Kris B. Mamula
Pittsburgh Post-Gazette
ERIE COUNTY, Pa. — Holes that have emerged in Erie County’s public safety net are lending urgency to talks that could lead to consolidation of emergency medical services, County Executive Kathy Dahlkemper said Tuesday.
An Erie County task force has been meeting for about a year to address problems facing volunteer fire departments and ambulance services, including flat Medicare reimbursement, rising equipment costs, and first responder recruitment and retention issues.
But difficulties crewing ambulances in recent months have added new urgency to the talks, Ms. Dahlkemper said.
The Pittsburgh Post-Gazette earlier this week documented how a caller to the Erie County 911 center wound up going to the hospital by private vehicle after three volunteer fire departments in the southeast part of the county were unable to raise an ambulance crew. EMS officials cited the 51-minute wait by the patient and a breakdown in the public safety net as an extreme example of what ambulance services face in many rural parts of Pennsylvania.
“You can’t deny the facts,” Ms. Dahlkemper said. “We have to do something. Any one of us could be in that situation, and the reality of that is hitting home.”
In light of ambulance crew problems, county task force members have been discussing consolidation of smaller ambulance services to improve reliability and increased municipal involvement in funding for needed for staffing and equipment, Ms. Dahlkemper said.
“We are seeing some agencies potentially combining to become one agency,” she said. Among the questions being asked, “is there a regionalization solution to this?”
Some officials have said that tax support for EMS services is the only long-term solution because revenue from billing for care isn’t keeping up with expenses, but many smaller municipalities are too strapped to raise property taxes.
Union City Borough, which has been in discussions with Union City Township about the local ambulance service’s staffing problems, has all but ruled out raising taxes to increase fire department support, borough council member Dan Brumagin said.
Meanwhile, the state Health Department issued a statement Tuesday acknowledging first responder recruitment problems in parts of Pennsylvania, but said there is no minimum standard for required EMS coverage. Each municipality makes that call by itself.
“Local EMS operations vary significantly from one municipality to another based on community needs, available resources and decisions from local municipal officials,” spokesman Nate Wardle wrote in the statement. “There is not a required standard of coverage for a community.”
EMS recruitment and retention is a decades-old problem that may have accelerated in recent years, said Howard Mell, a physician and spokesman for the American College of Emergency Physicians in Irving, Texas.
“If no one shows up, you’re on your own kid,” said Dr. Mell, who is also a firefighter-paramedic. “That’s a harsh reality that’s happening more and more.
“Obviously, the solution is always money. We don’t have a problem paying somebody to pick up our garbage, but gosh forbid we have to pay someone to pick up our patients.”
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