In 2021, the roughly 1,200 EMS agencies and companies in Pennsylvania were called for service nearly 2.5 million times. That’s about an average of 6,700 calls per day. However, staffing shortages and a lack of funding continue to impact their ability to respond to those calls.
“As many of us are all well aware, EMS services are in peril,” said State Senator Pat Stefano (R-Fayette/Somerset/Westmoreland). “EMS providers are facing serious staffing and funding challenges,” he added.
“Our organizations and clinicians are on the brink just months, weeks, or even days from insolvency,” said Barry Albertson, Past President of the Ambulance Association of Pennsylvania.
“We have to look at every option available to us to ensure that we can fund emergency medical services in the commonwealth, or people are going to lose their lives,” said David Basnak, President and Executive Director of EmergyCare.
Rising costs for fuel, staff retention, and equipment, paired with a low Medicaid reimbursement rate, are all making it harder for first responders to answer the call.
“These financial struggles have become dire. EMS agencies across the commonwealth have shut down, or forced to alter their level of service,” said Albertson. “Ambulance providers receive below cost reimbursement for 70 percent of all transports. It is calculated that Medicaid currently reimburses 44 percent of our costs and Medicare reimburses 67 percent of our costs,” he added.
Albertson says the funding model for EMS has been inadequate for decades, but now, it’s unsustainable.
“Since 2002, after implementation of the Medicare ambulance fee schedule, costs have risen 70 percent, while reimbursement rates have risen only 27 percent,” said Albertson.
“We have to continue to increase this reimbursement rate because it’s vitally important for our EMS providers,” said Representative Martin Causer (R-Cameron/McKean/Potter), sponsor of House Bill 2434.
Causer’s bill would raise the Medicaid reimbursement rate for EMS providers, especially in rural areas.
“As a legislator representing a very rural area where hospitals are few and far between, and ambulance companies are struggling to keep their doors open, I am truly worried about this crisis and the lives that could be lost if we don’t act now,” said Causer.
Lawmakers say it’s a bipartisan issue that both the House and Senate need to act on fast.
“I don’t want to say that it’s critical because it’s at a breaking point right now,” said State Senator Katie Muth (D-Montgomery/Chester/Berks). “The stress on the job that these first responders deal with is immense,” she added.
Albertson said EMS companies and agencies cannot operate efficiently with little to no income.
“The reality is that EMS is a business, like it or not, and like any business, whether a nonprofit or a for profit, income must at least equal, or exceed the cost for us to remain solvent,” said Albertson.
Earlier this year, Senator Stefano’s SB 739, now Act 10 of 2022, was signed into law by Governor Tom Wolf. The bill provided $25 million to EMS providers, roughly $37,000 for each agency. Albertson says the relief helped, but it’s not a long-term fix.
“This is akin to putting a Band-Aid on a trauma patient when you really need tourniquets,” said Albertson.
Lawmakers are now pushing legislation that goes even further. Stefano is also the sponsor of SB 861 which would allow Pennsylvania to join 21 other states in the EMS Compact to facilitate the movement of EMS personnel across state borders in times of crisis.
HB 2097, sponsored by Representative Joe Hamm (R-Lycoming/Union) would extend the waiver for required personnel on ambulances. The bill passed the House in April and received first consideration in the Senate today.
HB 2601, sponsored by Representative Jim Rigby (R-Cambria/Somerset) would give municipalities the option of seeking additional EMS funding.
SB 698, sponsored by Senator Lisa Baker (R-Luzerne/Pike/Wayne/Wyoming) would allow for counties and local governments to establish new revenue streams for EMS.
HB 1293, sponsored by Representative Kurt Masser (R-Columbia/Northumberland) would provide direct reimbursement to EMS agencies.
“If we expect our emergency medical service providers to respond when we call 9-1-1, we need to do our part to support them,” said Causer.