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Taking action on the shrinking availability of EMS in rural America

NAEMT encourages all states to recognize EMS as an essential service and urges Congress to fund the SIREN Act

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NAEMT President Matt Zavadsky discusses how this NBC News coverage highlights the plight of rural communities, and exposes a dilemma for communities in both rural and urban areas, and shares NAEMT positions on lobbying Congress to enact the SIREN Act, and for states to recognize EMS as an essential service. Read more here.

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A western-themed mailbox sign is shown at left as a paramedic unit from King County’s Medic One stands by on Twisp River Road in Twisp, Wash.

AP Photo/Ted S. Warren

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.

NAEMT position on EMS as an Essential Public Function

Read NAEMT’s position on EMS as an Essential Public Function below:

Matt is an EMS/mobile healthcare consultant with PWW | Advisory Group, focusing on assisting local communities, EMS agencies, fire departments, ambulance services, hospitals and other healthcare organizations evaluating and improving their EMS and mobile healthcare delivery systems. Prior to joining PWW|AG, he served as the chief transformation officer for MedStar Mobile Healthcare, the Public Utility Model EMS system serving Fort Worth and 13 other cities in North Texas where he helped guide the development and implementation of innovative programs with healthcare and community partners to transform the role of MedStar in the healthcare system and community. Matt has a master’s degree in healthcare administration, with a Graduate Certificate in Healthcare Data Management. He is an emergency medical technician (EMT), past president of the National Association of Emergency Medical Technicians (NAEMT) and the executive director for the Academy of International Mobile Healthcare Integration (AIMHI), an association comprised of high-performance and Public Utility Model EMS systems across the United States and Canada.