With San Juan Island EMS asking the public to pass the highest levy amount possible – .50/$1000 of assessed home value – this August, locals are yearning for transparency of the budget.

“The board would like to be as transparent as possible,” said Bill Williams, San Juan County Public Hospital District board chairman.

One of the areas requiring clarity concerns employee salaries, including the four full-time paramedics and the chief. In 2015 San Juan EMS paramedic salaries averaged almost $92,000 per year. While this isn’t too far off from The City of Seattle’s paramedic salaries, which start at $75,300 and up to $91,152 after three and a half years, but Seattle paramedics also double as full-time firefighters and work about 2,500 hours a year.

“Our paramedics work an average of 4,032 hours per year,” said EMS Chief Jerry Martin. “Compare that to Orcas at 2,190 hours per year; we’re almost double.”

At just over 4,000 hours worked per year, San Juan EMS paramedics earn just $24.52 per hour while Orcas paramedics are at $31.56. The difference is that San Juan Island paramedics work almost all of their hours “on call,” spending two weeks out of every month as either the lead or backup paramedic, which requires that they be available 24 hours a day for those seven days. During this time they are not allowed to leave the island, must be in constant contact with the EMS station and/or other staff and be able to respond to calls within minutes. That’s 336 hours per month that each paramedic spends on call to justify their average $7,666 per month salaries.

There’s another way to look at the situation though: per number of calls each paramedic actually responds to during their on-call work weeks. SJEMS averages just under 1,500 calls per year, and approximately 1,000 of those are classified as Advanced Life Support calls which require at least one paramedic. This averages out to less than three calls per day requiring a paramedic response. As expected, calls rise seasonally with the influx of summer residents and tourists. Summer months can see multiple calls per day, but the rest of the year it’s possible for paramedics to go days without a single call.

With Island Air medical transport having separated from EMS this year the number of transport calls for paramedics are likely to fall meaning even fewer actual time in the field.

One suggestion from the public has been to staff less full-time, year-round paramedics and then bump up the summer months with seasonal, per-diem staff. The problems with per-diem paramedics, according to Martin, are the length of time it takes to train them, that they’re required to be San Juan Island-certified and that most paramedics are unwilling to take temporary positions. Another option is to cut wages or the number of employeed paramedics, but Martin warns against the dangers of understaffing.

“In the summer months we can handle the potential two, three or four calls at a time that may come in,” he said. “But that’s with two paramedics on all the time.”

Martin’s own salary of $120,000 per year has been questioned by the public. While within the parameters of the industry standard, Martin makes more than both the San Juan County manager and sheriff, both of whom oversee the entire county and more than twice as many employees as Martin, who is in charge of 12 full-time staff members. One must also factor in, however, that Martin coordinates the 40 volunteer EMTs and is also responsible for digging EMS out of the financial hole it’s currently in.

“I’ve heard people say they want wages cut,” said Martin. “But my main focus is to be patient-centric. Patient care is the front most of what we want.”