When Pittsburgh Chief of Emergency Medical Services Amera Gilchrist assumed her position in May 2023 her staff included just 14 emergency medical technicians.
Today she has 34, and the increase includes 15 Pittsburgh EMS Freedom House EMT Training Academy graduates. The new program started last year, and both cohorts had a 100% completion rate, according to Geoff Webster, a founder of Pittsburgh Futures Collaborative, a nonprofit that has worked with Mayor Ed Gainey’s administration.
Another EMT cohort just took its national registry test, and the seven trainees have six more weeks remaining to finish the 12-week certification program, Gilchrist said. With this success, she and her staff added an advanced EMT training program, a middle-ground position between an EMT and a paramedic, meaning they can start some IVs and medications and provide some advanced airway procedures. Three members of the original Freedom House EMT Training program were among the eight who finished it on May 1; that group also had a 100% graduation rate.
Staffing EMS services has been difficult nationwide, Webster said, and the city’s program has been successful in large part because the director has been flexible and innovative in creating it with her staff. He said that PFC has worked with Gainey and his entire management team to apply a set of principles to their work with clear goals on safety and delivering services but with innovation.
He said Gilchrist and her staff’s success is a good one because of the measurable outcomes and a curriculum for the trainees that included the support necessary so they could achieve the required skills rather than failing. Webster said the latter was “astoundingly important.”
Prior to starting the Freedom House EMT program, Gilchrist said she had reviewed how the city had hired paramedics, mainly sponsoring staff to attend classes toward that certification and degree. Paramedic scarcity is a nationwide problem.
“Initially, when I became the chief, I wanted to do this as an apprenticeship program,” she explained. “That would be something you have to do for a year. It doesn’t take a year to be an EMT. We came up with the idea [and] how we could support it ourselves.”
She worked with city’s training division to develop the EMT training program curriculum, with current staff as educators. And it had an important component: support.
“I wanted to make this a better process for anyone coming in,” she said. Prior training programs “didn’t have nurturing or follow-up. My idea was let’s do this in house. We are more invested in the training.”
The other major plus: getting a salary. “They don’t have to work while they are training and going to school,” she said. “Their only responsibility was to go to school while they are working.”
She presented her ideas to the public safety director with the assurance that it wouldn’t have an upfront cost to the city. She said keeping in mind her own background and the challenges she faced to get to her current position helped, too.
“A lot would fail the test because they didn’t have the support, and in the program pursued through Freedom House, any difficulty [the trainees experience] are reviewed,” the chief said. “That’s what helped that success rate.”
Webster said the chief has also been successful because negotiations with the EMS union, the Fraternal Association of Paramedics Local 1, permitted combination units with paramedics and EMTs on shifts for the first time.
Right now the city has 13 advanced life support units. When Gilchrist became chief, the service ran three such units for 12 hours from 6 a.m. until 6 p.m. She started to work on staffing levels, and combined with basic life support units – four to five that run during the day and a steady three on night shift – services and response times have improved.
“This is huge. The city has never run 17 to 18 transport units daily. It has really helped out a lot,” Gilchrist said. It also means the city has cut down on mutual aid requests from nearby cities and towns. “We used to ask for that a lot. We used to run out of units every day. Now that doesn’t happen all that often,” she said.
Webster said the increased staffing helped during a particularly hectic time – the St. Patrick’s Day parade and days around it when people celebrate within the city.
Gilchrist said in 2024 the city had multiple units going out of service over that holiday time frame, and mandated overtime was the only way to respond to all the calls.
“It was really challenging,” she explained. “What happened this year, with the combo units, I believe only one unit for six hours went out of service [because] someone went home sick. We actually had more than enough coverage. It was a stark difference from last year. It was a huge difference. You have to look at the whole weekend – Friday until Monday. Last year was horrible. The parade is probably the tamest of the activities. All the [celebrations] on the South Side, North Shore, Downtown …. It really depletes resources.”
Right now the service has more than enough EMTs but needs more paramedics. Those EMTs help with deficiencies, though, she said.
Beyond the staffing, the Freedom House EMT Training Academy was definitely an idea she came in with as she assumed the top leadership spot. It wasn’t just about staffing.
She said she wanted to pay homage to how the department started and honor the members who brought emergency medical services to the city. “But I also wanted to be able to get people who are interested in EMS who could not find pathways or have the finances to go to school,” she continued. “I wanted to create that pathway for them. Some of my best stories are about the people who started this program, who were unable to buy houses and cars. They can do that now.”
The city funds the program, she said, and it hasn’t needed to seek outside resources. The service paid for most of the required books and materials out of the budget. The program will continue, she said, as long as the city is able to support it. Most likely another advanced EMT training will be offered.
Webster, a city resident who lives on the East Liberty-Shadyside border, said his organization’s goal is to make Pittsburgh “the greatest place for people to live.” His nonprofit formed in January 2023. He said he clicked with Gainey because he believes he is a servant leader with an administration that has been based on safety and habitual excellence.
His group worked with the city’s top leaders who in turn mentored their directors and chiefs such as Gilchrist. His prior work with Pittsburgh Healthcare Initiative and PUMP Futures, he said, shows he has a long history of trying to transform the region. Currently he is senior adviser and principal at Value Capture LLC on Pittsburgh’s North Shore.
With PCF’s co-founder, Paul O’Neill Jr., he said the nonprofit exists to help leaders set common goals that are value based and universal. They look to corporations like Toyota, which he said hasn’t had a layoff in 70 years and has made money even during recessions and the pandemic.
“The reason is they understand that people are the only appreciating asset in the world,” Webster said. “When you put respect and skills into people, they become more valuable. Everything else you buy depreciates.”
Western Pennsylvania has thousands of well-meaning organizations and individuals working to assist residents and provide them what they need to live their lives. A main issue that prevents the region’s growth is that that process is not systemic.
He did not work directly with Gilchrist but said he knows she and her staff let everyone practice to the top of their abilities, then grew their skills, a great example of solving the EMS service’s issues systemically. “That’s,” he said, “the holy grail for excellence.”
Helen is a copy editor at the Pittsburgh Post-Gazette, but she's currently on strike. Contact her at hfallon@unionprogress.com.