BALTIMORE — The Baltimore City Fire Department will downgrade four Advanced Life Support (ALS) units to Basic Life Support (BLS) as the agency struggles with persistent staffing shortages and rising overtime costs, WMAR reports.
The move leaves just 17 ALS units available for the city’s highest-priority calls.
The changes come as Baltimore faces one of the heaviest EMS call volumes in Maryland. IAFF Local 734 President Matthew Coster said paramedics are already stretched thin, and the downgrades will only intensify the strain.
| READ NEXT: What the EMS Counts Act means for dual-role EMS providers
“We’re strained as it is, and our paramedics will be working harder to take those runs — because those runs don’t stop,” Coster said. “Whenever we don’t have the units in service, I’m always concerned that lives are at risk.”
City officials say the downgrades, which start in July, are part of a data-driven, phased strategy to balance operational demands and control ballooning overtime. Baltimore is currently short about 40 paramedics and 20 EMTs. The department’s reliance on overtime has grown so acute that last year’s top-paid city employee was a paramedic who earned more than $358,000 — more than half of it in overtime.
District 4 Councilman Mark Conway, who chairs the public safety committee, called the situation unsustainable.
“ALS units have paramedics with higher training, but we don’t have enough. So what ends up happening is we have to backfill those positions with overtime, and that’s incredibly expensive,” he said.
Like many departments nationwide, Baltimore is searching for creative solutions. The department is piloting ways to better deploy ALS resources and expanding a telemedicine program that connects low-acuity 911 callers with virtual consultations, WMAR reports. Nurse diversion initiatives are also set to launch soon, aiming to redirect non-urgent cases to more appropriate care.
But the fire union remains concerned — not just about response capabilities, but also about the city’s $5.2 million budget for private EMS contractors. Conway called the private contracts a “band-aid,” not a solution.
| MORE: eBook: How to fund community paramedicine
“We need to be thinking about how we close those gaps and support our fire department, give them the internal trainees, the internal paramedics to do the job,” he said.
The department plans to launch a new recruitment campaign to address the ongoing personnel shortage and bring new EMTs and paramedics into the fold.
