COVID-19 to blame for medic shortage, Calif. county officials say

Academies teaching new paramedics saw a 50 percent drop in enrollment last year, or higher, according to the AMR regional director in the county


Ken Carlson
The Modesto Bee

MODESTO COUNTY, Calif. — The COVID-19 pandemic caused a shortage of paramedics in Stanislaus County and the emergency medical system has not recovered yet, according to a discussion before the county Board of Supervisors this week.

"We are seeing light at the end of the tunnel as far as staffing is concerned," said Cindy Woolston, regional director for American Medical Response in Modesto, by far the largest ambulance service provider in the county.

Woolston told county supervisors Tuesday that academies teaching new paramedics saw a 50 percent drop in enrollment last year, or higher, as the coronavirus sickened thousands of people and restrictions were placed on education activities.

Woolston said AMR needs those new recruits to fill full-time positions and serve on ambulance crews. Vacancies have resulted in staffing problems and complaints of slower response times and gaps in the EMS system, according to Tuesday's discussion.

The regional director noted that AMR employees were among those who contracted COVID-19 and "quite a few were out for a long period of time." The director did not disclose how many employees were stricken.

As of this week, the ambulance company was trying to fill nine vacant positions for full-time paramedics and 14 openings for EMTs.

Woolston said the EMT positions will be filled soon because academies are turning out graduates again. "We are starting to see the pipeline come back as restrictions are lifted," she said.

It will take longer to bring on more paramedics. AMR recently awarded eight scholarships for employees to attend paramedic schools starting in August and October. Woolston said paramedic recruits are ready within a year to work ambulance calls.

She said fewer people are going into the emergency medical services field, creating a problem at the national and state levels. The shortage is not isolated to American Medical Response, Woolston said.

California Assemblyman Freddie Rodriguez, D-Chino, offered a different perspective when contacted Thursday. He said COVID-19 might have created some staffing shortages, but the low pay and difficult working conditions in the private-sector ambulance industry has been an issue for years.

Rodriguez, who worked more than 30 years in the private-sector ambulance industry, said his first job as an EMT paid $3.10 an hour in 1984. It took 30 years to make more than $20 an hour in the industry, he said.

"These people go to school to learn to save a life and come out working for almost minimum wage," said Rodriguez, who is chairman of the Assembly emergency management committee. Private companies like AMR have to compete with the salaries and benefits offered by fire departments and other public-sector employers, he noted.

"Paramedics tend to love their jobs and some will work a second job to maintain their finances," Rodriguez said.

A UC Berkeley Labor Center study in 2017 found that EMTs and paramedics in the private sector earned 39 percent less than those working for public-sector agencies.

County will separate from EMS agency

Tuesday's discussion before county supervisors was part of an update on county plans to withdraw from Mountain-Valley Emergency Medical Services Agency, which oversees ambulance service in Stanislaus, Calaveras, Mariposa, Amador and Alpine counties.

In Stanislaus County, American Medical Response is the largest provider of ground ambulance service. The EMS system also relies on smaller private companies, fire departments that respond to medical calls and healthcare district ambulance service.

As the largest county in the Mountain-Valley partnership, Stanislaus has long been dissatisfied with the joint powers agency and has tried different approaches to shorten response times and improve service for the public. The county says it lacks local control to set priorities and implement policies that would improve EMS response.

At a special meeting May 14, the Mountain-Valley JPA board accepted the resignation of executive director Lance Doyle. The county has cited inconsistencies between Mountain-Valley's administration and county practices. Cindy Murdaugh, a deputy director, was appointed as interim executive director.

County Chief Executive Officer Jody Hayes served notice March 31 that the county would withdraw from the Mountain-Valley JPA between Oct. 1 and Dec. 31. County leaders wanted to allow time for the other member counties to explore other options for managing emergency medical services.

Tuesday, Stanislaus supervisors gave approval to extend the termination notice to June 30, 2022, providing time for negotiations with Mountain-Valley for Stanislaus to administer the emergency medical services in the 2021-22 fiscal year.

The four counties aside from Stanislaus have until Dec. 31 to decide what model to pursue. One of their ideas is adding more counties to the JPA. Stanislaus could choose to serve as its own EMS administrator or offer to administer the EMS agency under a contract with the four counties.

Stanislaus County supervisors are expected to consider recommendations Aug. 31.

"This is something we have to get right," county Supervisor Buck Condit said. "At times it deals with life and death and our relationships with hospitals. I am glad to see discussions are going well."

Condit, who retired last year from a career as a firefighter, said he hears concerns expressed about extended EMS response times. An emergency medical call may trigger a response from an EMT-certified fire crew and an ambulance service.

At times, Condit said, a fire engine that's responded to a call with basic life support has to call in support from an engine staffed with paramedics until an ambulance is deployed to transport the patient.

"Sometimes the difference is 30 to 40 minutes," Condit said.

Local response system is strained

Richard Murdock, county fire warden and assistant director of the office of emergency services, said issues with deploying ambulances have impacted the EMS system. When AMR does not have a crew available, local healthcare districts respond under mutual aid agreements, he said.

For the public healthcare districts, too many responses outside their boundaries is a sensitive issue because local taxes help support the ambulance service.

Woolston said terms of a labor contract allow AMR to require a full-time employee to backfill an ambulance shift. The company is in negotiations to include the same language for part-time employees, which would help solve the company's staffing shortage.

"We hope to have that agreement in two to three weeks," Woolston said. "We have the academies going now and will have more staff to work on shifts by the end of June."

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(c)2021 The Modesto Bee (Modesto, Calif.)

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