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Citrus County paying price for meager EMT pay

Scott Baxter had no gripes about his job. He felt at home among his co-workers and thought his supervisors always treated him well. Most of all, he loved working as an emergency medical technician, or EMT.

He just couldn't afford to stay at Nature Coast EMS, the county-created non-profit ambulance system.

Nature Coast, which took over from Florida Regional EMS last fall, pays entry-level EMTs $5.88 an hour _ a shave above the $5.15 minimum wage and lower than any of the neighboring counties' wages.

Baxter made a few pennies more than that because he had 1{ years of experience, but when a better-paying job opened up with Lake/Sumter EMS in February, Baxter took it.

"Based on the system and the personnel, I definitely preferred Citrus County," Baxter said. "The only reason I'm over here is because of quite a big difference in pay."

Baxter is not alone. Since taking over the ambulance system Oct. 1, Nature Coast has lost nine EMTs and eight paramedics, mostly to neighboring ambulance systems or other better-paying jobs. One EMT, Scott Moss, found he could make a better living driving a delivery truck.

"I love being an EMT and would do it for the rest of my life," Moss wrote in his Oct. 27 resignation letter. "But I have a family of four and make less than $300 a week."

The rash of departures _ more than a third of the field staff has turned over since Oct. 1 _ means the remaining EMTs and paramedics often work double shifts to make sure the ambulances are covered, said Nature Coast executive director Teresa Gorentz.

Normally the crews are on for 24 hours and then off for 48 hours, but some find themselves working a straight 48 hours or more, she said.

Gorentz said 48-hour shifts are "common practice in this field," as EMTs and paramedics can slip in naps at the station between responding to 911 calls.

"The people in this field do learn to rest when they get the opportunity," Gorentz said. "We will not allow an employee to continue working when they demonstrate signs of fatigue."

But the long shifts are still draining for the crews, said Kelly Perryman, an EMT who left in May to take a better-paying clerical job at Seven Rivers Community Hospital.

Working on an ambulance crew requires mental sharpness to handle any medical task and an emotional reserve to cope with the stress of the job, Perryman said. As the double shift wears on, the crews can feel worn down, she said.

"A lot of times you're working a 48-hour period in a two-day span when the normal person is pulling that many hours in a week," Perryman said. "There have been days where you become very irritable."

"We do have our lax days where we can sit around, but you have to grab a nap because you never know when you'll be out there," she added.

On a few occasions, an EMT or paramedic has worked longer than 48 hours straight. Gorentz said such shifts have happened fewer than five times since Oct. 1, including an instance last month when a medic logged a 66-hour shift.

"As soon as we could find someone who could come in to take his place, we sent him home," Gorentz said.

Certain rules kick in when an ambulance worker stays on for more than 48 hours, Gorentz said. The worker is moved to the slowest call station so he can get more nap time between fewer 911 calls, and he cannot make any long drives to transport patients to Gainesville- or Tampa-area hospitals, she said.

Even with those rules, Gorentz said, workers can stay on shift longer than 48 hours only as a last resort.

"You want those to be infrequent: the exception, not the rule," Gorentz said.

Curbing costs

As an EMT with 4{ years' experience, Perryman was earning about $6.21 an hour. She left a week before the Nature Coast Emergency Medical Foundation approved a 3 percent pay raise in May, which would have brought her up to $6.40 an hour.

"I wasn't even making as much as cashiers at the grocery store or Wal-Mart," Perryman said. "People that work at fast food restaurants made more than I was."

The lowest pay scale for county employees starts at $6.40 an hour for senior center aides and Chassahowitzka campground attendants. The maintenance workers who mow the grass at county parks start at $7.11 an hour.

But the county does not run the ambulance system. Last year the County Commission created the non-profit Nature Coast Emergency Medical Foundation to run the system for it, keeping the pay scale used by the previous operator, Florida Regional EMS.

Commissioners expect to help pay for Nature Coast's equipment and operating costs in the first few years, but hope to see the system become self-sufficient like a similar non-profit in Volusia County. With that goal in mind, Gorentz said she must balance employee salaries against the commission's mandate to keep costs down.

As it is, Gorentz runs the Nature Coast office on a three-person skeleton crew to curb administrative costs. She wears the hats of executive director, finance director, human resources director and interagency liaison.

In the proposed Nature Coast budget for next year, Gorentz has cut costs 4.8 percent from this past year, while still finding money for another 3 percent merit increase for the EMTs and paramedics. Gorentz will present the proposed budget, which would cover the year starting Oct. 1, to commissioners this month.

Crystal River police Chief Jim Farley, who sits on the governing board for Nature Coast EMS, said the second 3 percent raise is greatly needed.

"Being a cop, I've been around EMT people all of my career, and I have a special respect for them," he said. "You never know when you're going to be the one lying on the pavement and they're going to have to take care of you."

County Commissioner Gary Bartell said he would be sympathetic to a proposal to raise the wages for the ambulance crews. He first heard about the high turnover at Nature Coast last month, when he talked to several EMTs and paramedics who had left for better pay at neighboring systems.

"If we're going to lose good, valued employees and we're not on an equal basis with surrounding counties, then it's always a concern," Bartell said.

Doing more

Gorentz spent part of Friday interviewing applicants for the five open spots at Nature Coast. One of the 27 paramedic positions and four of the 20 EMT jobs are empty now, but Gorentz is confident she will fill them soon. The salary here may not be the highest in the region, Gorentz said, but Nature Coast offers other perks, such as paying for training classes and providing what she calls a "healthy" working environment.

Nature Coast is looking into ways to increase benefits, she said, but it will still face the challenges in finding qualified workers.

As educational requirements for EMTs and paramedics increase, and as other industries promise better pay, ambulance systems across the state will continue to compete for a shrinking pool of EMT and paramedic job candidates.

"I don't think you could call one system that said they were 100 percent filled with EMTs and paramedics," Gorentz said.

"We are doing a lot," she added. "Can we do more? Yes. But people, we're 10 months old."

_ Staff writer Carrie Johnson contributed to this report.