They were
told.
They did
nothing.

Brownouts begin. NUA documented. Chief says resources are adequate.

The Chief began taking two of the city's 12 ambulances out of service almost daily due to overtime costs — a practice called a brownout. A Local 73 paramedic supervisor ran a cardiac arrest that took 13 minutes to reach — against a national standard of 8. An I-Team investigation found 27 instances where no ambulance was available citywide in a six-month period. City officials' response: the unavailability windows lasted less than two minutes each. The public was safe.

ICMA independent study: EMS is under-resourced. Add 6 ambulances minimum.

The International City/County Management Association completed an independent assessment of STLFD. It found EMS demand far heavier than fire suppression demand — nearly 74% of all calls were EMS. It recommended adding a minimum of 6 ambulances to the 12-unit fleet at a cost of approximately $1 million. It documented frequent NUA periods. The fire suppression side, the report noted, exceeded industry recommendations for similarly sized cities. City response: no ambulances were added. The fire suppression fleet was not reduced.

Pandemic accelerates collapse. Two-thirds of paramedic positions unfilled.

By late 2020, fewer than two-thirds of city paramedic positions were filled. The city's personnel director confirmed the figure publicly. IAFF Local 73 President Demetris Alfred identified non-competitive pay as a primary driver. Jenkerson said he would again propose adding ambulances in the next budget cycle. The union planned to push for higher pay in upcoming negotiations. City response: the residency requirement for paramedics was repealed. No ambulances were added.

"You call 911 and you expect an ambulance. In St. Louis City, they're waiting hours."

A South City Hospital paramedic told regional press that patients in St. Louis were sometimes waiting hours for an ambulance. Police officers were transporting patients in squad cars when no unit was available. Hospitals reported waiting two to three days for patient transfers because no ambulances could come. The city's 12 ambulances were handling 200 to 250 calls per day. City response: private ambulance agreements were expanded. No fleet increase was authorized.

Post-Dispatch investigation: "The city did nothing." A man dies waiting.

A St. Louis Post-Dispatch investigation documented the case of a man whose ambulance arrived nearly an hour after the call. He arrived at the hospital in critical condition. He died that evening. The investigation confirmed the ICMA recommendations had never been acted on — 8 years after the study was published. Only 10 of 12 ambulances were running on a good day. More than half of paramedic positions were vacant. City response: six private ambulances were contracted to stage in the city. No city fleet increase.

No unit available: 200+ times in a single month. Fox 2 investigation.

A Fox 2 investigation found that St. Louis had no ambulance available more than 200 times in a single month. Staffing had declined to between 6 and 10 operational ambulances on any given day — below the already-inadequate authorized ceiling of 12. Jenkerson acknowledged NUA events could last 15–20 minutes. Entry-level paramedic salary: $50,752. Maximum after years of service: $72,202. City response: Chief stated he was unaware of any instance where a patient died or worsened due to delayed response.

FY24 data confirms the ICMA picture — at greater scale.

Annual report data: 80,633 EMS calls. 22,718 diverted to private. 29,719 transported by STLFD. Paramedic turnover at 31.8% annually. The system is generating $17.4M in EMS-linked revenue while receiving only $12.1M in EMS-specific appropriations. The city has authorized 12 ambulances. The ICMA said 18 was the minimum a decade ago. Fleet size: 12. Unchanged since the ICMA report. Unchanged since the Post-Dispatch investigation. Unchanged since the Fox 2 report.