E M S P A C
EMERGENCY MEDICAL SERVICE PUBLIC ADVOCACY COUNCIL
1. Why is EMS Different?
EMS is the only First Responder Service that by direct action prolongs human life, expedites extrication from trauma and extends the ER into the streets and homes of America.
EMS is exposed to high levels of risk at working fires and active crime scenes alongside PD and Fire Suppression. Our members are exposed to assault and chaos from suddenly uncontrollable scenes.
EMS is a community health resource doing wellness checks, advising on appropriate medical resources and increasingly engaged in Community Paramedicine, something incredibly fiscally important to the Hospital Systems. Because if patients are readmitted a month after discharge, the hospitals cannot bill.
2. Why do EMS members deserve more?
Outside a highly moral and just argument that EMS members contribute highly to health outcome and public safety, EMS is also a multimillion dollar business.
The majority of EMS 911 and Inter-Facility Transports (IFT) in 48 States is carried out by enormous private commercial ambulance companies such as American Medical Response (AMR).
EMS is highly lucrative. Ambulance calls are billed from $300 for a basic life support IFT to dialysis; to $724 + $60 for Oxygen + $10 a mile for BLS 911 and between $1,200 to $2,000 for ALS 911 or above $10,000 for a Critical Care flight transport.
EMS members have been paid minimum wages for far too long. Regardless of Sector EMS needs to be compensated for both its moral and monetary worth.
3. What are the differences between a Trade Union, a Public Advocacy Council and Political Action Committee?
A Union is the legal collective bargaining organization for a body of workers. The only legal representative a garage or agency has to redress grievances with their employer and the only entity able to establish employer to employee benefits in a periodically re-negotiated Collective Bargaining Agreement. There are currently seven separate unions representing about half of the NYC area workforce.
A Public Advocacy Council such as EMSPAC focuses on EMS member engagement regardless of sector. It strategizes relationships and messaging with the media. It negotiates inter-union action and forges relationships with politicians, the private sector, and civil society groups.
A Political Action Committee is a fund created by an alliance of unions and allies that is used for direct political lobbying in the policy realm and the contribution to political campaigns.
4. What is EMSPAC?
EMSPAC is a public advocacy organization led by active duty EMS members and allied civilian professionals who hope to advance wages, secure benefits, and increase public understanding and appreciation of the EMS Service. We lobby for tangible goals in the realm of collective bargaining to be achieved by both union to management negotiations as well as laws which protect EMS workers on the job.
5. Who funds EMSPAC?
EMSPAC is an ALL volunteer, ALL member supported mutual aid network led by active duty EMS members. It does not accept financial contributions from any of the labor or management stakeholders it is engaged with.
6. How many EMTs, Paramedics, Supervisors, and Officers are there in the Greater New York Area?
We say 13,500 but it is an estimation.
That number is a little hard to pin down with many members working 2-3 jobs, some working 2 full-time jobs at separate garages. We know that FDNY EMS has 5,000 and they manage 2/3 of the annual 1.5 million 911 calls. We know 1199SEU represents 1,200 members and New York Presbyterian EMS has 400. We know that Private Commercial EMS has several hundred members working at hospitals in the 911 system so you can place that number as 2,000. We know that the thirteen Private IFT garages table up to nearly 5,500. We know Hatzallah alone has 1,200 members and there are 46 other VACs in the area.
From that we estimate FDNY 5,000 + Voluntary Hospital including Private contract EMS to hospitals 2,000 + 5,000 Transport staff in the Privates + 1,500 Volunteers is around the total even adjusting for overlap. Thus the total number of EMTs and Paramedics is 13,500.
7. Why do so many people leave the field of EMS?
70% of the FDNY EMS has less than 4 years on the job. 4 years is also the average time its members stay. Most people use EMS as a stepping stone into another career and that is because the pay is low and the benefits are unevenly spread out. There is a high level of disregard and contempt shown to EMS by Fire Suppression and nursing. There are very real stresses of being around constantly sick, dying, and maimed people. The job is hard on the back, body, and mind.
There is total lack of respect or appreciation from owners, officers, and managers besides the yearly EMS Week BBQ or some liquor drenched holiday party. The job is surrounded by stigma and negative energy. The public often doesn’t care if we live or die. Public figures like Mayor Bill de Blasio openly belittle our field. The hours are long, the mandations are constant, you lose your civilian friends and miss holidays, birthdays, weddings. The time off is pathetic and quite often we are our own greatest enemy; we simply treat each other like shit with a sort of garage-based tribalism.
8. Which EMS Sector’s progress should come first?
EMSPAC fights for ALL EMTs, Paramedics and EMS Officers/Supervisors regardless of Sector. The FDNY EMS has specific needs and grievance as do Privates and Voluntary Hospital members. FDNY EMS has the most job security with low wages. Voluntary EMS has higher wages and benefits with less security. The Private sector has poor wages and poor benefits.
As their funding mechanisms are different, each union representative of the majority of these sectors has set priorities to its upcoming bargaining. EMSPAC argues that everyone should endorse the same high level demands articulated in the BCBO 2020, but autonomously pursue its sector priorities.
FDNY EMS should have direct parity with Fire Suppression, Voluntary EMS should have greater security and ability to transition to ER roles, and Private EMS needs to be advanced across the board.
Since no sector commands the numbers needed to form a Political Action Committee with enough fiscal and voting leverage, all 7 Unions and outside allies are needed to participate.
9. Aren’t the Basic Collective Bargaining Objectives (BCBO) unreasonable?
The BCBO 2020 represents nearly verbatim benefits and wage structures of the other First Responder and essentially health worker trades. Specifically those of fire suppression, law enforcement and nursing.
An EMS is a uniformed First Responder medical profession; we see it natural to emulate demands in directly comparable professions.
As it is the unions not the EMSPAC sitting with the management we make recommendations that have to be tempered by reality-based funding considerations. We aim to set the bar higher with BCBO 2020 but these are goals formulated around what firefighters and nurses have had for quite some time.
10. How does EMSPAC perceive these salary and benefits will get funded?
We think this question has to be segmented by sector. In the case of FDNY EMS this is an appeal to a reality where 95% of all fire suppression calls are to show up briefly on EMS runs and a large portion of the daily 4,000 EMS calls are billed to insurance companies. The EMS Bureau simply deserves more of a budget.
In the case of Voluntary EMS this means a larger portion of the bill from admitted patients needs to be invested back in the EMS Department.
In the case of the Privates, a larger share of Medicare and Medicaid needs to reimburse calls and more profits need to go back into payroll.
Because three different mechanisms fund these sectors we cannot expect across the industry adoption of BCBO goals uniformly.
11. Is government intervention via EMS Legislation contrary to market forces and Health Care realities in the United States?
Everyone will claim that it is.
However the US has one of the most bloated, inefficient health systems on Earth. It is driven by profiteering and medical apartheid for the rich and poor.
A state and national EMS Advancement Law would set minimum wages and standard protections below the bar of the BCBO but certainly improve reality for the work force.
Couples alongside EMS Advancement Legislation will also have to be reimbursement reforms that the private sector has long argues for. But Private Sector and Hospital System profits need to invest back in EMS.
12. Is a “20 and Out,” 3/4 Final Year Salary realistic in this economy?
This benefit is already held by police (22 years), Firefighters (20 years), and Sanitations Workers (20 years). This benefit is appropriate for all high physicality, dangerous frontline essential fields and EMS needs to gain it.
Many studies suggest a mental and physical toll EMS work takes on its members with high rates of line of duty injury as well as burnout and suicide.
We propose a state-administered, pay in Pension for a full-time career EMS that carries between agencies. Structuring this appropriately for each sector is to be a negotiation by labor unions but this BCBO Goal is one of the most important.
13. What about Community Volunteer Ambulance Corps? What stake do they really even have in this?
As an unpaid service, volunteer agencies still rely on grants and state funding VACs are still regulated by EMS protocols and are operational assets of the FDNY in states of emergency and natural disaster.
While VAC members are not paid or have benefits we all perform the same functions in the field. As a result we encourage VAC participation in the EMSPAC alliance to leverage common numbers and needs.
VAC groups are some of the most dedicated EMS and their service should be recognized. The 48 NYC agencies take thousands of calls off the system.
14. If I support EMSPAC will my job be vulnerable?
In EMS regardless of Sector the ideology of out-of-sight, out-of-mind took hold many years ago and got us where we are today.
No manager of any sector can encourage or allow politics on the job. We discourage activists from handing out any printed materials at work or discussing EMSPAC in units with live recording cameras.
You can be fired or jammed up for hundreds of small and big things in EMS. Constitutionally you have protected rights to free speech and association. We discourage EMSPAC activism on the job. You will get jammed up.
If you feel like you are being targeted or discriminated against for your involvement contact your union and out legal affairs unit immediately.
Just remember that no other service got one raise, benefit or protection they didn’t fight for.