EXCELSIOR SPRINGS, MO—The Excelsior Springs Fire Department is grappling with a severe shortage of paramedics, which Fire Chief Joe Maddick attributes largely to the COVID-19 pandemic. Currently, the department is operating with five fewer paramedics than needed, which could compromise its ability to provide advanced life support services to the community.
Paramedics, trained to perform more advanced medical procedures than EMTs, such as intubation and medication administration, are essential for the department. According to Chief Maddick, the ideal number of paramedics for the department’s 25-person team is seven. This would ensure at least two dedicated paramedics for each of the three shifts and a floating position to cover scheduled time off, known as Kelly Days.
The shortage is not unique to Excelsior Springs but reflects a broader crisis in the emergency medical services (EMS) and firefighting industry, exacerbated by the lingering effects of the pandemic. Maddick noted a significant drop in applications for available positions, a stark contrast to the pre-COVID era when openings would attract hundreds of candidates. This decline in interest is partly attributed to a shift in preference among some first responders towards roles that exclusively involve firefighting, avoiding the demanding and sometimes traumatizing ambulance calls that come with EMS duties.
To address this critical shortage, the department is considering innovative recruitment strategies, including focusing on its Cadet program aimed at young adults and high school students. Although nowhere near finalization, Maddick said he’d like to see a program that could cover the costs of EMT, paramedic, and firefighting training and even potentially offer wages during their training. “There are a lot of departments doing that right now, I don’t know if we could ever afford it or not, but it’s an option, something that we’re considering,” Maddick explained, highlighting the competitive nature of recruitment in the sector.
The comparison with police training underscores the challenges faced by the fire department. While police officers can be trained in as little as seven months, paramedic training can take up to three years. This lengthy process means that even if new training efforts were to start immediately, it would take years before new paramedics could join the force.
In the meantime, the department is considering temporary measures to maintain service levels, including deploying Basic Life Support Ambulances with a paramedic accompanying the fire engine. Emergency responders would evaluate the patient’s condition upon arriving at the scene. Should the situation not require a paramedic, EMTs could manage the patient’s transport, allowing the paramedic to remain available in town for calls requiring Advanced Life Support. “Twenty years ago, I would have never even considered that a possibility, but it’s a different environment now,” said Maddick.
Despite offering a competitive starting salary of $58,000 to $60,000 (with holiday pay), the department has struggled to retain personnel against larger, better-funded departments in the Kansas City metro area. A challenge faced by many smaller departments in attracting and keeping skilled firefighters and paramedics.
Chief Maddick remains hopeful, emphasizing the unique appeal of working in a department that sees more active fire duty than many others. “That’s what these guys and gals live for,” he said, underscoring his team’s dedication. While Excelsior Springs navigates the difficulties of a paramedic shortage, the fire department’s innovation gives some hope of finding viable solutions.
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