How Critical is the EMT Shortage? HVA Responds

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By Doug Marrin, STN Reporter

Are Emergency Medical Services in a critical state? Some think so. We checked with Huron Valley Ambulance (HVA) to hear what they had to say about it.

Area fire departments have recently sounded the alarm about staffing shortages' impact on ambulance services. Last month, CAFA Chief Robert Arbini spoke to the Sylvan Township Board, DAFD Chief Robert Smith responded to Dexter’s City Council questions, and CAFA Board Chairperson Tom Osborne reported to Chelsea City Council.

See article: Chelsea Area Fire Authority is looking to address a pressing issue

See article: The Critical State of Ambulance Response

One concern raised surrounded a comment by an HVA Vice President that the ambulance company could hire 300 people, interpreted to mean the company was short-handed by 300 EMTs. Another concern was the excessive wait times for an ambulance to arrive on the scene.

Karl Rock, Regional Vice President for HVA, is the one who said his company could hire 300 people. “In a conversation with one of the area fire chiefs, the subject of staffing came up,” says Rock. “I made an off-the-cuff remark that HVA could hire 300 people. It was not related to how many EMTs we specifically need but an illustration of what the staffing challenge feels like these days.”

Fifty-five people is what we need to be fully staffed,” says Ron Slagell, President and CEO for HVA. While their staff shortage is nowhere near 300, Slagell admits it is a pressing problem. “I’ve been doing this since the 1980s,” he says. “This has been a staffing crisis that none of us have ever faced in our careers.”

HVA serves Washtenaw County, western Wayne County, parts of Lenawee County, and southwest Oakland County. Slagell says there have been problems as far as delayed response times, but these incidents are the exception, not the rule.

“You know, 80 or 90-percent of our calls are still having very good response times,” he says. “There are more outliers, but I guess my concern is that the focus has been on only a handful of situations. And yes, those were bad situations for those patients, but the vast majority of people are still getting a good response time.”

Slagell pointed out that the call's severity affects the response time. Life-threatening cases are responded to quickly with sirens and flashing lights. Less severe calls, such as a broken bone, would have the ambulance travel slower without lights and siren.

“If you don’t have a life-threatening emergency, we’re not going to jeopardize our crew,” says Slagell. “Plus, with the hospitals overwhelmed, the patients are still waiting for care even after they arrive. Coming in by ambulance doesn’t put you higher up on their priority list.”

“Unfortunately, there are some newsworthy headlines out there that don’t represent the majority of cases,” adds Rock. “We recognize that times have changed, and we are working to make improvements.”

CAFA is looking to purchase an emergency vehicle for transport. Code allows for alternate transportation if an ambulance doesn’t arrive within 10 minutes. CAFA Board Chairperson Osborne told Chelsea City Council that down the road, Chelsea Fire would like to bill for its ambulance services which would provide revenue for training the department’s paramedics in Advanced Life Support procedures, the same as HVA.

Slagell agrees that systematic redundancies and backups need to be implemented to address the current situation, but they have to be careful not to break the system in the process.

“We do want to look at some solutions to have enough backup resources to address this because this isn’t specific to HVA,” says Slagell. “We want to have a solution that will supplement the system and not fragment the system.”

By system, Slagell means the interworking agencies that provide an emergency response from the 911 call operators to the first responders and medical transport to the medical reception at the hospitals.

“We all need to work together as community partners in the EMS system to make sure we have a system,” he says. “And once we survive this pandemic and the staffing shortage, what we put in place in the interim doesn’t further fragment or create problems down the road for years and decades to come.”

“What we want to do at the end of the day is work not only with our first response partners but also with the healthcare systems that we work within,” says Rock. “Because at the end of the day, we want to make sure the patient gets to the right facility.”

Photo: Doug Marrin

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