PAX Centurion - September / October 2013

Page 44 • PAX CENTURION • September/October 2013 617-989-BPPA (2772) The hidden cost of layoffs Boston EMS Corner: Ed McCarthy S o much has happened at Boston EMS since the last edition of the Pax Centurion that it is difficult to decide where to start. Between the layoffs imposed at EMS, to the budget issues, to the reductions in training and staffing, the contract negotiations or lack thereof, and the organized union activity the BPPA/EMS divi- sion has orchestrated, I feel like I am poised in front of a giant game of ‘whack-a-mole’ trying to decide which topic to hit. I suppose what stings to most people are the layoffs and the devas- tating effect they have had on Boston EMS. But the layoffs aren’t the whole story. People who have left EMS for a variety of reasons, such as retirement are not being replaced, particularly in the higher ranks. If you do not replace vacated positions, is that a cut? I think so. In a city where EMS gets busier and busier ever year, the PHC 2014 budget for EMS contains 20 FEWER FTE (Full Time Employees) than 2013. The core responsibilities of those that have left have been shifted onto the remaining few who already had full workloads. In fact, Boston EMS is twice as large an opera- tion as it was in 1995, with half the administrative staff. At the Public Health Commis- sion’s budget hearing, the entire Boston City Council stated quite clearly that any reductions at Boston EMS should NOT impact services delivered to city residents. Boston EMS is the best EMS service in the world; a true asset to the city, and the council recognized that. They wanted response times to stay the same, and the number of units on the street to be maintained. So office workers were laid off, and Training Captain, Deputy Super- intendent, Lieutenant, and Paramedic positions were not filled. That wouldn’t hurt the service right.....? Right....?Yes, the nine positions eliminated were not BPPA jobs, and yes, they were administra- tive positions, and not “street EMTs”, but they were people, OUR PEOPLE, who performed necessary tasks at EMS; tasks that are no longer being performed in an already short-staffed department. When you add the nine laid off to the vacated positions created by attrition, a clearer picture begins to form. Boston EMS didn’t get to be the best of the best by accident. It took a lot of hard work by a lot of dedicated people. So in a stunning example of administrative shortsightedness, many of the people who helped make Boston EMS the best service out there were dismissed, and the positions that maintain the level of excellence at EMS remain vacant. To say that Boston EMS has not been hampered by this is foolish. Let’s take a little walk down memory lane, and take a look at what Boston EMS used to be able to do: In the past , Boston EMS tracked CardiacArrest data, examined EKG tracings closely, evaluated the effectiveness of CPR being done, and compiled information not only on how many people survived CardiacArrest, but on how to improve outcomes. The ability to do this has been severely hampered, as there is no one to do it in a timely fashion and any data gathered is of little use, weeks or months later. Does this impact the effectiveness of Boston EMS on the street? I think so. In the past , Boston EMS kept track of the location of everyAuto- matic Defibrillator in the city, and ensured they were inspected, intact, and operational. If someone were to suffer a cardiac arrest, and there was such a device in the building, bystanders could be directed to it and coached in the use of it. That ability is now severely limited due to staffing shortages. Could that cost someone their life someday? I think so. Will that negatively impact the cardiac arrest survival data? Who knows? There’s no one to compile it regularly. That doesn’t hurt the service, right.....? Right......? In the past , Boston EMS took great pains to ensure that new EMTs were highly trained and evaluated, even after graduating from theAcademy, and going to work on the city streets. Personnel accompanied new employees on actual calls, and documented their develop- ment as Boston EMS profes- sionals. These reports used to be reviewed in the Training Department, and any difficulties or shortcomings that were iden- tified were addressed, making the new employee a better EMT. Can’t do that anymore either, as the once five Training Captains has now been reduced to a drastically overloaded two. In the past , Boston EMS had the ability, with its Training De- partment to adequately run academies of recruits, and train them to become Boston EMS EMTs. The ability to do this was helpful, given the statistic that, on average, fourteen employees leave the service ev- ery year for various reasons. If you factor that into the FTE numbers mentioned above, EMS could be in really big trouble staffing-wise in a year or so. Good thing that the Training Department is fully staffed, and up and running. Oh, wait a minute......Never mind. In the past , Boston EMS reviewed ambulance call documentation, looking for ways to improve the effectiveness of our service. EMS was able to spot trends, identify areas where similar illnesses were cropping up, and over time identify locations where illnesses of a specific type were more common, and take steps to alert health officials, and address them. EMS shared this collected data with a variety of agencies and concerns. EMS even shared data on the prevalence of air bag deploy- ment in motor vehicle accidents to some auto makers who were look- ing for clues on how to make their safety systems better. Not anymore. Do you think that hurts the effectiveness of Boston EMS? I do. In the past , Boston EMS EMTs and Paramedics were trained about new trends, and occurrences that were developing in the medi- cal field in a timely fashion, so that crews could wield the new infor- mation out on the streets. When the new ‘designer drug’Molly reared its ugly head in early September 2013, resulting in one death, and several lengthy hospitalizations, Boston EMS learned about the drug not from training, but from a few hand-outs printed off the internet, If you do not replace vacated positions, is that a cut? I think so. In a city where EMS gets busier and busier ever year, the PHC 2014 budget for EMS contains 20 FEWER FTE (Full Time Employees) than 2013. The core responsibilities of those that have left have been shifted onto the remaining few who already had full workloads. In fact, Boston EMS is twice as large an operation as it was in 1995, with half the administrative staff. See Layoffs on page 46