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Wicomico County examines multimillion-dollar options to shore up EMS amid staffing shortages
Summary
Emergency services presented three principal EMS models—augmenting volunteers with county-funded paid staff (1:1 model), a countywide ALS chase-unit network, or a fully county-run ambulance service—each carrying multi-million-dollar recurring costs and capital needs. Staff recommended phased implementation and further CIP/budget analysis.
County emergency services delivered an in-depth presentation on options to address persistent EMS staffing shortages and response-time gaps.
Director Lorenzo Cropper described three broad approaches: (1) fund paid providers embedded at volunteer stations in a 1-for-1 augmentation model (staff estimated a recurring annual salary cost in the range of $8–9 million when fully phased), (2) implement a countywide ALS chase-unit concept—strategically located paramedic units that respond and leave transport to volunteer companies (estimated salary-only costs of roughly $2.8–$5.6 million depending on single versus dual paramedic staffing plus supervisors), and (3) operate a fully county-run ambulance system with multiple staffed units and associated capital for new stations (higher recurring and capital costs, capital estimate roughly $9–10 million for facilities depending on scope). All concepts assumed phased implementation over multiple years.
Cropper and task-force members emphasized workforce constraints: paramedic and EMT supply is limited regionally, training pipeline capacity is tight, and neighboring counties are competing for the same providers. Several chiefs and council members urged a pragmatic phased approach—starting with a small number of chase units or targeted paid positions—while others described standards and facility needs (NFPA/OSHA compliance) for housing chase units.
Council members directed staff to include EMS options in the upcoming CIP and budget discussions and asked administration and chiefs to return with more detailed capital and operating cost estimates and a phased plan that could be considered during the next budget cycle.
