Re: enrollment dip?

[Guest guest]

In a message dated 11/05/2001 12:29:24 PM Central Standard Time,

washcoems@... writes:

> Not trying to be smart, but there's no doubt in my mine you have " increased

> training requirements UP, increased rules & regulations UP, expenses UP

> (through the roof) salaries DOWN, revenues DOWN, = enrollment DOWN. It all

> started with something called Project Alpha, followed by the BBA of 97.

> Until the BEM really see the workforce needs/time lines ect' in the best

> interest of the Public Health nothing will change much in the next 10

> years, other than the same decline. Once it reaches a Crisis people will

> scream, but on deaf ears.

> Ron

>

Gosh, lets see. For the last three weeks, we have talked about what a

Medical Director could allow Basic EMT's and Intermediates to perform, the

decrease in enrollment in EMS college courses, the continued low pay, and how

to make the test harder for those that are still here. Why an individual

would take the same basic courses for 2 years and become a paramedic instead

of a nurses. (That ones easy, so he could lose thirty thousand dollars a

year).

For two years we let a few people try and make a lot of people think they

were talking for the majority. We built rules to eliminate ourselves for

what they thought was the good of THEMSELVES, and received nothing in return.

We all know what happened, but very few know or care how to stop it. Now it

will be too late.

Education is a mighty tool and one that should be sought by everyone.

Teacher's all over America love and crave education, but when they went to

College to become teachers, they knew what their salaries would remain and

still remain today. It was a simple fact of life. Continued education makes

for a better teacher and a better paramedic. It is going to required for

everyone still. It remains the Employer's job to make his commitment to his

employees, what type of medic is on the streets today. It is hard to go

through a one week class on protocols, a protocol test, three months with an

FTO on a unit before you can even be released to a truck for a 6 month

probation period, when you can walk next door, show your certification or

license, try on a uniform and get on a truck in about 2 hours. It is our

biggest obstacle in hiring. We try and put a medic where he will be able to

function under any type medical problem by himself. He will always have

another paramedic as a partner (unique ideas to cut down stress on every

other bad call) and get to really work in his trade.

Be given CE's every month and M & M class. We have so far survived the

onslaught of many and continue to hold our ground to those who would like us

to lower our standards and cost. Hopefully we can hold them off and the

Texas Department of Health also. It will be our duty to try and hold on to

the life long Certified Medics that have stuck with us for many years and

continue to be the backbone of a great City system. By the way, the

retirement is great too.

Each time I have to write this same song, it seems more and more people are

listening to the music, but just have not realized it is past time to sing

along.

Andy Foote

EMTP

[Guest guest]

Jane,

I was going to contact you privately because I too am interested to see what

size dip there has been in EMS education seekers. However, I wanted to reply to

the list on a couple of comments you have made in reply to Ron's post:

<<<However, the pay in EMS agencies in our area of the

state has not come up to reflect increased education and in any attempt to

recognize EMS professionalism>>>

AND it never will. The pay will only increase when the " market " dictates that

the value of an EMS person is higher. No amount of education, title

manipulation, or fancy words will increase this. There is NO magic pot of money

sitting here in my closet as an EMS administrator that I can go pull extra money

out of because it took someone 3 years to get their red patch as opposed to 12

months.

What so many people fail to realize is that in our capitalistic society we can

make money by either collecting more money (increase rates, better collections,

etc), INCREASING taxes, or both. There is no EMS agency out there that has an

unlimited amount of cash on hand to just dole out to any and everyone. Whatever

amount of money is collected is all there is and choices have to be made on

where to spend it.

Salaries and associated costs are #1. (believe it or not....they are....being

60 to 70% of our expenses, they are always the #1 issue) Secondly are the costs

of a proper working environment (ambulances, stations, uniforms, etc). Then add

on top of that the seemingly endless numbers of classes that all EMS

" professionals " HAVE to have (ACLS, BTLS, PHTLS, PALS, NALS, APPLES, dapples,

frapples, mapples, Advanced Medical Life Support, and the newest GEMS; HazMat,

Terrorism, EMD and how to spell it, etc, etc) plus continuing education. Then

add on top of that insurance costs and legal fees (read the discussion on

Refusals by Gene G. and P. to see the importance of this). And the list

goes on and on and on.

Before you know it the cost to an EMS agency for EACH transport is $300, 400,

500, 600 or higher...and this is just to provide the " basic " services.

To pay ALL these bills we have to get the money. Whether this money comes from

taxes or user fees (and again...it is one or the other or both for EVERY EMS

agency in the country) we either increase taxes (not a popular thing to do with

politicians) or we increase user fees (not that any insurance company or private

pay user will pay it).

This is how it works....SO....the pay will not EVER come up in response to

increase educational demands or requirements....that is attempting to drive the

market from the wrong end. Knowing how to be a good paramedic is not what

drives the market...it is what the market expects out of every paramedic...so by

increasing all these things you are only developing a better bargain for the

market.

For example, you need a rechargable drill and you are willing to pay $100 for

it. You go to Home Depot and see a DeWalt unit with 2 batteries for $99.95 and

next to it is a Ryobi unit with 2 batteries, a " hands-free " flashlight, and a

reciprocating saw (all certified by Bob Villa) for $100.95. Which do you buy?

DO you take the Ryobi unit to the cash register and demand to pay $150 for it

because it has all the extras??? No, you purchase it because there is no real

difference for the casual user (90 to 95% of the users) between Ryobi and DeWalt

and you are getting better value....

That is what all the increased EMS education is currently providing for our

payors. They expect someone to show up and take them to the hospital without

additional injury and be nice to them. When the get the whiz-bang Licensed

Paramedic with every additional certification plus some not made up yet...it is

a bargain. They just got the Ryobi tool set instead of the DeWalt drill only.

The only difference is that we are upset that the customer is not demanding to

pay us more.

<<<However, until EMS agencies find a way to pay Paramedics in most areas of the

state in such a way that they don't have to have their families on WIC or other

federal social programs, it makes no sense to many potential students to become

an EMS professional>>>>

HERE is some suggestions: Right now TODAY all EMS education programs need to

develop curriculum and training on Medical Documentation...not JUST liability

issues but to round out the course and provide the latest information on MEDICAL

NECISSITY and how to write a PCR so that it will be PAID. Education folks need

to understand that EMS is a service and as such we need to get paid for it.

Everybody stands to benefit from this...it isn't a bad thing. I am not talking

about the " mother, jugs, and speed " days of no pay, no go. But we have the

pendulum swung the exact 180 degrees from this by saying " oh, don't worry about

the money....we just want to get you checked out " . If the patient is elderly

and is on a " small " fixed income how much compassion and caring does this

show??? If we can educate our EMS folks to be able to distinguish between

medically necessary according to payors and not...then we could tell the elderly

patient " your chest pain is a medically necessary reason to go to the hospital,

Medicare will pay all but about $40 and we can work out a payment plan for that

over the next 6 to 10 months so come on, lets go to the hospital... " Which way

is more compassionate? Which one is more professional?

So, after this long and exhaustive diatribe, EMS folks will get paid more when

we actually make more for the work that they do. If increased education is

going to lead to this it must do so by educating our folks on how to perform

better both clinically AND economically so that additional money will be brought

into the door. Then we can pay more to our folks and provide them with better

working conditions. That is the magic pot of money.......

Of course we haven't begun to talk about lobbying gov't for increased

reimbursement through Medicare/caid; being more serious with private pay

patients, and the ability to increase taxes/contributions by providing

value-added services to the community such as education, prevention, and etc.

Since most everybody is tired of this ranting...I will leave those topics for

other times.

Dudley Wait

[Guest guest]

Not trying to be smart, but there's no doubt in my mine you have " increased

training requirements UP,increased rules & regulations UP,expenses UP (through

the roof) salaries DOWN, revenues DOWN, = enrollment DOWN. It all started with

something called Project Alpha, followed by the BBA of 97. Until the BEM really

see the workforce needs/time lines ect' in the best interest of the Public

Health nothing will change much in the next 10 years, other than the same

decline. Once it reaches a Crisis people will scream, but on deaf ears.

Ron

enrollment dip?

For those of you out there who are affilitated with college EMS

training programs, I am interested to know which (if any) of you have

experienced a dip in enrollment in the last year? And, if so, how

much? Have you begun to see a trend reversal recently in applicants

for spring or next fall?

If you would like to respond, please e-mail me privately at

jhil@.... I am in need of this information as quickly

as I can gather it.

Thank you.

Jane E. Hill, Department Chair

Emergency Medical Services Professions

Tyler Junior College

[Guest guest]

Good morning, Ron. I appreciate your response. I agree

with the portion of your email regarding salaries down,

revenues down and regulations going up. However, the

increased training requirements are not the issue. This

was necessary to meet the national standard of care. It

really didn't impact overall expense in our program

(increased the overall cost very little). In fact, it

allowed students to be able to space out their payment

for the program over semesters, making it a little

easier on the pocketbook.

However, the pay in EMS agencies in our area of the

state has not come up to reflect increased education and

in any attempt to recognize EMS professionalism.

Students can't afford to choose EMS as a career when

they can go to school for the same amount of time and

become an RN. Is this increased education a bad thing

then? NO! It means increased quality of care delivered

to our families and friends. However, until EMS

agencies find a way to pay Paramedics in most areas of

the state in such a way that they don't have to have

their families on WIC or other federal social programs,

it makes no sense to many potential students to become

an EMS professional.

We are looking for information and solutions. Anyone

who can help us with that issue, please contact us -

either here on this listserver - or privately.

Jane E. Hill, Department Chair

EMSP

Tyler Junior College

> Not trying to be smart, but there's no doubt in my mine you have " increased

> training requirements UP,increased rules & regulations UP,expenses UP (through

> the roof) salaries DOWN, revenues DOWN, = enrollment DOWN. It all started with

> something called Project Alpha, followed by the BBA of 97. Until the BEM

really

> see the workforce needs/time lines ect' in the best interest of the Public

> Health nothing will change much in the next 10 years, other than the same

> decline. Once it reaches a Crisis people will scream, but on deaf ears.

> Ron

> enrollment dip?

>

>

> For those of you out there who are affilitated with college EMS

> training programs, I am interested to know which (if any) of you have

> experienced a dip in enrollment in the last year? And, if so, how

> much? Have you begun to see a trend reversal recently in applicants

> for spring or next fall?

>

> If you would like to respond, please e-mail me privately at

> jhil@.... I am in need of this information as quickly

> as I can gather it.

>

> Thank you.

>

> Jane E. Hill, Department Chair

> Emergency Medical Services Professions

> Tyler Junior College

>

>

>

[Guest guest]

Very interesting, Jane. I had an opportunity to work with high school kids in a

health occupations program. They want the EMT certification because they can

get some

elective college, a job as an ER tech until they finish with nursing, PT, or RT

degrees, or get some tuition reimbursement for working in the campus clinic/EMS.

Some

even want to go to paramedic school for the same reasons, but none want to go

into EMS

as a profession - not even as a firefighter.

I tell these kids of all the wonderful patient encounters myself and others have

had

over 21 years, the reward of a job well done and done well, and the virtues and

camaraderie of EMS. My cohorts in the other health professions can not hold a

candle

to the intense patient contacts that we have in EMS.

One kid told me his dad said he had too much going for him to be a paramedic.

Another

said that her mother told her 'other people do that but somebody has to do it'.

These

parents, as most, don't want to see their kids in a profession that pays nothing

and

has great life/health risk. How do we put ourselves on the same par as RNs,

RTs, and

PTs? We already have college based programs with high caliber folks like Jane

teaching like them. We already have a certification/licensure process like

them. We

go pell-mell over the wall to care for our patients and the communities

well-being

like them.

What we don't have is consensus like them. We need to organize, joining EMSAT

is a

good start. Beyond that, this stupid jumping through hoops from state to state

and

1000 different levels of certification across the US has got to go. Showing we

are in

this on a nationwide front will be the only way we will ever get paid near what

we are

worth, and start to steal students away from other programs.

aloha,

mikey

[Guest guest]

Interesting thoughts, Mikey. I agree that many parents

discourage their children from careers in EMS. I had one

who decided to go on to be a Paramedic and her father

told her that when she decided to choose a real career,

he would help her with anything she needed.

Interesting, huh?

What can we do as a group to raise community awareness?

Our neighbors and friends apparently still don't

understand that highly trained and qualified people

should come to their homes when they are in need, and

these people are not nurses, doctors or physical

therapists. If something doesn't change soon, we will

be back in the days of throwing them in the back of the

pickup truck or modified hearse, and both personnel

jumping in the front seat and driving like hell to a

hospital where real professionals are....

Jane

>

> Very interesting, Jane. I had an opportunity to work with high school kids in

a

> health occupations program. They want the EMT certification because they can

> get some

> elective college, a job as an ER tech until they finish with nursing, PT, or

RT

> degrees, or get some tuition reimbursement for working in the campus

clinic/EMS.

> Some

> even want to go to paramedic school for the same reasons, but none want to go

> into EMS

> as a profession - not even as a firefighter.

>

> I tell these kids of all the wonderful patient encounters myself and others

have

> had

> over 21 years, the reward of a job well done and done well, and the virtues

and

> camaraderie of EMS. My cohorts in the other health professions can not hold a

> candle

> to the intense patient contacts that we have in EMS.

>

> One kid told me his dad said he had too much going for him to be a paramedic.

> Another

> said that her mother told her 'other people do that but somebody has to do

it'.

> These

> parents, as most, don't want to see their kids in a profession that pays

nothing

> and

> has great life/health risk. How do we put ourselves on the same par as RNs,

> RTs, and

> PTs? We already have college based programs with high caliber folks like Jane

> teaching like them. We already have a certification/licensure process like

> them. We

> go pell-mell over the wall to care for our patients and the communities

> well-being

> like them.

>

> What we don't have is consensus like them. We need to organize, joining EMSAT

> is a

> good start. Beyond that, this stupid jumping through hoops from state to

state

> and

> 1000 different levels of certification across the US has got to go. Showing

we

> are in

> this on a nationwide front will be the only way we will ever get paid near

what

> we are

> worth, and start to steal students away from other programs.

>

> aloha,

> mikey

>

>

>

>

>

[Guest guest]

Huzzah and Hooray. Agree 100%.

gg

E. Gandy, JD, LP

EMS Professions Program

Tyler Junior College

Tyler, TX

[Guest guest]

Jane, you hit the nail on the head and sunk it in the board!!!!!!!!!

Joby Berkley

je.hill@... wrote:

> Good morning, Ron. I appreciate your response. I agree

> with the portion of your email regarding salaries down,

> revenues down and regulations going up. However, the

> increased training requirements are not the issue. This

> was necessary to meet the national standard of care. It

> really didn't impact overall expense in our program

> (increased the overall cost very little). In fact, it

> allowed students to be able to space out their payment

> for the program over semesters, making it a little

> easier on the pocketbook.

>

> However, the pay in EMS agencies in our area of the

> state has not come up to reflect increased education and

> in any attempt to recognize EMS professionalism.

> Students can't afford to choose EMS as a career when

> they can go to school for the same amount of time and

> become an RN. Is this increased education a bad thing

> then? NO! It means increased quality of care delivered

> to our families and friends. However, until EMS

> agencies find a way to pay Paramedics in most areas of

> the state in such a way that they don't have to have

> their families on WIC or other federal social programs,

> it makes no sense to many potential students to become

> an EMS professional.

>

> We are looking for information and solutions. Anyone

> who can help us with that issue, please contact us -

> either here on this listserver - or privately.

>

> Jane E. Hill, Department Chair

> EMSP

> Tyler Junior College

> > Not trying to be smart, but there's no doubt in my mine you have " increased

> > training requirements UP,increased rules & regulations UP,expenses UP

(through

> > the roof) salaries DOWN, revenues DOWN, = enrollment DOWN. It all started

with

> > something called Project Alpha, followed by the BBA of 97. Until the BEM

really

> > see the workforce needs/time lines ect' in the best interest of the Public

> > Health nothing will change much in the next 10 years, other than the same

> > decline. Once it reaches a Crisis people will scream, but on deaf ears.

> > Ron

> > enrollment dip?

> >

> >

> > For those of you out there who are affilitated with college EMS

> > training programs, I am interested to know which (if any) of you have

> > experienced a dip in enrollment in the last year? And, if so, how

> > much? Have you begun to see a trend reversal recently in applicants

> > for spring or next fall?

> >

> > If you would like to respond, please e-mail me privately at

> > jhil@.... I am in need of this information as quickly

> > as I can gather it.

> >

> > Thank you.

> >

> > Jane E. Hill, Department Chair

> > Emergency Medical Services Professions

> > Tyler Junior College

> >

> >

> >

[Guest guest]

Well, here I have set reading all that you all have written. For the most

part I have to agree, but until the level of pay, and professionalism goes up

and we are recognized as health care professionals, we can forget it. We

will only be ambulance drivers. Education is only one of many keys to get us

where we need to be. EMS is a Health Care Profession and for those of us

that go out there and work in it deserve better. We are the first ones in

the mess and usually the last ones to complain.

Jim

[Guest guest]

Thanks, Joby!!!!

> Jane, you hit the nail on the head and sunk it in the board!!!!!!!!!

>

> Joby Berkley

>

> je.hill@... wrote:

>

> > Good morning, Ron. I appreciate your response. I agree

> > with the portion of your email regarding salaries down,

> > revenues down and regulations going up. However, the

> > increased training requirements are not the issue. This

> > was necessary to meet the national standard of care. It

> > really didn't impact overall expense in our program

> > (increased the overall cost very little). In fact, it

> > allowed students to be able to space out their payment

> > for the program over semesters, making it a little

> > easier on the pocketbook.

> >

> > However, the pay in EMS agencies in our area of the

> > state has not come up to reflect increased education and

> > in any attempt to recognize EMS professionalism.

> > Students can't afford to choose EMS as a career when

> > they can go to school for the same amount of time and

> > become an RN. Is this increased education a bad thing

> > then? NO! It means increased quality of care delivered

> > to our families and friends. However, until EMS

> > agencies find a way to pay Paramedics in most areas of

> > the state in such a way that they don't have to have

> > their families on WIC or other federal social programs,

> > it makes no sense to many potential students to become

> > an EMS professional.

> >

> > We are looking for information and solutions. Anyone

> > who can help us with that issue, please contact us -

> > either here on this listserver - or privately.

> >

> > Jane E. Hill, Department Chair

> > EMSP

> > Tyler Junior College

> > > Not trying to be smart, but there's no doubt in my mine you have

" increased

> > > training requirements UP,increased rules & regulations UP,expenses UP

> (through

> > > the roof) salaries DOWN, revenues DOWN, = enrollment DOWN. It all started

> with

> > > something called Project Alpha, followed by the BBA of 97. Until the BEM

> really

> > > see the workforce needs/time lines ect' in the best interest of the

Public

> > > Health nothing will change much in the next 10 years, other than the same

> > > decline. Once it reaches a Crisis people will scream, but on deaf ears.

> > > Ron

> > > enrollment dip?

> > >

> > >

> > > For those of you out there who are affilitated with college EMS

> > > training programs, I am interested to know which (if any) of you have

> > > experienced a dip in enrollment in the last year? And, if so, how

> > > much? Have you begun to see a trend reversal recently in applicants

> > > for spring or next fall?

> > >

> > > If you would like to respond, please e-mail me privately at

> > > jhil@.... I am in need of this information as quickly

> > > as I can gather it.

> > >

> > > Thank you.

> > >

> > > Jane E. Hill, Department Chair

> > > Emergency Medical Services Professions

> > > Tyler Junior College

> > >

> > >

> > >