EMS and Ambulance Services are not an Essential Service

Healthcare resources are more scarce than ever. The new normal has EMS as the “healthcare safety net” for most of the United States. Local EMS agencies, City EMS, are finding it more difficult to recruit qualified applicants. Moreover, they are finding it harder to find suitable personnel to apply and be trained.

Many rural EMS agencies across the country have closed due to financial hardship. Others are relying on volunteers to augment staffing. The job of EMTs and paramedics has become more difficult due to a myriad of responsibilities that were once dealt with by other jobs – positions that are no longer filled.

The fact remains – ambulance services are not an essential service. That is the current position most ambulance services find themselves in. At present, only 11 states have designated EMS as an essential service. As such, most states don’t fund them like they do police and fire services.

Essentially ignored

While ambulance services often seek reimbursement for services, especially transportation, the insurance reimbursement is inadequate. Medicare and Medicaid reimbursement rates are less than the cost of providing care. This economic model makes it increasingly difficult for EMS providers to compensate EMTs and paramedics at a rate comparable to their healthcare peers. The quality and value they bring to patient care are not reflecting the care and value they bring to the community and patients.

Historically low wages combined with a dangerous work environment often put off many well-suited candidates. Another drawback comes from the work schedules. Many staffing schedules do not reflect the inherent overtime due to calls for service coming in a few minutes before shift change. These calls, and night calls disrupting sleep on stations working 24-hour shifts, significantly impact the circadian rhythms of personnel. Such natural sleep cycle disruption impacts personal health and stress levels.

Opting for change

These are only a few of the reasons EMS agencies are finding it difficult to fill many positions. The workforce pool is drying up, and many providers are leaving the streets in favor of private employment with health systems, doctors’ offices, industry, and theme parks. Others have sought higher compensation in other fields. At least four area paramedics are now physicians, while others have gone into nursing, physical therapy, or become physician assistants.

On the level

On the state level, only 11 states recognize EMS as an essential service:

Connecticut
Deleware
Hawaii
Indiana
Louisiana
Nebraska
Nevada
Oregon
Pennsylvania
Virginia
West Virginia