Challenges for the road ahead, no matter the state of pandemic and politics

Fiscal, retention and operational considerations for election week and the EMS purse and pay


In this two-part pre- and post-election series, I will first consider those things that will remain an EMS constant, no matter the outcome next week. In turn, following the election, assuming we have a clear result, I will consider going forward into the 117th United States Congress and the POTUS, whether we are facing a lame duck, business as usual, or anything in between.

— Rob Lawrence

The final weekend of political TV ads is upon us – possibly. As we all know, next week’s election day doesn’t mark the beginning of presidential, Senate, gubernatorial, sheriff, and locally elected officials too numerous to mention polling, but the end. Voting closes, counting starts, and the need for public safety vigilance, rapid reaction and response continues.

Tensions are high and the potential for civil disorder exists, all in the week where we climb the third peak of the COVID-19 surge. In fact, we could be facing a violence and virus super spreader week ahead. As Winston Churchill once famously said, “this isn’t the beginning of the end, it’s the end of the beginning,” and a lot will be asked of us operationally over the next week, particularly if any of the variables and factors take a turn for the worse.

Prepare for civil unrest

It's not just a president on the slate but many officials who will inevitably have the power to make our future days better or worse by responding to those four little, yet important words – “all those in favor.”
It's not just a president on the slate but many officials who will inevitably have the power to make our future days better or worse by responding to those four little, yet important words – “all those in favor.” (Getty Images)

High on the to-do list this week has inevitably been those preparations usually employed when the long-range radar indicates a storm is coming and essential actions need to occur. By now, I’m sure emergency planners and emergency operation centers (if they ever closed) have issued their incident action plans in the event of any disturbances on, around or after the election.

A further consideration leading up to election day is the weather. The northern states are now seeing cool-to-freezing weather and snow on the ground. This places citizens attending rallies or protests at increased risk of cold-weather injuries or hypothermia.

Pandemic over politics

Vaccine or not, the pandemic and its consequences will continue into 2021. Once out of phase III trials, the logistic effort to distribute and administer a COVID-19 vaccine will take a long time to roll out. Any political claim that we are home and dry should be treated with a grain of salt for the next year at least. This places us all on the footing that we will still be on this continuous operation until this time next year. As Ray Barishansky noted, this is a “marathon of sprints.” Leadership and the continued energy of leaders is still required

The public sector purse

A simple check of the NEMSIS TAC public-facing charts demonstrates that our overall call volume continues to plummet. As we all know, despite our best efforts to gain payment for our pandemic levels of treatment in place, income must surely be following the downward trajectory. Federal bailouts have come our way, but this week’s announcement of no relief this side of the election represents a further fiscal blow.

States and cities are also experiencing the hit and are issuing warnings of massive budget deficits. As line items are cut and reduced, the public sector/public safety and their bottom lines inevitably come into sharp focus. We are already seeing signs of reduction, furlough and threatened layoffs. No matter the political color of the new administration, the lack of available income will inevitably impact the amount of available tax based funded responses.

Too many and not enough staff, little money to pay them

Politics or not, recruitment and retention has come into sharp focus as money and workforce availability have become too tight to mention. NAEMT President Matt Zavadsky, MS-HSA, EMT, chief strategic integration officer MedStar Mobile Healthcare in Fort Worth, Texas, reminds us that we perhaps don’t have a paramedic shortage, but a maldistribution of the workforce. This is borne out to a degree as we see stories in the trade news of the inability to recruit in one area despite the large sign-on bonuses contrasted against other areas where hiring freezes are being enacted.

Perhaps we are seeing the beginning of market forces at work where a buyers’ market is evolving, and the employee will determine the hourly rate they will work for versus accepting the standard offer from the employer. This is a challenging proposition given the market is funded by reimbursement and those with the funds (government and insurance companies) set low rates and contest payments at every turn.

The road ahead

I didn’t intend to be a Donald Downer or even a Joe Joyful, but to tell it as it currently is. The challenges may seem insurmountable, but we are all in this together – globally. The items covered in this article are staples that we will have to continue to contend with no matter the results of the election. To some degree, some of those issues have always been in place, no matter the state of pandemic and politics.

Next week, I will examine the state of play, the balance of politics, and identify the legislative road ahead. It's not just a president on the slate but many officials who will inevitably have the power to make our future days better or worse by responding to those four little, yet important words – “all those in favor.”

Challenges for the road ahead, no matter the state of pandemic and politics: EMS One-Stop With Rob Lawrence

In this week's EMS One-Stop extra, Rob is joined by NAEMT President-Elect, Chief Bruce Evans. In addition to reviewing the narration of Rob's EMS1 article, Rob and Bruce discuss the vaccination task ahead, the downturn in call volume as well as a reduction in tax income and its associated public safety economics issues.

Bruce Evans, MPA, NRP, CFOD, SEMSO, is the fire chief at the Upper Pine River Fire Protection District. Chief Evans arrived in La Plata County after serving as the EMS chief and as an assistant chief at the North Las Vegas Fire Department in Southern Nevada. He had served at the Henderson (NV) Fire Department for 18 years, seven as a fire captain and six as an EMS captain. He is an NFPA Fire Instructor III and served as a college faculty member at the College of Southern Nevada's Fire Technology program teaching various fire and EMS topics for 21 years.

Bruce has over 35 years’ experience in a variety of emergency services settings and is the 2010 recipient of the International Association of Fire Chiefs James O. Page award for Leadership in EMS and the National Association of EMTs Presential Leadership Award in 2014. Bruce is an adjunct faculty of the National Fire Academy in the EMS, Incident Management and Terrorism Training programs serving as a technical writer for several of the courses at the National Fire Academy. He is currently on the Board of Directors for the National Association of EMTs. He has an appointment to the National Academies of Medicine and sits on the preparedness committee. He holds a master’s degree in Public Administration, bachelor’s degree in Education, and associates in Fire Management.

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