2017 EMS PRESENTATION. ATCEMS Employee Association

Transcription

1 2017 EMS PRESENTATION ATCEMS Employee Association

2 TOPICS: Experience and Retention Attrition Maintaining Performance Metrics Pay Comparisons Call Volume and Workload Hazards and Risk/Public Safety Pay Parity

3 Training/Education Experiential Learning + Employee Retention Experience Excellence

4 PATH TO EXCELLENCE 0-1 years = Training & Education: academy, field training, clearance to independent duty. 1-5 years = Experiential Learning in the field: high volume patient contact, interaction with peers, exposure to a wide range of events and conditions. 5 years = Attain Proficiency and Experience

5 EXPERIENCE MATTERS Experience is associated with better patient outcomes across a variety of medical conditions. Photo: SXSW 2014 Retention, Learning by Doing, and Performance in Emergency Medical Services Guy David, Tanguy Brachet; Health Serv Res Jun; 44(3): BACKED UP BY NUMEROUS PEER REVIEWED STUDIES: Luft, Hunt, and Maerki 1987; Tu, Austin, and Chan 2001; Birkmeyer et al. 2002, 2003; Halm, Lee, and Chassin 2002; Elixhauser, Steiner, and Fraser 2003; Gandjour, Bannenberg, and Lauterbach 2003; Huckman and Pisano 2006; Marcin et al. 2007

6 EXPERIENCE GAP GETS WIDER Year Average Tenure of Medics Leaving CURRENTLY 45% OF ALL FIELD MEDICS HAVE 5 YEARS TENURE OR LESS % % of medics leaving the department with 5 years tenure or less 75.0% 50.0% 25.0% 47.2% 50.0% 64.7% 77.2% 74.1% 95.2% 0.0% % OF MEDICS LEAVING THE DEPARTMENT IN 2017 HAVE 5 YEARS TENURE OR LESS

7 RETENTION TOTAL % RAISE IN SALARY DURING FIRST 3 AND 10 YEARS DEPARTMENT 3 YEARS 10 YEARS ATCEMS 10.2% 35% APD 23.9% 41.8% AFD 28.7% 41.9%

8 EMS ATTRITION IS EXPENSIVE This is what it costs the City of Austin for every medic ATCEMS loses $106, (2017) Total Cost of Attrition = $6,023, Total Cost of Attrition = $15,477, Source: The Longitudinal Study of Turnover and the Cost of Turnover in Emergency Medical Services (2010). Prehosp Emerg Care Apr 6; 14(2): (Note: adjusting for inflation and differences in MFI) Costs are related to: Advertising and recruitment, Vacancy, Hiring, Orientation and training, New-hire productivity, Pre-turnover productivity, Termination Vacancy costs (e.g., labor and expenses linked to overtime due to understaffed conditions) and new-hire productivity costs (e.g., time required of new new-hire productivity costs (e.g. time required of new hires to reach cut-loose status) contributed the most to overall cost.

9 THERE IS MUCH TALK OF EXCELLENCE Our innovations are world recognized and are models in the EMS industry. ATCEMS Annual Report 2014 * The vision of the Austin-Travis County EMS Department is to be recognized as a national leader. ATCEMS Annual Report Strategic Objective: Be an employer that quality EMS professionals want to join; where they can grow into recognized industry leaders. ATCEMS Strategic Plan 2012 * Note: 2014 is the last annual report published

10 BUT CAN WE MAINTAIN IT? We need to embrace recruiting and educating clinicians who can be decision-makers with a medical education that goes beyond the current pattern recognition-based approach and diverges from the assumption that most patients will be transported while we increase pay, increase autonomy and hopefully increase job satisfaction so that we can stem the hemorrhage of the EMS workforce. Mark Escott, MD; ATCEMS Medical Director Managing the Personnel Crisis in EMS Journal of Emergency Medical Services, July 6, 2017

11 PAY AND RETENTION SOURCES: JEMS Salary Survey 2015; ATCEMS Pay Scale; King County Medic One Pay Scale.

12 HIGHEST PAYING HOURLY 1. Nevada $ Washington $ Maryland $ Alaska $ Delaware $ New York $ Hawaii $ Colorado $ Missouri $ New Jersey $23.79 LOWEST PAYING 1. Oklahoma $ Montana $ West Virginia $ South Dakota $ Kentucky $ Kansas $ Mississippi $ Nebraska $ Wyoming $ Alabama $17.98 Monster.com (2016) EMT/PARAMEDIC WAGES HOURLY WAGE COMPARISON IS UNRELIABLE TOO MANY VARIABLES ATCEMS pay scale EMT/Paramedic average Hourly wage $16.98

13 ANNUAL SALARY A BETTER COMPARISON MEASURE HIGHEST PAYING STATES ANNUAL 1. Washington $65, District of Columbia $57, Alaska $54, Hawaii $49, Connecticut $46, HIGHEST PAYING METRO AREAS Kennewick-Richland, WA $75, Seattle-Bellevue-Everett, WA $74, Tacoma-Lakewood, WA $71, Olympia-Tumwater, WA $70, Anchorage, AK $61, Bellingham, WA $60, Santa Cruz-Watsonville, CA $59, Elgin, IL $58, Bremerton-Silverdale, WA $57, Redding, CA $57, US Bureau of Labor Statistics 2016 TOP PAYING FOR EMT & PARAMEDIC ATCEMS pay scale EMT/Paramedic average annual wage $42,382.71

14 METRO AND MICRO AREAS NATIONWIDE WERE EVALUATED BY AN INDUSTRY ANALYST FOR: Average EMT/paramedic salaries Housing affordability (percent of income spent on rent) Area amenities (including arts, entertainment and recreation) Employment attractiveness (a metric that combines job availability, density and competition) AND THE BEST 100 WERE RANKED #51 Austin-Round Rock, TX #3 Amarillo, TX -- #4 Baton Rouge, LA -- #13 Abilene, TX #37 New Orleans-Metairie, LA -- #42 Dallas-Fort Worth-Arlington, TX

15 POPULATION GROWTH AND WORKLOAD POPULATION WORKLOAD IMPORTANT WHEN COMPARING SYSTEMS ONE OF OUR BUSIEST AMBULANCES RAN 7166 CALLS in 2014 AMBULANCE RESOURCES vs. STAFF VACANCIES Department (2014 data) Average Calls per apparatus / ambulance ATCEMS 3401 Austin Fire Department 1124 Williamson County EMS 1506 Montgomery County 1818 BY 2016 AVERAGE CALL VOLUME HAD INCREASED 18% TO 4000 per AMBULANCE Fort Worth / Medstar 2298

16 ATCEMS REVENUE GENERATION Largest departmental contributor the the General Fund. EMS revenue is about 30% of total other revenue and the largest single contributor. Financial Forecast & Economic Outlook Fiscal Years ; p.45 Returns revenue greater than half their total budget. EMS Annual Budget -- $83,786, EMS Annual Revenue -- $43,533, Approved Budget Volume 1; p.387

17 EMS NET COST DEPT GENERAL FUND % NET COST FTEs EMS 4.2% $40,252, FIRE 18.8% $182,435, ONLY 4.2% OF CITY GENERAL FUND POLICE 39.4% $382,255, HEALTH 6.2% $60,058, HUMAN SERVICES Financial Forecast & Economic Outlook Fiscal Years ; p.46 COA Budget Approved Volume 1 p

18 SMALL SLICE OF THE PIE Financial Forecast & Economic Outlook Fiscal Years ; p.46 COA Budget Approved Volume 1 p

19 COST OF LIVING: HOW AFFORDABLE IS AUSTIN ON AN EMS SALARY?

20 1 in 5 ATCEMS employees work a second job. Austin-American Statesman, investigative report; July 25, 2017

21 COST OF LIVING vs ATCEMS SALARY RANK Medic I (entry level) $38, $38, $39, $39, Medic I (4 years) $42, $42, $43, $43, Low Income for a family of 1* $42, $43, $43, $45, Medic II (entry level) $47, $47, $47, $48, Captain (entry level) $55, $55, $56, $57, Captain (6 years) $59, $59, $60, $61, Low Income for a family of 4* $60, $61, $62, $65, Medic I (17 years) $63, $64, $64, $65, Medic II (11 years) $64, $65, $66, $67, Commander (entry level) $66, $66, $67, $68, Medic I (25 years) $67, $68, $69, $70, Captain (13 years) $72, $73, $73, $75, % MFI for family of 4 $75, $76, $77, $81, Captain (14 years) $77, $78, $79, $80, Medic II (20 years) $79, $80, $80, $82, Commander 11 years) $81, $82, $82, $84, * Represents 80% MFI which is considered "low income" by HUD and COA EMS Data Source: EMS 42 hour pay scale. MFI Data Source: HUD; effective date as of February of each year.

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23 Active Single Family Homes Under $500k

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28 HIGHEST INJURY RATE WITHIN CITY OF AUSTIN A 2013 internal audit by COA found that ATCEMS medics suffered on the job injuries at a higher rate than other city employees AND the industry average.

29 HIGHER FATALITY RATE THAN FIREFIGHTERS Industry Fatality per 100,000 FTEs EMS 7.0 Firefighter 6.1 All Workers 4.0 Fatal and nonfatal injuries among emergency medical technicians & paramedics. Reichard A, Marsh S, Moore P.; Prehosp Emerg Care 2011; 15(4): Also see: Injuries and fatalities among emergency medical technicians and paramedics in the United States. Prehosp Disaster Med Aug; 28(4): doi: /S X

30 In 2016 Austin-Travis County EMS had 108 on the job injuries to medics That s 21% (1 in 5) of its workforce

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32 ATCEMS PROVIDES ON-SITE MEDICAL CARE AT SPECIAL EVENTS ACROSS AUSTIN 2011 = 150 events 2016 = 600+ events EVENTS SUCH AS F-1, SXSW and ACL HAVE TENS OF THOUSANDS OF ATTENDEES

33 The EMS workplace is inherently dangerous.

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