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Southern California has a paramedic shortage. What’s being done about it?

April 2, 2023

An ambulance’s flashing lights are a welcome sight in a medical emergency.

But a different light — a warning one — has been flashing in Southern California, which like the rest of the nation is struggling with a shortage of paramedics and emergency medical technicians that’s had a ripple effect on public safety and patient care.

The shortage delays how long it takes an ambulance to get to a scene, and sometimes, ambulances arrive with no paramedic, Riverside County Supervisor Kevin Jeffries wrote in a newsletter to constituents.

When that happens, a fire engine paramedic rides with the patient to the hospital, taking that fire engine out of service until the paramedic gets back, Jeffries added.

Chaffey College Fire Technology-EMS instructor James Sloan, left, teaches emergency medical services students at Chaffey College’s Fontana campus Thursday, March 30, 2023. (Photo by Terry Pierson, The Press-Enterprise/SCNG)

Chaffey College emergency medical services students test one another for dehydration as they learn how to treat pediatric patients at Chaffey College’s Fontana campus Thursday, March 30, 2023. (Photo by Terry Pierson, The Press-Enterprise/SCNG)

Chaffey College Fire Technology-EMS Instructor James Sloan, second from right, shows emergency medical services students how to use Broselow Pediatric Emergency Tape to treat children during a class at Chaffey College’s Fontana campus Thursday, March 30, 2023. (Photo by Terry Pierson, The Press-Enterprise/SCNG)

Chaffey College Fire Technology-EMS Instructor James Sloan teaches an emergency medical services class at Chaffey College’s Fontana campus Thursday, March 30, 2023. (Photo by Terry Pierson, The Press-Enterprise/SCNG)

Chaffey College Fire Technology-EMS Instructor James Sloan teaches emergency medical services students to use Broselow Pediatric Emergency Tape to treat pediatric children in a class at Chaffey College’s Fontana campus Thursday, March 30, 2023. (Photo by Terry Pierson, The Press-Enterprise/SCNG)

Emergency medical services student John Cardoza studies a Broselow Pediatric Emergency Tape in class at Chaffey College’s Fontana campus Thursday, March 30, 2023. (Photo by Terry Pierson, The Press-Enterprise/SCNG)

Emergency medical services students, from left, Robert Tinoco, John Cardoza and Michael Quintero use Broselow Pediatric Emergency Tape in a class at Chaffey College’s Fontana campus Thursday, March 30, 2023. (Photo by Terry Pierson, The Press-Enterprise/SCNG)

Emergency medical services students, from left, Joaquin Tomilloso, Robert Tinco, John Cardoza and Michael Quintero, use Broselow Pediatric Emergency Tape in a class at Chaffey College’s Fontana campus Thursday, March 30, 2023. Southern California counties have been dealing with a shortage of paramedics and EMTs blamed in part on a disruption in paramedic/EMT classes due to the COVID-19 pandemic. (Photo by Terry Pierson, The Press-Enterprise/SCNG)

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American Medical Response, Riverside County’s emergency medical transport provider — which also is active in Los Angeles and San Bernardino counties — cited the paramedic/EMT shortage in a discussion of why it failed to meet response time benchmarks.

That failure led Riverside County officials this month to deny a one-year extension of AMR’s contract, which runs through mid-2026.

Besides Riverside County, Los Angeles, Orange and San Bernardino counties reported dealing with a shortage of paramedics and EMTs, who offer emergency care but have less advanced training than paramedics.

“We do have a shortage of both EMTs and paramedics,” Orange County EMS Medical Director Carl Shultz said via email. “We really don’t have much input into this situation, as there is not much we can do to expedite a remedy of the situation.”

In an emailed statement, LA County’s Department of Health Services acknowledged the shortage, but said it is “actively recruiting highly talented paramedics and EMTs to serve our county through incentives such as competitive benefits package and commitment to career development.”

Tracey Martinez, a spokesperson for the San Bernardino County Fire Protection District, said via email that the district has “thought outside of the box with creative solutions such as adjusting deployment models and hiring EMTs, and then sending them to paramedic school.”

“The shortage was much more prevalent at the end of 2021 and early 2022,” Martinez wrote. “With our adjustments to our business practices, we have minimized the effects it has had on our fire district.”

Nationwide, the turnover rate for paramedics in 2021 was 27% while the rate for EMTs, who have less advanced training than paramedics, was 36%, the American Ambulance Association reported.

The turnover rate increased in 2022, “meaning that EMS agencies are experiencing a full turnover of all staff every 3 (to) 4 years,” the association reported.

“Greater than one third of all new hires (leave) within their first year of employment. Not surprisingly, this converted into a relatively high rate of currently open positions, especially for EMTs and paramedics at EMS agencies around the country.”

Like shortages of nurses and other healthcare providers, the paramedic/EMT shortage has its roots in the COVID-19 pandemic, which put paramedics and EMTs in routine contact with COVID-infected people before vaccines were available.

The pandemic led many in the field to reconsider their career choices, AMR Director of Regional Operations Jeremey Shumaker said in an emailed statement.

Citing federal Bureau of Labor Statistics data, Shumaker said that between 2020 and 2030, EMTs and paramedics were projected to leave their professions at a higher rate than all other occupations in the U.S. economy.

“The cancellation of EMT and paramedic training programs and drastically reduced class sizes during the onset of the pandemic only further exacerbated the crisis,” Shumaker wrote.

“The number of new paramedics entering the EMS industry in 2020 and 2021 was dramatically reduced from previous years,” he added. “Compounding that problem is the reduced number of EMTs entering the EMS industry is now resulting in fewer EMTs being eligible to begin paramedic school.”

Besides limiting the number of EMT students who could be in a class due to coronavirus protocols, the pandemic also restricted students’ access to hospitals where they get hands-on clinical training, said Joyce Johnson, vice president of career education, counseling, nursing, and allied health at Mt. San Jacinto College in Riverside County.

Starting this fall, the four-campus college, which has 32 students enrolled in its EMT program, is expanding its one-semester EMT course offerings, Johnson said.

“You essentially can come in and within 18 weeks be trained to take the national registry exam and to go right into the workforce.”

Shortages in other healthcare fields also affect response times. A lack of hospital emergency room staff means paramedics and EMTs have to wait at the hospital until they can hand off their patients, meaning they can’t respond to other 911 calls until they leave, Jeffries and AMR said.

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Riverside County’s shortage is easing, said Dan Bates, EMS administrator with the county’s EMS Agency.

“Trends are currently moving in the right direction that we’re starting to see more enrollments (in paramedic and EMT schools),” he said. “So that’s a positive note.”

“We hope to continue to see increased enrollment, which will minimize that gap,” he added. “But that’s the hard part, right? Like it takes (as long as two years) to produce a paramedic.”

Riverside County also is changing its emergency medical services model to ease the strain on paramedics and EMTs. One way is through an emergency medical dispatch system that can handle more minor calls, like less-severe cuts on fingers, without the need for an ambulance.

“We’re trying to find all these different innovative solutions and really collaborate … to ensure that we are getting the right resources to those in the community when they call 911,” Bates said.

Orange County Register

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Southern California has a paramedic shortage. What’s being done about it?

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