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EMS in its own state of emergency

EMS in its own state of emergency
Dee Howard, BSN-RN, Executive Director of MS Healthcare Alliance, Inc.

Everyone dreads that moment when you need to call 9-1-1. Here at the Mississippi Healthcare Alliance, our mission is to improve the health status of Mississippians. A big part of that begins pre-hospital with emergency medical services. Our Alliance is keenly aware of the challenges that face first responders and are working to help advocate for them. Emergency medical response, including ambulance service, is in its own state of emergency.

The Covid-19 pandemic and its variants continue to wreak havoc on healthcare systems across the globe. It is not widely known that COVID has exacerbated certain severe challenges that have plagued Mississippi’s EMS first responders and ambulance for decades. Those challenges include a massive shortage of EMS personnel, rising medical costs and inadequate reimbursement.

News media often report on staffing woes in hospitals. Because hospitals are full and lack sufficient staff, ambulance crews often must wait lengthy periods with their patients on their stretchers before they can transfer care to the hospital staff. Every minute an ambulance crew waits for a hospital bed is a minute the crew cannot respond to other 911 calls. In 2020, the National Association of Emergency Medical Technicians (NAEMT) conducted a survey to evaluate the impact Covid was having on EMS agencies. According to the report, 67% of respondents reported an increase in offload times, which ultimately limits the number of ambulances available to respond to 9-1-1 medical emergencies.

Low pay and burnout lead some EMS personnel to change fields; low pay and burnout also hamper recruitment of new caregivers. The American Ambulance Association reports the EMS personnel shortage is a national crisis with a turnover rate of more than 30% per year. Currently Mississippi has an EMS job vacancy rate of 15-40% based on the agency you query.

Rising medical costs and inadequate reimbursement also impede agencies providing emergency medical service. Compensation from Medicare, Medicaid and even some private insurance has long fallen short of covering virtually every EMS agency’s costs. Some EMS agencies may have to close. The National Rural Health Association says about a third of rural EMS agencies in the U.S. are in immediate jeopardy of closing because they can't cover their costs. EMS agencies cannot and do not ask for insurance prior to providing 911 service. Further, insurers (private and public) choose how much they pay EMS agencies; they set the rates for EMS agencies’ lifeblood.

Our elected leaders are currently in the thick of the 2022 Legislative Session at the State Capitol. We are fortunate to have several key political leaders in the state fighting for EMS. On their agenda is the question of not only how to allocate and spend federal funds to address the impact from pandemic but also to find other innovative ways of shoring up ambulance response around the state. My hope is their colleagues will remember: Ambulance service providers are critical to the healthcare safety net for all citizens. As our Legislature navigates the session, I hope they remember the challenges facing community-based EMS responders and help find solutions to overcome our challenges.



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