Part one of two

This week: Association has a plan for the future of emergency services in Carroll, but can government afford it?

Next week: Some stations are in tough fiscal straights, and the fire association is seeking new ways to raise money.

Carroll County emergency officials say they're seeing warning signs whereby the county could soon face a shortage of paramedics to serve the public.

Officials of the Carroll County Volunteer Emergency Services Association, which employs paramedics and other staff for the 14 volunteer fire departments in the county, say the county is facing a shortage of paramedics, and cannot move forward with a $7.4 million Future of Emergency Services plan because county government is trying not to spend money on new projects.

"I think if (the county commissioners) had more money, they would give it to us, but the fact of the matter is they don't have the dollars and cents right now," said Doug Alexander, CCVESA president.

"Unfortunately, we can't change (the fact) that we need more money," he added.

The Future of Emergency Services plan would increase current levels of funding of emergency services by at least $3.7 million annually, said Neal Roop, the association liaison to county government. But the association needs double to have the staff they need to respond to calls, Roop said.

Currently, the Board of County Commissioners provides $3.7 million in funding to help implement 24-hour/seven days-a-week EMS service at each of the county's fire stations. That's separate from the $6.3 million provided for CCVESA, which includes money for 12 part-time drivers for both fire trucks and ambulances, among other expenses.

What the county does not cover (ambulance and equipment), departments have to make up through ambulance transportation billing and fundraisers, Alexander said.

Thirteen of the 14 volunteer fire companies in Carroll have at least one paid, around-the-clock medic crew, which includes one medic, one driver and two personnel. Harney does not have EMS service. Sykesville/Freedom and Westminster fire departments have two paid units.

Another company, which Alexander declined to name, is requesting for a second crew, but it has not been approved or budgeted, he said.

"It is very difficult for us to get full- or part-time medics to cover our shifts," Alexander said. "It is not uncommon for a unit to be staffed with two EMTs due to inability to find a medic able to work the shift. There are occasional times when the unit has only one person paid to staff it. In those cases, our companies hope for a volunteer to be available to cover any calls, or depend on the next due unit to handle the call."

The Future of Emergency Medical Services plan would provide a framework of how departments and the county can help fund more paid paramedic and other EMS positions by restructuring the jobs and pay to attract and retain more medics.

County officials say they can't afford it. In fact, the county's latest allocation to the association was increased by a little more than one percent compared to last year -- so that the New Windsor Vol. Fire Department can house a hazardous materials response unit.

"It's Band-Aid time," Commissioner Dean Minnich told Alexander at a recent Emergency Services Management Board meeting regarding the county's financial approach toward the issue.

But Alexander said the county's fiscal state notwithstanding, emergency services face several major issues, including the availability of paramedics, keeping pace with senior housing -- which traditionally has higher demand than other residential categories -- and an increased overall demand for services.

In 1995, county emergency services responded to .02 calls per single-family dwelling during the course of the year. That increased five times to .10 this year, according to data in the plan.

"We get called for everything under the sun," Alexander said, from minor injuries inside homes to seniors asking for help from one bed to another. Those calls where they help patients at the scene cannot be charged using ambulance transportation billing because they are not loaded up in the ambulance and driven to a hospital.

But medics, he said, have a responsibility to answer the call.

Find me a medic

Currently, the 14 fire departments in the county have about 850 active volunteers who respond to calls, Alexander said. About 250 to 300 paid EMS workers work full or part time, he added.

One long-term problem for the county is that it's hard to retain paramedics once they're trained here.

Although Carroll does have some veterans who work part-time, the county is essentially a farm club for young paramedics to be seasoned enough to move to higher paying, more structured departments in surrounding counties.

"Our system is not conducive to recruiting and retaining paramedics, because the system lacks mobility, and there's no up-or-down movement (for advancement)," Alexander said. Essentially, a career cannot be had, he said.

Also, the starting rate and pay scale varies from department to department in Carroll. Paramedics' pay starts at $15 an hour and can be up to $22 an hour, depending on the department, Alexander said.

EMT drivers make about $12.50 to $18 an hour, also depending on where they are stationed in Carroll.

That disparity creates competition within the county where paramedics bolt for the higher-paying departments in other parts of the county, he said.

"We're robbing Peter to pay Paul is what it comes down to," he said.

It also can affect work load.

"One station may have the guys sit on the couch for 10 hours a day, and the next station may be working their ass off from 7 to 5," he said. "It's very inconsistent."

Plus stations, such as Westminster, are so busy, Westminster Fire Chief Jim Bangerd said, that they can affect other stations such as New Windsor and Reese, requiring them to grab calls because their medic units are already on the road.

The Future plan would set a standardized pay rate that all departments would follow, Alexander said. Additionally, staffing hours and responsibilities would be streamlined so departments can help each other out more often, he said.

Under the plan, it would be up to departments whether they would want to hire full- or part-time employees, Alexander said.

Carroll County Government provides partial funding for some paid positions at the fire departments, but that has not grown quickly enough to meet demand for service. To afford more staff, departments have not increased pay as much as surrounding counties, Alexander said.

"We haven't quite kept up with the pay scales," Alexander said. "Some of the companies have had to put on additional personnel because their needs have increased, and we haven't been able to get additional money to allocate positions that would be funded by county government."

Paramedics are mostly part-time workers in the county, Alexander said. The part-time employees are a mix of entry-level paramedics and medics who work full time as paramedics outside the county.

Minnich said the county needs to ready itself for the plan.

"We're reaching the point where both expectations of citizens who are moving into the county and some of those who grew up here ... that we can't have volunteer fire companies and volunteer EMS forever. The day is coming," Minnich said. "And we should be preparing for the day for paid firefighters and emergency services for 24/7."

However, the county's finances cannot meet the demands of the plan, and should reprioritize its wants and needs, Minnich said.

"I thought we would be further along on this plan, but we're not," Minnich told Alexander at the recent meeting.

"I'm still with you on your objectives and on your ideas," he added, "but in all candor and reality, I think it's been pushed back."

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user comments (1)

user jroberts says...

There's a multitude of problems with Carroll County and their delivery of EMS. As someone who was heavily involved in the EMS system there, I think I have some insight into the issues. 1) Each company wants to be their own little fiefdom. They want the county to bail them out and provide all this money, but they want absolute control over everything. These companies are the same ones who change leadership from year to year based on a popularity contest veiled as an "election." You have EMS and Administrative leaders controlling these things who have not set foot on an ambulance in 5+ years and are so out of touch, it's embarrassing. 2) The companies could have banded together and pushed for this "Future of Emergency Services" proposal a long time ago. But the timelines keep getting pushed back, usually because one department wants to act like a baby and get their own way. Gamber, one of the companies who initially wanted a county-based system, has now decided to write letters to impede the process- all because they want things their way. This should have been completed at least two years ago, but there are a bunch of incompetent twits who have voting power within the Association that make progress and change difficult, it not completely impossible. 3) EMS has a history of being the red-headed stepchild in Carroll County. For example, there simply is no money for EMS training any longer. Carroll County had a very successful training program for initial and continuing education. Along comes a few hoseheads who take over training, and there magically is no more money. But suggest purchasing a reserve fire engine for $250,000, and people are throwing money at that project. The County continues to run an EST program for kids in high school at a cost. Well, guess what- those kids can get that training for FREE from Maryland Fire & Rescue Institute in their down time just like every other person who wants to join the fire department. So there's money to piss away for an EST program that produces only a handful of worthwhile providers, but nothing to keep EMS providers with their mandated certifications? 4) The pay is atrocious. Of course Carroll is going to be a "Farm system" for real departments when you pay a Paramedic with several years of experience $16/hour. Add to that having a group of managers who can't spell EMS in many situations and create hostile environments, or your job requirements are to make sure Bingo is ready to go vs. actually providing care. 5) Shortage of Paramedics is a complete lie. There's MORE than enough medics in Carroll County. What these guys are trying to fool you with is that EVERY station with an ambulance wants a Paramedic crew. Anybody with some EMS management training knows that too many medics within one system causes medics' skills to decrease- because they're running fewer calls. There is no need for a 24/7 paramedic crew in places such as Union Bridge, New Windsor, Lineboro, and Gamber. How about doing a study to see what real professionals with EMS strategy and coordination experience suggest? But no- it's the "my way or highway" mentality in this County. I'm glad things have not changed since my departure in 2008. The "hundreds of years of service uninterrupted by progress" continues in full force.

Posted 9:19 AM, 02.02.10

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