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County EMS Struggling Under the Weight of COVID Surge

"All of public protection has seen a lot of impact from the current pandemic, but really specifically EMS. They really are on the frontlines every day."

Volusia EMS.jpg
A Volusia County Emergency Medical Services ambulance rolls toward the Advent Health ER, Thursday August 5, 2021.
David Tucker/News Journal
(TNS) - The Volusia County, Fla., Council's discussion on Emergency Medical Services turned heated Tuesday, with the division struggling amid the lingering COVID-19 pandemic and a short supply of paramedics.

In July, EMS had 5,000 transports. Public Protection Director Joe Pozzo said that's the most they have ever seen, approximately a 15% increase over the 4,200 to 4,500 they were transporting under normal circumstances.

"All of public protection has seen a lot of impact from the current pandemic, but really specifically EMS," Pozzo told the council. "They really are on the frontlines every day."

On top of that, offload times at hospitals have increased as the hospitals have been inundated with COVID-19 patients.

"We're in the thick of this," Councilwoman Barb Girtman said. "It's hard to keep your people throughout this period when everybody's sacrificing. They're putting themselves and their families in harm's way every day."

EMS has lost at least 21 paramedics this year, prompting the county to offer $4,500 recruiting and $5,000 retention bonuses this month.

Pozzo said they have added three ambulances in the past year and two additional ambulances were approved in May, but they can't staff them due to a shortage of paramedics.

Volusia Council clashes over a way forward

Pozzo was on the hot seat for nearly two and a half hours Tuesday in the marathon council meeting that stretched from 9:30 a.m. to 8 p.m. , and things got a little ugly.

Councilwoman Heather Post said she had been frustrated by her conversations with Pozzo about how to balance revenue with the needs of the community.

"Revenue and monies should never ever come before the safety of our citizens," she said. "I'm not here to rag on you specifically, Joe. I'm not a county employee. I work for the people. We've had these discussions many times. Safety to me is number one."

Councilman Danny Robins cut her off and motioned to move on.

"I've sat here for 15, 20 minutes watching this dedicated employee get beat up. This is a witch hunt," Robins said.

"It's gone on long enough," Councilman Ben Johnson agreed.

"You want me to call for a vote to cut off a councilmember?" County Chair Jeff Brower asked.

Post didn't stop, leaving a chaotic scene as councilmembers repeatedly asked Brower and County Attorney Mike Dyer to call things to order.

Billie Wheeler interjected to say dealing with the day-to-day of EMS operations was beyond her expertise and should be left to Pozzo and the county manager.

After several minutes, the council voted to move forward.

" Mr. Pozzo , I hope this ends with you requesting money to make some solutions," Post said.

Post asked what they could do with pandemic relief money and Pozzo said adding three additional ambulances now would help. EMS has budgeted to add those ambulances one at a time over the next three years.

"In order to have us at the adequate — not phenomenal — adequate response times, he needs all of this now," Post said. "If he needs this to get us, right now, to adequate response times across the board, then I think we should be doing everything in our power to get him to that level today."

County Manager George Recktenwald said EMS was given everything they asked for in the budget.

"If we don't have the bodies, none of this is going to matter," Robins said.

'Error in judgment' results in death in Deltona

Post also asked Pozzo to explain what happened with a death in Deltona of a patient awaiting medical transport.

Pozzo said several weeks ago, Volusia County and Deltona both responded to an early morning crash on Howland Boulevard . The county got there first and took the first patient. Two more patients needed to be transported.

Pozzo said Deltona requested to transport one of those patients on a ambulance only meant to run at night, but the request was not approved. That person died.

"It was an error in judgment," Pozzo said.

Pozzo said system status controllers have since been retrained and Deltona has since been approved to staff that ambulance 24 hours a day. He's in similar discussions with Port Orange's new Fire Chief Joe Wulfing .

Port Orange's previous fire chief was fired after getting into a heated discussion on the subject with Pozzo.

EMS revamped after 2018 issues with response times

EMS was overhauled in the past three years after issues with response times drew scrutiny.

Since 2018, Pozzo said they've established additional EMS service centers to fill gaps in coverage; separated out interfacility transfers from the rest of calls; and instituted an award-winning E-911 redirect program to triage calls and only use ambulances when necessary.

EMS is operating dynamically, meaning they deploy from different locations throughout the county instead of returning to stations to await calls, especially in the 12 hours defined as peak times.

Post asserted that approach this isn't working and is part of what is driving away personnel.

Johnson noted emergency responders all over the country were struggling due to COVID-19.

"We shouldn't be micromanaging them at this time," Johnson said.

Post replied that it was their job to make sure policy was implemented and that she expected to be informed of changes made to the model agreed upon in 2018.

"When I have to find out these things from personnel, when I have to find out these things from the public, that's not appropriate," she said. "I would expect that council be told."

Recktenwald said there have been no changes to the agreed upon model, but the closest unit must always respond, according to county ordinance.

"The model hasn't changed. It's just that they're a lot busier," he said. "These are command decisions that are going on all day long... You can't get into the day-to-day operation of what we're doing."

Brower said he understood decisions would be made on the fly, but he wanted communication to improve.

"You need to respect us enough that you can come to us," Brower said. "I guarantee you we're going to hear about it and we want to be responsible to the people we serve in this county."

Robins said he thought the council was on the brink of overstepping its bounds by getting involved in day-to-day operations.

He addressed Pozzo: "You have my support, 110%. If you need something, you call us."

Johnson and Lowry said the same.

"We have a council up here. It's not up to one person to direct," Lowry said. "I kinda get a sense that most of us are pretty well pleased with the decisions and the effort that has been made in this emergency time."

A new EMS director was hired this month, Michael Colman , and he'll take the reins Sept. 7 .

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