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Year in Review: Pennsylvania EMS funding

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(The Center Square) — Though Pennsylvania officials have not fixed the EMS system across the state, some progress has been made in 2023.

Staffing shortages, low pay, and legal hurdles remain, but the year brought more focus from local and state officials on the emergency safety net.

Reimbursement rates

In October, Act 15 was signed into law that requires Medicaid to reimburse EMS agencies for every ambulance mile traveled with a patient. Previously, agencies wouldn’t get a payment until they traveled 20 miles.

The reimbursement rate has long been a sticking point for EMS, as many crews couldn’t break even on ambulance runs.

Labor shortages still a problem

Agencies in small towns and rural areas have spent years warning of closures, and 2023 was no different. County leaders warned in February of a system collapse exacerbated by the pandemic. Officials will note that it’s hard to recruit and keep good workers because Sheetz and McDonald’s offer comparable wages with less stress.

As a result, some outfits have warned that they can’t guarantee quick responses to 911 calls. Worker retention, as EMS leaders have told legislators at several hearings this year, is a constant struggle.

No way to ‘BBQ their way to a new fire truck’

The struggle to find people and pay them isn’t the only financial burden. Rising costs of protective equipment and larger capital needs means that agencies can’t “BBQ their way to a new fire truck” as in decades past.

As Pennsylvania’s population has stagnated and shrank, the pool of volunteer firefighters and EMS workers has shriveled up, too. What used to be accomplished through community volunteerism and donations is no longer enough.

Perennial problems ignored

The struggle of Pennsylvania EMS is not a new one. Instead, leaders say a crisis is the result of legislators and local officials kicking the can down the road. Announcements of EMS closures and mergers to preserve services have become routine across the commonwealth.

Localities that demand coverage but refuse to provide EMS funding is another long-term issue.

‘Adversarial’ relationship

EMS leaders also say the state EMS bureau plays the role of antagonizer more than coordinator, leading to more stress and unnecessary paperwork. Spending guidelines for how agencies can use money, too, can be vague and liable to abuse. The business model is “broken” and Pennslyvanians are left in the lurch.

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