The 2014 – 2019 Emergency Medical Services (EMS) levy is projected to collect over $450 million in revenue, which supports life-saving services in Seattle and King County. King County and its partner agencies employs more than 4,000 paramedics and emergency medical technicians (EMTs) who provide these services. This audit focuses on how King County and its partner agencies are addressing workforce planning and financial management.

Nearly 30 percent of King County’s EMT and paramedic workforce will be eligible for retirement by the end of the 2014 – 2019 levy period. High turnover rates could present cost and staffing challenges such as retirement payouts and hiring costs and an increased need for recruitment. In addition, about 85 percent of King County emergency medical responders are white males, a number which is consistent with national statistics. This lack of gender and racial diversity presents legal and staffing risks. Further, it may result in missed opportunities for enhanced efficiency and customer service that could be gained through broadening the skills, experiences, and perspectives on response teams. While there has been effort by some individual agencies to address these challenges, these efforts have not included key strategic workforce planning best practices. Finally, while EMS has been largely successful at managing budget variances, EMS is missing opportunities for further managing unanticipated revenues.

To help address potential equity, financial, and staffing impacts to emergency medical service agencies throughout King County, we recommend EMS work with its partner agencies to focus on strategic workforce planning and diversity efforts. We also recommend policy and financial planning improvements to strengthen EMS’s ability to manage economic uncertainties that cause levy expenditures and revenues to be higher or lower than forecasted.

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