As an EMS physician, I am fully aware of the importance of funding emergency medical services. While I understand concerns one may have related to voting on EMS fees, I don’t understand why one would not want to fund such a necessary community resource. I applaud efforts the County Commission and Ambulance Authority have employed, utilizing the Emergency Services Fee Act of 1975, to institute the funding. I can assure you, in my 38 years with TCEMS, the agency has never been better staffed or prepared.
This funding has allowed for full-time staffing and the implementation of much needed updates. At a time when many rural EMS agencies are closing due to a lack of funding (80 over the past decade according to the WVOEMS), TCEMS is beginning to dramatically expand and improve its services. Why? Because of the investment citizens have made assuring the availability and provision of quality emergency medical services to their community. In recent years, the state of WV has essentially cut all funding to WV EMS. WV’s EMS agencies are now dependent upon billing to fund the services they provide.
Keep in mind, the legislation governing such billing inhibits this as well. EMS agencies can only bill if a transport occurs and then only for loaded mileage. This means, if they revive an overdose with Narcan and the patient refuses transport, EMS cannot charge for the fuel, crew wages, or medications utilized. A transport to WVU can only be billed for loaded mileage, meaning only 50% of the agency expenses can be billed. Even if agencies do receive payment, Medicare and Medicaid reimbursement is only a fraction of the actual cost. The West Virginia Coalition on EMS has warned the WV legislature that the State must examine its long-term funding strategy for EMS, for without significant assistance, some rural squads may face closure within the next 60-90 days and the remaining agencies may not be financially positioned to replace these lost services.
The days of volunteer EMS are in the past. Initial education requirements for EMTs are in the hundreds of hours and for Paramedics in the thousands, not including the many hours required to maintain certification. Workers compensation/OSHA regulations also make it impossible to provide services with volunteers. The number of trained EMS professionals in the State is also limited, requiring agencies to keep compensation competitive. Again, the State has no plan to address this either.
In conclusion, when you vote, please consider: TCEMS is beginning to thrive in a time when most rural EMS agencies are struggling, this is happening solely because of the current EMS ordinance fee and the wise decisions of the County Commission/Ambulance Authority, lastly, based upon the State’s current financial condition and its prior decision making, can you take a chance of losing the EMS ordinance fee and depend on the State of WV to provide these services?
P.S. Martin, MD
Associate Professor WVU School of Medicine
Tucker County EMS Medical Director