Tanner: County at risk as more EMS employees exit

WINNSBORO – Fairfield County was facing a critical personnel shortage in its emergency services department a year and a half ago, with paramedics and emergency medical technicians (EMT’s) chasing better pay in neighboring counties.

But a salary increase passed by Fairfield County Council in November, 2016 stopped the bleeding – that is, until Richland County recently upped the ante by again raising the pay for its EMT’s and paramedics.

“Richland is offering a 10 percent pay raise for EMT’s and paramedics, immediately opening eight new positions, budgeting for 48 new positions next budget year with a $2.5 million budget increase for equipment and supplies,” Tanner said. “Starting pay for Richland’s new paramedics is 19 percent higher than Fairfield’s, even with last year’s increase. With 75 percent of our EMS employees living out of the county, we’re in a difficult spot,” Tanner said.  “While we must be doing something right for them to drive 30 miles over here to work, our employees work 14 hours a week more and make $19 a week less than those in Richland and Lexington Counties,” Tanner said.

As a result, Tanner said it is increasingly difficult for Fairfield to attract and retain paramedics and emergency medical technicians (EMT’s). He said the shortage has become critical, putting the County’s residents at risk.

To that end, Tanner asked Council to raise hourly rates for EMT’s from $8.55 to $9.85; paramedics from $13.42 to $15.81; sergeants from $14.77 to $17.66; lieutenants from $16.11 to $18.50 and captains from $17.45 to $19.35.

County Administrator Jason Taylor said the overall increase would cost the county $357,000 annually.

Tanner explained the potential crisis for the County.

“We’ve had to shut down substations, and that has increased response time, affected patient care and could cause us to lose our advanced life support (ALS) care.” Tanner said.

“DHEC (Department of Health and Environmental Control) requires us to have a paramedic on the truck 95 percent of the time [to maintain ALS service],” Tanner explained. A truck with only basic life support (BLS) service, manned only by EMT’s, cannot perform procedures involving IV’s, defibrillation, intubation, chest tubes, and invasive procedures or administer medication, Tanner said. Paramedics, he said, can perform these and other life-saving procedures.

“There aren’t many calls we can send a BLS truck to and maintain our DHEC certification. There is a massive difference between BLS and ALS service,” he said.

“I’ll show you the impact that would have on this county,” Tanner said, backing up his claim with examples of the kinds of life-threatening calls the department makes on a daily basis.

“EMT’s can do nothing for low sugar diabetics in crisis except put them in the back of the truck, take them to Richland and hope the patient doesn’t die or get permanent brain damage on the way. A paramedic can immediately treat the diabetic on the spot and may not even have to transport them to the hospital. In car wreck situations, when only EMT’s on the truck, a patient with broken ribs can die on the way to the hospital when tension pneumothorax builds from punctured lungs. In that same situation, a paramedic can perform pleural decompression, can manage pain and the patient arrives in stable condition and is taken to surgery,” Tanner said.

“To run all six trucks every day in the county we must be fully staffed with at least one EMT and one paramedic per truck.

“Because of the shortage of paramedics, in November we were fully staffed for only 9 days. We were down one truck for 16 days and down two trucks for five days. In December, it got worse and by January, those numbers had deteriorated to the point that we were fully staffed for only one day. That means that an area of Fairfield County was not covered for 30 of 31 days. We’re that short staffed now. We were down to 14.5 days at five stations, 14.5 days at four stations and one day we were down to three trucks running in the county,” Tanner said.

“When you’re down like that, is it caused because you don’t have lower ranking staff?” Councilman Neil Robinson asked.

“We can put an EMT in the truck but without a paramedic in the truck 95 percent of the time, we will lose our ALS license,” Tanner said. Last year, Tanner told Council that it is critical to keep the trucks staffed.  “If we can’t keep them staffed, people will die. Paramedics are the primary emergency health care providers in this county. They are the ones who save your life,” Tanner said.

To the County’s credit, Tanner said, Fairfield EMS has the best equipment and substations of all the surrounding counties.

“[Long-term], we have a mentoring program in the school system and have reinstated the Explorer Post program to create home grown employees. Our benefits are great,” Tanner said. “We just need to keep up with the competitive pay market.”

“If we made it competitive a year ago and employees are searching for the higher paying jobs, if we grant it now, what’s to say we won’t find ourselves in this same situation a year from now?” Councilman Douglas Pauley asked.

“There’s no guarantee,” Tanner said. “But I believe you get what you pay for, and I think every citizen in Fairfield County deserves the best shot at life by getting the top quality paramedic to come save them in their medical or trauma crisis.”

“But my main concern is their dedication to Fairfield County,” Pauley said. “Do we offer longevity for staying in the county to offset raising the salaries?”

“We are working for long term solutions. But we don’t just compete against Richland and Lexington Counties. A private service on the DHEC website offers a $20,000 signing bonus to paramedics and $10,000 to EMT’s,” Tanner said. “That’s why we are trying to get more home-grown employees who are dedicated to staying in the county. I think we have a long-term solution in place, but we have to bridge the gap to get there.”

“I recommend we postpone this until we have further information on it,” Robinson said.

“The Administrative and Finance Committee recommended the pay raise, not to compete with other counties, but to raise it enough to keep the people here that we’ve got and get some new ones,” Douglas, a member of that committee said.

“Neil, what is it you need to know?” Douglas asked Robinson. “He’s here now. You can ask him what you need.”

“I’m not comfortable with the increases,” Robinson said. “I think we need to revisit it.”

“Mr. Robinson, is your concern, and you and I talked about this earlier, is your concern not with [pay for] the EMT’s and paramedics, but with the leadership positions?” Smith asked.

“Throwing money at EMT’s is what we’re doing,” Robinson said. “If we’re going to continue to throw money, let’s do it where we need it the most.”

“I made a personal phone call to Lexington County and got some salaries of EMT’s, paramedics, lieutenants and captains, and their figures were substantially less than the finance committee gave me,” Pauley said. “So, I, too, would like more information before we make a decision on this.”

But Tanner came armed with current pay stubs of paramedics and EMT’s from Richland and Lexington Counties to back up his requests for higher salaries.

“The Director of Lexington County EMS told me yesterday that he does not have an EMT who makes less than $60,000 a year. He’s in charge of payroll and budget and there’s no reason for him to give me false information,” Tanner said. “As for salaries at the top, I would get half the increase that paramedics and EMT’s would get. But there needs to be a separation of pay between the paramedic in the field and the people with the most responsibility. Otherwise, why wouldn’t I just go back in the field where there is less responsibility?”

Council voted 4-3 to defer a vote on Tanner’s request. Council members Dan Ruff, Neal Robinson, Bertha Goins and Douglas Pauley voted to defer the vote. Mikel Trapp, Jimmy Ray Douglas and Chairman Billy Smith voted against the deferral.