EMS funding reform efforts continue at Statehouse

Published: Mar. 22, 2023 at 6:20 PM EDT
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MONTPELIER, Vt. (WCAX) - Rural emergency medical service providers have been sounding the alarm that many don’t have the resources and staff to guarantee services. On Wednesday, a key legislative committee took up a sweeping bill aimed at shoring up EMS services and making them financially sustainable.

EMS services are on life support in many towns across the state

“We have a personnel crisis that’s being complicated by an antiquated reimbursement system,” said Drew Hazelton, with Rescue Inc., a private company that serves 15 towns in southern Vermont and New Hampshire.

What used to be a service to transport car crash victims to hospitals is now a hospital on four wheels. The medical technology on board has evolved by leaps and bounds. But EMS officials say the funding structure has largely stayed the same.

“What I’m seeing is troubling, I’m concerned,” said Jeffrey Spencer, who has worked in EMS for over four decades. He now manages the books for 34 ambulance service providers across Vermont and New Hampshire. He says up to 75%of ambulance calls are funded by Medicare and Medicaid and the reimbursement rate for services is woefully inadequate. “There’s clearly a cost shift from the health care reimbursement system to the patient and then to the taxpayer, no doubt.”

And for private insurance companies, Spencer says some local EMS squads are out of network and patients are left footing the bill. The situation is so grim, some EMS providers have resorted to fundraising. “These costs are being pushed out onto the volunteers to find and fund,” Hazelton said.

A proposal before lawmakers would carve out up to $20 million annually to shore up local departments and provide grants to train the next generation of first responders. It also creates a study committee exploring whether rural communities should consider switching to a regional EMA model.

Long term, we need to solve the funding model challenges to make sure we can invest in the capacity we need in our big cities and our small towns, so wherever you live, there is an ambulance that can come whenever you need it,” said Katherine Sims, D-Craftsbury.

Even though it’s too late in the session for the bill to survive on its own, lawmakers are looking to attach parts of it to a proposed overhaul of Vermont emergency dispatch services that will get a vote this year.

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