Emergency medical services across the state are facing a crisis — one that will have dire consequences if local governments turn a blind eye, according to Ken Hellendall.
As call volumes rise alongside an aging population, EMS groups in Berks County and elsewhere must manage despite shortages in staff and funding, said Hellendall, EMS consultant for the state Department of Community Development.
“Municipalities — you are responsible for EMS in your community,” Hellendall told a full dining hall in a recent speech at the 16th annual Berks Municipal Officials Dinner, hosted by Albright College and the Center for Excellence in Local Government.
“If the EMS system in your town fails and someone dies, you will be part of that lawsuit,” Hellendall told officials. “It pays to help in advance.”
Hellendall, a former emergency services director, EMT, firefighter and police officer, gave a presentation on the issues affecting Pennsylvania’s emergency services and how those problems can be addressed.
“The number of emergency medical technicians since 2012 has dropped by 6,000 people,” Hellendall noted. “These numbers are appalling.”
Fewer emergency workers have also led to fewer agencies — Hellendall said the number of EMS agencies in Pennsylvania has shrunk from over 2,000 in the late 1980s to under 1,000 today.
Burnout an issue
Burnout is a problem for EMS workers, many of whom work for low pay amid a highly stressful environment, Hellendall said.
“Every EMS person I know, I know very few that don’t work two or three jobs just to make ends meet,” he said.
He said state data shows the average EMT pay is about $18.75 per hour, or $39,000 a year — more than $20,000 less than the average salary of firefighters and police.
“We’ve got to do better with the pay,” Hellendall said. “People have to have a family life.”
He also noted that constantly dealing with suffering patients can take a psychological toll.
You take somebody that’s critically ill to the hospital, and you have no idea if they live or die,” Hellendall said. “It’s a very unwelcome scenario.”
Hellendall urged officials to thank EMS personnel often.
“EMS people do something heroic every day,” Hellendall said. “Please honor them.”
In addition, ambulances can be sidetracked by unnecessary calls that can keep them from providing timely lifesaving aid, he said.
“We have professional patients who call for everything,” Hellendall said. “People call the ambulance because we have to go, we can’t say no. They’re using us as a taxi.”
Solutions could involve having a separate professional to answer mental health calls or calling a ride-sharing service for patients requesting non-urgent transportation, he said.
He noted that state law requires ambulance services to have 24/7 service available.
“How many agencies across the state can’t do that anymore? More than you would like to think,” Hellendall said.
To avoid the rise in response times that comes with short staffing, Hellendall advised agencies to set aside the borders of service areas and work with other agencies to ensure the nearest ambulance reaches the patient.
“We’re in this for the patient, not for us, and we forget that,” Hellendall said. “Forget what your bunker coat says.”
He noted EMS agencies in Montgomery County have been operating under a system allowing ambulances to respond to calls outside their service area.
“A 35-year-old man collapsed with a massive heart attack on the sidewalk,” Hellendall said. “An ambulance happened to be coming through the next town up…saved his life. That’s what we’re here for.”
Rising costs
The price of keeping ambulances on the road is also an issue, one that has worsened amid insurance reimbursements that don’t cover disproportionately rising costs.
Hellendall said reimbursements from Medicare and Medicaid often only cover a fraction of the costs of providing service.
“If your agencies are doing a good job, they’re collecting 50% on their calls,” Hellendall said. “The county here, if you collected 50% of your taxes and didn’t get the rest, what happens? No county.”
Income generated by billing for services is no longer sufficient to fund EMS agencies, Hellendall said, and municipal governments will have to work with agencies to come up with funding solutions.
The most direct way to generate funding would be to implement a tax increase or fee specific to an ambulance service, Hellendall said.
Other options for local governments could include paying for fuel, vehicle maintenance, EMS training or assisting with employee costs like insurance and uniforms.
Mergers, sharing personnel with fire services, and finding ways to incentivize volunteering are also options for managing costs, he said.
EMS in Berks
Paul Janssen, director of the Center for Excellence in Local Government, noted that financial issues have recently affected some ambulance services in Berks, including Kutztown Ambulance, which terminated operations in August, and Western Berks Ambulance, which ceased operations in Amity and Union Townships and Birdsboro earlier in 2023.
Both organizations claimed a lack of municipal funding contributed to their folding.
Janssen also noted that most ambulance agencies in Berks already offer significant mutual aid, with a recent study by the Center for Excellence in Local Government finding that 15 of Berks’ 17 EMS agencies provide aid outside their service area equal to the mutual aid they receive within it.
The agency that provides the most mutual aid in the county is Reading’s EMS service, Janssen said.
Maidencreek Township Supervisor David Franke said he’d worked in EMS and noticed opportunities for increased funding from the state, citing states that fund services via revenue from legal marijuana sales.
Nonetheless, Franke said municipalities can’t afford to ignore their EMS services.
He said EMS services in Berks are in better shape than other counties, but communities need to cooperate to ensure the money is there.
“We do need to come together…because money is a reality,” Franke said.
Hellendall said the funding deficit EMS groups are facing is too great for community fundraisers to fill the gaps.
“We’re too far gone for bake sales,” Hellendall said.
Berks Commissioner Christian Leinbach said people need to realize that funding EMS is a responsibility of local governments by law.
“I’ve had conversations with the public, many of them think that the county needs to start its own EMS or the state needs to provide the money,” Leinbach said. “That isn’t going to happen…(EMS) is a statutory legal responsibility of a municipality. If there is a belief that (a) death occurred because your municipality didn’t have appropriate EMS service, you’re going to get sued.”
Source: Berkshire mont
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