Oklahoma City Council Updates EMSA’s Ambulance Staffing Rules

EMSA Trucks

Hogan Gore

The Oklahoman, Oklahoma City


The Oklahoma City Council approved an emergency ordinance change to the city’s ambulance code during its meeting Nov. 23.

The proposal, which passed unanimously and went into effect immediately, allows for the Emergency Medical Services Authority to stand up units made to respond specifically to non-life threatening calls, known as basic life support.

Previously, city regulations required each ambulance unit to include personnel who can provide advanced life services, or assistance in life-threatening situations, for all calls regardless of the severity of the situation.

The new plan is intended to keep more of the advanced life services crews available to respond to serious issues, while allowing the newly formed basic life services crews to take over lower tier cases that require less intensive care.

Related: Ambulance Crew Configuration: Are Two Paramedics Better Than One?

The move is anticipated to improve response times by 5% to 10%, according to officials.

In addition to lower staffing numbers, longer wait times created by stays at hospitals that can last hours, COVID-19 decontamination and fewer advanced life services qualified employees, Oklahoma City medical emergency responders are fielding 7.7% more calls this year than last.

“It’s a pandemic. We have increased call volume, high wait times in the ER waiting for patients to be offloaded into hospital beds, sometimes as much as five or six hours,” said Dr. Curtis Knoles, associate chief medical officer of the Medical Control Board, which oversees EMSA operations in Oklahoma City and Tulsa.

According to Knoles, the average wait time to offload patients can be as much as 90 minutes, which is not feasible for advanced life services responders who may be needed elsewhere for more serious 911 calls.

In August, prior to the new plan, EMSA was assisted by the Oklahoma City Fire Department in transporting heart attack patients and those with similar symptoms.

However, that is not a practice that EMSA or the Medical Control Board was keen to continue, as fire responders have other, secondary duties to perform while responding to calls even though each fire unit is equipped with an advanced life services paramedic.

Outside of changes to response codes and assistance from the fire department, EMSA is also trying to educate and retain new employees by offering paid training, which will begin in January with the potential for multiple classes to happen simultaneously.

“A pool of paramedics nationwide is just not there,” said James Winham, EMSA president. “How we are countering that is we are offering our own paramedic schools in house.”

Nearly 10% of calls in 2020, or 22,600 cases, fell under the basic life support umbrella, according to EMSA data. As a result of these numbers, leaders of the city’s Medical Control Board, EMSA and the fire department believe five to seven teams of basic life services responders should be available daily.

The Medical Control Board and EMSA have already invested $20,000 in new ambulance monitors that will be used to streamline the tiered dispatch system in Oklahoma City.

The tiered-response plan is expected to have a financial impact with an estimated loss of revenue between $200,000 to $250,000 per year, as basic life services responses bring in less money than advanced life services calls, by about $70 in each case.

Moving forward, the change in EMSA operations is effective for both Oklahoma City and Tulsa, as both cities are required to have compatible operations.

Appointments and questions

Before breaking for the Thanksgiving holiday, the Oklahoma City Council appointed members to six MAPS 4 subcommittees and approved salary increases for a few city officials.

The MAPS 4 implementation plan, approved in September, is now underway with the project’s subcommittees filled with 54 newly appointed members, who have the responsibility to make recommendations to the MAPS 4 Citizens Advisory Board, which reports to the City Council.

MAPS 4, passed by voters in 2019, contains 16 projects that address things like homelessness, post-incarceration programming, and youth and senior well-being, along with traditional MAPS projects like the fairgrounds coliseum, updates to the NBA Thunder’s arena and a multipurpose stadium.

The Civil Rights Center subcommittee will focus on the development of the Clara Luper Civil Rights Center, while MAPS 4 mental health and homelessness initiatives fall under the purview of the Community subcommittee.

The Connectivity subcommittee is responsible for projects related to transportation, sidewalks, trails and street lights. The Neighborhoods subcommittee will deal with parks, youth and senior wellness centers and an animal shelter.

The new fairgrounds coliseum and updates to Paycom Center, which are the first projects to begin construction using MAPS 4 money, will receive oversight from the Venues subcommittee. Members of the Innovation District subcommittee will provide direction related to the new business district.

Each of the committees consist of nine members, some of which have had previous experience working with MAPS 3 projects.

However, the appointments to these positions did face some opposition based on a lack of inclusivity, communication and community involvement.

“I am not comfortable with these appointments, I don’t feel as if the community, our city, was considered in these appointments,” said Ward 7 Councilwoman Nikki Nice.

Nice cited a lack of communication between the mayor and council on appointment recommendations and the placement of people with previous MAPS experience as issues that held back further community engagement.

“In my opinion this is a very biased system, and our city and the folks that really truly could have been a part of this, are not,” Nice said.

The final say on who was appointed to each subcommittee came from Oklahoma City Mayor David Holt, whose appointments were then approved by the city council. Holt says he asked for and received recommendations in the months leading up to the appointment decisions.

The six subcommittees will meet monthly, or as necessary, moving forward and throughout the MAPS 4 implementation process. For more information on the subcommittees and their members visit the MAPS 4 tab on the Oklahoma City government website.

City pay raise

Outside of filling the open MAPS 4 positions, the council approved proposals to increase the salaries of three city officials during its meeting.

City Manager Craig Freeman received a bump to $268,224 per year, an increase of just over $10,000 from his salary a year prior.

Municipal Counselor Kenneth Jordan also received a raise from his 2020 salary of $207,684, up to $215,982, for 2022.

For City Auditor Jim Williamson, his salary will increase to $175,788 from $169,031 for the upcoming year.


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