EMS One-Stop

This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

Like many other states across the U.S., California’s ambulance services are both understaffed and underfunded.  In what has turned into a vicious circle, poor reimbursement levels hamper the employer’s ability to increase pay and compete with other sectors that offer better hourly rates for less risky or skilled employment. In fact, California has not had an increase in its Medi-cal (Medicaid) rate in 20 years.

In this podcast, Host Rob Lawrence doesn’t talk about the EMTs on the truck – he talks to the EMTs on the truck.  He gets their views on what keeps them on the job and what is driving them away.  As Rob notes, “In talking to this amazing cohort of EMTs, it is clear that the passion to serve and care for those they treat is there, but the living wage they receive is not!”

Recurring themes emerge from the discussions (which are reflected in various EMS industry surveys):

• Having a good and receptive boss/leader

About the guests

Alyssa Catalan – EMT with Shoreline Ambulance based in Orange County California

Doricela Mozo – EMT with. Medic 1 Ambulance based in Irwindale CA

Tyler Coombes – EMT with PRN Ambulance based on North Hills California

Ryan Walters – EMT with Falck Ambulance based in Orange County

Lasalle Jones – EMT with AmbuServe Ambulance based on Gardena California

Damian Henriquez - EMT with AmbuServe based in Gardena California

Top quotes from this episode

“We do have patients’ lives in our hands, and unfortunately, the pay does not reflect that whatsoever, so a lot of us are working two other jobs, like myself, I work here and I have another job and I have the most overtime than anyone else in the company and I still don’t have enough to pay my bills.” —  Damien Henriquez

“I have to work twice as much as a normal worker would have to to afford to live, and that’s one of the reasons why I’ve amassed about 40,000 work hours, I have a 20-year career but I’ve only been here 14 years.” — Ryan Walters

“One of the great things about EMS – coming to work and not knowing what type of call you are going to get, whether it’s interfacility transport, 911, just never knowing what kind of call am I going to get, sometimes you get really cool calls, sometimes you get calls that are very difficult, but after the call, just knowing that you accomplished it and what it took to accomplish is really rewarding.” — Lasalle Jones 

“Do you realize EMS as a whole is a bubble that’s about ready to pop? Do you want to be proactive or reactive? Do you want to get ahead of it before it bursts or do you want to figure it out after? Right here, right now, we are trying to be proactive so everyone can get a living wage.” — Damien Henriquez

Episode contents

01:25 – Meet the panel

02:56 – The view of the new EMTs

04:55 – Time served EMTs

07:17 – How can we help you make a living?

10:22 – What’s keeps you motivated and on the truck

13:56 – What is the FTO seeing as people come in?

21:40 – If you had a rider down the escalator with an elected official, what would you say to them?

25:54 – Get involved

26:24 – Final thoughts

Additional resources on this topic

California’s Fund First Responders Website

California Ambulance Association

Rate and review the EMS One-Stop podcast

Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at [email protected] to share ideas, suggestions and feedback.

This episode of EMS One-Stop with Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. 

Like many other states across the U.S., California’s ambulance services are both understaffed and underfunded.  In what has turned into a vicious circle, poor reimbursement levels hamper the employers’ ability to increase pay and compete with other sectors that offer better hourly rates for less risky or skilled employment. In fact, California has not had an increase in its Medi-Cal (Medicaid) rate in 20 years.

As part of the ongoing legislative campaign, California’s ambulance service owners and operators have created a coalition with all the labor unions that represent EMS in the state to campaign for increases.

In this episode of EMS One-Stop, both labor and leadership sit down with Rob Lawrence to discuss politics, funding and working as a team.

About our guests

Melissa Harris - president and CEO of Ambuserve Ambulance, Medic1 Ambulance and Shoreline Ambulance; and board member and treasurer of the California Ambulance Association

Shelly Huddleson - national labor representative for the International Association of EMTs and Paramedics

Chad Druten - COO Emergency Ambulance Service based in Brea, California; president of the Los Angeles County Ambulance Association, president of the Ambulance Association of Orange County

Ryan Walters - president of IAEP Local 370 representing EMTs and paramedics working at Falck in Orange County and Los Angeles

Jim Karras - vice president and chief operating officer of Ambuserve Ambulance, Medic1 Ambulance and Shoreline Ambulance; vice president, Los Angeles County Ambulance Association; and secretary of the Ambulance Association of Orange County

Top quotes from this episode

“EMTs are one missed shift away from poverty. This is the industry I love. I’ve seen people leave, people that I wish we could hold on to, but they have to provide for their families.” — Ryan Walters

“Unlike the In and Outs, the Jack in the Boxes, the Del Tacos who can raise their prices to meet the escalating minimum wage and escalating inflationary pressures that they are feeling, we don’t have the ability to do that. Our rates are set for us by the government and by government payers and they are capped and in some cases, they are fixed, so we are beholden to the State of California to help us and give us some relief.” — Jim Karras

“If we don’t do something soon with our Medi-Cal rates, then our EMS system is going to implode, it’s going to implode because our ambulance companies are either going to stop taking these Medi-Cal patients because they can’t afford them and so who is going to take care of them or they are going to start shutting their doors. When they shut their doors, our members lose jobs.” — Shelly Huddleson

“The patient is the one that’s most important here, the medical recipient, they are the ones that stand to lose the most and they are the only reason we exist, they are the only reason any of us have jobs and we can’t lose sight of that, so we are not just advocating for our industry, we are advocating for the citizens of California.” — Chad Druten

Episode contents

0:30 Rob sets the scene

1:00 Meet the guests

2:05 The campaign to increase reimbursement

3:08 EMTs are one missed shift away from poverty

3:45 Management and labor alliance

6:30 How labor and management can work together on political campaigns

9:00 We share a common humanity

11:00 We as an industry are not good at going hat in hand

13:00 The politicians are astonished at what we pay and that we are losing people to fast-food chains

14:00 Medi-Cal is for the patient to have equal access to healthcare

17:00 This is an economic nightmare

18:30 If you were in an elevator with a politician, what would your pitch be?

21:45 Find your champions – those elected officials that will fight for you

23:00 Acting as a coalition

24:40 Ambulance companies with staffing issues

26:10 Workers deserve a long and dignified career

28:30 The patient is at the center

30:00 A call to action

Additional resources on this topic

• California’s Fund First Responders

Rate and review the EMS One-Stop podcast

Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at [email protected] to share ideas, suggestions and feedback.

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

Host Kelly Grayson gets vulnerable on the podcast, as he shares his experiences with PTSD, resiliency and how best to deal with hidden emotions. Asked to be a guest author in a recent anthology on coping with traumatic stress, Kelly's contributed chapter in "But Not Broken" focused on a particular call that caused him to struggle for years and how he worked through it. 

Our co-hosts also explore how the act of writiung or journaling can have therapeutic benefits for first responders who are grappling with traumatic stress, as Kelly shares his tips for dealing with feelings through the written word. 

"Any of us can suffer from PTSD ... and as the saying goes, it's not what's wrong with you, it's what's happened to you," Kelly says.

Have an idea for an episode? Send an email to [email protected].

This episode of EMS One-Stop with Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. 

In the second EMS One-Stop international edition, Host Rob Lawrence welcomes Steinar Olsen, director for emergency medical services and national preparedness in the Norwegian Directorate of Health. Steiner describes the composition and deployment of EMS services across Norway – a country with the second largest coastline in the world and 1,100 miles from North to South (the distance from Seattle to San Diego or Chicago to Miami). Norway has one government/healthcare run system consisting of 400 stations, 520 ambulances, 4,500 EMTs and paramedics, aided by 14 helicopters and 12 fixed wing aircraft.

Educational requirements, current initiatives and future plans are discussed. Lawrence and Steiner also identify that EMS systems around the world encounter similar challenges, and international best practice exchange is always welcomed and encouraged. 

TOP QUOTES FROM THIS EPISODE

“Looking at just response times – you can waste a lot of money that could be used wisely in other parts of the service to create more health.”

“Between 25-30% of calls are handled with just a phone call or a combination of phone and video conference with the patient.”

“EMS in the next 20 years will develop from just lights and sirens to being an advanced platform for performing healthcare in the patients’ home instead of moving them to the hospital.”

EPISODE CONTENTS

1:13: Introduction – Steinar Olsen

2:08: Description of EMS in Norway

4:05: Ambulance stations, helicopters and fixed wing aircraft

6:07: Paramedic training and education

7:17: EMS as a gateway to healthcare

9:38: Norwegian support to international disasters and events (Turkey and Ukraine)

14:00: The next big things for EMS in Norway

16:00: Response times can waste a lot of money

17:35: Hear and treat – Nurse triage

20:00: The need for EMS nations to learn from each other

21:00: The challenge for treating patients in the future

23:34: The relationship between fire and EMS in Norway

24:50 : Vehicle extrication – Norwegian style!

26:15: Steiner Olsen’s final thoughts

27:10: Contact details

ABOUT OUR GUEST

Steinar Olsen is a RN and paramedic with 38 years of clinical and high-level management background from EMS and specialized healthcare services. He now serves as the director for emergency medical services and national preparedness in the Norwegian Directorate of Health. Steinar is also the regional chair of the European Regional Group for EMTs and national focal point to NATO joint Civil Military Health group. His previous experiences include serving in various positions in national healthcare, ranging from field disaster management to hospital management, project management through various national and international projects, including heading Norway’s contribution to Sierra Leone during the Ebola outbreak in 2014/15 and followed by various deployments to international humanitarian and consular crises.

ADDITIONAL RESOURCES ON THIS TOPIC

Patient Quick Release Extrication Paper

Norwegian Telemedicine and Nurse Triage Video (in Norwegian)

CONNECT WITH STEINAR OLSEN

Linkedin  

RATE AND REVIEW THE EMS ONE-STOP PODCAST

Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at [email protected] to share ideas, suggestions and feedback.

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

Inside EMS hosts Chris Cebollero and Kelly Grayson open this week's episode with the news of the death of Paramedic Pete Reed, a former Marine who was recently killed in Ukraine when his ambulance was shelled by Russian forces as he was helping to evacuate civilians out of the city of Bakhmut.

"I have tremendous respect for those who don't have a legal requirement to render aid but give of themselves, and in this case, Pete Reed paid the ultimate sacrifice," says Grayson. 

Our co-hosts also discuss a county in New York that is offering a 10% property tax exemption for volunteer providers and firefighters, as well as the sentencing details for a man who stabbed an on-duty EMS captain. 

"We see a lot of our peers who are getting assaulted and getting hurt on the job. Where is the justice for those people?" asks Chris Cebollero. 

Listen to the latest episode and subscribe to get next week's episode automatically in your feed. 

"Ten years from now, this work that you do still shows up on your work history and what will it say about you as you go forward and you go on to the next phase in your career?" — Chris Cebollero

"That's why we have this podcast. This is something we do to extend our advocacy and our passion for our profession beyond the guy in the other seat in the truck and beyond the classroom. It's a way to leave our mark and leave our profession a little better than we found it by spreading the message and getting advocacy out there to a broader range of people." — Kelly Grayson

This episode of EMS One-Stop with Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. 

In this episode of EMS One-Stop, host Rob Lawrence welcomes Matt Zavadsky back to the podcast to catch up on three key ongoing issues and developments: MedStar’s EMS-on-demand model via their MedStarSaver+PLUS program, the recent article by Zavadsky and Dr. Doug Kupas on the reduction of red lights and sirens with the additional news that MedStar ceased all RLS use during the recent ice-related weather event.  Finally, Zavadsky discusses the recent National Association of Emergency Medical Technicians’ 2022 EMS Worker Engagement Survey and the top five takeaways.

Top quotes from this episode

“One of the mantras we have always said is if someone is going to get paid to reduce our call volume, it should be us.”

“We take an oath to do no further harm, if we know that we are doing something that causes further harm while we are getting to a call that probably doesn’t need an immediate response, then we are not fulfilling our oath.”

“Our medical director has implemented a directive in the same theme of bad weather, bad driving that no patient will be transported with CPR in progress, meaning that you are just not going to transport patients in cardiac arrest … there is no reason for us to relocate corpses from the field to the emergency room.”

“Community expectation ... is it really what the community expects or is it something we have taught them to expect because we are competing for contracts?”

Episode contents

1:52       MedStar Saver Plus Model

11:37    NAEMSP2023 discussion

13:15    Red lights and sirens reduction

15:11    MedStar suspends RLS

19:07    Political navigation to reduce use of RLS with local officials

23:06    We stink at communicating effectively with our workforce

23:45    We stink at providing feedback to our employees about their performance (and their patients)

24:59    We don’t pay our people enough

26:21    California’s Medi-Cal Campaign

29:10    Work-life balance is a real thing

32:13    This is a long-term challenge that needs long-term solutions

34:33    Zavadsky’s final thoughts

34:44    Drs. Larmon, Kazan and Mackey

Additional resources

EMS-on-demand the next big transformation for the profession?

Culture shift: Reducing lights and siren vehicle operation

The EMS workforce: Critical condition!

About our guest

Matt Zavadsky is the chief transformation officer for MedStar Mobile Healthcare, the Public Utility Model EMS system serving Fort Worth, and 14 other cities in Texas. He has 43 years of experience in EMS. He is an at-large director for NAEMT and chairs its EMS Economics Committee.

Connect with Matt Zavadsky

Online

Linkedin

Twitter: @MattZavadsky

Rate and review the EMS One-Stop Podcast

Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at [email protected] to share ideas, suggestions and feedback.

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

This special episode of Inside EMS is a crossover post from FireRescue1's new Better Every Shift Podcast. Hosted by Madison (Wisconsin) Firefighter Aaron Zamzow and FireRescue1 Editor-in-Chief Janelle Foskett, the show brings kitchen table conversations to the airwaves, always focused on solutions, positivity and the realities of station life.  

Follow the show on Apple Podcasts, Spotify, Google Podcasts or wherever you listen to your podcasts. 

This episode of the Better Every Shift podcast is extra super because Zam and Janelle are talking all things Super Bowl with Glendale (Arizona) Captain Ashley Losch, digging into the fire and EMS preparations, training and coordination for this year’s big game. Captain Losch details the many moving parts of “Super Season,” what they’ve learned from the past two Super Bowls the city has hosted, plus how the Damar Hamlin incident prompted additional questions.

Plus, we get into all this:

• The big messaging change for this year

• Hot seat sneak peek: Best Super Bowl halftime shows of all time

• Glendale Fire on Instagram

Email [email protected] to share your feedback, and if you enjoy the show, take a moment to rate and review Better Every Shift on Apple Podcasts. 

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

This week, Inside EMS host Chris Cebollero is joined by Chief Gary Ludwig to discuss killing of Tyre Nichols, which led to the firing of five Memphis police officers and three members of the Memphis Fire Department. Ludwig previously served as the deputy chief of the department for 10 years, running their EMS program.

Chief Ludwig discusses professionalism, how a “normalization of deviance” may account for the lack of concern for bad behavior, and leadership’s role in keeping our workforce safe. The pair round out the episode by discussing whether it’s time for EMS to start wearing body cameras during patient care or at other times during a call.

“The cameras are rolling and people know the cameras are rolling and this is still the behavior.” — Chris Cebollero

“We behave on these cameras inappropriately, and nothing happens to us. You go on the next call, there’s cameras there – body cams, security cameras, Ring doorbells – there’s cameras everywhere. We behave inappropriately and there’s no consequences, even though it was captured on camera, so it becomes normalized.” — Chief Ludwig

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

As the industry waits for more details in the case involving two Illinois EMTs charged with murder in the death of a patient, cohosts Kelly Grayson and Chris Cebollero discuss the lack of compassion show by the providers and the scourge of apathy that plagues EMS. The conversation explores how EMS leaders can help keep industry personnel on a more professional path.

"Members of the workforce will stay for low pay if they are treated well, or good pay if they are not treated well, but they won’t stay for both.” — Kelly Grayson

"We must define our own professionalism, and every call we go on now has the opportunity to become a national news event. It is not 'if' but 'when.'" — Chris Cebollero

• Malpractice or murder: When do EMS providers cross the line from negligence to a crime?

This episode of EMS One-Stop with Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. 

In a recent blog post, Dave Williams, PhD, noted that half to two-thirds of Dallas city general funds are dedicated to police, fire and EMS. With significant tax dollar investments, elected officials, community leaders, and the media want to be good stewards. Still, they are frequently not equipped with the knowledge or data to determine if their services are built to get results and where there are opportunities for improvement.

In this week’s podcast, host Rob Lawrence sat down with EMS thought leader, Dr. Dave Williams, to discuss and identify the 12 questions local leaders can use to learn about their communities. Each point discussed should generate ideas for more learning and improvement both inside an organization and for those citizens and elected officials that surround it.

Top quotes from this episode

“I have been to dozens of ambulance systems around the world and met with leaderships teams and I can count on one hand the number of times they started by talking to me about their clinical outcomes.”

“Almost all of your staff are not your generation … which means they have a totally different value system and a totally different prioritization of things.”

“One of your real powers is to be able to help your community and its leaders understand what’s happening in it. The data that you have is a huge enabler for others to be able to change policy.”

Additional resources on this topic

• Williams’ Blog

About our guest

Dave Williams, PHD, designs and improves ambulance systems. He is known for leading objective, ethical and collegial approaches focused on patient and community needs, and incorporating evidence-based and best practice methods. He is one of a few researchers to study EMS system design. His published doctoral research focused on patient-centric EMS system design.

Dr. Williams is a former paramedic, EMS commander and researcher. Previous leadership positions include the Institute for Healthcare Improvement, Fitch & Associates, and Austin-Travis County EMS.

Dr. Williams is faculty at the Institute for Healthcare Improvement and serves as a senior improvement advisor. He served as faculty in emergency health services at The George Washington University School of Medicine and public safety management at St. Edward’s University. He supported professional development programs, including the National Association of EMS Physicians Quality and Safety program, the American Ambulance Association Ambulance Service Manager Program, and the National Academies of Emergency Dispatch Communication Center Manager Program.

Dr. Williams served as the vice chairman of the Board of CommUnityCare, the Federally Qualified Health Center system serving the City of Austin, Texas, and was appointed by the Travis County Commissioners Court to serve as a member of the Advisory Board of Austin/Travis County EMS. He is an alumni of Leadership Austin (Essential 2013).

He has contributed to several EMS leadership and research textbooks and published dozens of peer-reviewed papers and industry articles. He is a frequent keynote speaker.

Dr. Williams earned a B.S. in EMS Management and an M.S. in Emergency Health Services Management. He also earned a Ph.D. in Organizational Systems, where his research focused on the obstacles to patient-centric EMS system design.

Connect with Dave Williams

Online

Twitter @davewilliamsATX

Rate and review the EMS One-Stop podcast

Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at [email protected] to share ideas, suggestions and feedback.

Listen on Apple Podcasts, Amazon Music, Spotify and RSS feed.