New Orleans ambulance service has 40% turnover, officials say
Local EMS leaders said that a recent pay increase may help, but they cited burnout, attacks and industry-wide staffing struggles
By Matt Sledge
The Times-Picayune | The New Orleans Advocate
NEW ORLEANS — Attacks on medics, pandemic burnout and competition from the private sector contributed to 40% turnover at New Orleans Emergency Medical Services last year, officials told the City Council Friday.
With more than one-fifth of the jobs vacant, the agency is well below an industry standard for responding to the most urgent 911 calls.
EMS leaders said they're doing their best to juggle an onslaught of calls, and they expressed optimism about a recent pay increase. Still, they said they're swimming upstream against industry-wide staffing issues.
"More work is needed, and we anticipate persistent staffing challenges over the next few years," EMS chief Bill Salmeron said at a council budget hearing.
Every seven minutes, New Orleans EMS responds to a 911 call. It's a fast pace that has long contributed to a high turnover rate, along with the challenges of dodging drunks on Bourbon Street and treating gunshot wounds.
But the problem is getting worse. Annual turnover has shot up from 17% five years ago to 40% in 2021. The agency has a 23% vacancy rate.
As with New Orleans' dwindling Police Department, the EMS vacancies have reduced the number of high-priority 911 calls that are answered within 12 minutes. Against an industry standard of 90%, New Orleans EMS has 63% compliance this year, compared to 77% a decade ago.
One factor is the higher number of urgent calls in recent years, said a spokesperson for Mayor LaToya Cantrell's administration.
Burnout from the COVID-19 pandemic is fueling the turnover, Salmeron said. So is the recent increase in attacks on EMS staff; since 2019, more than 60 employees have reported being physically assaulted on the job.
"Respect for a uniform has gone down, and unfortunately, we're just a casualty of that," Salmeron said. "We are seeing a lot more mental health issues, a lot of overdoses. Things that are causing stress to a patient and family."
The situation has grown so dire that for the first time, EMS recently offered employees a self-defense course.
EMS also is preparing to pilot body-worn cameras, which would make New Orleans one of a handful of emergency medical services with such equipment. Council member Lesli Harris said she worried cameras could scare off patients.
"We have to balance the needs of the department with respect for the patient," Salmeron said. "So that is something that we will be working on, on what does that look like."
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Some EMS employees are leaving because they can find higher pay elsewhere, Salmeron said. The issue grew more dire in the pandemic as other health care workers left the profession.
EMS staffers are in line for a 10% pay raise over three years. The Cantrell administration is also offering $1,500 retention bonuses for emergency medical technicians and $4,500 payouts for paramedics.
Even with a higher base pay, Salmeron said he expects hiring trouble for years. Eventually, EMS would like to create its own training academy.
Farming out work
The agency's challenges continue even though it farms out some work to the privately owned Acadian Ambulance Service. On a typical day, New Orleans asks Acadian for five crewed ambulances. Acadian often sends only two because of its staffing challenges, Salmeron said.
Next year's budget proposal from the Cantrell administration envisions a $3 million drop in spending on EMS personnel, to $11.9 million. That brings the agency's budget close to the actual amount spent on personnel in 2022: $12.6 million. It's part of a larger push to make the 2023 budget more realistic, by factoring in vacancies.
On the other hand, the 2023 budget also envisions a $2.1 million bump in other expenses, largely to pay for another surge contract. Overall, the Cantrell administration has proposed an $18.9 million EMS budget for next year, compared to this year's projected spending of $20.1 million.
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