Open Letter to Pickens County Council on Emergency Medical Services Situation

 

An open letter to the Pickens County Council,

My name is Tommy M. Page, and up until about three weeks ago I was a Paramedic and Field Training Officer for PCEMS.

Last month, another citizen approached County Council during the monthly meeting with a list of concerns about the current state of our County EMS system, and you yourselves had a lengthy discussion on some of those matters later in that meeting. First of all, allow me to emphatically state that I was not the employee she had referenced in her statement, though many of her issues seemed to be lifted from the pages of my letter of resignation, the same letter that Administrator Roper referenced later that evening.

By all accounts, that letter has grown quite a set of legs and has made its way to many, if not all, of your desks, and it seems that many conversations may have been initiated on account of it.

I served this county for ten years, and had wholeheartedly hoped to retire here. I, like most of the employees of PCEMS, love the people I was honored to work with like family, and I know that, by far, our EMS service would be the employer of choice for a great many providers throughout the upstate, were it not for several major problems that have come to light during the current pandemic.

I have been made aware by many whom I have spoken with that my departure has caused a fair deal of pain and confusion in my wake, and for that I am truly sorry. Unfortunately, as all employees of Pickens County have been made unofficially aware, for one to approach or address this council as an employee means that one will likely no longer be employed here shortly thereafter, as though their rights as a citizen of this county are suspended if they wish to continue their employment.

I feel the things I intend to say need to be brought to your attention in a public forum, so that you and the citizens of Pickens County will have a better understanding of the general morale and beliefs of those you charge with maintaining the public's safety and well-being.

I felt forced to quit a job I loved so I could say what I feel I have been called on to say. I beg you to weigh that statement meticulously, to understand the pain it brings me, to understand the sacrifice I have made to try to better this situation.

There is not a person in this county that is not but one unfortunate event away from having their very lives in the hands of the employees of PCEMS. An accident, an acute illness, an assault, a heart attack, or a stroke could be waiting just around the corner for ANY of us. And when these things happen, the employees of PCEMS are expected to be there, to help keep each of us safe and alive, and to get us to definitive care from a physician. The vast majority of these employees perform this job with passion and zeal, out of genuine concern for the well-being of those entrusted to their care.

As for myself, though I am no longer employed by PCEMS, my family and I all live here in Pickens County. My children, my parents, my sister and her family, my brother and his family, all of them are residents here. Many of the people reading this, I am certain, share this commonality with me.

For those not familiar, PCEMS normally has nine ambulances on duty covering the entire county, but as of late it seems much more common that there are only eight available, and often enough only seven. All of us are put at greater risk when we have to shut down trucks nearly daily because we cannot get providers to cover shifts. Even more egregious is the increased risk these employees and those they serve are subjected to when the needs of the service force those employees to work harder and with fewer breaks due to both the increased call volume and the exacerbation of said volume as the increasing call load is being shifted onto a fewer number of responders.

The primary reason this is occurring is not because of a limited number of personnel to pull from on any roster, as every EMS system in the country is currently having the same issues due to the COVID Pandemic. I along with many of the current employees of PCEMS wholeheartedly believe this is due to the fact that the hourly rate of pay for the part-time employees we need to cover shifts is nowhere near high enough to incentivize them to work our open shifts when our full-time employees must be out for whatever reason.

Do not misunderstand, I am not speaking about setting pay rates competitively based on a projected annual salary, but on the base HOURLY rate offered by those services that also need this vital and very limited resource.

These part-time employees have bills to pay, families to support, and per the numbers being provided on the COVID incidence rate in our county, every time they pick up a shift they risk an exposure, no matter how well protected they may be. It is only natural that these part-time employees will only pick up shifts for which they feel they will be adequately compensated, and sadly that typically means service to the highest bidder.

As always, there are of course some outliers, as we do have a handful of part-time employees that do not work EMS as their primary source of employment and who serve simply for the love of serving, and some that love working with our employees enough that they would prefer to work here rather than elsewhere, but those precious few are already doing all that they can. The numbers do not lie, those precious few cannot keep our trucks rolling on their own, we need all the hands we can get, and that means hourly pay has to be brought up to or above the levels offered around us, period.

The only way to realistically have any chance of getting part-time employees to work our open shifts is to offer truly competitive, or preferably even better, pay than those services around us. And with the increased work load being put on our crews, they are becoming more and more exhausted, they are increasing their exposure to illness and injury, and they are feeling very unappreciated, especially in the face of all that they have done for the citizens of the county in the past two years.

Eventually, even the best care provider can become tired enough to miss something or to make a mistake, and mistakes in this profession can cost lives.

I am aware that PCEMS was just awarded raises, but in all honesty many of the employees of PCEMS felt that the average raise of just $0.50-0.75 an hour in the face of what they have been through over the past twenty or so months was pitifully insufficient, and some even described it to me as “insulting.” I am acutely aware that I got very lucky when I found my new employment, and feel no shame in stating that my new base rate is more than five dollars an hour higher than what I was making when I left PCEMS, with that being before any shift differentials or COVID incentives offered by my new employer (which are quite significant, again in the ranges of several dollars per hour, not mere cents).

I say this not as a brag or boast, but in an attempt to show what we are up against competitively on wages. In fact, were the staffing issues to be resolved, I'd happily take a pay cut to return, though I have my doubts as to whether or not that would even be possible after this parlance. Part-time employees will almost always turn down a shift making seventeen dollars an hour in favor of a shift making thirty, or even considerably more given the incentives being offered at some local services. And, human nature and personal necessity being what it is, if the pay rate of PCEMS part-time personnel is raised to the point it will need to be to get our shifts covered, full-time rates will have to increase as well, unless the goal is to see a massive shift of full-time personnel transferring to part-time. Given that anytime an EMS employee takes or uses vacation or sick time they actually lose money from their paycheck, most would forgo other benefits for the increased pay rate hands down, and find another source of insurance and such through a different full-time employer or elsewhere.

The overtime that is touted as the reason PCEMS hourly pay is so low when compared to surrounding services is completely lost when our employees need to take time for self care, often resulting in a loss of hundreds of dollars on a paycheck.

The argument can be made that no other department in the Pickens County infrastructure gets paid their overtime rate when they use their vacation or sick-time, but might I not only inquire which other department literally has the lives of our citizens in their hands as a default description of their employment, but also which other departments work 24 hours at a time with ZERO mandated or protected breaks for basic human needs (such as food, bathroom needs, or even sleep so that accidents are not exacerbated by increasing exhaustion)? The only departments I can think of that could possibly relate would be Law Enforcement and Fire Protection Services, and they, too, are woefully underpaid and underappreciated, truth be told. The people serving our community in PCEMS answer the call to duty throughout the day, regardless of the time or how recently ran their last call, and they deserve to be treated and compensated as though we actually appreciate what they do for our citizens.

Many of our newer and younger employees have never received a single time-in-service raise, and, in fact, during my ten year service I can only recall a single successful salary study that raised pay rates in that fashion, though afterwards it was widely believed that it had been only due to an accounting error that rates had been raised to the levels that they were. When this happened, though, PCEMS was the highest paid EMS service in the area, and we experienced a massive hiring boon, allowing us to bring on some of the most talented providers available locally.

That being said, when PCEMS pay rates were again surpassed by the local average, many left for greener pastures, so to speak. And again making an example of myself, we move forward to the present, to when I was still only making the base starting rate for FTO pay when I resigned after ten years, with nearly half that as an FTO and with my being recognized twice by County Council as the PCEMS Employee of the Year (2012 & 2018) during my employment.

If the lives and well-being of our citizens are as important to us as they should be, EMS should be the one department that would always be given the utmost priority in budget considerations, not just in payroll but in needed equipment, supplies, and training materials.

To my knowledge, every budget that had been submitted by any of the numerous directors that have served over the past ten years was slashed horrendously by the finance department prior even to any committee considerations, with our department heads then having to go before a committee to fight for what remained, often with minimal success.

To those on the outside of those decisions looking in, it seems as though the lives of our citizens are of much less importance than road maintenance, or a new jail, or Sister-City projects, or even replacing the trees outside the Administration Building because those that were originally there weren't “native species” and thus not in line with the desired aesthetic. When the lives of our family, friends, and loved ones are on the line, we shouldn't have to fight to have the personnel, tools, and up-to-date skills needed to give the best possible treatment for our citizens.

I understand that Administrator Roper is going to be riding with a PCEMS Supervisor to experience just what PCEMS does. While I appreciate that efforts are being made to experience what working EMS is like, might I suggest that rather than just one representative of the administration or Council scheduling a few hours riding with a Supervisor, EACH of you do a ride-along with one of the Easley crews for a full 24 hour shift on a day when one, or even two, of the three Easley units has been placed out of service due to under-staffing? As often as it has been occurring as of late, a day such as that should not be hard to schedule, and a true picture of what PCEMS does for this county could then be seen. See what it is like first hand to run three or four calls back-to-back while having to hold your bladder, to order a meal that you might get to take a bite of four hours later, or to run calls for fourteen or sixteen straight hours only to have the tones drop for more calls every time you sit down or lay your head on a pillow.

I hope that I have been able to effectively convey how serious this matter truly is. I personally know of several PCEMS employees already looking at other employment, and several more strongly considering doing the same. If even only those that I know of do make that jump, PCEMS will be very hard pressed to keep the number of shut down units to merely one or two trucks per day. And if that happens, it will very much appear that the citizens of Pickens County are being placed at an unnecessarily and highly increased risk because the bottom line was deemed more important than their safety and well being.

Money should never, ever, be more important than lives, especially when the funds that could be used to fix these problems are there and available. For example, Pickens County received $24,645,730 from the federal government via the American Rescue Plan Act of 2021, and utilization of this money for funding the issues I have addressed appears to be specifically both covered and allowable.

Councilmen and Administrator Roper, the citizens and voters of Pickens County are now relying on you for your guidance and heartfelt concern in addressing these issues. In fact, many of them may soon have their lives riding on it. All it takes is one unfortunate event.

Sincerely and with hope,

Tommy M. Page