Pa. ambulance providers plead for legislative action on revenue, staffing

Advocates want changes such as higher Medicaid payments, to keep a pandemic waiver on rig staffing, for personnel to be allowed to work across state lines


Eric Scicchitano
The Daily Item, Sunbury, Pa.

HARRISBURG, Pa. — Emergency medical service providers warn that Pennsylvania's ambulance system is on the verge of collapse and urge state lawmakers to pass legislation to improve reimbursement rates and ease labor shortages.

Lost revenue and a shrinking workforce are systemic threats to the EMS system years in the making but exacerbated by the COVID-19 pandemic, advocates and legislators expressed Monday at a press conference across from the State Capitol.

They called for action to increase Medicaid reimbursement rates, maintain a pandemic waiver on staffing ambulances, join an agreement with 21 other states allowing personnel to work across state borders, raise the ceiling for ambulance taxes in second-class townships, create county-wide public safety authorities to better regionalize emergency services, and require private insurers reimburse for emergency services even if the provider is out of network.

Call volume plummeted in the early part of the pandemic beginning in 2020, reducing revenues, but has since stabilized.

Barry Albertson, past president, the Ambulance Association of Pennsylvania, said EMS providers lost an estimated $959 million in revenues in the pandemic's first year. The median transport cost in 2020 was nearly $546, he said, adding that 7 of 10 ambulance transports are reimbursed below cost, and that costs have far outpaced reimbursement since an ambulance fee schedule was implemented 20 years ago.

"Reimbursement is our primary method of funding and it fails miserably in covering the cost of readiness as well as the cost of operations overall," Albertson said.

State Rep. Martin Causer, R- McKean/ Cameron/ Potter, proposed in a bill that reimbursements for Advanced Life Support (ALS) jump to $400 and Basic Life Support to $325. Current rates are $300 and $180 per trip, respectively.

His measure introduces a 10% "super-premium" for certain rural providers and raises mileage to $4 per mile for all transports. Currently, he said mileage is at $2 per mile available only after an initial 20 miles traveled.

"I am truly worried about this crisis and the lives that could be lost now," Causer said.

Causer's bill left a House committee last month but hasn't yet received a vote on the House floor.

The state Legislature approved a $25 million relief package in February. The funds are split evenly among qualifying EMS providers, about $31,000 each, and are intended to help with equipment purchases and cover overtime costs. The package is funded with money from the American Rescue Plan.

State Sen. Pat Stefano, R- Fayette/ Somerset/ Westmoreland, prime sponsor of the package, said the funding would soon be dispersed.

Stefano chairs the Senate Committee on Veterans Affairs & Emergency Preparedness. A bill proposing a permanent waiver allowing easier staffing of ambulances moved through committee to the Senate floor on Monday.

It got unanimous approval in the House in April.

"It's my hope we can get this to the governor before the end of June," Stefano said.

In a 2018 report, the Pennsylvania Fire & Emergency Services Institute estimated the number of paid EMS totaled 17,000 in the state, down from about 30,000.

The Pennsylvania Department of Health's annual data report on EMS showed 2,606 emergency medical technicians and 767 paramedics saw their certifications expire in 2021. About 63% of EMTs and 45% of paramedics with expired certifications were under age 40.

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(c)2022 The Daily Item (Sunbury, Pa.)

McClatchy-Tribune News Service

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