ATCEMS: Growing Overtime & Stress

EMS struggles to staff. (photo by Jana Birchum)

This week's events have left Austin-Travis County Emergency Med­ical Ser­vices staffers spread particularly thin. In an email sent to medics on staff on Thursday, March 12, the department was still scuffling to fill more than 80 shifts over an eight-day stretch.

That figure is comprised of a number of different types of shifts: standard ones, which put medics in regular rotations on ambulances around the county; contractual obligations like assignments to Austin Police Department-affiliated blood drawings; and, as of last Thursday, five shifts that needed to be filled for South by Southwest coverage, eight for events at the Circuit of the Americas, and another two at Rodeo Austin.

Asked about the perceived shortage in staffing, ATCEMS Public Infor­ma­tion Officer Commander Mike Benavides said, "That, while on the surface, appears outrageous; it really isn't.

"In the end, there are several things that haven't been reflected on the schedule that, by the course of natural means, helps to naturally fill the schedule."

He's speaking of the four-step process that ATCEMS uses to fill any vacant shifts, beginning with a voluntary phase and concluding – after a canvassing of the department's array of scheduled floaters and on-call medics – with a cumulative list that prioritizes those medics required to report for duty based on how much overtime they've previously accumulated.

Thursday's email marked the first stage in that process – in which medics can volunteer to work the shift for overtime pay. Should the department fail to accrue the necessary staff that way, Benavides says, schedulers will assign floaters pre-scheduled for certain stations to post up on other ambulances. He said that all medics are required to be on-call for emergency duty during one or two 12-hour shifts per month. (They get $2 per hour for every shift for which they're on-call, but aren't called.)

Benavides stressed that was merely the first step in a common procedure that EMS uses to fill open shifts on short notice. Indeed, as evidenced by subsequent overtime availability emails delivered on days before the listed week, many of the openings have been occupied by open medics.

ATCEMS Employee Association Pres­ident Tony Marquardt doesn't doubt that the shifts would get filled, but worries about the need to resort to such staffing measures. "Those vacancies represent our challenge to be fully staffed," he said. "Ideally, there wouldn't be that many vacancies advertised. Benavides is correct that every one of those vacancies will be filled, but they represent a significant amount of overtime to do it."

Reports from the March 2 Public Safety Commission meeting list ATCEMS as currently having 51 total vacancies – 32 reported, plus 19 positions that, at the time, were occupied by cadets in training (who've since graduated, though Assistant Chief Jasper Brown indicated that it will take four weeks before "they become an impact to the system") – and an estimated 25 more who can't contribute due to being on military duty, family leave, medical leave, or recovering from an on-the-job injury. Those vacancies have helped create a department in which overtime is routine – on top of the 48-hour work weeks medics are already expected to fulfill.

Opinions about the benefits of overtime currently appear split between ATCEMS's executive branch and those medics racking up the extra hours. While Benavides argues that overtime is a welcome requirement, one that helps fill the pockets of ATCEMS's 400-plus field workers, Marquardt counters that excess overtime is contributing to a growing trend of fatigue. According to a September 2013 audit of ATCEMS by then-City Auditor Kenneth Mory, that trend "is getting worse" and "may impact the quality of their work."

"Every ambulance will be staffed, and everyone will be taken care of, but it's at the expense of our frontline staff," says Mar­quardt. "All stations must be staffed, but the dynamic of how you choose to go about doing that is something that we have some differences about."