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Beyond Status Quo


Like many counties around the nation, Greenville County (S.C.) EMS is grappling with how to address an ongoing paramedic shortage. The busy EMS agency fields some 60,000 calls a year, and the need for qualified paramedics is sometimes acute.

“We are one of the largest emergency medical services in the state, so we have a lot of paramedics,” says Eric Longino, captain of human resources for Greenville County EMS (GCEMS). “That magnifies our current situation in the need for procurement, so instead of living day-to-day, we tried to look into the future to see how we could correct the shortage.”

Not satisfied with leaving things status quo, Longino analyzed and corrected the problem, both in the short and long term.

For Longino, the process began with carefully examining the way the agency typically handled recruiting and staffing. He began talking with other businesses outside of EMS about how they dealt with worker shortages, and many recommended developing an apprenticeship program. “Apprenticeships have been around for years, but they are more typically found in plumbing and electrical engineering,” Longino says.

Still, the idea intrigued him. Longino inquired about developing an apprenticeship program between Greenville EMS and Greenville Technical College, which was receptive to the idea.

“We are fortunate in this area because we have several community colleges,” he says.

With the community colleges on board as willing participants, Longino mapped out a program that would allow Greenville to capture people interested in an EMS career early on. GCEMS would then sponsor them, help pay for their educational costs and eventually have fully trained paramedics ready to go.

“The actual industry shortage is what motivated us to start thinking outside of the box,” Longino says.

Program Liftoff
The basic components of the program were started in 2009, and to Longino’s knowledge, the apprenticeship program is the first of its kind in South Carolina’s history. A $60,000 grant awarded by the South Carolina Department of Commerce funds the program, and the program is registered with the U.S. Department of Labor.

The apprenticeship program was designed to take someone with high EMS interest—but no experience—and bring them on as an employee. 

“We look for attitude, work ethic and dependability, because those are the things that we experience in our actual day-to-day operations,” Longino says. “Just because you have a paramedic certification doesn’t mean you can come to work late and not have a good work ethic. So we try to identify people who have those things.” 

In finding qualified candidates, Longino places special emphasis on the interview process in order to really hone in on those candidates who are very interested in EMS, as opposed to those who are simply looking for a job—any job. 

“When we meet with them, we try to find out why they want to be in EMS by asking behavioral-type interview questions,” he says. “I’m all about giving people chances. But with the bad economy, we have to be particular about who we hire. It’s very obvious in some of the interviews that some people only want a job and have no real interest in EMS.”

Longino estimates that almost 90 percent of current hires are displaced workers. They are people who have been interested in EMS for a long time, but haven’t had the opportunity to pursue the career path until now. 

“I was blessed because I’ve had several doors in my life open up because of EMS,” Longino says. “What we try to do in the apprenticeship program is give opportunity to people who may or may not have had those opportunities previously in their life.”

Program Logistics
The apprentice starts his or her training in Greenville’s logistics department. They work for six months, making sure the ambulances are clean and properly stocked with the requisite medical supplies and equipment.

“They work 35 hours per week during the week and go to EMT school at night,” Longino says. “Once they graduate EMT school, we put them through a modified orientation process, and then they transition to the ambulance and work in the field. At that time, they become full-time Greenville County EMS employees and work out of the ambulance. They are considered second-man status on the ambulance, and they are actually out there saving lives.”

Once this phase is completed, the apprentice graduates to intermediate school and then moves on to paramedic school. “The whole process, from start to finish, takes about two years,” says Longino.

As of January, 18 apprentices were making their way through the program. “At this point, the program is still new enough that we haven’t had somebody actually complete the paramedic program yet, but we have a couple that are actually toward the end,” Longino says.

So far, the program has worked very successfully. Longino admits that those candidates who have children sometimes have difficulty managing 35 hours of work, night school and family obligations. But all in all, he says the program has been successful.

From the minute apprentices begin the program, they receive wages, starting at $10.30 an hour. Once they get their basic EMT training, they’re bumped to $11.15 an hour. As a paramedic-in-training, they make $13.29 an hour, and as a fully trained paramedic, they make $15.16 an hour. Once a candidate passes their basic EMT training, they receive 11 paid holidays, state retirement, and full medical, dental and vision benefits.

The candidates who enter the program quickly find themselves not only immersed in EMS training, but also in the excitement of EMS culture. “They want to get out there and start saving lives, but there’s a foundation that you have to build to optimally finish, and learning basic EMS is the first step,” Longino says. “They can get a little frustrated back in logistics, and they want to get in the truck, but it’s a slow methodical process that we put them through to get them through their classes and get them certified.”

Granting Access
Greenville Technical College assumes the educational role and provides all the educational components of the program as an accredited college. GCEMS provides the hands-on experience. Combined, the two form the apprenticeship program.

“When we were thinking outside the box, the South Carolina Department of Commerce was pushing workforce grants,” says Longino. “They actually released a solicitation proposal, so we developed the documentation and justification and applied for the grant.” The South Carolina Department of Commerce has been funding a variety of apprenticeship programs for years, and, as mentioned, Greenville County is the state’s first EMS apprenticeship program.

“The grant pays for all the [candidate’s] education and books, as well as paying a 50 percent match of their salaries for the first three months,” Longino says. “Then the county is 100 percent responsible for their salaries. We also buy all our new apprentices uniforms, boots, stethoscopes and a blood-pressure cuff for school.”

Hiring and training quality EMS personnel is critical to Greenville County, since they field 60,000 calls a year. “That’s 60,000 times we have to get it right,” says Longino. “So we have to make sure we have the right people with the right training. We have to focus on patient care, so we try to get the best candidates we can get.” 

Despite some difficulties, Longino has found the program to be very rewarding. “You get people that have never been given an opportunity, and they get out there and start really experiencing EMS,” he says. “They come into the office and they are all excited because they’ve helped save somebody, and it’s nice to see that.”

The program has also had a considerable impact on Greenville County’s staffing shortage. Longino reports that the agency is now, essentially, 100 percent staffed. “It has helped in our logistics department by having people to stock the medical supplies for the ambulances. It’s been a win-win.”

Longino has been instrumental in spearheading the program and driving it to a successful outcome. But he’s reluctant to take much of the credit.

“I am nobody special. I work with some incredible administrators and employees, and, as a group, we realize how we can make this work,” he says. “This has never been done in South Carolina before, so we didn’t have a template to go from. Everything we created had to be from scratch, so many times we were scratching our heads and asking how we were going to do this. But so far, we have been very pleased.”


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