Louisville Metro Emergency Medical Services will place more of its staff in vehicles throughout the community -- including paramedics in "fly cars," instead of ambulances -- to improve response times and bolster services in the most critical cases, according to a new plan outlined yesterday.
EMS director Neal Richmond said the plan's overall goal is to reduce response times from the current average of 8 minutes.
It's "an approach that puts a prepared, skilled, productive provider on the street," Metro Mayor Jerry Abramson said, and is part of an effort to rebuild the emergency medical system following Louisville-Jefferson County merger.
But the Teamsters union, which represents paramedics and the lower-paid emergency medical technicians, plans to file a grievance over the plan, saying it violates the employees' contract and strips them each of thousands of dollars of guaranteed overtime pay each year.
Currently, emergency medical staff members work seven 12-hour shifts every two weeks and receive at least eight hours of overtime. Under the new plan, they would work eight 10-hour shifts over the two weeks and wouldn't be guaranteed any overtime.
Union steward Mike Will said the new system would cost some employees up to $7,000 a year. "We're going to work more days for less money," he said.
Before merger in 2003, a fire department-based medical service responded to calls in the old city of Louisville while a stand-alone ambulance service covered the rest of the county.
Abramson merged the services earlier this year, and Richmond has been tweaking the system ever since.
The city has added 46 EMS workers this year. It also has bought 11 new ambulances, refurbished seven others and purchased 10 Ford Explorers that are equipped with defibrillators and medical supplies.
The biggest sticking point in Richmond's changes is the schedule shift, which he argues is necessary to get more medical workers on the streets where and when they are needed.
Ten-hour shifts would give the agency more scheduling flexibility, he said.
The agency's lowest call volume is about 5 a.m. and its highest call volume is about 4 p.m., said Chad Carlton, a spokesman for Abramson. Yet until recently, Carlton said, the agency was evenly staffed around the clock.
Richmond said his planned system is "really dynamic, flexible."
Union leaders disagree.
"We'll have to work two days more in a week and have less downtime," Will said.
Will said the union is not planning to walk off the job -- "We are not going to put anybody in peril" -- but will file a grievance and ask an arbitrator to restore the old schedule.
"There is a dispute in contractual language," he said. "We are going to take this to arbitration and let the chips fall where they may."
Also under the new plan, slated to take effect next month, most ambulances would remain staffed with an emergency medical technician and a paramedic. But some will be staffed only with two EMTs, who would respond alone to less serious calls.
On other calls, such as heart attacks, paramedics in "fly cars" -- Ford Explorers that are not equipped to transport passengers -- also would be dispatched.
Currently, there are 22 to 24 ambulances on the road at all times in the city, Carlton said. Under the new plan, there will be anywhere from 23 to 30 ambulances on the road, along with 10 fly cars.
Many ambulances are currently assigned to firehouses, but Richmond said the agency can improve response times and eliminate redundancy by moving some of the ambulances elsewhere, since firefighters also are dispatched on ambulance runs and many have emergency medical training.
The agency also is studying the city's hospital emergency rooms to determine how it can get ambulances in and out more quickly by streamlining paperwork and other tasks.