Texas agencies shift strategies to respond with fewer providers
"We've got to figure out new ways of delivering the services that are needed," said Arlington Fire Chief Don Crowson
Fort Worth Star-Telegram
Fort Worth, Texas — Ambulance providers in North Texas are rethinking the way they respond to calls, as pandemic-related staffing shortages leave agencies around the United States strapped for paramedics.
Arlington Fire Chief Don Crowson said his department is sending fire paramedics to compensate for shortages with American Medical Response, the city's ambulance provider, where staffing is down two-thirds. The change has not hurt the department's response time, Crowson said.
However, he does not see the issue going away.
"Maybe this COVID experience is a wake-up call for the industry itself," Crowson said. "We've got to figure out new ways of delivering the services that are needed."
An AMR spokesperson did not specify staffing levels for Arlington or its surrounding service areas when asked and instead provided a statement about COVID's effect on staffing.
"The loss of EMS education programs for over a year and the decrease in EMS enrollment have created a significant nationwide resource gap for trained EMTs and Paramedics," the spokesperson wrote. "Paramedics take up to two years of training before certification and require hands-on instruction, so when the schools closed, we lost that new pipeline of recruits."
Emergency officials say the pandemic's effect on EMS schools and competition with hospitals, which usually offer better pay and greater stability, have contributed to the shortages. The pandemic halted clinical and in-person training and left working first responders with a higher demand and burnout, according to an October letter from EMS advocacy groups to Congress.
The shortage has affected areas like Wilson County in Tennessee, where employee shortages caused an EMS station to temporarily close, according to the Lebanon Democrat. Officials have also sounded the alarm on ambulance staffing issues in Texas, including El Paso and East Texas.
Shortages of nurses have led some hospitals to seek out paramedics, according to Matt Zavadsky, MedStar spokesperson.
"There are a bunch of paramedics at MedStar, at AMR, at the fire department who are fertile ground for recruitment because if you can recruit a paramedic to come into the ER and work, you've got a really inexpensive nurse," he said.
The competition between hospitals, fire departments and ambulance groups means agencies are sometimes "robbing from each other," said Jeff McDonald, Weatherford College EMS program director.
"It's kind of good for those people who like the money, but it's not a sustainable model," McDonald said.
North Texas EMS officials are retooling or have reworked response protocol to send different levels of emergency care for different needs.
American Medical Response, which serves Arlington and Ellis, Johnson and Collin counties, has raised paramedic pay and brought in extra resources to help fill in gaps, Crowson said.
Zavadsky said MedStar, which serves 15 cities including Fort Worth, Burleson and Lake Worth, has softened the industry employment shortage by finding new ways to treat people who may not need paramedic attention. MedStar has traditionally sent primarily advanced life support ambulances, which require both emergency medical technicians and a paramedic on board. During the pandemic, the provider began sending basic life support vehicles, which have two EMTs, for less dire calls. The agency also began offering telehealth video calls for people who may not need to visit the hospital.
Zavadsky said the adjustment has allowed MedStar to hire more EMTs than in previous years.
"We've actually done really, really well with recruitment because we changed how we deliver our services," he said.
The American Ambulance Association called on leaders of Congress for funding to recruit, pay and retain workers through sources including Medicare and the Health Resources and Services Administration.
Crowson said funding could help, but agencies should still examine their existing response protocol. Crowson is considering improvements to basic and advanced life support with help from a consultant.
"Could we be more efficient in the way we're doing business? I think we can," Crowson said.
The fire department will receive funding in the city's newly approved budget to create six new squads and hire dozens of firefighters in attempt to catch up with city growth. The adjustments, Crowson said, could help the department whittle its average response time of 6 minutes, 22 seconds to its 2022 goal of 5 minutes, 20 seconds.
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