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Beaufort County EMS asks council to fund fourth shift to cut overtime and reduce staff fatigue
Summary
EMS leaders sought council support to add a fourth rotating shift (27 positions) to reduce chronic overtime and responder fatigue; staff estimated net new recurring cost about $702,000 (offset in part by reduced overtime) and asked council to consider the request in next year’s budget.
Beaufort County EMS leaders told the county council they want to add a fourth rotating shift to reduce overtime, limit staff fatigue and improve retention.
"Beaufort County EMS Responders are physically and mentally exhausted," John (EMS director) told the retreat, and he described the current schedule as three 24-hour shifts with 48 hours off. Staff said persistent vacancies — roughly 26 open responder positions at the time of the workshop — and frequent back-to-back shift coverage were driving excessive overtime and increasing safety risk.
Staff proposal: Add a fourth shift comprised of 27 positions. County finance staff estimated the recurring annual cost to onboard the fourth shift, after accounting for reduced overtime, at approximately $702,000 compared with the current-year budget baseline. The EMS director and finance staff briefed the council on how a fourth shift would reduce required backfill and provide a more sustainable work–life balance for front-line responders.
Justification presented: Officials cited call-volume and operational time-per-call data: EMS crews average roughly 5.3 incidents per shift and an estimated 3.5 hours of total incident-related time per event (response, patient care, restocking, reports), adding up to roughly 18 hours of active duty work within a 24-hour shift. Staff said near-miss reporting within the EMS system increases around the 36-hour mark, and that the cumulative effect of consecutive shifts elevates risks for medical errors and driving incidents.
Local comparators: Presenters pointed to other South Carolina counties and municipalities that have converted to a four-shift model and reported improvements in retention and reduced overtime. Councilors said these peer cases were salient when weighing a change.
Council response and next steps: Council members generally expressed support for the concept but raised operational and recruitment questions: - Several council members asked how the county would staff the new shift given current vacancies; staff said the county would recruit and that the shift change itself could help recruit by offering better hours. - Members asked for a detailed station-level analysis of call volumes and how a fourth shift would be phased in; staff said they would prepare that data. - Finance indicated the proposal will be considered as part of the FY26 budget process and asked for formal committee review; councilors suggested the finance or administration committee be the venue for further discussion.
Ending: EMS leaders asked for council direction to include the fourth-shift funding request in next year’s budget cycle. Staff will return with a more detailed operational plan showing where new positions would be assigned, recruitment targets and a station-by-station workload analysis to justify the requested positions and estimated overtime savings.
