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Baltimore鈥檚 EMS staffing problems highlighted after notice of highest-earning paramedic

A Baltimore City Fire Department paramedic earned $358,586 last year鈥攎ostly from overtime鈥攗nderscoring severe understaffing that fuels employee burnout, long EMS wait times, and city budget concern

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Baltimore City Fire Department

Baltimore Sun Staff Photo/TNS

By Brooke Conrad, Carson Swick
Baltimore Sun

BALTIMORE 鈥 Baltimore city鈥檚 highest-paid employee in the last fiscal year was a Baltimore City Fire Department paramedic, who earned $358,586 鈥 68% of which came from overtime.

Such high overtime pay among first responders in Baltimore is a symptom of significant understaffing, a that fire department employees and city leaders say leads to employee burnout and long wait times for emergency help. Most recently, it鈥檚 driven agency overspending and .


A spokesperson for Baltimore Mayor Brandon Scott said overtime payments were the most common reason for the higher-than-expected pay

Baltimore Mayor Brandon Scott and City Council President Zeke Cohen didn鈥檛 respond to questions about the staffing challenges, but some council members are calling for action 鈥 including improving recruitment and reducing fires in vacant homes.

Though there鈥檚 a positive aspect to overtime in terms of increased pay, it can also take a 鈥渉uge toll on morale,鈥 said Mark Conway, the City Council鈥檚 public safety chair. The $245,428 in overtime earned by the fire department paramedic who made the most in the city in fiscal year 2024, David Lunsford, was more than double his annual salary of $113,158.

When a worker鈥檚 overtime pay is , Conway said, 鈥淵ou have to wonder if you can do your job at the highest capacity, and if it is good for your mental health or your partners.鈥

Conway also noted that overtime hours get racked up by employees working special events, such as Orioles and Ravens games.

Firefighter union president Matthew Coster claimed BCFD is the country鈥檚 busiest in terms of calls per capita, based on his own research comparing run volume against population.

鈥淭hese medics are working extreme amounts of overtime to keep 鈥 our units on the street and open,鈥 Coster said. 鈥淭hat鈥檚 why we鈥檙e pushing, as unions, to get recruitment efforts and staffing up to the proper level鈥 so their members aren鈥檛 burned out, injured faster, 鈥渁nd things like that.鈥

Burned-out paramedics

It鈥檚 not uncommon in Baltimore to have to wait 45 minutes or more for paramedics to arrive at the scene of emergencies. Several times, such delays have cost someone鈥檚 life, said Kyle Lovell, a former fire department paramedic.

鈥淭here鈥檚 times that people have been thrown in fire engines and transported to the hospital because the wait would be too long for an ambulance,鈥 he said.

Lovell described a situation when he received a call about a baby who had stopped breathing on the south side of Baltimore City鈥檚 harbor. Despite being about 30 minutes away, Lovell was the nearest available BCFD paramedic and stepped up to the task.

鈥淲e had to drive all the way from the Alameda Shopping Center to Cherry Hill,鈥 Lovell said. He added that the baby ultimately survived, despite the delay.

Medics work on an eight-day rotating schedule of two 10-hour days, two 14-hour nights and four days off. Lovell usually worked an additional two 14-hour shifts of overtime.

鈥淭he money was great, don鈥檛 get me wrong. I was paid very well,鈥 Lovell said, noting his base salary was $92,000 around the time he left the department, and he was paid around $50,000 to $60,000 more annually in overtime.

Lovell left the department after eight years for a lower base salary of $60,000 in Wisconsin , saying the extra money in Baltimore ultimately wasn鈥檛 worth the feeling of burnout.

Lunsford, the city鈥檚 highest-paid employee, 鈥渨ent to work every freaking day,鈥 Lovell said. That included 鈥渁 few鈥 24-hour shifts in the past 30 days, said Coster, the union leader.

鈥淗e鈥檚 definitely a dedicated paramedic to Baltimore City,鈥 Coster said.

Lunsford could not be reached for comment.

鈥淚f we didn鈥檛 have those employees working those extreme overtime hours, we would be closing down units on a daily basis鈥 We can鈥檛 continue to staff the fire department with overtime,鈥 Coster said.

He added, 鈥淭he unions do not like to push our medics on a 24-hour shift, but sometimes they do it to get the hours out of the way鈥 or if they know they鈥檙e going to have a longer time off, they鈥檒l work a 24-hour shift in order to have more time off,鈥 he said.

What can be done

While there have been improvements to recruitment, there鈥檚 still more work to be done, said City Council Member Odette Ramos, who previously served on the public safety committee.

鈥淭he only way to deal with overtime is to hire people,鈥 she said.

The combination of staffing shortages and the high number of fires stemming from the city鈥檚 vacant properties is dangerous for employees, she said. Baltimore has twice the rate of vacant home fires as other areas of the country, .

The high number of fires is 鈥渢otally overwhelming for our firefighters,鈥 Ramos said. 鈥淚 mean, they sometimes have five or six fires that they鈥檙e going to [per] shift, which is pretty substantial, and it鈥檚 exhausting.鈥

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Last December, Maryland Gov. Wes Moore awarded to clean up vacant housing in Baltimore City 鈥 an initiative Ramos welcomes with open arms, in addition to efforts by Mayor Brandon Scott, the Greater Baltimore Committee and others.

鈥淭here is still a long way to go,鈥 she said. 鈥淲e are nowhere near our goals.鈥

Fire Department spokesperson John Marsh said the department is continuing to address ongoing staffing challenges.

鈥淲e recognize the increased demands on our sworn members, particularly regarding overtime,鈥 Marsh said in an email. 鈥淒ue to staffing shortages, many of our firefighters and EMS providers have taken on additional hours to maintain the high level of service our city depends on.鈥

Marsh said the department has also boosted recruitment efforts and streamlined the hiring process.

In addition, Ramos said the department is looking at how to deploy EMTs 鈥渕ore efficiently and effectively so that everybody gets a chance to get an EMT and they鈥檙e not waiting an hour.鈥

Conway said the City Council could address the overtime issue by performing oversight and making sure 鈥渢hat everything is on the up-and-up, that there is true accountability when supervisors are signing those overtime slips,鈥 he said.

In addition to reviewing employee salaries, the city also could examine changing schedules so they鈥檙e not as taxing, Ramos said.

鈥淥ur first responders, they鈥檙e so important to our city. We want to make sure they鈥檙e getting what they need,鈥 she said.

Lots of work, few breaks

Another recently retired paramedic, Rhonda Johnson , who worked in the department for 34 years, said there were times when she鈥檇 reached the end of her shift and was heading back to the fire station, only to receive more calls that she was not allowed to refuse.

鈥淭he EMS officers, they鈥檙e always going home on time. They鈥檙e sleeping at night. They鈥檙e sitting down and eating dinner. The firefighters [are] doing the same thing. Not the medics,鈥 she said. 鈥淪o nobody wants to be a medic in Baltimore City . Once they get the training, they go elsewhere.鈥

Johnson said she often felt like she needed a 鈥渕ental break鈥 during her shift.

鈥淚鈥檓 telling you, some of these calls out here, we see the worst of the worst,鈥 she said.

Lovell said the fire department has a 鈥渘o-fail mission.鈥

鈥淲hen we fail, people die,鈥 he said. 鈥淲hen people call 911, they are having one of the worst days of their lives, and they have a problem that they cannot solve.鈥

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