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The $21M Texas EMS recruitment and retention initiative

State EMS Director Joe Schmider on how Texas’ data-driven plan brought in 10,915 new providers

Recruiting and retaining EMS professionals has been an ongoing challenge across the U.S., made worse by the COVID-19 pandemic. In this episode of the EMS One–Stop podcast, host Rob Lawrence sits down with Joe Schmider, Texas State EMS director, to discuss the $21M Texas EMS Workforce Initiative — a data-driven approach to recruiting and retaining EMS providers statewide.

Schmider details how Texas identified a 40% non-utilization rate among certified EMS professionals, successfully secured state funding, and launched an innovative recruitment and retention campaign. With over 10,915 new personnel added since 2019, this program serves as a model for other states struggling with EMS workforce shortages. This episode is full of actionable insights for EMS leaders, policymakers and recruiters alike.

Key quotes from Joe Schmider

“We were seeing about 40% of our certified people — licensed paramedics, EMTs, advanced EMTs — were not using their skills on an ambulance.”

“We worked with our associations here in Texas, the Texas EMS Alliance and the Texas Ambulance Association. They went and met with some legislators, worked the room a bit, and we got $21 million of federal dollars through the state to us for 2 years to put in place a recruitment and retention program.”

“We pushed out 3,152 scholarships. An EMT scholarship was worth $2,000, an advanced EMT scholarship was $3,200 and a paramedic scholarship was $8,000. The money went directly to the education program, not to the student. They had 1 year to complete their training and then had to serve 96 hours a month on an ambulance — either as a paid or volunteer position — for 1 year at the EMT level and 2 years at the paramedic level.”

“We spent $1.5 million on an advertising campaign throughout the state of Texas. We hired a media company to develop commercials, billboards and social media campaigns. The use of social media was incredible — 50 million views over 2 years, which was an incredible number. We never expected that.”

“The second thing people do [when considering EMS careers] is they watch us as EMS professionals. Do I want to work with these people? Do I want to be a part of this? I once saw two EMTs standing on the back of an ambulance smoking a cigarette at an event. I went up to them and said, ‘Are you kidding? What message are we putting out when we do stuff like that?’ We have to think about our image.”

“People leave the EMS profession for two reasons: money or the way they’re treated. Depending on which survey you look at, it could be money first or treatment first, but it’s always those two reasons.”

Episode timeline

00:08 – Rob Lawrence introduces guest Joe Schmider, Texas EMS director

00:26 – The EMS staffing crisis and how COVID-19 accelerated workforce shortages

01:36 – How Texas used data to identify a 40% EMS non-utilization rate

02:51 – How Texas EMS leaders secured $21 million in funding

04:31 – Structuring EMS scholarships and training requirements

06:41 – The success of the recruitment campaign: 3,152 scholarships awarded

08:46 – How Texas reached 50 million views in its EMS recruitment campaign

11:16 – EMS workforce retention: The challenges of pay and treatment

13:46 – Addressing rural EMS shortages and workforce gaps

16:01 – How Texas EMS associations helped advocate for change

18:21 – The future of EMS funding and advocacy efforts

21:01 – Lessons from corporate retention strategies: What EMS can learn from HEB grocery stores

24:01 – The importance of EMS provider wellness: Texas’ Wellness Wednesday initiative

26:01 – Final takeaways: Lessons for other states and EMS leaders

28:01 – Closing thoughts and how to access Texas EMS resources

Additional resources

Recruitment & Retention Resources
EMS1’s EMS trends state-of-the-industry survey provides targets for reducing stress, staffing challenges and leadership shortfalls
Rob Lawrence and Scott Moore on how to retain EMS staff through the first year
Paramedics: don’t settle for a living wage. Instead, be audacious and demand a thriving wage for your lifesaving career of community service
Promote a paradigm shift in your recruiting practices to hire your next employee and keep them engaged
If we want to keep up, it’s time we change gears and evolve from a traditional recruitment strategy
With a rising percentage of the workforce working a side gig or as a freelancer, services will need to adapt to recruit generations satisfied by being their own boss

Rob Lawrence has been a leader in civilian and military EMS for over a quarter of a century. He is currently the director of strategic implementation for PRO EMS and its educational arm, Prodigy EMS, in Cambridge, Massachusetts, and part-time executive director of the California Ambulance Association.

He previously served as the chief operating officer of the Richmond Ambulance Authority (Virginia), which won both state and national EMS Agency of the Year awards during his 10-year tenure. Additionally, he served as COO for Paramedics Plus in Alameda County, California.

Prior to emigrating to the U.S. in 2008, Rob served as the COO for the East of England Ambulance Service in Suffolk County, England, and as the executive director of operations and service development for the East Anglian Ambulance NHS Trust. Rob is a former Army officer and graduate of the UK’s Royal Military Academy Sandhurst and served worldwide in a 20-year military career encompassing many prehospital and evacuation leadership roles.

Rob is a board member of the Academy of International Mobile Healthcare Integration (AIMHI) as well as chair of the American Ambulance Association’s State Association Forum. He writes and podcasts for EMS1 and is a member of the EMS1 Editorial Advisory Board. Connect with him on Twitter.