The Aiken County Department of Emergency Medical Services continues to struggle to provide local residents with the help they need, even after a series of employee salary increases and other efforts to correct a disturbing — and potentially life-threatening — situation.
“We’re kind of on our end,” Aiken County Administrator Clay Killian said recently. “I hate using the word crisis, but when we can’t provide help to people who need it, that’s not where we want to be.”
In August, there were 71 incidents in zero mode and on 161 occasions, there were calls on hold.
“Status zero is when every truck (ambulance) is on call, and while they’re all tied up, we don’t get any more calls for service,” Killian said. “If we get a call to the service and they are all on hold, that call becomes a hold call.”
Since 2019, Aiken County Council has increased salaries for EMS workers by more than 30%, which includes four cost-of-living increases received by all county employees.
The district also conducted a basic Emergency Medical Technician (EMT) training course in collaboration with the South Carolina Fire Academy with student costs covered.
In addition, the county paid EMS workers to continue their education and tried harder and spent more money to hire EMS employees.
In May 2021, the county’s EMS manager, Chris Delauch, stated that his department had undergone a “major transformation.” He said there were only three vacancies on staff with more than 70 budgeted posts. The number rose to more than 20 in 2020.
Recently, in February and March of this year, there were no status zeros and no pending calls.
But that good news did not last long.
The number began to rise, and in July there were 32 zero cases and 49 pending calls.
As of September 9, there are 13 vacancies for EMS employees.
“It appears that the main problem is that there is a shortage of people willing to work in the EMS at the moment,” said county council chairman Gary Bunker.
Finding new employees and retaining existing employees are major challenges.
“You’re saving people’s lives, but it’s hard work and it’s very stressful no matter the pay,” said Killian. “There will probably always be some disruption due to fatigue. It takes special people to do what these people do.”
According to a 2021 study conducted by the American Ambulance Association and Newton360, an EMS-based performance management software company, voluntary and overall turnover was in the 20% to 30% range for emergency medical technicians (EMTs) and paramedics.
The study’s executive summary stated that, “With such high percentages, an organization is looking to replace most of its workforce within four years.” “In other words, over four years, there will be 100% turnover.”
The study indicates that business volume has been on an upward trend since 2008.
The executive summary described the involuntary turnover rate as “relatively low”.
“They are leaving the industry in droves,” Killian said. “We lost two of our remaining ones to go to nursing school. Hospital emergency rooms are hiring paramedics because in some cases they can do more than nurses can and hospitals don’t have to pay that much.”
Meanwhile, Aiken County’s population is growing and that means the volume of calls is likely to rise.
COVID-19 also continues to cause employment issues from time to time locally.
While Aiken County has arrangements with Gold Cross EMS and SouthStar EMS of Augusta, along with Aiken Rescue Inc. Nonprofits, to offer a supplemental ambulance service, their ability to help is limited by many of the same issues with EMS.
“We’re doing our best to figure out what to do,” Killian said. “We are trying to start another core EMT class (in partnership with South Carolina Fire Academy) in October. For this class, we will not only pay for the class, but we will also put them (students) on the county payroll.”
Killian also discussed some of the other steps the county plans to take.
“We are developing policy now and will meet with PR (public relations) managers, and possibly some CEOs at area hospitals to talk about how we can reduce response times (how long it takes ambulances to get back on the road after delivering patients to emergency rooms).
In August, turnaround times ranged from less than 25 minutes to an average of 46 to 47 minutes, according to county EMS statistics.
At the Doctors Hospital in Augusta, the time taken was the longest. Killian said it was the second longest — “about 42 minutes” — at Aiken Regional Medical Centers.
“This is where we receive about 50% of our patients,” Kilian said.
In addition, the county plans to access assisted living facilities.
“They all have transportation contracts with mostly private services to do public transportation, but sometimes we get a call that’s not really a 911 call,” Killian said. “We will try to help educate them better about when they should call us and when they should use their regular transportation to take someone to their doctor and not to the emergency room.”
One possible solution that Bunker mentioned is “to keep increasing wages steadily.”
“It has become a kind of bidding war there,” he added.
Bunker said he is now looking very strongly at Ambulances 11 and 12. We now have 10 cars budgeted.
He continued, “If we buy two more ambulances, we can withdraw these funds from the capital projects sales tax (money)”. “However, the problem with buying ambulances now is that there seem to be none or very few available for purchase due to supply chain issues.”
Another strategy is to change the county’s 24 hour, 48 hour shift schedule for EMS workers.
“What is described as the gold standard is 24/72 switching, which means it will go on for 24 hours and off for 72,” Bunker said.
Killian tells Aiken Standard that 12-hour shifts are also under study.
However, the 12 hour and 24/72 shifts will create the need for more EMS personnel and the downside to both is clearly “we can’t find the people we need right now,” Killian said.
Bunker believes that the county has sufficient funds available in the short term to maintain wage increases and/or hire more EMS workers due to the lower cost due to the large number of vacancies among budgeted jobs for county employees as a whole.