'They are on the move consistently': Volusia EMS personnel need their own stations

The county's EMS workshop acknowledged unsustainable overtime demands amid a need for EMS stations to help with working conditions.


File photo by Nichole Osinski
File photo by Nichole Osinski
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Overtime hours. EMS stations vs. "respite" centers. Ambulances.

These were all topics addressed during a five-hour Volusia County Council workshop to examine the operations of its emergency medical services, where officials discussed existing challenges, the division's efforts to address them, and future staffing needs. 

Improvements to EMS have been trickling in since 2019, with the addition of a new nurse triage program and the implementation of a hybrid deployment model, though the system continues to run primarily on dynamic deployment, where ambulances are dispatched throughout the response area based on call volume. However, while a dynamic deployment model tends to allow for faster response times, it also takes a toll on EMS staff — and in a time where there is a national paramedic shortage at the same time as increased demand, the average paramedic in Volusia County worked 362 hours of overtime in the last year, as of March 1, said Jason Lademann, president of the Volusia County EMS union. 

The average EMT has worked 256. 

"The union recognizes that the county has acknowledged that there's been a huge workload placed upon the paramedics and EMTs of Volusia County EMS, and we appreciate that," Lademann said. "The county has acknowledged that overtime demands that we've been facing year after year are not sustainable."

The union is also mindful that the current overtime data is "skewed downward," he added, since employees who have been recently hired have yet to collect a full year's worth of data to contribute to the average hours of overtime worked. 

Michael Colman, director of Volusia County EMS, said during the workshop that there is a plan in place to fix this, but it will take two years. In the meantime, the EMS union has stepped up to fill the staffing voids.  

"But at some point, we have to now let the valve out, let some relief out for these guys," said Colman, who was hired in August 2021. "Start staffing this relief factor that we've talked about and really try to move this forward."

The reality is, though, Colman continued, that even if the council gave them the budget to hire all of the employees necessary to fill the vacancies, the division would have trouble finding candidates. 

EMS stations

While overtime hours may be high, Lademann said the most pressing issue is the need to provide EMS stations for paramedics and EMTS. 

"Although the overtime demands issue is a close second place, the overtime demands are a reflection of retention," he said. "And that first priority of providing stations for EMS personnel to work at addresses one of the contributors to turnover that we've identified, as we've studied those who have departed the organization in recent years."

And being without a dedicated place to go to when deployed, but not active on a call, is hard on EMS personnel. 

The union president told the council members during the workshop that EMS need a space to write reports, perform training, check out equipment, eat their meals, wash their hands and rest away from a constantly-running ambulance. And he suggested that it be a permanent building.

"When we look at leases and rentals, it makes us vulnerable to changing political priorities with different partnerships," Lademann said. "And when we look at things like modular structures, although they might give us access to a building in a faster fashion, those type of buildings also leave us vulnerable to severe weather or hurricane deployments." 

He also said that when the time comes for these buildings to come to fruition, the county refer to them as "EMS stations" rather than "respite centers."

"When government provides a building for police officers, we call it a police station," Lademann said. "When government provides a building for firefighters, we call it a fire station, but in recent months when government has considered providing buildings for EMS employees, we call it a rest area. So we ask for parity and we ask to be termed equally and treated equally as far as the need for buildings and how we term them because we want the public to know that we are working from those places."

Modular buildings

The county is planning to put one modular building for EMS employees at Fire Station 46 in DeLand, but Colman said if the county decides to go in a different direction after seeing how this one fares, that they can always pivot. 

"We've gone through a lot of ideas of how to drop these stations around, because the reality is that this county is growing super fast," Colman said. "So we don't know where that station is going to be in a few years, and if we do a lot of brick-and-mortar stuff ... and then all of the sudden dynamics change, we have people in other areas, now we need to abandon that spot and then that's not good for the taxpayers and all the effort that was put into this."

During a July 2021 workshop, $1.8 million of American Rescue Plan Act Transition Funds were directed to be set aside for the EMS stations. 

Volusia County Council member Heather Post asked why ambulance personnel weren't being allowed to use fire stations in the interim. Typically, EMS personnel aren't at these stations for very long anyway, she pointed out. 

"They are on the move consistently," she said. "Why aren't we sort of allowing them to base out of the nearest fire station from wherever they would be stationed instead of the 7Eleven so that they can actually use the fire station, fridge or the fire station restroom?"

Colman said rest locations are based on the response time standard of eight minutes and 59 seconds. In order to meet that, they need trucks in the "most ideal place," and fire stations wouldn't necessarily be those places. Plus, it would take longer for EMS personnel to get on the road.

"I'm not discounting your idea, it's just if we do that, then we have to agree that 8:59 isn't a reality that we could get there for a while," he said.

County Council Chair Jeff Brower asked if EMS personnel are allowed in fire stations, and County Manager George Recktenwald said they are. However, he also added that during the pandemic, there were situations where the county was aiming to keep first responders as isolated as possible. 

Lademann said that what they need for arrangements like this to be successful is a formal arrangement. 

"When it's an informal arrangement, and we find ourselves in the position where we have to knock on the door because we don't have a door code, or we don't have badge access to enter the building, you get a strong sentiment that you're very much a visitor," he said. 

Post said that this isn't a new idea; it's been discussed several times in the past and that now, they are told rest locations are needed to help with morale, recruitment and retention. 

"This not something that we should wait on," she said.

Recktenwald said the best course of action would be to attend the monthly Volusia County Fire Chiefs Association meeting and put together a list of participating stations for an agreement to come before the council in the near future. 

New Smyrna Beach Fire Chief Shawn VanDemark, who is also the fire chiefs association vice president, said they "certainly have an appetite for this."

"Getting these men and women to have a place where they can stop being a paramedic for five minutes is a big deal," he said. "We have a great partnership with them. We run every single call we run in the city with them, so there's not going to be an issue there." 

He also said that he couldn't see paramedics stationed with them impacting response times, as there are many throughout Volusia, both county and municipal-run. 

'Mandatory' overtime

When it comes to working overtime, Colman shared with the council that it's not really voluntary.

"If somebody doesn't volunteer for it, somebody else will be 'voluntold' for it," he said, adding that it's unfortunate and that the division is aware this is hurting recruitment. 

In fiscal year 2021, some paramedics racked up over 500. The most overtime worked by one paramedic was 944 hours, according to the presentation to the council. This poses a concern for burnout. 

As a solution, EMS is asking for five EMTs and five paramedics each for fiscal years 2023 and 2024. The division is also hoping to fill its vacancies — 15 paramedic and five EMT positions.

"We have seen a positive slope of improvements to achieve some of the goals of improving working conditions and improving them retention, and the EMS division has experienced the workforce shortage much like every other organization out there," Lademann said. "But our issues have been mildly exacerbated by the fact that we had a significant number of vacancies, even going into the workforce shortage. So we're certainly now feeling the pinch and the need to be able to attract and retain high-caliber and long term EMTs and paramedics to serve right here in our communities."

 

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