Cleveland EMS

File:Interior of an ambulance.jpg

Prior to 1975, emergency ambulance transportation in Cleveland was provided by a combination of Cleveland Police patrol wagons, four Cleveland Fire rescue squads,{{cite news |author1=Diana Tittle |title=EMERGENCY! |work=Cleveland Magazine |issue=August |date=1976 |pages=36–42; 94–97}} and private ambulances mostly run by funeral homes.{{cite book |author1=Ryan Corbett Bell |title=The ambulance : a history |date=31 August 2012 |publisher=McFarland & Co |isbn=978-0-7864-7301-4 |page=71}} The June 3, 1974, death of Councilman Michael Zone exposed severe shortcomings in this existing system, as it took over 25 minutes for help to reach him after he suffered a heart attack.

Due in part to the public outcry after Zone's death, Mayor Ralph Perk established the new City of Cleveland Division of Emergency Medical Service (CEMS) the following year with 120 Emergency Medical Technicians (EMTs) answering their first emergency calls on Monday, October 13, 1975.{{cite news |author1=Joseph L Wagner |title=New Ambulance Run Monday |agency=The Cleveland Plain Dealer |date=11 October 1975|page=4A}}

This new division of EMS, separate from the police and fire departments, immediately found itself very busy, answering over 60,000 calls annually by 1977.{{cite news |author1=Michael Ward |title=Too many of CEMS' 60,000 calls were not true emergencies |agency=The Cleveland Plain Dealer |date=3 March 1978|pages=4–7}} While considered a vast improvement over the previous system, it also found itself to be the center of controversy. A 1976 feature in Cleveland Magazine illustrated several ways that Mayor Perk maximized the political gain from the new CEMS service just prior to the 1975 mayoral election. The same article also outlined problems within the CEMS leadership, a lack of continuing medical education, broken ambulances, a poor driving record with 84 accidents with 2 years, understaffing, and most disturbingly, that CEMS lacked Advanced Life Support (ALS) paramedic units and had no definite timetable to implement them.

The lack of paramedic-level care would persist throughout the 1970s as the administration of Mayor Dennis Kucinich refused to allow those CEMS personnel who had trained as paramedics to perform advanced skills or administer medications. Assistant Safety Director Tonia Grdina told the Plain Dealer at the time, “The major criticism of the EMS is that its personnel frequently treat victims on the scene instead of transporting them to the hospital immediately.”{{cite news |author1=Diann Burns |title=City's curb on paramedics is questioned |agency=The Cleveland Plain Dealer |date=6 November 1978 |page=1}}

In 1980, Mayor George Voinovich recruited Mitchell Brown, a veteran of Pittsburgh's Freedom House Ambulance Service, to head CEMS in a move to improve the service.{{cite news |author1=Christine J Jindra |title=Pittsburgher to head city's Emergency Medical Service |agency=The Cleveland Plain Dealer |date=4 January 1980 |page=15A}} Things would get worse before they got better, however, with budget cuts dropping the number of CEMS ambulances from 12 in 1982, to 8 by 1985.{{cite news |author1=Steve Luttner |title=Cut in EMS fleet cost 100 lives last year, council told |agency=The Cleveland Plain Dealer |date=3 March 1985 |page=13A}} Despite these budget challenges, Brown was able to implement a new in-house communications center, called Radio Emergency Dispatch (RED) center, and upgraded two CEMS units to ALS status on February 1, 1985.{{cite news |author1=V. David Sartin |title=Ambulance radio link is off to a good start |agency=The Cleveland Plain Dealer |date=7 February 1985 |page=23A}} Brown was later promoted to safety director, where he vetoed a 1988 proposal by the Cleveland Fire Department to take over CEMS.{{cite news |title=Safety chief vetoes merger of EMS, Fire Department |agency=The Cleveland Plain Dealer |date=9 June 1988 |page=14E}}

Despite an increase in the late 1980s to 14 EMS units,{{cite news |author1=Mark Russell |title=White wants to add four EMS vehicles |agency=The Cleveland Plain Dealer |date=30 September 1999 |page=2B}} during the early 1990s many of the same concerns persisted regarding CEMS, including deaths due to delayed responses,{{cite news |author1=BENJAMIN MARRISON |title=Council sounds alarm over EMS tardiness |agency=The Cleveland Plain Dealer |date=19 March 1992 |page=1A}} unreliable vehicles,{{cite news |author1=Percy Allen |title=New ambulances bring some aid to city's EMS |agency=The Cleveland Plain Dealer |date=15 June 1991 |page=4B}} low employee pay, high turnover,{{cite news |author1=Benjamin Marrison |title=Stress, low pay prompt EMS workers to quit |agency=The Cleveland Plain Dealer |date=24 May 1992 |page=14A}} a large number of low-priority calls,{{cite news |title=Cleveland's $8 million taxi |agency=The Cleveland Plain Dealer |date=16 March 1992 |page=4C}}{{cite news |author1=Karen Mcnally |title=Some use EMS for basic care |agency=The Cleveland Plain Dealer |date=20 September 1992 |page=6g}} and an overall high call volume given the number available ambulances. Public proposals to improve EMS very similar to those advocated during the mid 1980s{{cite news |author1=Steve Luttner |title=Volunteer plan may assist Cleveland EMS |agency=The Cleveland Plain Dealer |date=24 November 1984 |page=6A}}{{cite news |author1=David F Stahley |title=Don't rely on volunteers for city EMS |agency=The Cleveland Plain Dealer |date=3 December 1984 |page=4B}}{{cite news |author1=Wally Guenther |title=Officials take shots at EMS merger plan |agency=The Cleveland Plain Dealer |date=27 May 1988 |page=6B}} again graced the pages of the local newspaper, the Plain Dealer. Councilman Ken Johnson proposed forming a volunteer EMS first-response unit,{{cite news |title=Councilman proposes volunteer EMS unit |agency=The Cleveland Plain Dealer |date=14 November 1990 |page=6B}} while Cleveland firefighters continued their campaign to take over EMS,{{cite news |author1=Anthony E Missig |title=Merge for safety |agency=The Cleveland Plain Dealer |date=5 December 1990 |page=8B}} and the same ambulance company manager who penned a 1984 op-ed again proposed letting private ambulances respond to 911 calls.{{cite news |author1=David F Stahley |title=Who should answer the ambulance call? |agency=The Cleveland Plain Dealer |date=3 December 1990 |page=6B}}

Mayor Michael R. White instead chose to embrace the recommendations of an EMS/Fire task force and invested heavily in CEMS.{{cite news |title=EMS: Don't bet your life on it |agency=The Cleveland Plain Dealer |date=26 April 1992 |page=2C}} RED center was upgraded with a new computer aided dispatching and call-prioritizing system in 1993,{{cite news |author1=Catherine L Kissling |title=Call priorities a relatively new idea |agency=The Cleveland Plain Dealer |date=29 March 1993 |page=5A}} and by 1997 20 CEMS ambulances were in service reducing response times by 28%.{{cite news |author1=Christopher Quinn |title=Killings still on decline in Cleveland |agency=The Cleveland Plain Dealer |date=4 July 1997 |page=3B}}{{cite news |author1=Robert K Vickers |title=Cleveland boosts emergency service EMS bases, hours, ambulances added |agency=The Cleveland Plain Dealer |date=19 December 1996 |page=7B}} This increased investment in CEMS was credited with helping Cleveland realize its lowest homicide rate in decades, with CEMS crews saving many victims of penetrating trauma who would otherwise have been perished.

During the 1990s working conditions for CEMS EMTs and paramedics also improved, as the city switched to from 8-hour shifts to 12-hour shifts.{{cite news |author1=Donna J Miller |title=EMS workers to protest change in hours, pay |agency=The Cleveland Plain dealer |date=8 April 2007 |page=B4}} Additionally after a protracted battle between the city administration and [https://www.care1975.com/ the Cleveland Association of Rescue Employees (CARE)], the main labor union for CEMS, safety equipment such as ballistic vests, helmets and protective coats were obtained for the first time.{{cite news |author1=Benjamin Marrison |title=EMS wins grievance over safety equipment |agency=The Cleveland Plain Dealer |date=29 January 1994 |page=2B}}

It is also worth noting, that on November 5, 1993, CEMS came close to suffering its first line-of-duty death when paramedic Christopher Holt was struck by an automobile at the scene of a freeway accident. Through the incredible efforts of his CEMS colleagues and staff at Metro hospital, Holt not only survived critical injuries, but returned to work the following year.{{cite news |author1=Michael O'Malley |title=Recovering medic returns to work |agency=The Cleveland Plain Dealer |date=16 July 1994 |page=1B}}

As the new century dawned, the 21 ambulances of CEMS took on increased importance as the region saw the first of several hospital closings, with St Luke's closing in 1999,{{cite news |author1=Diane Solov |author2=Olivera Perkins |title=St Luke's mum after emergency room stops taking severely injured patients |agency=The Cleveland Plain Dealer |date=13 May 1999 |page=1C}} Mt Sinai in 2000,{{cite news |author1=Regina Mcenery |title=Mt Sinai closing hospital releasing patients, workers |agency=The Cleveland Plain Dealer |date=16 February 2000 |page=1A}} and St Alexis/St Michael in 2003.{{cite news |author1=SARAH TREFFINGER |title=St Michael hospital can't escape fate this time |agency=The Cleveland Plain Dealer |date=19 December 2003 |page=B1}}

Through union concessions and chronic understaffing, CEMS was spared from the budget cuts that affected the police and fire departments in 2003.{{cite news |author1=Lilia j Mills |title=EMS-city talks were long but civil |agency=The Cleveland Plain Dealer |date=19 December 2003 |page=A12}} The following year, 24 of the laid-off firefighters and police officers who had EMT or paramedic training were re-hired to work for CEMS to fill vacancies created as other employees left the division.{{cite news |author1=Mike Tobin |title=Laid-off safety workers set to fill EMS vacancies Police, firefighters will fill positions by end of year under mayor's plan |agency=The Cleveland Plain Dealer |date=12 November 2004 |page=B3}}

File:Cleveland EMS mobile unit.jpg

Attrition within CEMS accelerated greatly after a 2007 decision by Commissioner Edward Eckart to switch CEMS workers from the 12-hour shifts they had worked since the early 1990s, to 8-hour shifts in order to save money on overtime.{{cite news |author1=Mark Puente |title=Cleveland EMS employees win ruling over work shifts |agency=The Cleveland Plain Dealer |date=29 December 2007 |page=B3}} This move backfired, as 88 CEMS workers resigned within 2 years and overtime spending soared as the remaining personnel were forced to work extra mandatory shifts to provide ambulance coverage.{{cite news |author1=Henry J Gomez |author2=Gabriel Baird |title=EMS workers bolt for Memphis Cleveland staff shrinks because of schedule, salary |agency=The Cleveland Plain Dealer |date=29 March 2008 |page=B1}} [https://www.care1975.com/ CARE] challenged the schedule change, and ultimately prevailed in court. 12-hour work shifts were resumed.

Despite the move back to 12-hour shifts, CEMS continued to face cutbacks, as the City of Cleveland was especially hard-hit by the global recession caused by the housing crisis. By 2010, despite no change in call volume, only 15 CEMS ambulances remained in service.{{cite news |author1=Mark Puente |title=Cleveland EMS changes call policy Agency puts brakes on non-emergencies |agency=The Cleveland Plain Dealer |date=11 January 2010 |page=A1}} Further strain was added to CEMS when the Cleveland Clinic administration closed Huron Road Hospital in 2011, leaving the entire east side of Cleveland without a trauma center.{{cite web |author1=Angela Townsend |title=Trauma transport time rises after Huron Hospital closing |url=https://www.cleveland.com/metro/index.ssf/2012/05/ems_response_and_transport_tim.html |website=Cleveland.com |date=3 May 2012 |access-date=22 January 2019}}

In a bid to improve EMS, city officials decided to implement the long-proposed idea of merging its fire and EMS divisions, boldly announcing in November 2011 that the merger would be complete by the end of 2012.{{cite web |author1=Thomas Ott |title=Cleveland moves to merge Fire Department, ambulance service |url=http://blog.cleveland.com/metro/2011/11/cleveland_moves_to_merge_fire.html |website=Cleveland.com |date=9 November 2011 |access-date=22 January 2019 }} As one of the initial steps, city officials ended the expensive and inefficient{{cite web |title=CEMS Ambulance vs CFD Rescue Squad.pdf |url=https://www.care1975.com/history/historical-run-stats/ |website=CARE history |access-date=22 January 2019}} practice of using fire department heavy rescue squads staffed with 4 firefighters as backup ambulances. The city then used the money saved to open three additional CEMS ambulances for a total of 18 CEMS units.{{cite web |author1=Laura Johnston |title=Cleveland takes first step toward integrating the Fire Department with Emergency Medical Services |url=https://www.cleveland.com/metro/index.ssf/2013/02/cleveland_fire_department_take.html |website=Cleveland.com |date=February 2013 |access-date=22 January 2019}} The city also cross-trained 6 CEMS paramedics at the Cleveland fire academy.{{cite web |author1=Dave Davis |title=Cleveland.com Metro News Cleveland's goal is to merge EMS and fire divisions by year's end |url=https://www.cleveland.com/metro/index.ssf/2013/06/clevelands_goal_is_to_merge_em.html |website=Cleveland.com |date=18 June 2013 |access-date=22 January 2019}} Despite these steps, city officials abandoned the merger plan after the [http://www.iafflocal93.org/ firefighter's union] voted down a merger proposal in May 2014.{{cite web |author1=Leila Atassi |title=Cuyahoga Prosecutor says former Cleveland Fire Chief Paul Stubbs ignored payroll abuses; Mayor has remained steadfast in defense |url=https://www.cleveland.com/cityhall/index.ssf/2014/04/cuyahoga_prosecutor_says_forme.html |website=Cleveland.com |date=13 April 2014 |access-date=22 January 2019}}

After the merger plan was abandoned, the city again decided to invest in CEMS to meet the demands of a rapidly increasing call volume. After the passage of an income tax levy in 2016, additional staff were hired and new ambulances were purchased to increase the total number of units to 25 during the daytime and 21 at night by the beginning of 2018.{{cite web |author1=Courtney Astolfi |title=More ambulances coming to Cleveland in effort to cut down response times |url=https://www.cleveland.com/metro/index.ssf/2017/09/more_ambulances_coming_to_clev.html |website=Cleveland.com |date=18 September 2017 |access-date=22 January 2019}} During this time, local trauma care also improved, as University Hospitals attained Level 1 Trauma center status at the end of 2015. This relieved MetroHealth of the responsibility of being the sole Level 1 trauma center in Cuyahoga County and helped fill the void left by the sudden closure of Huron Road hospital 5 years earlier.{{cite web |author1=Brie Zeltner |title=University Hospitals to join MetroHealth, Cleveland Clinic in regional trauma network |url=https://www.cleveland.com/healthfit/index.ssf/2017/02/university_hospitals_to_join_m.html |website=Cleveland.com |date=8 February 2017 |access-date=22 January 2019}}

Cleveland Emergency Medical Services began carrying nasal-spray Narcan, the opioid antagonist drug that reverses an opioid overdose in 1985. In 2016, the division's ambulances began offering Project DAWN (Deaths Avoided with naloxone) Narcan kits to citizens. Narcan, a naloxone nasal spray, can be used by untrained individuals relatively simply. The kits were also available at EMS headquarters.{{cite web |last1=Neidermier |first1=Kevin |title=Cuyahoga County and Cleveland are Stepping Up Narcan Distribution |url=https://www.wksu.org/post/cuyahoga-county-and-cleveland-are-stepping-narcan-distribution#stream/0 |website=WKSU 89.7.org |publisher=Kent State University |location=Kent OH |date=10 March 2017}} Project DAWN is a community-based overdose education program that dispenses Narcan to combat Ohio's opioid overdose crisis.{{cite web |title=Cleveland EMS Providers to Distribute Overdose Kits |url=https://www.emsworld.com/video/12253063/cleveland-ems-providers-to-distribute-overdose-kits?page=8 |website=EMSWorld |publisher=HMP Global |location=Malvern PA |date=2 September 2016}}

During the 2020 global pandemic, Cleveland EMS saw its first decline in call volume in several years. This mirrored local and national trends, where people avoided healthcare facilities because of concerns they might contract the CoVID-19 virus.{{Cite web |last1=Moinca |first1=Robins |title=Patients Avoiding Local Emergency Rooms to Steer Clear of COVID-19 |url=https://www.wkyc.com/article/news/health/coronavirus/patients-avoiding-local-emergency-rooms-to-steer-clear-of-coronavirus/95-c5fde088-f0e8-4d3a-8bf4-f72256a75e2e |website=wkyc.com |publisher=WKYC |location=Cleveland Oh |date=31 January 2021}} During this time, Cleveland EMS continued to answer emergency calls, with medics wearing increased personal protective equipment, including N95 respirators. Despite these measures, several EMS providers still contracted CoVID-19.{{cite web |last1=Gallek |first1=ed |title=Could EMS Crew Coming to You Have COVID-19 and Not Know It? |url=https://fox8.com/news/i-team/i-team-could-ems-crew-coming-to-you-have-covid-19-and-not-know-it/ |website= fox8.com |publisher=Fox news |location=Cleveland Oh |date=31 January 2021}} Cleveland EMS providers were among the first local healthcare providers to receive the CoVID-19 vaccine once it became available in late 2020. They also helped distribute the vaccine to others by staffing vaccination clinics.{{cite web |last1=Goldenberg |first1=Sarah |title=Paramedic of Frontlines of Coronavirus Pandemic: Get the Vaccine |url=https://www.cleveland19.com/2021/01/23/paramedic-frontlines-coronavirus-pandemic-get-vaccine/ |website=cleveland19.com |publisher=WOIO |date=31 January 2021}}

In 2022, Orlando Wheeler was appointed Interim Commissioner of EMS replacing Nicole Carlton. Cleveland EMS also began receiving 15 new ambulance funded by ARPA monies.

{{cite web |last1=Astolfi |first1=Courtney |title=Potential ambulance reduction, changes to police inspector general, and other takeaways from Cleveland's public safety budget |url=https://www.cleveland.com/news/2023/02/potential-ambulance-reduction-changes-to-police-inspector-general-and-other-takeaways-from-clevelands-public-safety-budget-hearings.html|website=cleveland.com |publisher=Advance Ohio |date=17 February 2023}}

By September of 2023, Orlando Wheeler was appointed to the commissioner position permanently. {{cite web |last1=Astolfi |first1=Courtney |title=Cleveland EMS looks to boost staffing by upping entry wages for experienced paramedics|url=https://www.cleveland.com/news/2023/09/cleveland-ems-looks-to-boost-staffing-by-upping-entry-wages-for-experienced-paramedics.html|website=cleveland.com |publisher=Advance Ohio |date=19 September 2023}}

{{reflist}}

{{Official website|http://www.city.cleveland.oh.us/CityofCleveland/Home/Government/CityAgencies/PublicSafety/EMS}}

• [https://www.care1975.com/ Cleveland Association of Rescue Employees 1975 Homepage]

Category:Ambulance services in the United States

Category:Healthcare in Cleveland

Category:Government of Cleveland