Emergency services are facing an increase in financial problems
By Michael McNutt and Jim Killackey
The Oklahoman (Oklahoma City, OK)
Copyright 2007 The Oklahoman, All Rights Reserved
Oklahoma’s ambulance services — especially those in rural areas — offer a “threadbare safety net” of emergency medical care because of worsening financial problems, a governor’s task force concluded.
The Governor’s Emergency Medical Service Readiness Task Force has called on legislators to appropriate $20 million — $5 million a year for the next four years — to save the system from collapse.
Medicare cuts and the growing number of Oklahomans without health insurance get much of the blame.
“EMS (emergency medical services) have been overlooked by not only the public, but also by elected officials for decades,” said Bob Hawley, executive director of the LeFlore County EMS in Poteau.
“Most people think that EMS is just like the fire or police departments, Always there.
“The sad fact is that ... local jurisdictions don’t adequately fund their ambulance service,” Hawley said.
In the past five years, 45 emergency medical service agencies have closed, leaving neighboring communities with the burden of providing care with no additional revenue, the task force states.
Governor concerned The task force, which met for 16 months, submitted its report to Gov. Brad Henry on Tuesday.
Henry said he hasn’t had an opportunity to review the report, but added he is concerned about the availability of emergency services, particularly in rural Oklahoma, said his spokesman, Paul Sund.
“The governor will support whatever action is appropriate to protect Oklahomans, but before he decides on a course of action, he first wants to review the report,” Sund said.
The report states that emergency medical service workers require extensive training, yet their pay is far below that of other public safety professionals, making recruitment and retention difficult.
“Other factors that put the system at risk include Medicare budget cuts, no statewide mechanism for dedicated public funding of EMS, and an aging population,” task force Chairman Greg Reid said. “Demand for services is increasing at a time when the ability of providers to respond is declining.”
Oklahoma has an estimated 650,000 residents without any health insurance, and that strangles reimbursements, officials said.
In 2001, Medicare paid $423 for an emergency call involving the EMSA in Oklahoma City. It now pays $340 for the same run, said Ann Singer, EMSA senior vice president.
In fact, more than 20 percent of EMSA patients “cannot or will not pay,” Singer said.
The panel’s recommendations Funding: Remove the constitutional cap on the taxes communities can levy on themselves to pay for EMS and establish a state fund to assist regional EMS systems to evolve to a sustainable budget.
Recruitment and retention: Offer tuition reimbursement for people who complete advanced emergency medical technician training and work in the field, offer state funding to EMS training institutions for rural outreach and emergency medical technician program accreditation, offer tax breaks for emergency medical technicians and offer line-of-duty death and state-funded retirement benefits for emergency medical technicians.
Medical direction: Provide medical director training and development and provide for confidentiality of quality improvement activities to protect services and medical directors against lawsuits.
Preparedness: Improve communications, form public-private partnerships to secure federal preparedness funding and organize state-sponsored regional response teams.