TO: Mayor and City Council
THROUGH: Krishna Namburi, City Manager
FROM: David Gerboth, Fire Chief
SUBJECT:
title
Addition of four ambulance medic positions to the Fire Department’s EMS Division.
Ward(s): All Wards
Councilor(s): All Councilors
Neighborhood(s): All Neighborhoods
Result Area(s): Safe and Healthy Community.
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SUMMARY:
summary
The Salem Fire Department currently operates five 24-hour ambulances and three peak ambulances for EMS services. Since July 2025, EMS call volume has continued to rise beyond projections and is causing strain on the current ambulance and staffing model. To improve and sustain ambulance services, four additional ambulance medic positions are requested to allow the department to staff an additional 24-hour ambulance.
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ISSUE:
Shall City Council approve the addition of four full-time equivalent (FTE) ambulance medic positions in the Fire EMS Division as of January 12, 2026?
RECOMMENDATION:
recommendation
Approve the addition of four full-time equivalent (FTE) ambulance medic positions in the Fire EMS Division as of January 12, 2026.
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FACTS AND FINDINGS:
Analysis of EMS call volume, unit utilization, and temporal demand patterns shows sustained and concentrated pressure on ambulance resources in specific areas of the city. Several units regularly operate at or above recommended utilization thresholds, which reduces unit availability, increases response times during peak periods, and contributes to cumulative workload strain on EMS personnel. These conditions increase overtime usage and elevate the risk of service disruption during high-demand events.
The current deployment model consists of five 24-hour ambulances and three peak ambulances operating on a 40-hour schedule. Utilization data indicates one peak ambulance consistently functions at demand levels comparable to a 24-hour unit, particularly during late afternoon and evening hours. Converting this peak unit to 24-hour operations directly supports two stations experiencing the highest call volume and improves coverage during the city’s busiest response windows.
Operating an additional 24-hour ambulance requires four positions totaling 4.0 FTE, consisting of two Single Role EMT-Basics and two Single Role Paramedics. This adjustment increases total ambulance medic staffing from 52 to 56 FTE and reduces reliance on forced overtime, improving workforce stability, fatigue management, and clinical performance.
The estimated annual fiscal impact of adding four positions is $643,984. This cost is expected to be offset within the EMS Fund through a combination of increased revenue from billed transport services and measurable reductions in overtime expenditures associated with backfilling and extended shifts. This recommendation improves system reliability without expanding the total number of ambulances in service.
Implementation of this change allows the department to stabilize response performance while collecting post-implementation data on response times, unit availability, overtime usage, and revenue recovery. These metrics will inform future deployment decisions and staffing adjustments as demand continues to evolve.
BACKGROUND:
In 2024, the City Council authorized the Fire Department to begin providing direct emergency medical services effective July 1, 2025. This action transitioned EMS delivery from a contracted model to a city-operated system. To support this change, approximately 60 budgeted positions were added to the EMS Fund.
Of these positions, 52 staff front-line medic units assigned to ambulances and provide 24-hour emergency medical response. The remaining positions support supervision, training, quality assurance, logistics, scheduling, and program administration. These roles ensure clinical oversight, regulatory compliance, workforce sustainability, and uninterrupted service delivery.
The authorized staffing reflects the initial deployment model required to meet projected call volume, maintain unit availability, and align with industry staffing standards for municipal EMS operations. This structure establishes operational control within the Fire Department while creating a foundation for future system evaluation and adjustment based on performance data and community demand.
DAVID GERBOTH
FIRE CHIEF
Attachments:
1. None.