This problem of "busy" is really a discipline problem, not so much a system problem.
Let me explain, I was down in the NOLA area in the middle of the month and staying out in LaPlace. All of the JPSO traffic was being carried on the LaPlace tower and some of the NOPD, now why? Well obviously someone in the area was monitoring the JPSO & NOPS traffic, it was not a transient thing, (like a deputy on the way somewhere else) but was that way 24/7. There should be no reason for this to be the case, I mean it was great for scanner people in St. John, but tough on the system load. Since the LaPlace tower is a 5 frequency tower, one for CCh leaves 4 voice channels available. That means if NOPD (think it was 2nd & 3rd Districts) are on the air and a couple of JP districts are talking are all talking at the same time the entire LaPlace tower is tied up and the system will not issue a system grant for any other affiliated TG even if the tower where the person trying to get a channel has plenty of capacity. Nobody in St. John should be monitoring JPSO or NOPD on the system causing the load on the LaPlace tower to be so heavy. Hence, it is not the system in JP or Orleans that is the bottleneck, it is the smaller outlying towers that are causing those "Busy" signals because someone who shouldn't be has affiliated radios on the smaller sites.
BTW, for those not-so-interesting TG's (like not listened to 24/7 elsewhere) they won't have the problem since no one out of the area is tying up the outlying sites with those TG's; so your fear of EMS/FD problems only will come to fruition if someone at another site decides to start monitoring.