'No units available' – Henrico EMS is facing an increase in emergency calls, and staff can’t keep up

At least once a week since this past January, Henrico County’s EMS system encounters a “no units available" situation, during which emergency calls are still coming in, but no EMS units can respond.

In the past, these “no-units-available” situations have still occurred, but never this frequently, said Henrico EMS director Monty Dixon. And despite the department adding several more units in recent years, an increase in emergency calls within the county is putting progress at a standstill.

“It feels like the snowball is gaining momentum, going down the hill,” Dixon said at a Henrico Board of Supervisors meeting Aug. 12. “Our call volume has increased, despite our efforts to revamp the model, despite our efforts to introduce more paramedics into the system.”

Since last year, 911 calls in Henrico have increased by almost 8% – more than double the 1% to 3% growth rate Henrico EMS has predicted in the past. In Fiscal Year 2025, Henrico EMS received about 51,200 calls (a 7% increase) and Henrico Fire received around 10,300 calls (a 9% increase).

Just last month, Dixon said Henrico EMS set a record for the most calls ever received in a 24-hour time period, with 174 calls. 

“It seems to be a Virginia trend and a nationwide trend that nobody can exactly explain. We’re not sure why our volume increased, and it’s still on the rise.”
– Henrico EMS Director Monty Dixon

‘We don’t know what’s going on’

The department has significantly expanded its staff; in 2019, Henrico EMS added peak-time ambulances to its fleet, which operate seven days a week. Including Tuckahoe’s and Lakeside's volunteer rescue squads, Henrico currently has five peak-time units that have been “incredibly successful,” Dixon said, and respond to 25% of the county’s 911 calls.

Henrico EMS has also recently added three new 24/7 transport units. The addition of more staff has allowed the department to reduce both its response times (the time it takes for units to arrive on scene) and its commitment times (the time from when units are dispatched to when they are clearing the call and back in service). The county’s average response time has decreased to just five minutes 30 seconds.

But even with more units, staff cannot match the rise in 911 calls, putting the department at a “net zero gain,” said Dixon. And EMS officials still are unaware of what has been causing the increase in call volume.

“We don’t know what’s going on, to be quite honest,” she said. “It seems to be a Virginia trend and a nationwide trend that nobody can exactly explain. We’re not sure why our volume increased, and it’s still on the rise.”

In Henrico, as well as both regionally and nationally, call volume surges can be partly attributed to a simple reason, said deputy fire chief of operations Douglas Clevert Jr. – people are more likely now to call 911 for emergencies than in the past. 

“People use 911 more. If you’re sick, people are going to tell you to dial 911. And during a storm, if a tree falls, most people don’t know who else to call, so they dial 911,” Clevert said. “It’s a nationwide trend with call volume going up. We’re just seeing the effects of it here in Henrico as well, and trying to stay ahead of that.”

Impacts of recent growth in the county

But more calls also can be attributed to the recent growth in Henrico’s population, with more houses being built, more businesses coming in, and bigger schools being created, said Clevert. And new attractions, such as Henrico’s new Sports and Events Center, bring in more visitors, who also may need to call local EMS.

“As we grow as a county, we're building homes, we're building apartment complexes, we're bringing businesses, and that also brings 911 calls,” he said. “You know, growing up in Short Pump, West Broad Village was not there. That is a patient generator.”

Local and regional hospitals have also seen a surge in patients, Dixon said. And since about 65% of Henrico’s calls will require transport to the hospital, crowded hospitals have caused the county’s transport units to be out of service for longer periods of time.

“One of our hospital partners yesterday called us and asked us to divert all traffic for several hours from that hospital, because they had 60 calls and no beds. Those are hard factors” Dixon said. “One of our units sat on the wall [for more] than an hour-and-a-half. So we’re losing our units, which we already don’t have enough of, to wall time from the hospital.”

Going forward, Henrico EMS wants to continue to add more units, with the goal to add an additional peak-time unit at Fire Station 8 by next month. Next July, the department also wants to add a specialized medic unit to Station 8 and an additional civilian medic quick response vehicle to Northern or Eastern Henrico.

The changes likely would drop commitment times by 3%, Dixon said, and the department also wants to consider adding civilian medic transport units that would work 24-hour shifts.

But Henrico EMS likely still will face other challenges, said Henrico Fire’s medical director Dr. Jeff Ferguson, such as impacts from the implementation of the “One Big Beautiful Bill,” which has been projected by different Virginia organizations to significantly decrease Medicaid coverage in the state. 

“If [people] have less access to primary care, they’re going to rely more on the emergency department, which in turn, will rely more on EMS to get them transported to hospitals,” he said. “So the theoretical risk is there, and we suspect the call volume will go up.”

Liana Hardy is the Citizen’s government and education reporter. Support her work and articles like this one by making a contribution to the Citizen.