Pennsylvania EMS ‘can no longer BBQ their way to a new fire truck’
By Anthony Hennen | The Center Square
RADNOR, PA – Long-simmering problems in Pennsylvania’s emergency medical services system have created stress points for ambulance services and fire departments big and small.
The House Democratic Policy Committee held a panel on Friday to hear from first responders on where their legislative priorities should be to address the growing crisis.
Creating stable funding sources and recruiting more workers and volunteers were paramount.
“We are several decades into this crisis. The COVID-19 pandemic highlighted it once again,” Radnor Fire Company Executive Director Brian Zimmerman said. “Positive legislation” in recent years “has done little to move the needle on sustainable funding for EMS,” he added.
As the state population gets older, the decline of volunteerism means dramatically fewer recruits. Inflexible training requirements keep would-be firefighters from joining a local company. And low reimbursement rates mean ambulance companies cannot recoup their operating costs.
While fire companies could fill a financial gap with various forms of fundraising in the past, that strategy no longer works.
“The cost of services and goods has changed drastically over the years and has reached a point where an agency can no longer BBQ their way to a new fire truck or ambulance,” Zimmerman said in his written testimony.
The EMS system has been neglected compared to other government services, he argued.
“Police departments are not holding basket bingos, beef, beers, or fill-the-boot drives,” Zimmerman said.
The result has been a patchwork of local agencies that are shorthanded, stressed, and overworked.
“EMS and hospitals in our area is pretty much a disaster,” Edgmont Fire Company Vice President Ron Gravina said. “Funding allocations over the years have baffled me. I don’t understand, on the other hand, how funding — at least in our experience — has become stagnant. In some cases, it’s been reduced.”
Equipment costs have increased, too – at a dramatic rate.
“If the fund is going to stay stagnant, then at some point we’re not going to be able to afford it,” Gravina said.
Bill Cairns, chief of the Rocky Run Fire Company, estimated that a fire engine they purchased in 2000 for $175,000 would cost them $800,000-$1 million today.
Staffing those more-expensive trucks has been held back by inflexible training requirements.
“It’s a lot to ask a frontline firefighter to commit to 280 hours of training to go into a burning building,” Gravina said. “Training is extremely important, don’t get me wrong, but there’s gotta be a happy medium somewhere.”
People working multiple jobs and the disappearance of shift work have been barriers to recruitment, Cairns added.
What might help, he said, are tax incentives for serving. Those benefits could be “a huge, huge bonus.”
Staffing issues hit firefighters and ambulance services alike.
“The turnover rate in EMS is huge,” said Don DeReamus, legislative committee chair of the Ambulance Association of Pennsylvania.
A high turnover rate for EMS workers — 30% — has been driven by low pay for a high-stress job, as The Center Square previously reported.
“It’s impossible to ignore how staff shortages were creating significant and mounting concerns,” said Rep. Lisa Borowski, D-Newtown Square.
The trouble, however, isn’t insurmountable.
“There are tools and opportunities to make corrections immediately,” said Tim Boyce, director of Delaware County’s Department of Emergency Services.
Boyce advocated giving municipalities the ability to form taxing authorities to share costs and for the General Assembly to support counties that bear the costs for 911 services and emergency communications.
DeReamus argued for a “reasonable” statewide ambulance fee schedule for insurers so that ambulatory services can get reimbursed for their costs. Currently, he said, the average cost to run an ambulance on a trip is $550, but the average reimbursement is only $350.
