By Sean McDonnell
cleveland.com
CLEVELAND — Cleveland’s paramedics and EMTs are asking City Hall to beef up hiring for Cleveland EMS, saying that Mayor Justin Bibb’s proposed budget leaves the department understaffed.
EMS commissioners in October told City Council that they wanted another 11 positions in 2025, recovering some of the positions cut from the budget two years ago. But when Bibb’s budget was released in early February the additional staff wasn’t included.
The mayor’s decision to not ask for more EMS staff raised some council members’ eyebrows. Now the union representing EMS workers wants those staffers added to the final budget.
“When he (Bibb) was campaigning he would always say, Cleveland can’t wait,” said Timothy Sommerfelt, vice president of the Cleveland Association of Rescue Employees. “And that’s true. Cleveland also can’t wait for an ambulance.”
EMS staffing is just one of hundreds of line items that council members and Bibb’s administration reviewed together during the city’s budget hearings the past two weeks. Negotiations between Council President Blaine Griffin and Bibb are expected to start in earnest this week.
In the background of the EMS staffing debate are two revenue issues: An increase in ambulance rates and the city’s struggles to collect on those bills.
In 2023, Bibb reduced the budget for EMS — and in other departments like police — because those positions were largely vacant and hiring was difficult. The total EMS budget for staff was reduced from 332 to 304 positions.
A presentation that EMS Commissioner Orlando Wheeler brought to council during operational review meetings in October said EMS would ask for 315 positions in 2025. But Bibb’s budget released in February keeps staffing levels at 304.
Cleveland EMS currently has 292 staff, with nine more trainees expected to start on March 31.
Sommerfelt said hiring has become easier because of increased wages Bibb negotiated with the union in 2023. And EMS leaders said during budget hearings that there are trainees in the pipeline to fill vacancies.
Sommerfelt said the union is supporting the EMS commissioners, who initially said 315 was the right staffing level.
EMS workers can have an outsized impact on health outcomes, Sommerfelt said, since they’re often the first healthcare providers that a person interacts with in an emergency.
And Cleveland EMS is investing in that care. The new budget includes money for ventilators and money to support the department’s future plans for a blood transfusion program. Paramedics also want to do more outreach in the community, like CPR training and first aid training.
These are great programs, Sommerfelt said. But EMS needs additional staff to do this community outreach and to allow paramedics to train on this new equipment.
“If we don’t get this increase, we’re going to have to take away paramedics from 911 response duty for these programs,” Sommerfelt said.
An EMS worker costs roughly $110,000 with salary and benefits, Sommerfelt said. Considering the time it would take to hire them, he said bringing the department to 315 would add about $1 million 2025’s budget.
Also in the EMS budget is a revenue issue that may finally get fixed.
In July 2022 Cleveland substantially raised billing rates for ambulance services, bringing the costs between roughly $750 and $1,300. That’s more than double the previous base rates that were between $350 and $500. Cleveland had been far cheaper than its peers.
The EMS workers’ union pushed for those increases, and so did council members, saying the revenue could be invested back into EMS.
But Cleveland has failed to collect more revenue because the city department that used to handle these bills was plagued by vacancies.
Cleveland’s EMS revenue was $16.8 million in 2021 and $14.4 million in 2022. But it tumbled to $8.6 million in 2023 and $4.1 million in 2024. To fix this issue, Cleveland handed over billing to an outside company starting Jan. 1.
How much Cleveland is still owed from past years is hard to measure. Not all EMS bills are collectable because of circumstances that get worked out with hospitals and insurance companies, city spokesperson Sarah Johnson said.
But Cleveland expects to collect between $15 million and $16 million for 2024, and it’s already seeing some success at getting that money. The new billing company has collected $4.7 million in just a month and a half, collecting on both old and new bills.
Cleveland is budgeting for $16 million in EMS revenue for 2025, which finance staffers say is a conservative estimate.
Councilman Charles Slife said it was surprising when EMS came to budget hearings without the additional positions they pitched in October. He said a number of council members think those staff should be added to the budget.
Councilman Mike Polensek, who chairs council’s public safety committee, has also said he’s asking for increased staff in budget negotiations — adding that EMS is one of the quality-of-life services Cleveland needs to invest in.
“We aren’t patching a pothole here,” Polensek said. “This is life and death.”
While the point of Cleveland EMS isn’t to generate revenue, Slife said the spirit of raising ambulance rates in 2022 was to help fund the department.
If revenue collections are improving, it makes sense to increase EMS staffing levels, Slife said.
“They are a really crucial component of our public safety infrastructure,” Slife said. “If there’s an opportunity to increase the funding, why would we not take that opportunity?”
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