OCEAN CITY — There has been an alarming increase in the number of times the Ocean City Fire Department’s ambulance service has not had the crews available to respond to 911 calls, resort officials learned last week.
During a budget work session last week, Ocean City Fire Chief Chris Larmore brought to the Mayor and Council’s attention an alarming increase in the number of times the department has not had crews available to respond to 911 calls for emergency medical treatment.
“Our biggest immediate challenge in the very simplest of terms is we are unable to cover the shifts that we have,” he said. “There are several factors behind that. It is our desire to maintain the level of service we have all come to expect.”
Larmore said an analysis of the calls for service and the times when crews weren’t always available revealed the growing challenge.
“I have been informed about our out-of-crew status, or those times when a person calls 911 and we don’t have an immediate crew available to respond,” he said. “We can generally split a crew, find a crew or rely on the volunteers. We want that to decrease. We certainly don’t want that to increase.”
Larmore said the challenge was defined clearly by the number of times crews weren’t immediately available to respond to calls within the last year.
“It went up 300 percent,” he said. “There were 60 times we were out of units and out of personnel to respond to calls. That number was in the low 20s the previous year.”
Larmore said he and his staff began exploring the reasons for the alarming increase. It is not an increase in call volume in the height of the summer season that is causing the issue, but rather the shoulder months and offseason.
“Naturally, my question is what happened?” he said. “I handed that task to my crew chiefs and they worked dozens of hours to analyze it. The long and short of it is it’s the number of calls in the offseason that is causing the majority of the problem. In-season we’re pretty good.”
Larmore said the overall number of calls for service increased throughout the year, but the biggest spike was seen in the offseason.
“We analyzed every call, where the call was and what other calls surrounded them that caused us to be out of units,” he said. “Over the last four years, we’ve seen a 10-percent increase in call volume. You can say that’s not really dramatic, but the real key is call volume in the offseason. The increase in call volume in the offseason is 21 percent and we have not increased the staffing proportionate to that. When we looked at the time period from 8 a.m. to 8 p.m., it almost increased 40 percent.”
Obviously, having a crew available on the other end of a 911 call is paramount for the department. However, many of the challenges have been created by the consistent growth in the shoulder seasons. Contributing to the problem is the increased number of calls from outside town limits.
“Aside from the safety of our people, providing resources is our top priority,” he said. “That we can’t always do that is concerning. You have accomplished the goal of expanding the shoulder seasons by bringing people in with special events. What has happened is we have not expanded to match that.”
Larmore said the challenge is exacerbated when the calls become more complicated or when they come in bunches.
“If you look at the calls we’re getting, it’s the duration of the calls and when they start coming in together to the point we can’t handle them,” he said. “There are hours when we can’t provide the service unless we make some changes.”
Larmore said there were two basic issues, one being the need for more funded shifts. The other includes mandates for part-time employees such as the Affordable Care Act and the Medical Leave Act, for example.
“We used to be able to get 800 to 900 hours out of our part-time staff,” he said. “Now, that’s down to 300 to 400 for a lot of reasons. That’s based on availability, federal and state mandates and other things we can’t control.”
For that reason, the fire department is seeking to convert three part-time employees to full-time employees because it’s easier to manage the schedules of full-time employees. Larmore explained three full-time employees could equal 6,000 hours and it would take 15 part-time people to cover the same number of shifts for a lot of aforementioned reasons.
Converting three part-timers to full-time would come with a cost, obviously. The salary package would essentially be a push, but the full-time employees would be eligible for full benefits. Larmore estimated the total cost of converting three part-time staff to full-time would cost an estimated $165,000.
City Manager Doug Miller said the proposed budget included increased funding for the ambulance service, but perhaps not at the full amount.
“In this budget, we have put in funding for the fire department to try to address this issue,” he said. “At this point, we want to identify that there is a problem and that we’ve taken a first step to address it.”
Simply throwing more money at the problem wouldn’t solve it entirely although it certainly could help. Larmore said there would be challenges to finding the part-time staffers to fill the shifts.
“We’re looking to fill additional shifts,” he said. “Even if money was no object and so said go ahead and fill those shifts, we couldn’t do that. We simply don’t have the people to fill those shifts.”
He said a change in how neighboring departments are filling their staffing needs has contributed to the problem.
“Nine out of 10 county departments now have career people,” he said. “It wasn’t that way long ago. Virtually everyone has doubled their career staff and they are pulling from our people.”
Larmore said there was real reason for concern with the inability at times to cover shifts and promptly answer all calls.
“I have to advise the Mayor and Council from my position that I still have a concern that we can provide equal service,” he said. “I don’t want to come back here after the fact when one of those calls doesn’t get answered and tell you we can’t provide the service. We’re not going to have crew-availability going forward that we have had in the past. When I look at a 300-percent difference, I am very upset about that.”
There was considerable discussion about possible alternatives to addressing the issue including relaxing some of the mandates for part-time employees, reducing the number of staff on each and every call. The assumption is not every single 911 call for ambulance service requires one EMT and two paramedics. There was also more discussion about approaching the county for additional funding to address the volume of calls outside city limits, such as West Ocean City, for example, which accounts for a considerable percentage of the department’s total call volume.
The Mayor and Council instructed Budget Manager Jennie Knapp to explore just how to fund the requested staffing changes. The elected officials also passed a motion seeking to have Worcester County form a task force with representatives from all of the county departments to determine a fair and equitable funding formula.