The $21M Texas EMS recruitment and retention initiative

Recruiting and retaining EMS professionals has been an ongoing challenge across the U.S., made worse by the COVID-19 pandemic. In this episode of the EMS One–Stop podcast, host Rob Lawrence sits down with Joe Schmider, Texas State EMS director, to discuss the $21M Texas EMS Workforce Initiative — a data-driven approach to recruiting and retaining EMS providers statewide.

Schmider details how Texas identified a 40% non-utilization rate among certified EMS professionals, successfully secured state funding, and launched an innovative recruitment and retention campaign. With over 10,915 new personnel added since 2019, this program serves as a model for other states struggling with EMS workforce shortages. This episode is full of actionable insights for EMS leaders, policymakers and recruiters alike.

Key quotes from Joe Schmider

• "We were seeing about 40% of our certified people — licensed paramedics, EMTs, advanced EMTs — were not using their skills on an ambulance."
• "We worked with our associations here in Texas, the Texas EMS Alliance and the Texas Ambulance Association. They went and met with some legislators, worked the room a bit, and we got $21 million of federal dollars through the state to us for 2 years to put in place a recruitment and retention program."
• "We pushed out 3,152 scholarships. An EMT scholarship was worth $2,000, an advanced EMT scholarship was $3,200 and a paramedic scholarship was $8,000. The money went directly to the education program, not to the student. They had 1 year to complete their training and then had to serve 96 hours a month on an ambulance — either as a paid or volunteer position — for 1 year at the EMT level and 2 years at the paramedic level."
• "We spent $1.5 million on an advertising campaign throughout the state of Texas. We hired a media company to develop commercials, billboards and social media campaigns. The use of social media was incredible — 50 million views over 2 years, which was an incredible number. We never expected that."
• "The second thing people do [when considering EMS careers] is they watch us as EMS professionals. Do I want to work with these people? Do I want to be a part of this? I once saw two EMTs standing on the back of an ambulance smoking a cigarette at an event. I went up to them and said, ‘Are you kidding? What message are we putting out when we do stuff like that?’ We have to think about our image."
• "People leave the EMS profession for two reasons: money or the way they’re treated. Depending on which survey you look at, it could be money first or treatment first, but it’s always those two reasons."

Episode timeline

00:08 – Rob Lawrence introduces guest Joe Schmider, Texas EMS director

00:26 – The EMS staffing crisis and how COVID-19 accelerated workforce shortages

01:36 – How Texas used data to identify a 40% EMS non-utilization rate

02:51 – How Texas EMS leaders secured $21 million in funding

04:31 – Structuring EMS scholarships and training requirements

06:41 – The success of the recruitment campaign: 3,152 scholarships awarded

08:46 – How Texas reached 50 million views in its EMS recruitment campaign

11:16 – EMS workforce retention: The challenges of pay and treatment

13:46 – Addressing rural EMS shortages and workforce gaps

16:01 – How Texas EMS associations helped advocate for change

18:21 – The future of EMS funding and advocacy efforts

21:01 – Lessons from corporate retention strategies: What EMS can learn from HEB grocery stores

24:01 – The importance of EMS provider wellness: Texas’ Wellness Wednesday initiative

26:01 – Final takeaways: Lessons for other states and EMS leaders

28:01 – Closing thoughts and how to access Texas EMS resources

Additional resources

• Connect with Joe Schmider: joseph.schmider@dshs.texas.gov/512-484-5470

• Texas EMS Careers and Education