June 6, 2020 — “You say we’re overpaid to comparable agencies. There are no comparable agencies. Western Lane Ambulance District (WLAD) is in a league of their own and we have worked tirelessly to get there,” said 14-year WLAD veteran Danielle Holmes during a joint board meeting of WLAD and Siuslaw Fire Valley and Rescue (SVFR) on May 28.
The comments come after a WLAD budget meeting where cuts to employee benefits were discussed in an effort to balance the district’s budget. While negotiations between union employees and the district are ongoing, in the meeting, WLAD/SFVR Chief Michael Schick proposed cuts that included decreases in health benefits and PERS payments.
Some members of the budget committee suggested the district entertain even deeper cuts, including an overhaul on overtime scheduling and possible salary cuts.
But during the joint meeting weeks later, WLAD employees and medical partners spoke out against proposals, suggesting it could create an upheaval in the current system.
“With the cuts the chief is proposing, you will not be able to retain the experience, compassion or dedicated employees you have now,” Holmes said. “You will be left with high-turnover people who are just looking for a few extra bucks because no one will be able to financially afford this community. We’ve always tried to work with our administrative staff — both on and off negotiation — including refraining from writing numerous grievances with contract matters. We still want what is best for this agency and have been willing to cut back on whatever we have to, as long as it doesn’t jeopardize care of a patient.”
The discussion covered a host of issues, ranging from the need for highly trained staff in an isolated region, to the emotional toll that EMS positions have on employees and family members. It was argued that while the numbers may have shown high benefits for employees, they ignored the worth of the employees.
“If you make decisions that decimate the crews, absolutely the net result will be harm to the citizens of Florence and Western Lane County,” said Cory Miner with Lane EMS. “Make no mistake, your husbands, wives, sons, daughters, mothers, fathers, friends and neighbors will not be afforded the level of care they deserve.”
However, expected increases in PERS costs by the state, along with the amount of calls WLAD receives, has put the district in a difficult position. No board member has discussed cutting services that would put people at risk, but employees suggest making cuts to benefits would force well-trained staff to look elsewhere for employment. WLAD could increase its tax levies, but some budget committee members argued that taxpayers would not be comfortable footing the bill for such benefits.
“We’re absolutely not looking to cut services, but we want to be able to afford the services we have,” Schick told Siuslaw News in an interview this week. “The board was very moved by all the comments, and we’re thankful we had them. I think everybody wants a financially stable district — that’s our goal. Everybody would agree on that. It’s just, how do you get to that point?”
The current discussion on wages and benefits began on May 14 during a budget committee meeting, where WLAD hoped to pass the budget for 2020-21. The district had planned to have both labor negotiations and a strategic plan worked out by the budget meeting, but the COVID pandemic put a halt to those early in the year.
WLAD is legally required to pass a budget by July, which meant that Schick was legally required to at least make a proposal that included possible budget cuts, though nothing was set in stone. The cuts he proposed included having employees make full payments on insurance deductibles and PERS payments.
“We are absolutely aware of the tremendous impact it will have on our employees, and we didn’t come up with those proposals lightly,” Schick said.
However, some budget committee members suggested that more cuts were needed, and there were systemic issues with how things were structured, citing issues from overtime to benefits that balloon WLAD compensation packages compared to other similar ambulance service entities. One of the members, RJ Pilcher, spoke at the joint meeting to give specific numbers to the entire board.
“Personnel services are 58.69 percent of total expenditures,” he said. “Paramedic top base rate is $84,140 a year, or 46.9 percent over the 90th percentile of paramedics in the state of Oregon. Paramedic supervisors’ top base rate is $96,761 a year, or 68.94 percent over the 90th percentile of paramedics in the state of Oregon. EMTs top base rate is $61,516 a year, or 37 percent over the 90th percentile of EMTs in the state of Oregon.”
Pilcher stated that health insurance payments by the district were beyond what most other agencies paid, as well as vacation benefits accrual and other benefits, such as gym memberships.
“It is always important to treat all the employees of WLAD with dignity and respect. Your true and only fiduciary responsibility is to the ratepayers. I am not sure the rate payers would be willing to approve of an optional levy if they knew how much overmarket payroll and benefits are,” Pilcher said.
But Schick questioned whether or not the comparison is apples to apples.
“I can’t really refute those numbers, but I think Mr. Pilcher was looking at more statewide agencies — as well as private agencies — which typically pay a lot less,” he said.
Simply comparing salaries WLAD to other agencies omits the context, as the benefits and wages are high for a host of reasons that are unique to the Siuslaw region.
The ambulance district’s location and age of the population are integral parts of the wage equation.
“There is no other district in the state that has the amount or percentage of critical care, training medics that we have,” said Dr. Matthew Danigelis in public comments during the joint meeting. “Because of that, the overall increase in patient visits and the high acuity of our patients in general, we have a much higher admission and transfer rate than most other hospitals due to the — basically — elderly nature of our town.”
Older patients get sick more, which in turn fills up PeaceHealth Peace Harbor Medical Center.
“We’re transferring sick patients, an hour plus, by ground to RiverBend on a daily basis, often many times a day,” Danigelis said. “These patients just aren’t broken femurs from the dunes that need morphine every 20 or 30 minutes. These are people that are in cardiopulmonary failure, are on multiple drips. They need ventilator management because their airways are being controlled by a machine.”
These are not skills that average paramedics possess, Danigelis stated. That training not only costs money, but it also makes employees more employable and more likely to move to other higher paying agencies.
Miner argued that cutting wages and benefits could lead to an underdeveloped workforce, putting lives at risk.
“If you change the level of care based on decimating these crews, you’re going to wind up in a situation where lives are in danger by not being able to get to the medical care that they need in a timely fashion,” he said.
Multiple public speakers argued that the benefits and pay not only ensure that employees have skills to perform their duties, but also to ensure that employees with those skills can afford to live in a region with traditionally high housing costs and general cost of living expenditures.
While the district could outsource to a private agency to cut costs, they most likely would not be able to provide the same level of care needed in a unique region like that of the Siuslaw.
“It would definitely be cheaper, but you get what you pay for with that model,” Schick said. “I don’t think there’s any serious thought of bringing in a private ambulance company here. I don’t think we’ll get the same level of service.”
But providing that level of service takes a toll on employees that even the highest benefits would have difficulty covering.
For the past three months, Holmes has been on leave for issues relating to PTSD, depression and anxiety.
“Whenever I mention I’m on leave from work for these things, not one person has ever asked why. They haven’t because there’s no need to,” she said.
Holmes described seeing first-hand the deaths of coworkers and community members as she tried in vain to save them.
“I still cannot get the screams out of my head of the countless family members as we tried desperately to save their loved ones, only to hear it again that we failed,” she said. “I’ve seen babies that have taken their first breaths, and ones that will never breathe again. I have left triage to save one person to save another while they screamed at me to stop and save their friend. My hands have done more things than my mind will ever forget.”
Holmes addressed a concern brought up by WLAD board member Larry Farnsworth that scheduling was too dependent on overtime.
“Do you think for one second that work is dropped off at the door when we leave? I can attest that it doesn’t,” she said. “I can attest that we go home so physically and mentally exhausted that we’re zombies for the next 24 hours, unable to fully engage our families or even tell them what’s wrong.”
Holmes stated that the money paid in overtime does not make up the life events that a perpetually on-call life takes away from employees, including holidays, birthdays “and watching children take their first steps.”
“Why don’t we just take those days off? Because no one wants to burden another employee with any more time away from their families,” she added.
Other benefits were also discussed, including a paid gym membership.
“The gym membership is something we’ve had for 20 years,” said Division Chief Matt House, who serves with both WLAD and SVFR. “That is to ensure that our employees are in good shape and preventative care. If somebody injured their back, it’s a lot more expensive than preventative care with a gym membership.”
Another reason for high wages is the length of employment of current employees, some of whom have worked for decades in the district.
“The longevity of our employees is fantastic,” Schick said. “We have people that have been here for a long time, but they’re usually at the higher end of salary and benefits for us.”
Having a large pool of career employees can help in emergency situations, as WLAD board director Mike Webb pointed out.
“In 2015, we lost our lead office person, and our executive director passed away,” he said. “Our office was in complete disarray, and yet our office continued to function, and function very well because of the quality of staff that we have. We couldn’t have done that without the type of people that we have. Not a chance. … We don’t have a district where if someone passes away, we’re going to be left without a leader. There’s reasons we have benefits.”
Still, there are rising costs that make benefits difficult.
The state has suggested that it will be increasing the amount of payments agencies will have to make.
“That’s a couple of years from now, so it wouldn’t be in this budget. And that’s the big debate, as far as the budget,” Schick said. “If expenses are going up 5 percent per year, but our revenue is only going up 3 percent a year, how long can you do that?”
Webb pointed out that in 2012, the call volume was 1,890. But last year, it was almost 4,000 “with the same tax revenue.”
“Currently, demand for our services is much, much higher than what they were in the past,” he said. “That’s a big driver of why we have declining revenue compared to expenses. We have the best crew ever, and we have for a very, very long time. It’s important to keep these people and keep them as happy as we can within reason. Everybody has to be able to afford to live in this district, but within our means. If we can’t, we can’t survive. But we still need to strive to provide the best service that we can, for the high quality that our people demand, and I think our voters would more than support going out and continuing to fund the district as they have in the past.”
Schick stated that he is confident WLAD and the union will be able to reach an agreement that can address some of these issues.
“We have a great relationship with the union, that’s never been in doubt,” the chief said. “But how do we solve these problems? We haven’t sat down and talked in detail yet. We’re doing the easy stuff with negotiations. We fully anticipate the union will come back with their own proposal, and we’ll compare it to the district’s proposal, and see where the compromises are.”
But the current negotiation is only for one year, and the conversation will not end when a final budget is signed in the coming weeks.
“It’s imperative we get a good plan for WLAD moving forward,” said WLAD board member John Murphey. He suggested they hold a strategic planning committee no later than July 10, and that multiple voices are heard, from SVFR and WLAD employees to City of Florence representatives, school districts and local nonprofits.
“After the strategic plan is done, we do that before we start in the budget process next year,” he said. “That way, it will be our budget driver.”
When the plan is being worked out, WLAD board member Cindy Russell stated that patient care should always be the driving factor.
“I feel that we’re looking at numbers, and given the field I work in, we need to look at quality before we look at numbers,” she said. “You can’t put a number on life. You can’t put a number on the care for a community. The community here expects and deserves to receive quality care.”