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Understaffing of Baltimore paramedics leads to long hours, overtime spike

Chronic understaffing of Baltimore paramedics led to a massive spike in overtime pay — with some paramedics working more than 2,000 hours of overtime last year and earning more than six figures, city officials acknowledge.

That has led city leaders to question whether it's wise for paramedics to work so many hours in an already taxing job, and whether taxpayers are best served through such liberal use of overtime.

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Two dozen Baltimore paramedics made a combined $1.9 million in overtime last year, according to statistics from the Fire Department, which includes paramedics. Some doubled their salaries and ended up making more than Fire Chief Niles Ford and even Mayor Stephanie Rawlings-Blake.

"It doesn't sound good when you have some individuals making more than the council president is making," said City Councilman Warren Branch, chairman of the council's public safety committee.

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"We most definitely need to hire more paramedics," Branch said. "I don't think there's a jurisdiction in the state that has the emergency response needs we have."

Nearly one-fifth of the city's 232 paramedic jobs were unfilled in 2014, so a small pool of paramedics volunteered to pick up the shifts needed to cover more than 160,000 medical emergency calls.

Baltimore's paramedic units have been understaffed for years, said Rick Hoffman, president of the firefighters union. But the problem gained urgency last year, when a new contract for Baltimore's 1,250 firefighters meant fewer were available to fill in for paramedics because of scheduling changes and a requirement that firefighters work more hours each week.

Firefighters with medical training previously covered up to 40 percent of paramedic shifts, Hoffman said.

Citing concerns over safety and burnout, Baltimore leaders are calling on the Fire Department to make quick hires. The fire chief also has ordered limits on so-called shift swapping — when paramedics decide among themselves to trade work shifts — to drive down overtime costs.

One paramedic, Rhonda Johnson, made about $120,000 in overtime on top of her $76,000 salary for a total of $197,0000 last year. Another, Ronnie Atkinson Jr., bumped his pay from $70,000 to a total of $188,000 with overtime. A third, Duvalle Johnson, earned increased pay of about $120,000 for a total of $186,000. They were the most highly paid.

Two of those paramedics could not be reached for comment. Duvalle Johnson declined to comment, citing departmental rules against talking to the media.

Rawlings-Blake makes $163,000 a year, and Ford makes $165,000. City Council President Bernard C. "Jack" Young makes $108,000.

Hoffman said paramedic ranks have "never been staffed at an adequate level" and that those volunteering to work overtime are doing a public service. He said the system is the "busiest, most overworked" in the country.

"God bless 'em," Hoffman said. "Some people saw an opportunity and said, 'I'll work as much as I can.' We need them on the street. They're not doing anything wrong. They're doing a hell of a public service for the community.

"If you keep up the rate they're going much longer, you're going to have a lot of burnout," Hoffman added. "I don't think a person could keep up that rate they're going longer than a year."

City Councilwoman Sharon Green Middleton agreed that the workload sounds intense. City records show that seven paramedics worked more than 2,000 hours of overtime last year, while 15 worked more than 1,000 hours of overtime.

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"They are working extreme hours," Middleton said. "A person can only work so much physically and mentally. They are our first responders. They should be at the top of the list when trying to fill positions."

Baltimore's high volume of emergency calls to 911 is well-known, and 80 percent of those are for medical services, officials say. The city's John F. Steadman fire station, located at the base of downtown's Bromo Seltzer Arts Tower, has been named the nation's busiest station by Firehouse Magazine.

City Councilman Brandon Scott said he's not concerned about the high pay for paramedics. He's concerned that some Baltimore residents treat 911 like a taxi service to the hospital.

"We all know we need more paramedics," he said. "But there has to be an ongoing effort to educate folks about what should and shouldn't be a 911 call. We have to get away from that."

In January 2014, the Fire Department implemented a new schedule that required firefighters to work 47.5 hours a week — up from 42 — in exchange for a 16.5 percent pay raise. The agreement was promoted as a way for the city save the city about $72 million over nine years, in part because it would cut down on overtime for firefighters.

Under the agreement, paramedics, whose shifts are typically busier, were not required to work longer hours. They got a 6 percent pay raise.

Immediately after the schedule took effect, overtime for firefighters fell drastically — from $500,000 over the last two weeks in December 2013 to $85,000 over the first two weeks in January 2014.

Over the same time, overtime for paramedics rose from $131,000 to $239,000. Paramedic overtime continued to climb until hitting a peak of $500,000 over two weeks in September during the Star-Spangled Spectacular festival in downtown Baltimore.

The net effect is that the department's total overtime is down, but overtime for the small pool of paramedics is up significantly.

Ford said the issue was compounded by paramedics leaving the department.

"We know we're going to have overtime because of vacancies," he said. "It's because staffing went down. But we have to take very good care of our overtime."

In December, Ford ordered commanders not to allow any shift swaps among paramedics that could result in overtime. The agency also has moved to hire 25 recruits to work paramedic shifts. The changes have begun to push overtime costs back down. During a pay period last month, paramedics earned $286,000 in overtime — the smallest amount over a two-week period in a year.

"Anytime we see something that's a possibility for abuse, we try to close it," Ford said. "We've put things in place to drive down overtime and swapping."

But he added that shift swapping "is not a bad thing" and that commanders would continue to approve swaps that don't drive up overtime costs. He said Fire Department employees sometimes swap shifts to attend higher education classes or family functions.

"The swaps are important," Ford said. "I have people who are trying to better themselves."

Rawlings-Blake said she's proud of Ford's efforts to manage overtime among paramedics.

"So far, the chief's efforts have cut overtime spending by 27 percent, and together we will continue to ensure that taxpayer funds are spent as efficiently as possible," she said.

She added that the city has made it a "priority" to hire more paramedics.

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