Deal is Near to End EMT Staffing Woes in Oahu

Many EMS providers leave their positions to become firefighters.


May 28--City officials say they're close to reaching an agreement with the union representing roughly 200 emergency services workers on a scheduling plan that they hope will curb staff shortage and overtime problems that forced them to shut down shifts at four ambulance stations during Easter weekend last month.

The city hopes the pilot project that converts most of its shifts for paramedics and emergency medical technicians to 12 hours from eight hours will reduce the amount of overtime they are forced to work and keep them happier, said Mark Rigg, director of the Department of Emergency Services.

This would mean the city would pay less in overtime and be able to draw from a larger pool of available workers to substitute for people calling in sick rather than force those already there to work double shifts.

Talks are expected to resume Wednesday with officials from United Public Workers, which represents Emergency Management Services Division workers, Rigg said Tuesday. "We are hopeful we will have an agreement in a couple of weeks," he said.

About 30, or more than 15 percent, of EMS' 220 funded positions are unfilled, a situation that has forced EMTs and paramedics to work double shifts of 16 hours.

Staff shortages and overtime have been a chronic concern in recent years for Oahu's Emergency Medical Services Division.

But the current problem was exacerbated by the recent unanticipated exodus of at least half a dozen emergency workers from EMS to the Honolulu Fire Department, the state or other counties. EMS workers often leave to become firefighters, who typically have more advancement opportunities and step pay increases, Rigg said.

Meanwhile, EMS cleared the way for 15 current EMTs to begin paramedic training classes at Kapiolani Community College in January, putting them out of commission for about 15 months, Rigg said. "It was a tough decision ... but we need paramedics or we're going to be short."

The situation reportedly has left some emergency workers so worn down that they have been taking sick days off to recuperate.

Rigg confirmed that four of the island's 20 ambulance stations each shut down for one eight-hour shift during the April 19-20 Easter weekend. The weekend was slow, and contracted ambulance operator American Medical Response was on standby, Rigg said.

The department is neither seeking out nor punishing anyone who may have purposely taken sick leave to recuperate. "My position is ... if you're tired and you've been working 16-hour shifts for two or three days, if you're too tired to come in, don't come in," Rigg said.

The staffing dilemma has required EMS to spend roughly $5 million in overtime annually, more than a third of the EMS budget.

The city had budgeted $4 million for EMS overtime in the current year and, with just over a month to go in the current fiscal year, is projecting spending $5.19 million in OT, city emergency services spokeswoman Shayne Enright said. The city paid $4.95 million in EMS overtime last year, she said.

State Health Director Linda Rosen said the consistently high EMS overtime costs have troubled officials at the Health Department, which reimburses the city for EMS operations through a contract, for a number of years.

Rosen, who has been the Health Department EMS branch chief since 2006 and has continued in that role even after becoming health director in February, said she has pressed Oahu EMS to convert to 12-hour shifts for several years.

While overtime is often necessary, Rosen said, chronic OT issues like those experienced by EMS leads to employee burnout and then retention issues.

Rosen said the larger fear is that"they've really reached the point where if they have more people leaving because of the forced overtime, they'll just have to shut down stations because they don't have the personnel."

Rigg said he agrees with the logic behind moving to a predominantly 12-hour schedule. "It requires less staffing to operate a 12-hour schedule than an eight-hour schedule on a daily basis, so we'd have more personnel available to us," he said.

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