Wicomico County officials, fire chiefs and emergency services staff reviewed recommendations from an EMS task-force SWOT analysis during a county work session, and the Wicomico Fire Chiefs Association expressed unanimous support for an option that staffs each station with one paramedic and one basic life-support provider.

The SWOT presented two primary options: option A (a chase-unit concept with two EMTs in each station plus three county-operated paramedic chase vehicles) and option B (a 1-paramedic/1-BLS provider in each station). Chiefs and staff discussed cost estimates, equipment needs, recruitment constraints and implementation priorities.

Why this matters: Emergency medical response is a core public-safety service. The county's choice of staffing model affects response times, budget planning and how county and volunteer fire departments coordinate care and billing.

Key findings and discussion

- Staffing estimates and constraints: The SWOT estimated option B (1-and-1) would require roughly 100 advanced life-support paramedics and about 100 EMTs to staff countywide 24/7 coverage; option A (chase-unit with EMTs in stations) would require roughly the same number of EMTs but about half as many paramedics (the report cited about 48 paramedics). Lorenzo Cropper, director of emergency services, and others cautioned that "there is a shortage of paramedics" nationwide and locally, making recruitment a major barrier to immediate implementation.

- Cost estimates: During discussion, one council member referenced an annual cost of about $7,430,000 (including a 125% factor for benefits) for one staffing scenario; speakers emphasized the numbers in the SWOT are substantial and will compete with other budget priorities. Staff and chiefs repeatedly described equipment and ongoing maintenance costs that would add to personnel expenses.

- Operational and policy issues: Chiefs noted questions about how county-employed paramedics would be integrated into volunteer firehouses, including issues of workspace, HIPAA compliance and chain-of-command. Chief Logan (Powellville/association leadership) and Chief Rob Frampton (Salisbury Fire Department) said departments already own a baseline of ALS equipment and that personnel costs, rather than equipment purchases, would be the primary recurring expense for a 1-and-1 model.

- Funding and incentives: Chiefs proposed multiple strategies to address recruitment: sign-on bonuses or stipends for paramedic training (Salisbury cited a $10,000 stipend it offers), tuition support or multi-year county-funded paramedic positions with service agreements, and use of grant programs (for example, SAFER grants) to offset start-up hiring costs. Several chiefs suggested phasing hires across multiple budget cycles (for example, adding 10 paramedic positions in year one, 10 in year two) rather than an immediate countywide rollout.

- Equipment and capital costs: Speakers noted that chase or county-employee vehicles still need ALS equipment (monitors, drug boxes, CPR devices) and that outfitting even a single set can be expensive. One participant cited life-pack monitor contract costs in the low tens of thousands; chiefs also discussed engine and ambulance acquisition costs (engines commonly near $1 million; ambulances around $400,000–$500,000) and multi-year lead times for apparatus.

- Reimbursement and billing: Council members asked whether insurance reimbursements would come to the county if the county operated transport units; staff said billing arrangements would have to be negotiated with each fire department and that jurisdictions such as Dorchester County have used agreements to return a portion of transport revenue to the county in some setups.

Chiefs' recommendation and next steps

The Wicomico Fire Chiefs Association reported unanimous support for the 1-paramedic/1-BLS staffing model (option B) and urged the county to phase funding and recruitment steps into upcoming budgets. County administration said it recognized merit in both options but that budget constraints and workforce shortages make immediate, full implementation unlikely without staged investment and targeted recruitment incentives.

There was no formal vote; councilmembers and staff agreed to consider the SWOT recommendations during the upcoming budget process and to explore grants and incentives for paramedic training and retention.

Ending

Council members called for continued collaboration between county administration, the fire chiefs and city providers to develop a phased, budget-aware plan that addresses recruitment, equipment and billing arrangements before any staffing model is adopted countywide.