Vt. lawmakers, stakeholders take on EMS challenges

Published: Nov. 30, 2022 at 6:02 PM EST
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MONTPELIER, Vt. (WCAX) - Making sure that Vermonters get the emergency services they need, no matter where they are, was the focus of roundtable discussions Wednesday involving lawmakers, state officials, and other stakeholders.

Across Vermont, communities big and small depend on emergency medical services.

“The single service you can call any time.When any social service fails, EMS is where the ball lands,” said Drew Hazelton with Rescue Inc.

The first responders deal with all kinds of emergencies including medical, mental health, and substance use calls. But the workforce is strained. National figures show 20% of EMS workers leave every four years, especially in rural volunteer-based departments

“Normally, we run three-member crews -- a driver and two providers in the back. Recently, in the last four to five years, we have had an okay time filling one crew. If a second call comes in -- really difficult,” said Tim Nisbet with the Hardwick Rescue Squad.

And then they have to call on other departments from further away. Staffing is only one challenge. There’s also education, training, retention, transportation, and sub-par Medicaid reimbursement rates. “The cost for volunteers to get trained has increased dramatically,” said Karl Stein with the Hardwick Rescue Squad.

Dozens of emergency medical services crews, state officials, lawmakers, and other stakeholders put their heads together to keep EMS services sustainable. Rural states have always leaned on the services, but training and the skill set to provide those services have become more complex. EMS played an outsized role in the pandemic, delivering COVID tests, vaccines, and other treatments. “EMS is not a part of the 1960s. Its part of our health care system,” Hazelton said.

The group hopes to take this conversation to the Statehouse in the next legislative session to look for alternative funding and recruitment. “Now is the moment -- before the whole system breaks -- for us to innovate and reimagine EMS in Vermont so everyone, no matter where you live in Vermont, has someone that can come to your aid if you need it,” said Rep. Katerine Sims, D-Craftsbury.

Nearly all providers Wednesday say part of the solution will be shifting how we view EMS, from just being first responders to the foundation of Vermont’s health care system.


Vermont officials are working on ways to make sure people are getting the level of care that they need when they reach out for help.

Right now, after calling 911, sometimes patients who need nursing home care for complex and chronic underlying conditions and who also need mental health and substance use help are brought to the emergency room. And because there is a shortage of step-down facilities to discharge those patients, it is creating a backlog that puts a strain on hospitals.

Now, the state is exploring creating a 100-bed skilled nursing facility that would intake patients from hospitals and give them the right level of care.

“We’re hoping to find a vendor who is able to do it in our current nursing facility system of care but to bring that specialized model of care to serve folks so they don’t have to stay in a setting that’s not right for them,” said Megan Tierney-Ward, deputy commissioner with the Vermont Department of Disabilities, Aging and Independent Living.

The state is still actively lining up contractors for the initiative, so the cost, location, and providers are still up in the air.

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