EMS World Q&A: Leroy Garcia

Editor's note: Garcia resigned from the Colorado General Assembly at the end of February for a new position at the U.S. Department of Defense, where he will serve as special assistant to the assistant secretary of the Navy for manpower and reserve affairs.

Leroy Garcia
Title: Colorado State Senator (3rd District)
Hometown: Pueblo, Colo. 
EMS Experience: AMR paramedic (currently practicing)

On one day Leroy Garcia, president of the Colorado Senate, is in Denver, advocating for legislation to benefit his constituents. On another he’s in his paramedic uniform, making split-second care decisions for the optimal outcomes of his patients.

A state senator since 2015 following stints with the Pueblo City Council and Colorado House of Representatives, Garcia is a trailblazer. After high school he enlisted in the U.S. Marine Corps. Upon his return from Iraq, he worked as an EMS provider, earning bachelor’s and master’s degrees as a first-generation college student. He became senate president in 2019.

Garcia discusses with EMS World what the experience has been like and why those in EMS might want to leverage their skills toward political office. 

EMS World: What initially drew you to EMS? What did you like about delivering prehospital care?

Garcia: I had never contemplated it. I actually started as a nursing major at a public community college out of high school and decided to join the Marine Corps. During that time I was in the reserves. I heard about an EMT class and thought that would be a really cool background experience as a nurse. I took the EMT-Basic class and loved it. I finished EMT school, got a part-time job, continued a little bit with nursing, and decided I was all in with EMS. 

Halfway through the paramedic program, I got an activation order to deploy to Iraq in 2003. I was attached to an artillery unit taking on the responsibility of mortuary affairs. My job was to do search and reconnaissance missions for killed Marines, help process their bodies, and ship them back to Dover Air Force Base.

When I came back I finished the paramedic program and graduated in 2005, and I’ve been working at American Medical Response (AMR) as an EMT. I went to work at the Pueblo County Jail as a medical supervisor. I worked for AMR full-time for a couple years as a paramedic and started tutoring students struggling to pass the National Registry of Emergency Medical Technicians. 

Several months later Pueblo Community College had a faculty position open in emergency medical services. I’ve been there teaching fundamentals, medical emergencies, special considerations, and lab sections. I went on to get my bachelor’s degree in management from the University of Phoenix and master’s degree in organizational management from Ashford University. 

So you still run calls? Do patients recognize you?

Garcia: I still maintain my credentials and run calls. Not as many these days, because I serve in the General Assembly January through May. Patients recognize me, but it’s less likely now because we’re all wearing masks. 

Two years ago I was on a call where a guy was complaining about some abdominal pain, and as I was starting an IV and assessing him, he said, “You look like that guy Leroy Garcia, the politician.” I said, “Well, sir, actually I am.” He said, “What are you doing here?” I said, “I work as a paramedic. We have a part-time legislature, and I am president of the senate.” He thought it was great.

How did your experience in Iraq inform what you do as a paramedic?

Garcia: My experience and background as a Marine and my training as a paramedic have really prepared me well for life and challenges. Both of those levels of training teach a high level of leadership and management in a way that’s independent. When you’re a paramedic, you might have one or two resources or colleagues that can help, especially in the area where I live. If you’re responding in Boone or Avondale [outlying communities east of Pueblo], it would be 25–30 minutes from a hospital. You have to be able to make critical decisions in a thoughtful way. You have to be confident. You have to lead, be calm, and address the life threats. 

You started your political career in 2010 as a Pueblo City Council member. What led you to take that first step? 

Garcia: I credit my deployment to Iraq for helping me become informed about politics and governing. In 2003 the Saddam Hussein regime had transitioned out to [allow] the establishment of democracy in Iraq. We have a wonderful democracy in this country. Any country that has a true democracy has to be cognizant that it could be frail, and you have to invest in it. 

I wanted to come back from Iraq and not just complain, like so many people do on social media or other outlets, instead of trying to be part of the solution. I decided I wanted to run for city council. I went to City Hall to ask for an application, and the clerk joked, “You’re way too young to serve on the council.” I took that as a challenge. Eight months later I was a council member, and she became a great friend. 

It doesn’t matter if you’re young, old, Latino, gay, straight, whatever—you should be part of this wonderful process we have. I enjoyed serving on the city council and the opportunity to go in a different direction.

How did the skills you developed in the military and EMS translate to political service? 

Garcia: There are areas of overlap, especially in my capacity as the first Latino senate president in Colorado and one of the presidents who’s served the longest. This will be my fourth year. It’s very uncustomary that things line up that way. It’s one thing to run for office and have the majority elect you. It’s a great honor—there are only 35 senators representing the entire state. It’s another thing to be senate president for four years and have unanimous consent. It’s one of the pinnacles of my profession, because not only have I been entrusted by my constituents to serve them, but from my senate colleagues on both the Democratic and Republican sides, there was no objection to my election. That means I have the trust and faith of my colleagues, which is a responsibility I take very seriously. 

When you think about that as a paramedic, patients are at their most vulnerable when they put their trust in paramedics and EMTs. They call 9-1-1, struggling and not knowing what the solution to their emergency is. The paramedics, EMTs, and other allied health professionals have to make sense of the chaos, the medical and traumatic challenge, try to resolve it, stabilize things, and hopefully return that patient to good condition.

What has surprised you about running for or holding office or serving in government? 

Garcia: I love every single day in public office. It’s a unique challenge and very comparable to the EMS profession, and why I think EMS professionals should think about running for office. They’re innovative, calm, and solution-oriented. We’re driven by getting results when we give medications, nebulizers, look at EKGs. We’re trying to resolve something. We need more of that in government—people who are geared that way and want to be part of the solution. That’s what I find so fascinating about this job. It is challenging in all aspects every single day. No days are ever the same. Some of these challenges are brought on by the federal government, some internally in the state. Some of these challenges are happening socially. It’s a fascinating world to be part of and work in. 

What kinds of legislation have you been able to support that’s impacted emergency care?

Garcia: One of my top priorities is being an advocate for EMS professionals and the health and safety and well-being of the EMS system. EMS is not just prehospital emergency medical services. 

I ran legislation several years ago to create community care-based paramedicine. I recognize, as do so many, the value of paramedicine and what it and EMS bring to the allied health professions. These aren’t just the first responders of the 1950s in this country. These are health professionals who are now practitioners. 

I ran legislation several years ago to allow paramedics to earn bachelor’s degrees. This is important because we recognize the skill set of these practitioners, the ability to decrease pressure in the hospital system and align patients with the appropriate level of treatment. Not all patients need to go to an emergency room. 

COVID-19 has complicated this because we know hospitals are strained and the risks associated with that. With investments in telemedicine, having a nurse navigation program is about connecting professionals as a continuum to patient care. It’s good for patients and their outcomes. It decreases costs. It streamlines and helps make these  systems work more efficiently. These policies have helped Colorado move in a direction that’s far more efficient and provides better health care options.

Our opioid pilot project is a mobile integrated health care process in which a paramedic or EMT helps connect patients to the resources they need. We need to connect them with behavioral health specialists, not put them in the emergency room, provided they don’t meet that criteria. It’s about aligning them where they need to go and helping them make sure they’re compliant with their medications and follow-up. It has proven to be a great model for better outcomes and decreasing costs.

We’re increasing the reimbursement rate for agencies. We recognize there’s been a lot of sacrifice on behalf of these agencies and programs to stretch their dollars. We share responsibility in the state of Colorado to make sure the reimbursements show up so they can provide the services needed in their communities. 

What are some of the big issues facing EMS in Colorado in 2022?

Garcia: There are several we’re committed to addressing. Most of it is grounded in behavioral mental health services and the federal money we’ve received. We have a behavioral and mental health task force. We know a great majority of the calls we’re running are behavioral- and substance abuse-related. There are people who are down and out on the streets because of substance abuse or patients who don’t have access to mental health care. There’s a continued effort this year to invest dollars in American Rescue Plan to help address the causes of this.

There also are a number of workforce challenges associated with burnout in the health care professions. We’re seeing it on both the EMT and paramedic sides. 

What is your position on the ketamine restrictions seen in Aurora and Colorado since the death of Elijah McClain? Are those an appropriate response?

Garcia: I absolutely believe it’s an appropriate response. We as practitioners have to be mindful and make decisions in conjunction with our other health professionals. We want to make sure these are good decisions. It’s important we talk about these substances like ketamine—or, this year, fentanyl. It’s important for readers to understand that from the health care professional side, if they have concerns on some of the legislation or policies that are being proposed, that they weigh in early and help us shape those policies.

What advice would you give any EMT or paramedic considering public service?

Garcia: EMTs and paramedics are geared toward serving the public. When you’re an elected official, you’re just serving in a different capacity. It doesn’t have to be in the senate. It could be on the school board, city council, or fire protection district. The reason it’s important to be involved is that decisions are made that will impact you and your profession. It’s important to be at the table. 

Carol Brzozowski is a freelance journalist and former daily newspaper reporter in South Florida. Her work has been published in more than 200 media outlets.