Nationwide shortages of emergency medical service providers have had a big impact in Forest Park, where the fire chief says his department is routinely filling half the available shifts while their third-party contractor struggles to keep up with the demand for staff.
Forest Park Fire Chief Phil Chiappetta said the village’s third-party provider, Metro Ambulance Service, is supposed to provide six paramedics to man the village’s ambulance in three two-person shifts throughout the day. But for the last several months at least, Chiappetta said no more than three contract paramedics have been available and that, until recently, that number was only two.
The shortfall means that Forest Park firefighters, all but one of whom are cross-trained and certified firefighter paramedics, have been working overtime shifts to cover the gaps. Chiappetta said finding volunteers to work those shifts has, thankfully, not been a problem, but that the lingering effects of what he described as a “statewide shortage” have led him to approach village hall about ending the contract with Metro Paramedics when it expires in April 2023 and converting the village’s ambulance staff to full-time fire department employees.
“This isn’t going to be a problem that’s going to be solved anytime soon,” Chiappetta said. “Right now, these companies, they’re coming to the town asking for more money to jack up the base pay for these guys, but when you start jacking up the price it doesn’t become cost effective.”
Michael Tillman, a vice president at Metro Paramedics, didn’t dispute Chiappetta’s characterization. He said paramedics are in short supply nationwide and that one part of a more complex web of issues is that base pay for contract paramedics is extremely low, something that is causing people to leave the business and dramatically shrinking the pool of students who are now attending and completing paramedic certification programs.
Tillman would not divulge how much his paramedics are paid, but he said Metro has been trying to raise pay for years, something prompted by incremental increases in the minimum wage in Illinois, which is now $12 per hour. Tillman said he’s lost clients in other municipalities as Metro has raised prices to try and subsidize wage increases, but that right now companies like his have few other options.
“We offer some benefits in that we provide [clients] with fixed contract costs … but we told them, one way or another you’re going to pay,” Tillman, who described the business model as a public-private partnership, said. “If it goes up in our world it’s certainly going to go up in the government sector.”
“Others have told us, hey, where [Metro] want[s] to go with wages, either they don’t have the budget or they can hire their own firefighter paramedics and we understand that.”
Because Metro has been unable to fulfill its end of the contract with the village, Forest Park taxpayers are not shelling out any additional tax dollars to make up for the shortage. Any overtime hours paid to Forest Park firefighters are deducted from the amount the village pays to Metro, so for now the financial implications in the village are minimal. That’s not the case, of course, for Metro, which Tillman said has openings in several municipalities throughout Northern Illinois.
“It hurts. It definitely hurts,” Tillman said. “But again, we’re one of those employers where we’re trying different things and just trying to survive.”
Tillman cited a number of factors for the shortage, including wages; the universal worker shortage hitting many sectors, especially those that are low-paying; the impact of a COVID-19 vaccine mandate that he said has cost him some paramedics; and the high cost of operating an ambulance in the first place, especially amid rising inflation.
According to Tillman, government-funded programs like Medicare and Medicaid reimburse the ambulance providers only a small fraction of what an ambulance run actually costs, and those losses translate to lower available pay for employees and greater expenses passed on to municipalities.
“Commercial insurance will pay that difference and so a lot of people scream about surprise billing … and a lot of that is driven by [government reimbursement],” Tillman said. “When the government payors reimburse at a rate that doesn’t keep up with the inflation that everyone’s realizing, that’s a problem.”
Chiappetta, for his part, said he’s hopeful for the prospect of bringing the paramedic service in-house, something that is buoyed by an effort from former chief Steve Glinke to cross-train staff to serve in both roles. In the meantime, the fire department continues to fill the open slots and ensure Forest Park residents can get the emergency services they demand and expect.
“I am very proud of the guys stepping up to fill these spots,” Chiappetta said. “They care about the residents. … Our firefighters are doing a great job going above and beyond because they know how important the ambulance service is to Forest Park.”