Emergency Medical Services are in trouble, especially in areas where ambulance services don’t receive adequate municipal support.

Ambulance crews often see people on the worst days of their lives, delivering emergent health care to them.  While the care they render has saved countless lives, Emergency Medical Services across the US are closing at an alarming rate.

The contributory factors leading to this ongoing demise and nationwide crisis are many and include:

• Lack of Community Support and Funding
  

  While many communities have had an ambulance service in their town for decades, for many agencies, the cost of maintaining an EMS operation has become prohibitive.  The declining number of volunteers; increased overall cost for supplies, equipment, and personnel; a limited career ladder for employees; these and other issues have served as factors impacting operations and survivability of the local ambulance service.  Many organizations have gone to their town councils and elected officials seeking financial help but sadly, many communities can’t support funding for EMS given the size of their local budgets.  As a result, the ambulance service closes and communities wait longer for the next closest available ambulance to come from a neighboring community.  Unfortunately, in these cases, lives and families are impacted, and NOT in a positive way.

• Declining Reimbursement
  

  A study conducted in 2018 related that, in the United States, the cost associated with sending one EMS crew to a request for help averaged about $560.  One must consider that we are now living in an aging America, with much of our population on Medicare or some other form of government-assistance.  The reimbursements to ambulance services from Medicare and Medicaid fall well below this figure.  Declining reimbursement causes ambulance services to cut costs and personnel in order to sustain operations.  Add in commercial payers (insurance companies) NOT recognizing the value or costs associated with quality pre-hospital care and also reimbursing at less than that $560 amount, and the crisis further complicates.

• Retention of Quality Employees
  

  There is presently a shortage of EMS personnel, which threatens to undermine the 911 emergency response infrastructure.  Turnover of EMTs and Paramedics runs in the range of 20-30% annually.  EMS personnel are now leaving the profession faster than they can be replaced, thus compromising EMS’s ability to respond to health care emergencies.  This is especially true in rural and underserved parts of the country.

• New Professionals Entering the EMS Workforce
  

  Nationally, the EMS workforce is shrinking.  Making matters worse, individuals who may have an interest in pursuing a career in EMS are often turned away by low salaries, extensive training requirements, and job-related hazards.  Many individuals who leave maintain their certifications, but choose to work in professions outside EMS. 

  The issues noted above are NOT new and have been building for years.  We are now however at a crisis point, and most assuredly, a crossroads for the ambulance industry.  It is a complex problem, but fixable if the public, our elected officials, and those working in EMS, join arms in this call to action.  CC4EMS can serve as a facilitator to bring all parties together by sharing information on our web pages to assist others in finding workable solutions in your community.  Working together, lives can be saved.