Austin Travis County EMS hiring Paramedics and paying them as Basics

ExpatMedic0 said:

Why would a new medic have this attitude? This system is forcing paramedics who want to work for ATC to first be hired as EMT-B's, this will only bring you new medics. Why would a good, well paid, Paramedic with 10 years of experience, possibly a family and financial obligations, come to this system to work as an EMT-B for far less salary. Especially for unknown period of time? Can you please tell me that? This is now what we call "a good ol boy system"

I am the person who started this thread and you can see next to my name that I have been posting on this EMS forum for over 7 years. In actuality I have been in EMS for close to 10 years, a Paramedic for a good portion of that, and now completing my undergraduate degree in Paramedicine.

I have never applied to ATC and I started with this thread to discuss the speculation surrounding the recent events. I even stated on the first post I was not sure if I have the story correct and invited people from ATC or anywhere in Texas to shine light on the matter for the rest of us.


So to reiterate, I will summarize things below and your welcome to make any corrections.
Its all over the news for the public and all of us to read. ATC is in a huge budget crises, coincidentally during this same time ATC makes the decision to start staffing an EMT with a Paramedic on every ambulance instead of the old system which was double Paramedic. Now they are hiring Paramedics and working them as EMT-Basics for an unknown period of time which is not a probation until they are promoted within ATC laterally to the Paramedic level, which in fact they are already licensed or certified as a provider? As a result nothing has changed, there still doing double Paramedic ambulances but due to the budget crisis now paying much less for the second Paramedic. There way of doing this is by not promoting him/her to paramedic or paramedic pay wage until a slot becomes available

PS: No offense to you buddy but I would never consider bragging about working for 15 bucks an hour when your forced to work overtime to make a good wage.You could pull that kind of cash at McDonalds as an assistant manager who is also working overtime.

Click to expand...

medicsb said:

Wut? No where near a good measure? C'mon. We know that cardiac arrest requires early CPR and defibrillation, both of which a good EMS system should be able to provide, whether through PAD or layperson CPR programs. Unfortunately, CPR isn't done quite as frequently by bystanders as one would prefer and AEDs are used even less frequently, so certainly there is a considerable amount of survivorship (or lack thereof) that can be attributed to an EMS system. For something we consider to be so easy to manage, many seem to not do it well. Reporting of cardiac arrest outcomes has become pretty standardized via the Utstein template, which allows for comparison between systems. If medics and EMTs in one locale are goofing around with loading and going or getting caught up in things other then ensuring good CPR, then it is no a stretch to see how CA outcomes can be adversely affected.

It is one of the most time sensitive conditions and one for which the management of is largely taken for granted.

It shouldn't be THE measure of an EMS system, but despite the fact that most EMS calls are low acuity, there is still a considerable quantity of high-acuity calls and CA is one that is relatively easily measurable.

Click to expand...

marshmallow22 said:

Yeah, I realize that pensions are under attack, however CA and NV based a lot of theirs on the housing market with mortgage backed securities and the tax revenue generated from those highly inflated home values. The bubble burst and so did CA and NV's pension system. Texas has one of the strongest economy's in the nation and did not have a fraction of "the bubble" that CA and NV did. And yes, I also contribute to my 457b plan. Yes, compared to other jobs that I've had in the past, this by far is the easiest, and most fun. So I do not mind putting extra hours, especially if I want to enjoy some of the nicer material things now and then.

Click to expand...

46Young said:

We'll use $30/hr since virtually none of us are or will be officers in EMS. Our basic FF/EMT's top out at $81k, or $27.88/hr, plus the incentives for medics that I've mentioned previously. techs $85k @ $29.21/hr, Master techs $89k @ 30.67/hr, Lt $97k @ $33.60/hr, and Capt I $113k @ $38.81/hr. for each of these positions that are 56 hours and not 40 hour day work, add 1.5 hrs x 52 weeks (the 3 hours OT per FLSA). For example, the FF gets an extra $2,174, and the Capt I gets an additional $3,027.

So, you haven't mentioned any additional pay, only $30/hr (a happy medium between field medics and Capt's) for 40 hrs and 8 hours @ $45/hr . That's $82,920/yr, for a $57,214.80/yr pension, plus $286,074 in the five year DROP assuming no COLA's. Pretty stellar for EMS. That's pretty good for a fire department as well. Charleston County EMS had a paltry 1.8% multiplier @ 28 years with a three year TERI (DROP), which they're apparently doing away with, and their top-out pay is under $70k, for comparison's sake.

$30/hr was just shy of what I was making in hospital based NYC EMS in 2007 (403b), and that was considered decent, so $30/hr in Austin with eight hours/week built in OT should make you quite comfortable. I'm honestly a little suprised, since most Third Service EMS employers offer starting pay of only $30-$35k tops, with a final step being only $50k give or take. That's like $10 or $11/hr to start, maybe $16-$17/hr after many years OTJ.

Going on $30/hr, the tenured medic would have to do only 7.2 additional hours of OT beyond their regular schedule each week to hit $100k. a 24 once a month and an occasional 12 would do it.

Edit: to the base, add around $16k or more to each top salary if they're a medic. Average $2k/yr in night diff, $5k in ALS cert pay, $7k in hourly riding pay as an engine medic or if they ride the box, and the built in FLSA @ 3 hours/week, the equivalent of 1.5 hour's pay per week, from $2,100-$3,000/yr. So, the basic FF/m gets $97k, the Capt I/medic gets $130k.

Click to expand...

46Young said:

The abundant OT you're talkng about (Marshmallow), 80 hours or so on a paycheck when OT is typically slow (Oct-Nov), suggests to me a few possibilities:

There is high turnover, which results in lots of vacancies

There is frequent sick leave abuse, which may be due to burnout, or inability to use vacation leave

ATC-EMS does not staff positions with full timers for the purposes of vacation/sick relief (referred to as pad personnel), but just has enough full timers to staff what they run on a daily basis

ATC-EMS would prefer to pay OT up to a point rather than hire additional employees (or hire less than they otherwise would), as this saves them money

For example, a new FF/EMT costs my employer as much in benefits as it does to pay their salary. Off the bat, there's the county'ss 33% contribution to the pension fund, their 75% of the medical insurance premium, vacation/sick days, paid county holidays, hiring, training, and uniforms. So long as the county doesn't pay $100k in OT to staff a FF position ($50k in salary + $50k in benefits), they make out. That's also one less pension to pay.

Which brings me to another point - this isn't directed at ATC-EMS, but just a general observation:

Employers may use a generous salary, particularly a generous starting salary to attract qualified employees, and also to divert attention away from undesireable features of the organization. Employers may like high turnover, since it greatly reduces their future pension burden. If the average employee stays only a few years, the employer's off the hook for the pension. The high pay keeps the application pool filled so that they don't miss a beat.

Take notice when an employer spends little to no resources on your orientation. For example, CCEMS gave us a one day orientation, then it was just me and my FTO on the bus (I was minimal staffing, no riding third)starting day #2. NS-LIJ CEMS in NYC had a two week in-class orientation, and then a few weeks riding as a third. My current hospital based IFT second job had a few days of orientation, and then as many ride-alongs (3rd person) as the trainee needs to be comfortable. My FD has a 24 week fire academy, and a four month ALS internship, Two months of which is riding as a third, and four hour class sessions weekly for the entire four months.

If a place throws you out on the street as minimum staffing as quick as possible, then they obviously choose not to invest money in orientation, since they expect the employee to not last too long. It's cheaper to hire someone else and put them through a one day orientation than try hard to keep the employee, and have to pay them a pension, and also their salary increases over the years.

Click to expand...

MedicSansBrains said:

Bro, it's on the web site for christs sake. Civil service pay scale. Quit beating him up http://www.austintexas.gov/sites/default/files/files/EMS/FY2014_Payscale.pdf

Click to expand...

RocketMedic said:

Expat, those problems were never really resolved though. A few staffing changes in management and a shift from literal dual-medic to "EMT/Medic" don't fix anything, they just rearrange furniture. ATCEMS won't go out of business, fail or disappear, but they're certainly not revolutionary or even particularly great at medicine.

If your idea of EMS is loads of titles, patches, specialty assignments, time-based metrics and such, ATC is a great place for you. It's urban life with a near-living wage coupled with opportunities to be a biking tactical rescue commando community paramedic and a lot of calls. Unfortunately, those calls have a caveat- you are primarily expected to be a transporter, not a clinician. If you get excited over big rigs, long and frequent hours, big numbers and patch count, go ATC or high-performance EMS.

If your idea of EMS is "patient care", in a general and nebulous sense, then go somewhere else.

Click to expand...

46Young said:

Their pay is based on a 42hr workweek

Click to expand...

46Young said:

They seem to have some sort of career ladder, which is more than I can say for most places. The pay seems appropriate for the cost of living in Austin, which is also more than I can say for most places. Their pay is based on a 42hr workweek, which is refreshing, since most EMS employers can't manage to pay what ATC-EMS does, and they have 48 or 56 hour schedules! I made less than $12/hr at Charleston before I left. Before I went fire based EMS, and went to Charleston, I would have applied to ATC-EMS if I knew about them.

Many EMS systems seem to favor EMT/Medic over a tiered system with dual medic units. For example, my department went to all 1&1 units recently. I don't like the medic/EMT setup, as I feel that the new medic's learning curve will be severely blunted due to running mostly BLS, but the all-ALS fleet saves $$$.

Austin is a populous city, with low socio-economic system abusers just like any city, so EMS is going to be busy there. Since they have a 42 hr. workweek and not a 56 hr schedule, high call volume is appropriate. Also, being in an urban environment where the hospitals are typically less than ten minutes away, I wouldn't expect the protocols/guidelines to be as progressive as a department in a rural area with long txp times.

With an urban system there's always a balance between load and go, and stay & play. Critical patients will typically get worked on-scene, a 12-lead will be obtained within 5 mins. of pt. contact when the 12 is indicated, but for the less than critical pts, I'll get an assessment/pertinent diagnostics, and begin interventions enroute . If some things don't get done, they don't get done. Calls are holding, and the pt. isn't going to have any change in outcome by going in the ambo, so if I don't get the line for the nurse because we had a 5 min. txp, then too bad. I'll stay and play for pain management, unless it's one of my known seekers, in which case I take my time setting up for a line, and finish it as we pull up a the ED. If the patient isn't in any acute distress, and I'm satisfied that they are stable, and clear for 12-lead and stroke assessment, I just want to get the call over as quickly as possible. The longer I take, the more times second due units will need to cover my response area. Urban, busy systems need to be efficient. We can't stay and play all of the time. We really are nothing more than transporters for many of our patients.

As far as looking to change the system your first month on the job, it takes time to develop your reputation before you have any sort of leverage to effect change. No one's going to pay much attention to the rookie. Being overly outspoken and negative about a new employer's way of doing business will get you on everyone's s*** list really quickly. A more realistic approach is to do your homework before taking the job. Forums like this can be helpful, but the best way to learn about the system, especially if you're flying in for an interview and assessment, would be to meet with employees, buy them lunch or dinner, possibly even schedule a ride-a-long, and learn how things work from actual employees, not random internet people.

If you think the grass is greener and leave for another system, and find out that it's not to your liking, it's best to remain quiet and look for a new employer. Continue to follow the rules, and leave when the opportunity arises. I left NY for a better retirement and environment, found Charleston (in 2007, may be different now) to be undesirable to me, and just kept quiet until my present employer offered me a job. I just told CCEMS that I was moving back up north. They just assumed that I returned to NY, IDK. Basically, a rookie or two year guy isn't going to change the system; it's better to leave. Also realize that the same place may be another person's dream job.

Click to expand...

Chewy20 said:

ATC is not based on a 42. ATC is based on a 48 hour week for field medics. There are a couple trucks that are on a 42 hour schedule as a trial right now. The new work week is in the talking and voting stages right now.

I am hoping to get on a 42 hour week due to not liking 24s. Plus the OT rate it higher.

Click to expand...

MedicSansBrains said:

42 hour work week is for the Comms medics. Scroll down and you'll see it 48 in the field.

Click to expand...

46Young said:

Even with a 48 hour workweek, the pay in Austin is still better than most places south of Northern Virginia down to Florida.

Who is voting for a 42 hr workweek? Is it the employees, is it supervision, or is it the local politicians? On the one hand, a 42hr workweek is shorter, and has a higher hourly rate (and a higher OT rate), but you'll be at work more often, and OT opportunities will be reduced. On the other hand, people who work 24's may like making less commutes to work, and may want to live further away from work. Alexandria Fire and EMS, for their EMS division, has a 42 hr workweek, but it's 24's. One on, two off, one on, four off. Some employees live 2-3 hrs away with that flexibility.

That's one thing I had to get used to after leaving NYC, the longer scheduled workweeks. After working for Charleston, I learned to look at what the hourly pay was, rather than the yearly pay. $45k/yr (medic after six months at Charleston in 2007) sounded really good, until I saw that it worked out to less than $14/hr. I find it exploitative for employers to have 56 hour schedules, and even 48 hr schedules, unless the base pay before OT was decent, approaching $20/hr outside of the Northeast. Employers get around the low pay by using a schedule that has built-in OT, which saves them money, and distracts you from the low hourly pay.

For example, a new hire at ATC-EMS on a 48 hr schedule is making around $33k/yr, and works a mandatory 8 hrs of OT each week. It's still better than the Southeast, but it's still not much to live on, unless you're single and renting a studio, or splitting the rent with a few roommates. For comparison's sake, Austin cops graduate the academy making $57,530/yr, and top out at $93,402/yr:

https://www.austintexas.gov/page/benefits-and-salary

Fire does pretty well also. Are they 56hr people?

http://joinafd.com/benefits-summary

EMS typically comes in third when compared to fire and police in most places. I made more than fire and police in Charleston, but that is atypical

Click to expand...

46Young said:

Question, what is "Comm" as part of the job title mean? Also, I understand EMS MEDIC I to be BLS, and MEDIC II to be a medic. What does an EMS Capt. do? Is it like a station commander, or is it a true supervisory position?

http://www.austintexas.gov/sites/default/files/files/EMS/FY2014_Payscale.pdf

Click to expand...

46Young said:

Also, just curious, how many employees are there overall, and how many Capt. and Commander positions are there? I'm just trying to get an idea of what the advancement opportunities are like. How does the promotional process work? Is there a test/oral interview, where you're scored and then put on a list that's ranked by score? Is this assessment and scoring performed by a third party, to avoid any favoritism? Or, do they just promote who they like best?

Edit: And discipline, how does it work? Is it progressive step discipline? If so, do employees receive the same punishment, and the same leniency as the case may be, as was given to previous employees? Or, is everyone treated differently even though it's a similar offense? These are things a prospective employee may want to know.

Click to expand...

Chewy20 said:

I think we are between 400 and 500 sworn personnel. No idea how many captain positions there are. But there's a bunch. We have 5 district commanders on at a time. Not sure how many actually hold the rank, but again there are numerous different positions outside of the field as well.

To promote you have a written and oral done by 3rd party for captain and up. It's based on scores. No favorites.

To promote to medic 2 you have to be paramedic certified and be here for 3 years to be eligible. Although we have had to waiver the time in length due to shortages. You're looking at about a year as of now. My academy just missed the 1 year cutoff for sept so they will test in January. The test is written and then you go through a 16 week academy 1-2 days a week to promote to Medic 2.

Things are really looked at on a case by case basis. Unless you do something agregious, you will be educated and told not to make the same mistake twice. We have a whole investigations department when it comes down to all that. Usually you are pulled off the truck until everything is sorted out, unless it was something minor and you will just get a write up. Hope I answered most questions. I'm on my phone. So grammar may be in the woods.

Click to expand...

MedicSansBrains said:

Wow I did not know the promotion period from I to II was three years technically. That's just on paper right? I understood it to be 1-2 years in practice. Correct?

Click to expand...