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Taking action on the shrinking availability of EMS in rural America

Rickey Stokes

Viewed: 823

Posted by: RStokes
Date: Nov 04 2019 5:59 PM

NAEMT thanks NBC News and Erika Edwards for a comprehensive and insightful article that sheds light on the shrinking availability of EMS in many communities across our country.

As healthcare resources become more scarce, the responsibility for healthcare delivery often falls to America’s safety net healthcare system, local EMS agencies. Many rural EMS agencies rely on volunteers for staffing and responding to ambulance calls. Increasing job responsibilities, training requirements and the changing economic environment have made it more difficult for EMS agencies to recruit and retain volunteers. Many rural agencies have closed.

The article highlights the plight of these rural communities, and exposes a dilemma for communities in both rural and urban areas. As noted in the article, only 11 states deem EMS as an essential service. Most states do not fund EMS as an essential service in the same way that police and fire services are funded. Moreover, payments for EMS care paid by insurance providers, Medicare and Medicaid are usually less than the cost of providing the care. This current economic model for EMS makes it difficult for EMS agencies to compensate EMTs and paramedics based on the value they bring to their patients and local communities, and the nation’s healthcare system. Low pay rates, dangerous work environments and challenging work schedules often discourage people interested in a career in EMS. Many who are in the EMS workforce leave the profession to seek higher compensated positions in other professions.

NAEMT urges all states to recognize EMS as an essential service. We also support meaningful EMS payment reform that will allow both rural and urban EMS agencies to compensate their personnel at a level in which they can sustain an EMS workforce capable of responding to the needs of their communities. NAEMT urges Congress to fund the SIREN Act passed into law in 2018. Once funded, this law will create a grant program for public and non-profit EMS agencies in rural areas, many of which are at the forefront of the opioid epidemic, to support recruitment, retention, education and equipment for EMS personnel specifically in rural areas.


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