Manatee County EMS Workers Continue to Get the Shaft

This week is National Emergency Medical Services Week and Manatee County will honor its employees at its annual awards ceremony. However, taxpayers would be much better served if the county better recognized what it called its "true heroes“ with improved working conditions and adequate financial compensation.

Last April, I wrote a column about the embarrassing working conditions of Manatee County's EMS workers and the unsafe environment it was creating for both the employees and our citizens. There was a light at the end of the tunnel, however, as EMS had unionized and was negotiating a contract with the county that would hopefully address most of the issues. I figured that now, more than one year later, things had to have improved considerably. I was wrong.

Union representatives remain bogged down in a negotiation process that seems designed to remain perpetual. Indeed, two-thirds of the initial union board now works elsewhere. This isn't surprising, as the department has suffered an unthinkable 30-35 percent annual turnover rate in recent years. That means that practically the entire department turns over every three years.

Why are so few emergency medical techs and paramedics eager to stay longer? It's simple: Manatee County pays much less than other departments in the area, and its chronic state of being understaffed means that employees have to work brutal schedules. The department has become a training ground for other employers to recruit from. When EMTs are starting at only $9.56 an hour and paramedics between $10.65 and $12.16, it's not hard for everyone from other municipalities to hospitals and private transport services to lure new talent elsewhere.

Over the last year, the department has consistently been down 12-15 people, forcing stations to draft 4-5 workers per shift. The department routinely forces double shifts and often does so without considering call volume, meaning that a worker can go from the busiest station in the department to the second busiest in back to back shifts, performing up to 40 calls in less than two days.

EMS departments are always going to have trouble keeping their best talent. An EMS tech can become a fireman in the same station and make more money, and many of them do. A paramedic can move into a hospital and do less stressful work for about 50 percent more pay. If they move up to a Physician's Assistant, they can nearly triple their income.

Nonetheless, the inability to recruit top talent or keep their best workers on local ambulances is chiefly owed to the fact that Manatee County pays EMS workers 22 percent less than other departments in the surrounding area. There's also little incentive for those who stick it out. Pay compression has created a situation in which employees who've been with the department for several years often end up training a new employee making only ten cents an hour less than they are.

There's also a lack of emphasis on skill improvement. The department has gained a dozen certified critical care paramedics, but these employees were not supported with time off or tuition and fee assistance for the $1,200 course. Imagine how many more employees might have gained critical new skills if more support were offered. Instead, employees describe a department in which the most talented employees with the greatest potential are often left bored and frustrated.

Combine the poor pay with the forced doubles, lack of emphasis on training and continuing education, low morale and the frustrations of inconsistent policy making and taxpayers are left with little confidence that local ambulances will be staffed by the best and brightest when a medical emergency leads them to their doorstep.

Institutional knowledge is a critical resource when it comes to medical first responders. The difference between a responder with 20,000 calls under their belt and one with 200 can be life or death by way of their ability to immediately recognize the severity of a situation and quickly initiate the proper protocols. Many employees see the state's defined benefit pension system as the reason to enter a career track that is otherwise so unrewarding, yet 70 percent of those who come to work for the department don't stay long enough to become vested in the Florida Retirement System.

The list of needed resources for the department to become the sort that Manatee County citizens will want to rely on when they or a loved one are suffering a medical emergency is long. More trucks, more employees to staff them, better pay scales to recruit and keep top talent, a modernized scheduling system, well defined and consistently enforced policies, and creating a culture of training and education that challenges and supports employees in improving their skills would be a good start.

This costs money, but the department has a 72.1 percent collection rate on its billing – a stat most private enterprises would kill for. Yet these same for-profit companies are routinely cherry picking county talent by paying them more money even after they've taken a profit from less efficient billing collection. Manatee County might make it look like it's saving the taxpayer money by running such a fiscally tight operation – though the amount it spends on overtime pay would temper such an argument – but if such savings come at the cost of public safety, what kind of value are we really getting?

Dennis Maley's column appears every Thursday and Sunday in The Bradenton Times. He can be reached at dennis.maley@thebradentontimes.com. Click here to visit his column archive. Click here to go to his bio page. You can also follow Dennis on Facebook.