Under one of two new initiatives aimed at lightening the load on paramedics as medical service calls are increasing, Sterling Heights has what it calls a peak demand unit to handle less severe 911 calls. Four emergency medical technicians, or EMTs, handle low-acuity calls such as stomach pain and lift assists on most weekdays. They are also firefighters and sometimes respond to fire calls.
The city has also partnered with Macomb County’s dispatch center to implement a color-coded system that helps it better prioritize 911 calls. More advanced EMS units respond to more severe calls.
Sterling Heights Fire Chief Kevin Edmond said both initiatives are targeted at dealing with the “constantly increasing” EMS calls in Michigan’s fourth-largest city and paramedics “getting burned out.” The peak demand unit, which launched in October, frees up paramedics who have more advanced training than the EMTs to respond to high-acuity calls.
“They have taken a significant load off of the EMS system during the hours that they’re here, and that’s when most of our calls happen,” Edmond said. “And I think it’s improved morale.”
Sterling Heights’ two peak demand ambulances are some of the first in southeast Michigan, though some communities are trying other ways to take the stress off the EMS system.
The Detroit Fire Department is planning a “nurse navigation” program that city officials hope will further reduce the department’s response times by enlisting nurses to speak with patients experiencing minor medical issues. Announced more than a year ago, the program is still being contracted out.
Livingston County, meanwhile, has what it calls a Community Paramedic program. Using paramedics in specialized roles to perform basic, “nonemergent” clinical tasks in people’s homes, the program aims to reduce hospital admissions and readmissions, along with emergency room visits, and extend health care access to different populations, according to the county’s website.
Greg Flynn, who chairs the EMS section for the Michigan Association of Fire Chiefs, said that for a long time, EMS providers had to “triage and prioritize” the call severity and when units would be dispatched to particular calls. He said the approach Sterling Heights is taking is “innovative for southeast Michigan .”
“There is evidence of some best practices there that have been in EMS for a long time, but definitely applaud them for taking the initiative to move this forward,” said Flynn, who serves as West Bloomfield Township’s fire chief.
EMS calls increasing
Medical service calls to the Sterling Heights Fire Department are on the rise. The number of EMS calls rose from 10,559 in 2015 to 13,862 in 2025, a 31% increase, according to city officials.
Before its new color-coded initiative, 911 dispatchers previously just used three categories to describe calls in Sterling Heights ― “life threatening,” “non-life threatening” and “EMS not breathing.”
Under the new color-coded initiative that rolled out Oct. 1 with the Macomb County Communications and Technology Center, five colors ― blue, red, orange, yellow and green ― are used to categorize calls. The dispatch center provides services to 14 communities in the county.
In the old system, the Sterling Heights Fire Department would at times send more resources than it actually needed, and it would send fewer resources than it needed at other times, Edmond said. Fire departments in Michigan more commonly use three levels instead of five, he said.
“So now what we did is we matched up with the five different levels, trying to get the right resources to the right patient at the right time,” Edmond said.
Peak-demand units ready to respond
Sterling Heights’ new peak demand unit, which includes two ambulances, works Tuesday to Friday from 8 a.m. to 6 p.m., the peak hours for EMS calls.
During the call to transport the patient from the dialysis and rehabilitation center to Corewell Health in Troy in February, Willson and Prantera, the EMTs, jumped into action within seconds, hitting the road in a red ambulance with highlighter green stripes on its back.
The two men, who are EMT/firefighters and were hired last year, drove to Corewell Health Beaumont Troy Hospital Rehabilitation & Dialysis Center and rolled a stretcher into the building. They used a tool called a Power-LOAD to load the patient in the stretcher into the ambulance, without having to lift it themselves. The tool is meant to prevent back injuries.
The two EMTs then drove their ambulance across Dequindre Road to the ambulance entrance of the Troy hospital ― a less than a half-mile drive away. They removed the patient from the vehicle and rolled him into the hospital. The patient’s pulse was very high, they said.
Willson said EMTs can’t administer any medications or start IVs, but paramedics can.
Around the same time, another call came in from the same facility, this one requiring Advanced Life Support. If the peak demand unit hadn’t been there, the paramedic ambulance would have handled the lower-acuity call.
“And I would have had to pull one of the other four ambulances from different parts of the city over there to handle the ALS call,” Edmond said.
The two peak-demand ambulances supplement Sterling Heights’ five existing paramedic ambulances. Edmond compared the number of transports ― or the times that an ambulance transports one or more people to the hospital ― in October, November and December 2025 to the same three-month period in 2024, which was before the unit was created. Each of the five paramedic ambulances had fewer transports in the 2025 period than in 2024, so they weren’t as busy, he said.
“If their transports went down, that means that they’re not going on as many calls,” Edmond said. “That means that they’re getting some relief on the workload by these two basic ambulances being in the system.”
The two peak demand ambulances had about 180 transports in October through December, he said.
Working as an EMT
Willson said he never “really knew” he wanted to work in “anything medical,” and he originally just wanted to be a firefighter. But medical response is now a part of the firefighting job.
“Now that I’m doing it, I actually like it a lot more, but I really didn’t plan on it in the first place, to be honest with you,” Willson said of the EMT work.
Over the years, Willson served briefly as an EMT at the Birmingham Fire Department before working for the Great Lakes Water Authority from 2020 to 2025. He was also a volunteer firefighter in Troy in 2025.
He said the peak demand unit positions are “the perfect foot in the door.” He said the unit was a way for him to get into a larger fire department without having to go to paramedic school beforehand.
Edmond said the EMT/firefighter role is “an entry-level position into the fire department.” Then, when a 24-hour position opens up in the fire department, the EMT can switch to that role. The department can send the person to paramedic school while they are in a 24-hour position, which is what Willson and his colleagues will be doing.
Willson likes that he and the other EMTs are able to respond to fires when they occur during the peak demand unit’s hours. He said firefighting is “the fun stuff.”
Color-coded system
Under the new dispatch system, someone will call 911, tell the dispatcher what the issue is and answer questions. The dispatcher enters the answers into a computer, and a program calculates what the medical priority would be, Edmond said. The dispatcher will ask more questions if it’s “a lesser call” than if it’s a critical call, he said.
A “blue” call would be cardiac arrest, and a “red” call would be a stroke or heart attack. An example of an “orange” call is someone who’s sick, and it’s unclear whether a paramedic is needed. A “yellow” call could be a person experiencing back or leg pain. A “green” call could be a lift assist with no injuries. (A lift assist is when a medical worker lifts up a resident who has fallen.)
The peak demand unit just responds to yellow and green calls. Willson said they often respond to falls, but they also see people with stomach pain, potential bone breaks and other issues.
Elizabeth Bagos, the dispatch operations manager for the Macomb County Communications and Technology Center, said all of the communities that the center serves, such as Clinton and Macomb townships, use the color-coded system. The center also works with a few private ambulance services, and it shares the colors with those services.
The new system allows first responders to determine “what is a true emergency” or what situations require an ambulance to use lights and sirens, she said.
“They ( Sterling Heights ) were running lights and sirens to a lot of things that we thought initially were a true emergency, and then once they would get on scene, they found that that’s not the case,” Bagos said.
“I believe we are definite leaders of medical priority dispatch,” he said.
Edmond said the Sterling Heights department is a leader in Michigan in peak demand units.
“I don’t know of anybody else who’s really doing it” in Michigan, though other places across the country do.
Why the initiatives were launched
Edmond said the fire department wanted to find a “better response system” for the rising number of EMS calls. He said the area’s aging population is contributing to the increase.
“I have been in the fire service now for 40 years, so I’ve seen the EMS stuff. And what I can tell you, with all the health, technology, science and everything, more people are living longer with more serious illness,” he said.
The peak demand unit leaves paramedics available to respond to heart attacks and strokes, Edmond said.
He said the unit also provides a career path for people who are EMTs, as they can gain experience and then become paramedics.
“I feel pretty confident, because they’ve played in this system for a while, that they’ll actually be very good paramedics for us,” he said.
Confronting paramedic burnout
The department’s nurse navigator program will eventually allow ambulances not to be sent to “very specific calls” that current data show do not need an ambulance, said Detroit Fire Department Medical Director Dr. Robert Dunne.
In the program, a nurse would call the patient or their family member, talk and coordinate transport to the hospital if needed. Department spokesperson Corey McIsaac said the department doesn’t have a projected start date for it.
Flynn, the West Bloomfield fire chief, said EMS provider burnout has been an issue for decades, but “there’s a brighter spotlight being shown upon it” now because providers aren’t coming in and taking their place.
“In the past, if somebody was going to make a career change because of ‘burnout,’ there was somebody in line to take that spot,” he said.
That’s not the case anymore. Flynn said the demand for EMS providers is greater than the supply of them.
Flynn said he doesn’t see other fire departments using peak-demand units, but they are used by full-time EMS providers ― or agencies that only provide EMS services. These providers look at their call volume and know during the day when dialysis patients are moving and patients are getting discharged from the hospital, he said.
“They have peak-demand units that come on to help offload that,” Flynn said.
Working in EMS is “a challenging, stressful career,” and burnout “unfortunately comes with the territory,” Michigan Association of Ambulance Services Executive Director Angela Madden said in a statement.
MAAS represents EMS agencies across the state, including some fire departments that provide EMS services, but not Sterling Heights’ department. Madden said the staffing shortage and “pandemic worries” exacerbated the problem in recent years.
“The good news is that Michigan has made great strides on the staffing side thanks to the state’s EMS Training Grants, which have helped agencies across the state train new paramedics and EMTs with little or no cost,” she said. “MAAS is hopeful that the additional staff across the state will help reduce the need for as much required overtime and help with burnout.”
©2026 The Detroit News.
Visit detroitnews.com.
Distributed by Tribune Content Agency, LLC.