How are vollys viewed by paid EMT's?

[rescue1]

Well, the unfortunate truth is that any job that someone will A) do for free or B) do for personal satisfaction rather then pay will never advance in salary or opportunity with any speed, if at all.

If people were willing to do software consulting for free, and there were long lines of people wishing to do software consulting just for their own enjoyment, then software consultants wouldn't be making 6 figures.
But at the same time, especially today with municipal budgets in the crapper, the transformation into a progressive paid system may not be a financial possibility.

So I'd say while this may not be the ideal system to rule all other EMS systems, I think it is an improvement over an all volunteer system for advancing EMS as a whole.

 

[Level1pedstech]

The above model is used fairly effectively by EMS squads in the Philly suburbs. I'm not a member of any, so I really can't talk about them with any expertise, but it's my understanding that everyone is held to identical standards, paid and volunteer, both for scheduling and training. Volunteers also have hiring preference. I hear its pretty effective.

I think this system is great, but the issue is that it requires you have be a combination system to start. For an all or almost all volunteer system (which is where a lot of the complaints arise about volunteers) this system obviously won't work, since you have no (or almost no) paid positions for the volunteers to "promote into".
The only other issue is if you can't keep volunteer recruitment high. So while some areas (very populated ones) will have no trouble with a constant stream of people volunteering for a few years to get a paid position, a more rural department may end up hiring all the volunteers and transform into a paid department.

The transition point from all volunteer to combination would be when the commitment is made and the funding is in place. There has to be some level of funding however there is no minimum requirement as to the number of paid staff you need to start with. A nearby department I know of started with a paid chief then added one paid FF/EMT at a time until they were able to staff two first out BLS engine companies with a full time Capt and a part time engineer. The other seats were filled with volunteers and interns from the local fire science programs.

Offering an intern program for the local fire science students is a great option if you have sufficent call volume. Also as I mentioned the recruitment process is easier and becomes more competitive once you start filling in the paid spots with those that have put in thier volunteer time. Residency requirements need to be wavied to allow people to come in from outer areas for shift time. The benefit for the department is this allows for less reliance on POV response because you have crews in quarters. Benefit for the volunteers is that while on 12 and 24 hour shifts the crews drill togeather and share all the house duties (cleaning,cooking) which helped build mutual respect.

 

[crashh]

I'm not quite understanding why, if a dept. has both paid and volunteer...why would one choose to be a volly when they don't get paid and the shifts would be covered anyway by paid emts yes? Sorry if i seem a bit obtuse about this...i've just never dealt w/it before.

our company is 100% volly. But we're different than others around us in that we are more of a corporation i think. We are in a contract with our town...and get paid a certain amount from the 2 colleges that reside here. So, we don't have to do fundraising...we have a fund to work with. We do get donations and such of course as well

 

[rescue1]

I'm not quite understanding why, if a dept. has both paid and volunteer...why would one choose to be a volly when they don't get paid and the shifts would be covered anyway by paid emts yes? Sorry if i seem a bit obtuse about this...i've just never dealt w/it before.

For the same reason anyone volunteers, I guess, because you enjoy it. And because most of these systems do not have the staffing to crew all the apparatus in the house with paid men, so the volunteers still play a key role in the system.

For example, I belong to a fire company that has 2 ambulances, 2 engines, and a combination rescue/ladder. During the day there are 4 career personal on duty, 2 FF/EMTS and 2 FF/Medics. At night it drops to 2 personal, with at least one medic.

Obviously, there are not enough paid guys to staff more then one or two apparatus at a time, so the volunteers respond in or staff the station to provide most of the manpower.
For EMS, this means if I'm at the station I could ask the paid EMT if he wanted a break if we got a call, and I'd replace him on the ambulance. At night, a second ambulance call requires a volunteer response since there is only staffing for one ambulance in house. Or for a fire call, the volunteers may provide the crew to an engine that is driven by a paid staffer.

As to why you'd CHOOSE to volunteer, it's because either a) You have another job and don't want to be a career firefighter or EMT or because b) There is a huge demand for each paid position...we have 8 full time career staff and like 40 volunteers. And we don't hire our volunteers either. So it's not like you can just waltz in and get a paid job.

 

[rescue1]

The transition point from all volunteer to combination would be when the commitment is made and the funding is in place. There has to be some level of funding however there is no minimum requirement as to the number of paid staff you need to start with. A nearby department I know of started with a paid chief then added one paid FF/EMT at a time until they were able to staff two first out BLS engine companies with a full time Capt and a part time engineer. The other seats were filled with volunteers and interns from the local fire science programs.

Offering an intern program for the local fire science students is a great option if you have sufficent call volume. Also as I mentioned the recruitment process is easier and becomes more competitive once you start filling in the paid spots with those that have put in thier volunteer time. Residency requirements need to be wavied to allow people to come in from outer areas for shift time. The benefit for the department is this allows for less reliance on POV response because you have crews in quarters. Benefit for the volunteers is that while on 12 and 24 hour shifts the crews drill togeather and share all the house duties (cleaning,cooking) which helped build mutual respect.

I agree, I think this system is a good middle ground for areas that cannot justify or afford an all or mostly paid system. I've always found volunteer morale to be higher in systems where stations are staffed and response times are quick...nothing sucks more then belonging to a station where there is doubt as to whether you can respond on each call.

That being said, the issue is keeping staffing in station if you only run, say, six or seven hundred calls a year between fire and ambulance. When you can go a whole day without a single call, it can be tough to keep volunteers in the station 24/7.

 

[Level1pedstech]

Do you think this system will advance pay, opportunity, or profesional status of EMS in the area?

Pay would be equal to other agencies in the area for full timers,part timers would make less but they are gaining experience.

Additional opportunities would depend on funding just like they do now. This model acts to consolidate current resources and man power into a more manageable system. The positions are there already,some have funding and some dont.

I think the public liked seeing our guys in uniform and looking professional when we responded to calls but also if we were in doing our shopping for chow. There were no barefoot wife beater wearing responders on scene and no POV responders racing to calls. The surrounding agencies looked upon us with high regard which I guess would qualify as having profesional status. Honestly I was more concearned with how I was viewed by the public you know the one who pay the bills.

 

[Level1pedstech]

I agree, I think this system is a good middle ground for areas that cannot justify or afford an all or mostly paid system. I've always found volunteer morale to be higher in systems where stations are staffed and response times are quick...nothing sucks more then belonging to a station where there is doubt as to whether you can respond on each call.

That being said, the issue is keeping staffing in station if you only run, say, six or seven hundred calls a year between fire and ambulance. When you can go a whole day without a single call, it can be tough to keep volunteers in the station 24/7.

Roger that,I remember having many 24's with out a call. The days were filled with drilling,drilling and more drilling. Then of course there was painting,yard work, toilet scrubing,cooking,dishwashing,PT and maybe depending on the Capt a little more drilling before bed. But I can say in two years I only sat in a recliner and watched TV once or twice so we were always doing something.

 

[Level1pedstech]

I'm not quite understanding why, if a dept. has both paid and volunteer...why would one choose to be a volly when they don't get paid and the shifts would be covered anyway by paid emts yes? Sorry if i seem a bit obtuse about this...i've just never dealt w/it before.

our company is 100% volly. But we're different than others around us in that we are more of a corporation i think. We are in a contract with our town...and get paid a certain amount from the 2 colleges that reside here. So, we don't have to do fundraising...we have a fund to work with. We do get donations and such of course as well

You would volunteer for the experience. There were only so many full and part time paid positions which were earned by putting in your time. There was no option to go in and shift as a volunteer or shift as a paid guy. Hope that makes it a little clearer.

 

[jemt]

FYI if volunteer squads were cut out of the picture, wages would be one sure thing to rise for EMS.

 

[Level1pedstech]

FYI if volunteer squads were cut out of the picture, wages would be one sure thing to rise for EMS.

Really,what makes you think so. Its such a simple idea but let me ask who would cover the work now being covered by volunteer agencies assuming there is no funding currently available for paid staff? The common simple answer to this question is money would have to be found somewhere. In which I reply have you looked at the economy and the budget deficits and the large number of agencies big and small that are closing stations and laying off people.

 

[jemt]

Really,what makes you think so. Its such a simple idea but let me ask who would cover the work now being covered by volunteer agencies assuming there is no funding currently available for paid staff? The common simple answer to this question is money would have to be found somewhere. In which I reply have you looked at the economy and the budget deficits and the large number of agencies big and small that are closing stations and laying off people.

Simple economics, supply and demand. If every city/town was forced to have paid EMS, demand would go up.


I don't believe politics that budgets couldnt afford to pay a couple EMT's 15 an hour

 

[rescue1]

FYI if volunteer squads were cut out of the picture, wages would be one sure thing to rise for EMS.

I'm not so sure. A big draw of people working in EMS is the fact that they love, or think they will love, doing EMS. Therefore, they will accept lower wages, regardless of whether or not the towns ten miles away have a paid system or a volunteer system.

The over-reliance on volunteers has certainly slowed the growth of EMS in some respects (educationally, mainly), but I don't know if it directly would impact wages.

 

[Level1pedstech]

Simple economics, supply and demand. If every city/town was forced to have paid EMS, demand would go up.


I don't believe politics that budgets couldnt afford to pay a couple EMT's 15 an hour

Forced by who? Once again you need a revenue source,this is not a supply and demand issue. The number of EMT's and the lousy pay they are offered is an example of supply and demand.

 

[ffemt8978]

Simple economics, supply and demand. If every city/town was forced to have paid EMS, demand would go up.


I don't believe politics that budgets couldnt afford to pay a couple EMT's 15 an hour

Wow....just, wow.

No, if every city/town was forced to have paid EMS, they would not have any EMS. They would instead contract with a neighboring agency that could afford the overhead costs associated with maintaining paid staff, or go into a regional EMS model. Neither of those options would ensure adequate response times or staff availability.

You do realize that your "couple of emts" at $15/hours equates to over $130,000 per EMT position per year? That provides one EMT to cover 24 hours per day, 365 days per year. That does not include things like unemployment insurance, health insurance, retirement, ongoing training, uniform allowances or other such items like minimum equipment, maintenance, and supplies for the station. So to have a minimum two person ambulance staffed 24 hours per day, every day, equates to over $260,000 per year in wages alone (leaving overtime out of the equation completely).

Considering my district's budget is less than that amount every year, where do you propose we obtain this money from? The taxpayers that fund us certainly don't want an increase in their taxes, and it's been brought to them on repeated occasions.

 

[Level1pedstech]

Wow....just, wow.

No, if every city/town was forced to have paid EMS, they would not have any EMS. They would instead contract with a neighboring agency that could afford the overhead costs associated with maintaining paid staff, or go into a regional EMS model. Neither of those options would ensure adequate response times or staff availability.

You do realize that your "couple of emts" at $15/hours equates to over $130,000 per EMT position per year? That provides one EMT to cover 24 hours per day, 365 days per year. That does not include things like unemployment insurance, health insurance, retirement, ongoing training, uniform allowances or other such items like minimum equipment, maintenance, and supplies for the station. So to have a minimum two person ambulance staffed 24 hours per day, every day, equates to over $260,000 per year in wages alone (leaving overtime out of the equation completely).

Considering my district's budget is less than that amount every year, where do you propose we obtain this money from? The taxpayers that fund us certainly don't want an increase in their taxes, and it's been brought to them on repeated occasions.

Thats a great break down and does a great job of showing the hidden costs behind those "15.00 P/Hr EMT's". I dont think many people realize the tremendous battle that these smaller agencies wage every day trying to provide help when the call comes in. Much of that work both in the field and in the office is done by volunteers,I just dont think people get the big picture.

 

[Level1pedstech]

Wow....just, wow.

No, if every city/town was forced to have paid EMS, they would not have any EMS. They would instead contract with a neighboring agency that could afford the overhead costs associated with maintaining paid staff, or go into a regional EMS model. Neither of those options would ensure adequate response times or staff availability.

You do realize that your "couple of emts" at $15/hours equates to over $130,000 per EMT position per year? That provides one EMT to cover 24 hours per day, 365 days per year. That does not include things like unemployment insurance, health insurance, retirement, ongoing training, uniform allowances or other such items like minimum equipment, maintenance, and supplies for the station. So to have a minimum two person ambulance staffed 24 hours per day, every day, equates to over $260,000 per year in wages alone (leaving overtime out of the equation completely).

Considering my district's budget is less than that amount every year, where do you propose we obtain this money from? The taxpayers that fund us certainly don't want an increase in their taxes, and it's been brought to them on repeated occasions.

For many years my all volunteer local department was really luck to have our levys approved by the tax payers. These days people are tax tired and who can blame them. Sadly it hurts the smaller agencies the worst and they are the ones most likely to spend the money the way it was intended.

 

[Veneficus]

Neither of those options would ensure adequate response times or staff availability.

I think it would really help all forms of EMS agencies a lot to get away from using response time as a measure of how desirable or effective a system is.

The 8:59 response time was an arbitrary number developed by the firs service because that was the average response times of paid departments around the nation. It was based on a time that would allow the possibility of a save of a structure that was on fire and reported early.

Building construction played a major role in that.

If we think about applying that time to EMS, which many places list as desirable, just from a logical point of view it is not realistic or beneficial.

Consider a major urban city with high call volume. How many rigs would you need on the road at any given time to maintain that?

What percentage of your call volume would actually benefit?

How much would it cost?

Apply that same logic to suburban and rural environments. It rapidly becomes cost prohibitive. So you are actually harming your agency by using that standard.

From a medical point of view, would 9 minutes, not including call to dispatch and chute time make a difference in cardiac arrest? an airway obstruction? Class III hemorrhage?

What about the time from initial call to actual intervention on the patient? 10 minutes? 12 minutes? 15 minutes?

Now look at more time dependant reasonably treatable conditions where EMS may effect some level of treatment. MI, Stroke, class II hemorrhage. 15 minutes, 20 minutes, even 30 may not be unrealistic. Possibly more in the case of ischemic stroke, which is 90% of them.

Non acute may wait indefinately.

Now seperate the issue of response vs. transport.

If you put a medic in a KIA (or other cheap car) You need only 1 staffer, not 2. You don't need a $90K+ transport ambulance.

At which point time extending intervention would be available much cheaper. With trasport capability available if/when needed. It may also make it reasonably possible to drive this person nonemergent.

While some may argue there woul be no reimbursement in place already for that, and certainly that is true, how much are you collecting compared to call volume now?

At what point would you actually save money not responding a transport unit to every call every 9 minutes?

 

[Veneficus]

For many years my all volunteer local department was really luck to have our levys approved by the tax payers. These days people are tax tired and who can blame them. Sadly it hurts the smaller agencies the worst and they are the ones most likely to spend the money the way it was intended.

I have no sympathy for a population that pays on average 20% less in taxes than every other modern nation and then complains it has no money to fund services like fire, police, and EMS.

That is not even counting people who after deduction and refund pay no or almost no tax at all.

 

[Level1pedstech]

I have no sympathy for a population that pays on average 20% less in taxes than every other modern nation and then complains it has no money to fund services like fire, police, and EMS.

That is not even counting people who after deduction and refund pay no or almost no tax at all.

As a person who when its all added up sees right about 40% of my income go to taxes of some sort I get you point.

 

[jemt]

Wow....just, wow.

No, if every city/town was forced to have paid EMS, they would not have any EMS. They would instead contract with a neighboring agency that could afford the overhead costs associated with maintaining paid staff, or go into a regional EMS model. Neither of those options would ensure adequate response times or staff availability.

You do realize that your "couple of emts" at $15/hours equates to over $130,000 per EMT position per year? That provides one EMT to cover 24 hours per day, 365 days per year. That does not include things like unemployment insurance, health insurance, retirement, ongoing training, uniform allowances or other such items like minimum equipment, maintenance, and supplies for the station. So to have a minimum two person ambulance staffed 24 hours per day, every day, equates to over $260,000 per year in wages alone (leaving overtime out of the equation completely).

Considering my district's budget is less than that amount every year, where do you propose we obtain this money from? The taxpayers that fund us certainly don't want an increase in their taxes, and it's been brought to them on repeated occasions.

I apologize I should have clarified my point. I wasn't insinuating that every city/town should have their own EMS system, I just making the point that if every city/town had paid EMS (be it municipal,third party, private entity etc etc.) pay and advancement would go up for EMS providers.

Many communities are already serviced by third party providers who offer zero dollar contracts to cities/towns in exchange to be able to bill their residences for services rendered.

As long as vollie services are around, pay and advancement in EMS will continue to grow at the turtle pace it is now.