A recent review of the state of Fire and Emergency Medical Services (FEMS) in Washington, DC indicates that the district’s shortage of ambulances and trained paramedics is rapidly becoming a serious public health hazard.
A report conducted by the Associated Press and the International Association of Firefighters (IAFF), released last Friday, reveals that the number of paramedics in DC is far below figures for other cities with comparable call volumes. The two cities whose staff sizes come closest to those of the district (San Antonio, Texas, and Columbus, Ohio) still have two to three times as many paramedics, and some of the other cities mentioned in the report have even more.
Astonishingly, Washington, the nation’s capital, has just 35 paramedics available at any given time, only 14 of whom are assigned to ride along on ambulances. The report compares this number to the 66 paramedics available at any moment in San Antonio, 96 in Columbus, and 166 in Phoenix, Arizona (which are themselves shamefully small numbers).
Washington is supposed to have close to 40 working ambulances available at any given second. Official estimates released by Kenneth B. Ellerbe, the current fire chief of the District of Columbia Fire & EMS Department, and media reports have revealed that the district’s resources clearly fall short of this figure, and that many FEMS vehicles are essentially inoperable or obsolete. Reports indicate that the department has not purchased any new ambulances in four years.
According to one IAFF official, the report reveals that DC has “one of the worst EMS systems in the country when compared to other major metropolitan areas.” Referencing the forced bankruptcy of Detroit, the official explained that the latter city’s EMS capabilities are “in dire straits too, but it has no money. DC doesn’t have that problem, but it seems no one’s trying to fix anything.”
Union figures call for 350 paramedics to be on staff, but FEMS currently only has 217 such workers at present, meaning that the city falls short by about 130 trained employees needed to effectively respond to calls. Many commentators have also pointed out that the department has had a virtual hiring freeze in place for about two and a half years. FEMS has lost more than 40 paramedics since 2011, but only 2 have been hired since then.
Earlier in the year, local news agencies reported on several of the equipment failures plaguing the department. In one incident, an ambulance broke down while en route to the hospital with a patient; in another, a wounded police officer had to wait half an hour before EMTs (emergency medical technicians) arrived to assist him.
Just this month, there have been three more DC ambulance breakdowns. Two vehicles suddenly caught fire due to problems with their air conditioning and coolant systems. Another ran out of fuel while accompanying a presidential motorcade. The motorcade ambulance apparently had a faulty fuel gauge that was ignored by department officials.
Prior to the ambulance fires, FEMS personnel had posted pictures of makeshift repairs to their vehicles on social networking sites, including the use of aluminum street signs inside the engines of four ambulances as temporary cooling systems, or “heat shields.” Other repairs reportedly involved piecing equipment back together with mudflaps, duct tape and fishing line.
For their part, city officials have responded by downplaying the severity of the problems. Deputy Mayor Paul Quander rejected the use of the word “crisis” to describe the situation and flatly dismissed the report, saying, “I’m more interested in how do you fix the issue.”
Immediately after the recent spate of fires, Quander called for an official police investigation to determine whether or not the fires were caused by the sabotage efforts of FEMS employees. When internal affairs reports argued that the fires were probably accidental in nature, city officials were quick to stress the tentative nature of the investigation’s conclusions.
Fire Chief Ellerbe and other departmental heads have stated that FEMS expects to extend its ambulance fleet by 30 vehicles in the coming months, and that job offers have been extended to 25 new paramedics. The new hires will be “single role” paramedics, overturning a longstanding policy of trying to establish an emergency response agency with employees capable of serving as both paramedics and firefighters.
The decision to hire 25 new paramedics is clearly inadequate if estimates that the department requires more than 130 new employees are correct. Ellerbe himself has stated that FEMS has received 125 to 130 job applications in response to its call for more employees.
For its part, the IAFF has stepped in to oppose the limited hiring decision based on the fact that the new hires will not fall under the purview of the union and would presumably be exempt from paying dues. Another group, the DC Ambulance Union, claims single-role paramedics for itself.
Competing interests within the higher echelons of city politics are at play as well.
In the face of these severe shortages, Ellerbe has called for radical changes to workers’ schedules, while refusing city funds allocated to the department. He favors a “redeployment plan” that would replace 24-hour shifts with more frequent 12-hour shifts with quicker turnarounds and less time away from the job.
Ellerbe has also proposed scaling back on available personnel during the “off hours” from 1 a.m. to 7 a.m. Earlier this summer, he attempted to pass a plan that would have left ambulances without a single paramedic during these overnight periods, but it was rejected by the city council. The city, however, did contract several private ambulance companies to cover events at sports venues.
Washington is currently sitting on a budget surplus of approximately $400 million. While official explanations of this surplus center on increased tax revenue from the influx of new residents, the role of austerity policies is obviously critical.
Even as the city continues to grow, Ellerbe and other ruling class politicians are determined to eliminate the basic public services essential to a civilized society.