Fire Service says Carroll Faces Shortfall in Paramedics
By EMT Kati Townsley Biddinger
December 30, 2009
Fire service says Carroll faces shortfall in paramedics Plan would create standardized pay and postions for career medics By Charles Schelle cschelle@patuxent.com
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."
Do fire companies' finances need a spark? Part 2 of 2: CCVESA president says some stations struggling By Charles Schelle cschelle@patuxent.com
Carroll County could potentially lose one of its volunteer fire departments in the coming years if funding does not improve, and emergency services cuts are possible, according to officials of the Carroll County Volunteer Emergency Services Association. "We've had a couple departments notify us that they are in trouble," said Doug Alexander, CCVESA president. "They don't know how they're going to be able to maintain the same level of service."
All 14 of the county's volunteer fire stations are members of CCVESA. One of those companies recently informed the association that it will be in "severe financial straits in the next couple years," Alexander said. Alexander declined to name the department because its staff asked him not to, he said.
"They don't want to throw a panic into the community," he said.
The association is also not proposing service cuts yet, but Alexander said, "The possibility of service adjustments exist ... whether it's a lot, a little or none at all."
The decision hinges on a domino effect, he said. For one thing, the association is waiting to see how the county is able to absorb state budget cuts, and how they might affect fire and rescue funding.
The Board of County Commissioners funded the association at a level of $6.3 million this fiscal year -- an increase of just a tad more than one half of one percent compared to fiscal 2009. Also, the county provides $3.7 million for paramedics and emergency services.
The rest of the association's funding comes from some municipalities' contributions, grants and fundraisers through individual departments, Alexander said.
Even volunteer fire companies have administrative and professional staff positions.
Neal Roop, CCVESA liaison, said in salaries alone for 2008, the association had a $1.5 million shortfall that companies had to pay through billing and fundraisers. That figure did not include insurance and benefits, he said.
If any volunteer station were forced to close due to finances -- or any other reason -- the Carroll County Emergency Services Master Plan helps guide officials to react, Alexander said.
"We have some measures put in place to cover their area or provide coverage," he said.
One measure would be to have volunteers step up and fill the gap, but the number of volunteers in the county have decreased through the years, he said.
"We still have them, and they're still very active, but to cover up staffing that has been downgraded is going to be difficult," he said.
If cuts were to happen, residents might have to wait a few extra minutes for help, he said.
"Some of it will be very obvious," he said. "Some will not be noticed at all."
Hooks, ladders and dollars
On the other side of the ledger, the association is hoping to boost its funding sources without tapping into government.
But it needs government help to start.
This coming year, the association will again request that the Carroll County Delegation to the General Assembly submit a gaming bill that would allow table games, such as roulette and card games, to be held in fire halls for fundraisers, Alexander said.
The bill did not make it out of the delegation last year.
"We can't get it off the ground to save our backsides, but we're coming back with it again," he said.
"Hopefully, that would be another type of fundraiser that we could have to provide a different funding source, different from what we have," he said.
The bill will not receive the support of delegation chairman Sen. Larry Haines (R-Dist. 5). Haines told The Eagle that he is opposed to any type of gambling expansion in Carroll County.
"I don't want to see Little Las Vegas come to Carroll County," he said.
Haines added that he does not think gambling will ever pay the bills that organizations hope they will pay.
"I don't believe the expansion of gambling is the solution to funding issues, and it never will be," he said.
Haines said the fire departments can rely on their other fundraisers and the donations from Carroll residents.
Existing fundraisers, from dinners to carnivals, have not produced as much money as in years past, Alexander said.
Hampstead Volunteer Fire Company's fundraising revenue declined by 14 percent this year, while another company --again, which Alexander did not name -- saw a decrease of 50 percent, he said.
Part of the reason for the decline is likely the economy, he said, but perhaps some people are tired of traditional fundraisers.
Departments hold a variety of events as fundraisers. For instance, Lineboro Volunteer Fire Department hosts its annual Bedlam in the Boro haunted house with carnival games.
Carnivals provide the largest income source for most departments each year, though Alexander said there's a catch with that strategy:
"You're basing the majority of your annual budget on the weather," he said, noting that if it rains, the budget takes a hit.
That's why Alexander hopes a gaming bill will provide a non-weather dependent source of funds.
Without new revenue streams, emergency services will either have flat funding or a decrease next year, Alexander said, and could see levels back down to 2008 levels.
Another option will be to have the county operate fire departments, but he said that's unlikely in his lifetime.
"It's a tough call," he said.
Roop said it's better for the fire companies and their employees to stay with the structure CCVESA has because they are a part of it already, where their power in decisions is reduced when county government is in charge.
Regardless, departments cannot continue to operate like they have, Alexander said.
"Things have got to change dramatically on both sides -- government-wise and corporation-wise -- if we're going to survive," he said.
What will Carroll County do to provide adequate emergency medical services during the next year?
"It's a question that quite frankly, has not been answered yet," Alexander said.
