By KATHY HAGEMAN
Dickinson County public information coordinator
If there’s one situation that keeps Dickinson County Administrator Brad Homman up at night it’s worrying about whether or not the county’s Emergency Medical Service (EMS) has enough staff to respond at night.
“If someone calls about a pothole, we can wait on that. But I can’t live with the fact that somebody had a heart attack and we didn’t have enough people to send out an ambulance,” Homman said.
In recent years, attracting and keeping paramedics and EMTs (Emergency Medical Technicians) has been a challenge, but recently the lack of applicants – particularly for paramedic positions – has become a problem.
“John (Hultgren, EMS/Health Department director) has expressed frustration and concern about our open EMS positions and not getting any applicants. There’s two vacancies that have been open for months,” Homman told commissioners.
After a lengthy discussion about the problem and solution, Dickinson County Commissioners on Aug. 25 approved a salary increase for paramedics, Advanced EMTs and EMTs. The increase will bring the starting salary for a paramedic up to approximately $62,000 with overtime.
Poaching from others
With a shortage of certified people and nearly every agency needing people, EMS services nationwide have only one alternative – poaching staff from other agencies. Not surprisingly, agencies offering the top salaries are winning.
“Right now, salaries are the thing that attracts people. It’s not surprising in this competitive environment,” Homman explained. “Today, we not only need to be competitive, we need to be attractive.”
When it comes to certified emergency medical first responders, Dickinson County is competing for staff with the City of Salina and Junction City - which have both fire and EMS, Manhattan EMS and even Newton EMS, Homman said. In reality, however, Dickinson County is competing with every agency in the state because of EMS’ unique work schedule.
Paramedics and EMTs work 24-hour shifts, so they only work 10 days a month.
“That allows them a lot of freedom other departments don’t have - the freedom to live elsewhere and come here and work,” Homman said. “We have people living in Newton, Salina, Hutchinson, Manhattan, Junction City. They come here and spend their 24 hours in the (EMS) quarters 10 times a month.
Even though the county offers good benefits and other perks, salaries are the big drawing card. In years’ past, salaries were only part of the picture. Unfortunately, that is no longer the case -especially for younger people who do not see the need for insurance at that point in their lives.
“People do this job because they want to. It’s in their hearts. But EMS is kind of a young person’s occupation. It involves lifting and sometimes they can get into some difficult situations so it is challenging. Not everybody is cut out to do this,” Homman explained. “But at this stage in their lives, salary is the thing that attracts them.”
He referred to several advertisements for EMS services across Kansas which are offering more than $62,000 for paramedics to start. Starting pay in Leavenworth is $62,969; Dodge City and Ford County is $19 per hour; Wichita in Sedgwick County is $20.63.
Some also are offering sign-on bonuses after 60 days.
Dickinson County’s starting pay for a paramedic is $51,247.
“So, we’re about $10,000 to $12,000 light compared to other counties,” commented Commission Chairman Lynn Peterson. “Obviously, the starting salary needs to be consistent or competitive with other counties.
“But the reality is, if we raise our level, all the others will raise theirs,” Peterson added.
“Something that came as a shocker to us was when we heard Marion County raised their starting salary for a paramedic to $62,000 for same reason – to get applicants,” Homman replied.
Attractive position
Despite the lower salary, Dickinson County EMS has a reputation as a good place to work, with newer facilities and up-to-date equipment, and it offers something other nearby agencies do not, Homman said.
“In Salina or Junction City, the job is EMS/firefighter. Here, we are just EMS. A lot of people don’t want to be firefighters, so we attract people from other services because of that,” he said.
Dickinson County EMS has 21 positions, including the director, assistant director and billing clerk, nine paramedics (the highest level of certification), three Advanced-EMTs and six EMTs.
“We try to have a paramedic on each group, so when a truck goes out we have one paramedic and one EMT, so they can provide all the advanced life support services we can,” Homman said.
Unfortunately, Dickinson County has been on the losing side of the battle when it comes to keeping paramedics.
“Not to minimize an EMTs role by any means, but the requirements to be a paramedic are much more strenuous. The difference is tremendous,” Homman said, explaining the demand for paramedics.
Typically, Dickinson County EMS has between 2,400 to 2,500 calls a year, but that number has increased each year. Staff transport patients to nearby facilities in Salina, Manhattan and Topeka, but in recent years, also to places in North Kansas City, Mo., Lawrence, Newton, Overland Park and others.
“The hospitals arrange those transports, we don’t. But we’re going to places we’ve never seen before,” Homman said.
Advanced training
Dickinson County EMS gives employees who wish to attain a higher certification the opportunity to attend the paramedic training center at Hutchinson Community College.
“We have paid the tuition for some of our employees with the agreement that, number one, they have to pass; and number two, they have to give us a minimum of two years of service,” Homman said.
“That has worked pretty well for us, but what we’re hearing now is that some agencies are sending their students to paramedic class and paying their tuition, expenses to stay there and paying them a salary while they are there so it’s just like going to the law enforcement academy.
“I’m not saying we need to do that at this point,” he added.
Increase
The proposal approved by the commission increased the current base salary for an EMT from $38,205 to $48,189; AEMT from $41,262 to $51,251; and paramedic from $51,247 to $62,000, amounting to an approximate $3 per hour raise, according to Assistant County Administrator/Budget Director Janelle Dockendorf.
Commissioner Craig Chamberlin asked how the increase would affect the current and 2023 budgets.
Dockendorf said the current budget (running through Dec. 31) could absorb the increase, but next year’s will be tight.
“Obviously, we’re going to have to prioritize what we are doing,” Dockendorf said.
Despite the challenge to the budget, commissioners agreed that keeping EMS staffed is necessary.
“We need to be rather aggressive with this,” Commissioner Peterson said. “It’s not something we can push into next year.”
Homman said he worries that the county will receive a 911 call and there will not be enough staff available to respond.
“So far, we’ve been able to cover all the shifts with overtime, but we’re taxing our staff and they’re getting tired. We’ve got a couple who worked a lot of overtime because they are team players, but they are to the point where they don’t want so much overtime.”