A group of new EMTs go through training as part of the civilian-to-EMT program.
A group of new EMTs go through training as part of the civilian-to-EMT program. Cleveland EMS Union leaders hope to bring in more experienced paramedics to the division after signing an agreement with the city increasing pay for paramedics transferring to Cleveland. Credit: Timothy Sommerfelt / Cleveland Association of Rescue Employees

Emergency Medical Service (EMS) union leaders say a new pay increase for paramedics transferring to Cleveland will help the division’s recruitment efforts. 

Cleveland EMS currently employs 152 paramedics and 46 Emergency Medical Technicians (EMTs) on ambulances, the mayor’s spokesperson, Marie Zickefoose, told Signal Cleveland. 

Paramedics have to complete 1,000 hours of training. That’s significantly more than the 150 hours of training required for EMTs.  

While every ambulance in Cleveland has at least one paramedic, union leaders say two paramedics per truck would provide higher-quality medical care to Clevelanders. 

The Cleveland Association of Rescue Employees (CARE), the union for EMTs and paramedics, signed an agreement with the city earlier this month increasing starting pay for experienced paramedics transferring to Cleveland. The city had been offering $16 an hour for the 12-week onboarding period, the same rate as for newly certified EMTs. Now, paramedics transferring to Cleveland will start at $27.59 an hour. 

“We want to be able to provide the best emergency medical service, the best healthcare for the citizens of Cleveland,” said Timothy Sommerfelt, a union representative. “And this is a huge step in the right direction.”

City hiring more EMTs than paramedics

The city’s 2023 budget includes funding for 304 EMS positions. About 280 of those are filled. That leaves 28 open positions for EMTs and paramedics. The city budget would allow EMS to fill all 28 open positions with paramedics, Sommerfelt said.

While staffing is a challenge, the department is able to assign each ambulance an EMT and a paramedic. Some ambulances are staffed with two paramedics. Running with one instead of two paramedics does affect the quality of service people get, said Mark Barrett, president of the union.

“Hiring EMTs and not backfilling paramedics, you’re going to get to that point where you have to lower your level of service,” he said. “So the goal here is to keep onboarding paramedics so you don’t have to lower that level of service.” 

Cleveland EMS loses about two paramedics a month, Barrett said. 

Before 2016, CMS had been phasing out EMTs with fewer than 30 EMTs working for the division, Sommerfelt, a union representative, told Signal Cleveland. 

In 2016, 66% of new hires were paramedics and 34% were EMTs. By 2022, 76% of new hires were EMTs, and only 24% were paramedics, Sommerfelt said. 

Paramedics learn more, do more

Sommerfelt said EMT training is “first aid on steroids,” or a “crash course” in emergency medicine. Skills beyond the basics, such as applying tourniquets and administering CPR, are learned on the job. 

A paramedic student from Tri-C trains with EMS providers in-between calls during a clinical shift.
A paramedic student from Tri-C trains with EMS providers in-between calls during a clinical shift. EMS union officials want to increase the number of paramedics in the division. Credit: Timothy Sommerfelt / Cleveland Association of Rescue Employees

Paramedic certification requirements include 400 hours of clinical rotations. That includes shadowing psychiatric nurses and emergency room personnel and spending time in a catheter lab and in a surgery center to learn how to place breathing tubes, Sommerfelt said. 

They ride along in ambulances and practice emergency response with an experienced paramedic observing them before they become certified. 

Requirements for EMTs have remained low because recruitment, especially in rural areas, is difficult, Sommerfelt said. 

“The tradeoff has been that we’ve really increased what we asked for [from] paramedics, both in terms of the clinical care they provide and the training that they endure,” he said. 

Sommerfelt earned his EMT certification his junior and senior years of high school and his paramedic certification 17 years ago. When he was in paramedic school, students were trained on a device that could look at the heart from one angle to detect life-threatening abnormalities. 

Today, paramedics can look at the heart from 12 different angles to find blockages, detect heart attacks or pinpoint other issues, Sommerfelt said. He said it’s one of several ways paramedics are doing more when they respond to emergencies.

Of the skills EMS providers are authorized to use in Ohio, 26% are basic life support, which EMTs can provide, and 74% are advanced life support, which only paramedics can provide. 

“Paramedics are one of the last few generalists along with the emergency room,” Sommerfelt said. “We have to handle everything that the city throws at us. And we have to be experts at it.” 

Criminal Justice Reporter (she/her)
Stephanie, who covered criminal justice and breaking news at the Chicago Tribune, is a bilingual journalist with a passion for storytelling that is inclusive and reflects the diversity of the communities she covers. She has been a reporter and copy editor for local newspapers in South Dakota, Kansas and Arizona. Stephanie is also a Maynard 200 alumni, a Maynard Institute for Journalism Education training program for journalists of color that focuses on making newsrooms more equitable, diverse and anti-racist.