AUSTIN (KXAN) — When seconds matter and lives are at stake, the ongoing Austin-Travis County EMS staffing “crisis” forced some communities to go underserved during the busy Labor Day weekend in order to staff UT football and an electronic dance music festival at COTA.

“Some of those ambulances shifted to cover those special events, and that’s really unfortunate,” Selena Xie, the Austin EMS Association union president, said. “But, that’s where we are because we have not been keeping up with pay.”

At least two ambulances were moved from their normal district to cover the events — on top of five other ambulances, out of 47, not being used because there was nobody to staff them, according to Xie and a concerned EMS employee who alerted KXAN.

ATCEMS admits it had to “take multiple units out of service” this weekend in order to meet “contractual obligations” to cover those “large special events.” It says decisions were made in a strategic way and response times were not affected.

“[O]ur department selects which units to ‘take down,’ or move around, based on multiple factors,” ATCEMS said in a statement. “Both historical call volume and anticipated call volume are analyzed, and the decision…is based on what will impact the overall system the least.”

ATCEMS said it’s in a “staffing crisis” with 157 unfilled positions, out of 665, and a 23.6% vacancy rate. Xie said the agency lost a record 60 medics this year and is hemorrhaging more.

“Our medics are still leaving,” she said, recounting a conversation with one who is leaving for Austin police due to pay. “They’re actively looking for other jobs.”

Starting salary at ATCEMS is $22 an hour, she said.

To prevent exhaustion among current staff, in recent months, operations shifted away from calling in employees to work unexpected, mandatory overtime shifts. Instead, ambulances are left empty, Xie said.

This holiday weekend — traditionally one of the busiest of the year for EMS, she said — saw several major wrecks, including a deadly one on Spicewood Springs Road.

“The workload on each ambulance is much higher, and response times are longer,” Xie said. “But, that’s where we are right now because staffing is so bad.”

Last week, the city signed a one-year labor contract with ATCEMS. Austin City Manager Spencer Cronk said the short-term agreement will increase starting pay for EMTs and paramedics, and it will allow the city to “aggressively focus on recruitment and retention” for, what he acknowledges, is a “serious staffing shortage” facing the city.

In a lengthy statement, ATCEMS says what happened this weekend is “the exception, not the rule” and blamed, among other things, pre-scheduled vacation time resulting in twice the amount of vacancies this past weekend.

ATC EMS Response

Nobody from ATCEMS was available for an on-camera interview Monday. Instead, the agency sent KXAN a lengthy statement, which is published below in full:

“As far as this weekend is concerned:

  • Yes, we did have to take multiple units out of service, and on Saturday several were moved around to provide service for special events (COTA and UT Football). ATCEMS has contractual obligations to provide coverage for large special events, and we have a specific staffing plan for those cases. 
  • Typically, special events are staffed by medics who pick up those shifts as voluntary overtime, as well as personnel who are assigned to the special events division. If those vacancies are not filled, we have the ability to use available on call personnel as needed, but the priority is staffing system units. In the case that we don’t have volunteers, or the on call personnel needed to fill special events vacancies, then system units are brought in as a last resort. Those units are specifically chosen to have the least impact on the overall system (for example, using units with low daily call volume).
  • In both cases (taking units out of service and using system units to staff events), our department selects which units to either “take down,” or move around, based on multiple factors. Both historical call volume and anticipated call volume are analyzed, and the decision on which units to take down or move, is made based on what will impact the overall system the least. This could include units that have a low daily call volume, or units that are positioned in an area with overlapping coverage by multiple other units. All of this is done in a strategic way, so that response times are NOT affected. When either of these things happen, our leadership is constantly monitoring the system, and making adjustments in real time, to maintain safe and equitable coverage across the city.
  • In addition to that, our commanders and shift chiefs were taking on lower priority calls (many which don’t require transport by ambulance, or can be dispositioned with outside resources, like mental health support or via telemedicine visits with our physicians). This was done in an effort to keep ambulances available for higher priority calls. Overall, our personnel and our system worked very well to ensure there was no impact to our service to the community.
  • We’ve also recently changed the way we triage and dispatch all 911 calls, in order to ensure we’re sending the most appropriate resource to each incident, as well as ensure our response time goals for high priority calls are upheld. We have 5 priority levels in our dispatch system, 1 being the highest, and 5 being the lowest. Over the weekend, no high priority calls (priority 1s & 2s) were affected by the changes we made to the system.
  • Our department leadership is well aware of the staffing issues we’re experiencing, but they are also committed to maintaining a healthy work/ life balance for our personnel. In past years, we’ve utilized personnel using an unscheduled, mandatory overtime list (called the accumulative list) that allowed us to call in personnel who were not scheduled to be on call, based on system needs. We also assigned all personnel to a secondary on call list, meaning in addition to their normal schedules, medics were required to be on call twice a month, instead of once a month like it is now.
  • In an effort to eliminate a secondary on call shift, as well as unscheduled mandatory overtime, the department elected to get rid of both the secondary on call list, and the accumulative list. The result of this is that if vacancies remain once we exhaust our regular on call list, we put units out of service, instead of calling in personnel for mandatory overtime on their days off. While this occasionally results in taking units out of service, ultimately it is far better for our personnel.
  • What happened this weekend is certainly the exception, not the rule. Other major impacts on staffing were unscheduled sick call, and prescheduled vacation. We recently completed a new “shift bid,” meaning our medics all chose new schedules and stations. In previous years, vacation time that was scheduled prior to someone’s new shift, was cancelled if that person moved to a different shift. 
  • This time, the department elected to honor those vacation shifts, which resulted in twice the amount of vacancies this weekend that needed to be covered. If the department had not honored those prescheduled vacation days, we would not have had the issues we did this weekend. But again, this was done for the benefit of our employees, so as not to disrupt their lives outside of work.
  • It’s not a secret that we’re in a staffing crisis. Currently our vacancy rate is 23.6%, with almost half of those vacancies being at the Field Clinical Specialist level. We have 665 authorized sworn positions, with 157 vacancies. We have been, and are still, actively changing our recruiting and hiring practices, to increase the number of people we hire, as well as retain current medics by ensuring they maintain a healthy work/ life balance.
  • Previously, the Field Clinical Specialist position was one that required a promotional process, meaning we could not hire directly in to that position, even if a candidate had the required certifications. Everyone was hired at the same entry level position (medic), then once medics finished their academy and field training requirements (typically this takes 6-9 months), they were able to participate in the Field CS promotion process.
  • We are in the midst of implementing a process that gives us the ability to hire directly into the Field CS position. This should see our application rates increase, because certified paramedics are able to come in and immediately start practicing at the paramedic level, as opposed to having to wait for a promotional process. 
  • We have a new cadet academy starting in several weeks, and we’re currently hiring four academies that are scheduled next year.”