Ambulance Authority struggling to keep up with calls

Jeremy M. Lazarus | 6/17/2021, 6 p.m.
The Richmond Ambulance Authority has long boasted of being a role model in emergency response.
The Richmond Ambulance Authority operates a fleet of ambulances out of its headquarters at 2400 Hermitage Road in North Side. Photo by Regina H. Boone

The Richmond Ambulance Authority has long boasted of being a role model in emergency response. The idea that a city-based ambulance—lights flashing and sirens blasting—would quickly race to the scene of an accident, a fire, a shooting, a heart attack or other life-threatening situation has become a common expectation.

But like other elements of Richmond’s public safety apparatus, the 30-year-old authority is now struggling to field enough staff to respond in a timely fashion to emergency and non-emergency calls.

That became evident Saturday afternoon when it took about 60 minutes for RAA to send an ambulance to pick up a pregnant woman who was injured in a collision at Bells Road and Richmond Highway.

She had her three young children with her when her car was struck, authorities reported.

According to confirmed reports, Latanya Thompson lay on the ground while firefighters who had responded quickly treated her. She gave birth prematurely on Tuesday, 22 days before her due date, although from another cause other than the stress of the situation.

At the time, eight ambulances were on the road, RAA reported, and all were occupied handling emergencies or the transport of patients to a hospital.

Based on predicted demand, RAA acknowledged that 12 to 16 fully equipped ambulances should have been providing coverage.

But that is no longer possible.

“Recently, on average, our Advanced Life Support ambulances have been 56 percent staffed during the day and 58 percent during the night compared to what our staffing calls for to more than meet demand,” RAA spokesman Mark Tenia said.

Mr. Tenia said staffing is now a major challenge, resulting in lagging response times on emergency calls and long delays on calls that RAA deems non-life threatening.

“RAA has held itself to a high standard, and for the first time since becoming a self-operating agency, RAA is facing unprecedented challenges in meeting that standard,” Mr. Tenia acknowledged.

Ironically, RAA was organized in 1991 to end a failing ambulance system that relied on private companies that had a reputation for slow responses.

RAA is now telling City Hall that “we are nearing a breaking point,” Mr. Tenia said. “Our system is set up to be effective and cost-efficient, but both our effectiveness and efficiency are starting to suffer” as staffing declines and response goals become impossible to meet.

He said for the past three years, RAA has been losing people more quickly than their replacements can be trained. In the first six months of this year, RAA hired 14 people but lost 30, he said. In 2020, RAA hired 50 new field employees, but lost 71.

The result: The shrunken staff of emergency workers “is responding to more calls and experiencing a heavier workload,” Mr. Tenia said, while having to wear more protective gear in response to the pandemic.

RAA is not alone in struggling with personnel shortfalls, although it has managed mostly to avoid the spotlight and the interest of 8th District City Councilwoman Reva M. Trammell or the council’s Public Safety Committee she chairs.

Most attention from the committee has focused on shortfalls in the Richmond Police and Fire departments, which have gone to mandatory overtime to fill staffing gaps as personnel leave faster than their replacements can be trained.

Police officers and firefighters unsuccessfully lobbied City Council for an overhaul of their pay scale to try and stem the losses. While Ms. Trammell spoke for them, a majority of the council, instead, opted at the prompting of Mayor Levar M. Stoney’s administration for a study of the proposed pay plan created by police and fire’s rank-and-file.

One reason for the council’s decision to slow-walk this issue was cost: The proposed plan that officers and firefighters advanced could collectively boost the two departments’ payroll costs $12 million a year.

Richmond Sheriff Antionette V. Irving also is struggling to find enough deputies. During her successful campaign for the Democratic nomination for re-election, she confirmed she had 110 vacancies among deputies working at the Richmond City Justice Center. She also has had to use mandatory overtime to try to keep minimal coverage of the jail. Deputies who work at the jail and others who quit said up to 15 pods or cellblocks often go unmonitored at night because of the staff shortages.

The causes for the shortfalls appear to vary by agency, with the rank-and-file often blaming the management styles of supervisors.

But across the board, pay for city public safety positions trail neighboring localities and private companies. The city’s trained and sworn personnel often work extra jobs or jump ship to a neighboring jurisdiction to improve their income.

Mr. Tenia said that pay is a significant RAA issue.

“It has been very difficult for RAA to remain competitive in the job market,” he said. He said emergency medical services like RAA have been impacted by a reluctance of people to apply for this kind of work during a pandemic.

In addition, “fewer students have been enrolling and completing classes to be certified as an emergency medical technician, or EMT,” which reduces the pool of people to draw from, Mr. Tenia said.

Increased incentives and improved pay would help, he said.

He said currently, new EMTs start at $35,828 to $36,902 per year. Those with more advanced certification and experience start around $38,000 a year. Paramedics, who have the most medical training, start at nearly $47,000. That is based on a 48-hour work week, or four days at 12 hours a shift.

Mr. Tenia said RAA is working on a plan to boost pay by reducing the work week to 42 hours, while keeping pay rates the same.

RAA currently has 126 emergency employees, with 73 being full time and 53 part time, he said. While he could not provide a comparison with full staffing, others have told the Free Press that RAA could use at least 70 more people.

As was the case with other public safety agencies, RAA got shot down when it sought $6.9 million in subsidy from the city for the 2021-22 fiscal year that will begin July 1, or a $1.9 million increase from the current fiscal year’s $5 million.

“The request was made in order to offset market changes, keep costs low for our patients and provide increases in employee pay to attract new people and retain current staff,” Mr. Tenia said. Instead, the council approved the mayor’s proposed $1 million cut in the city’s subsidy, reducing the RAA’s ability to reduce hours.