Emergency medical service providers across Vermont are pleading with lawmakers to rescue a system they say is “in crisis.”
But a report by the Vermont Department of Health found that while some first-response agencies are under severe financial stress, “the system is not in crisis.”
At a recent joint hearing of the House committees on Health Care and Government Operations, veteran EMS providers in Vermont begged to differ.
““I think most every EMS agency will tell you otherwise,” said Adam Heuslein, the longtime director of the Glover Ambulance Squad. “In my 30 years, I’ve never been more scared for the profession than I am right now … If pre-hospital health care is going to continue in Vermont, we need your help to help others.”
Heuslein and other EMS professionals say a decline in volunteer labor, combined with a rise in call volume, have pushed many agencies to the brink of collapse. They say first-response agencies are also dealing with a reimbursement model that doesn’t cover the cost of delivering services.
Scott Bagg, an EMS worker in central Vermont, told lawmakers that the financial pressures at rural agencies are especially acute.
“If the service were to close its doors, the next closest ambulance could be dozens of miles away. This would increase response time … and transport times, thus directly harming those in the most rural regions of our state,” he said.
“In my 30 years, I’ve never been more scared for the profession than I am right now … If pre-hospital health care is going to continue in Vermont, we need your help to help others.”Adam Heuslein, director of the Glover Ambulance Squad
Of primary concern for many agencies is the reimbursement rates they receive from Medicaid and Medicare, which they say fall well short of the cost to administer medical treatment and transport services.
Craftsbury Rep. Katherine Sims has introduced legislation that would boost reimbursement rates modestly next year.
But she said Wednesday that structural changes to the financing model for EMS services will be needed to keep the system solvent over the long term.
“The funding model for EMS is broken. It doesn’t work,” Sims said. “The cost of readiness, being available 24 hours a day, and the cost of providing service is not met by the reimbursement model.”
The bill, called H.622, would also establish a new task force to evaluate the EMS system, and come back to the Legislature next year with recommendations for “big-picture, transformational” changes to funding and governance.
“We want a coordinated system that relies on local EMS providers, regional EMS districts and statewide support, governance and funding,” Sims said.
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