Chapman says EMS pay is not competitive and ALS units are misused

Good afternoon, members of the City Council.

I'd like to first thank the committees for holding this hearing.

It is imperative that we discuss the importance of maintaining efficient ambulance response times in a city that houses over 8 million people.

My name is Jack Chapman, and I am here on behalf of 1199 and the EMS workers that we represent.

I've been working in EMS for over 15 years.

I think I can skip reading the statistics on the increasing response times at this point, as it has been well discussed.

There are many reasons for the rising delays in response times across New York City, including staffing shortages, higher call volumes, low pay, packed emergency departments, and hospitals removing their voluntary ambulances from the 911 system.

Much like other parts of our healthcare system, EMS has been affected by exacerbating staffing shortages and funding being taken out of healthcare.

EMS personnel across FDNY and private ambulances have an average starting salaries around $40,000 a year.

In a city as large and expensive as this, and for a job that can be both physically and mentally taxing, these wages are not competitive or attractive.

One could make the same amount of money simply taking advantage of the newly required hourly pay for delivery app drivers, and there would be no intensive training or prerequisites.

EMS personnel wages also lag behind firefighters, with many who are already in the FDNY system eventually leaving to become firefighters themselves.

Approximately 4,300 EMTs and paramedics left their positions between fiscal year 2019 and 2020.

In addition to increasing staffing shortages we are seeing in EMS, ALS call volumes across the city have increased over the past decade, outpacing non-life-threatening medical emergencies.

And the life-threatening medical emergencies have increased by 22.9% since 2015, compared with a 2.5% increase of non-life-threatening emergencies.

This increase is also happening at a time when many hospitals are reducing voluntary ambulance services from the 911 system.

So EMS personnel are now being asked to take on a bigger workload with an increase of ALS calls while working with an understaffed team and being paid minimal wages.

The city's first responders play a critical role in ensuring the health and safety of those living here.

And they are here in the event of illness or injury to provide on-scene treatment and transport to a hospital, but are being tasked with providing those services without the resources necessary to do so efficiently.

While FDNY recognizes the shortage of paramedics that they have, they do not have an active pathway to recruit credentialed paramedics.

Certified paramedics must join as EMTs and then be accepted to the department's paramedic program to then go through almost a year of paramedic school again when they're already credentialed to do this job.

It's also worth noting that many calls are often triaged in ways that upgrade them to require an ALS-level response, just for the ALS providers to arrive on scene to find a patient that does not require the interventions that they are able to provide.

ALS units are regularly sent to calls that BLS units are more than capable of.

capable of handling, which results in less ALS units being available.

The system is understaffed and overworked.

We are now at a point that we are seeing NYPD seek out alternative resources when they are unable to get an ambulance on scene because the EMS system is in such backlog.

There are many factors that have led us to where we are now, which is resulting in ambulances not being able to arrive in a timely manner to those who truly need them the most.

The time is now to effect meaningful change and provide our members with the pay and resources they need to effectively continue to provide rapid, on-scene care and transport for those who need it most.

One of our union officers just told me about an event that just happened at the nearby Virgin Hotel this past Saturday.

Where it took 40 minutes for EMS to respond to a stat ep, which is short for status epilepticus, and simply put stands for ongoing or prolonged seizures, and is a true life-threatening emergency.

Over 40 minutes for EMS to get on scene.

Chronic abusers of the 911 system, many of whom call daily, call themselves in in a way that identifies them as high-priority emergencies and take that resource away from those who need them the most.

Recognizing that that does not mean these individuals do not deserve a response, the city should try to find a way to identify this and create a plan to minimize wasting the resources that are so wasted every day.

Thank you for your time.