Austin EMS Medics Are Overworked And Overloaded During COVID-19. It's Taking A 'Huge Mental Toll.'

Jul 23, 2020

It's hard to maintain morale in a Texas summer, let alone this summer in the face of an unprecedented pandemic.

It's harder when, on top of all that, you're working outside in 110-degree heat indices, wearing two protective gowns, three facial coverings, carrying heavy gear and transporting patients to a hospital packed with COVID-19 patients.

That scenario is the day-to-day for Austin-Travis County EMS first responders, who are calling on the city to allocate more resources to the beleaguered department as the city's budget season ramps up and as more money comes in from state and federal coffers.

Selena Xie, president of the Austin-Travis County EMS Association, says the consternation has been rooted in a disconnect on the part of City Manager Spencer Cronk, the city's top executive who crafts the budget.

"We did not sign up to give this infectious disease to our immunocompromised kids or our elderly family members."

Last week, Cronk's office announced it was extending hazard pay to some city employees – including office workers as well as frontline workers at Austin Resource Recovery, Austin Energy and other departments. Excluded from that pot of hazard pay were first responders working for EMS, the Austin Fire Department and the Austin Police Department.

Xie was taken aback, especially as other cities and counties have extended hazard pay benefits to first responders amid the pandemic.

"People who have to go to the office or the workspace – including executives and upper-management – are going to get COVID hazard pay," she said, "but not EMS, who are literally taking all the COVID patients to the hospital."

The city's rationale for that exclusion is that those pay bumps are for folks that are required to work in-office and who aren't guaranteed yearly pay raises like first responders are in their contracts with the city.

"While I recognize the hard work of our sworn personnel, several avenues of additional compensation are provided to you (in addition to the guaranteed pay raises you have) that our civilian employees are not eligible for," Cronk wrote to Xie in an email.

Still, Xie argues, the back-and-forth showed a lack of parity at a time when medics are overworked in a time that couldn't have been predicted when the department negotiated its contract.

"We just don't have enough ambulances in a pandemic."

"We couldn't have known three years ago when we were bargaining for our contract that there might be a global pandemic," she said. "I did not think that we would need to put in a clause [that said], 'If there is a global pandemic, you need to offer us the same level of hazard pay.'"

Looming over all this is Cronk's proposed budget itself – namely its $8 million in cuts to APD's budget, despite calls from the community (and from City Council) to cut the budget by as much as $100 million. Xie says EMS feels overlooked, which isn't a first for the department.

While Cronk's proposal does set aside money to hire additional personnel at EMS, it doesn't allocate any more money for additional ambulances. That will be a problem as the pandemic marches on, Xie says.

Case in point, last week, she says, there was one ambulance available to take a call out of the entire fleet of 36 ambulances. That ambulance went from all the way down south in Circle C all the way to a call in the Mueller neighborhood, Xie said.

Lack of capacity is one thing, another thing is that each ambulance carrying a COVID patient has to be decontaminated, or "deconned," before it's called out again – which takes time and keeps first responders off the road.

"We're just seeing ambulances driving really far away to respond to calls, because we just don't have enough ambulances in a pandemic, when we have to do decon, when we're making sure that we're wearing the right PPE to calls," she said. "So at any given time you'll see three to four ambulances deconning."

Whether money gets shuffled around to bolster EMS' ambulance fleet remains to be seen. Council will begin public deliberation on the budget this week before the self-imposed Aug. 12 deadline to pass it.

In correspondence with Xie, Cronk also pointed to federal resources given to the department in light of COVID-19, namely the expansion of leave and family time under the Families First Coronavirus Response Act – "even though the Act allowed for the City to exclude emergency responders."

If the city had excluded EMS from that, Xie contends, EMS employees would have to burn their own sick time while awaiting results for COVID tests – which is how the majority of employees are using that time allowed by the federal money.

"We're using it to keep the community safe," she said. "It's not like we're just getting free time off."

On top of that, last week, Gov. Greg Abbott announced $41 million in additional federal money that could go toward overtime and hazard pay for first responders. Austin received $1.2 million in grants from the governor's office, but in an email, a spokesperson said the city would be using it to reimburse departments like EMS, the Austin Fire Department and the city's Homeland Security and Emergency Management division for PPE.

Xie says she hopes the back-and-forth over hazard pay and the budget takes a turn, but that she feels Cronk's response has been "cold" and that overall morale has suffered at a time when medics and EMTs are overworked and strained by the constant drumbeat of calls for service – COVID or otherwise.

"He just thinks we're just doing our job as usual and shares the sentiment of some people that I hear [who say] we signed up for this," she said. "Well, we did not sign up to give this infectious disease to our immunocompromised kids or our elderly family members."

Got a tip? Email Andrew Weber at aweber@kut.org. Follow him on Twitter @England_Weber.

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