AMU Fire & EMS Original Public Safety

Why Isn’t EMS a Required Service in All 50 US States?

By Allison G. S. Knox
Edge Contributor

In recent years, national discussion has focused on the argument that emergency medical services (EMS) should be an essential service. The very thought that EMS is not essential is a mind-boggling concept for many volunteer and professional EMTs and paramedics, who are keenly aware of the vital role that emergency medicine plays in every U.S. community.

Only a Few US States Deem EMS ‘Essential

However, EMS is not a required emergency service in all 50 U.S. states. In fact, the National Association of Emergency Medical Technicians (NAEMT) lists only a few states that officially call EMS an “essential” service.

Despite the clear need for it, not all municipalities mandate emergency medicine service providers for their constituents. This situation isn’t a slight to the citizens of their respective communities; it just means that policies to support EMS in that particular municipality either don’t exist or aren’t adequate.

Emergency Medicine as a Policy

Conducting change requires us to look at how we promote the importance of EMS and its role in saving lives and other critical situations. Rephrasing the description of the service impacts how individuals understand and utilize government programs, so it’s time to think about the service in terms of policy if we’re going to provide the appropriate support mechanisms to make it a mandatory required service in each state.

EMS Is Struggling

It’s vital that industry leaders rethink the overall policy structure of EMS in the United States, along with outlining and defining the goals of that policy restructuring. If policies are restructured, they must support staffing and budgets, because it has been noted by numerous scholars that EMS is struggling as an industry.

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The COVID-19 pandemic obviously hasn’t helped – with many burned-out EMTs choosing a new career path. Consequently, some EMS agencies are currently unable to staff their ambulances because they don’t have enough individuals interested in volunteering.

Other agencies are struggling because they don’t have an adequate budget to manage their ambulances effectively. There are numerous other issues affecting the industry as well.

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Requiring Emergency Medical Services in States Could Be a Game-Changer

All of these factors support new policies – from the state level downward – toward making EMS mandatory. Effectively, states would adequately support emergency medical providers if their state deemed that it was “essential.” Making EMS a required service would change the overall budgets for ambulances, and it could reshape the need for staffing – two issues that could be a game-changer for the industry.

Ultimately, the notion of police and fire services not being “essential” services in a person’s state of residence is unimaginable, and EMS is no different.

Allison G.S. Knox

Allison G. S. Knox teaches in the fire science and emergency management departments at the University. Focusing on emergency management and emergency medical services policy, she often writes and advocates about these issues. Allison works as an Intermittent Emergency Management Specialist in the Administration for Strategic Preparedness and Response. She also serves as the At-Large Director of the National Association of Emergency Medical Technicians, Chancellor of the Southeast Region on the Board of Trustees with Pi Gamma Mu International Honor Society in Social Sciences, chair of Pi Gamma Mu’s Leadership Development Program and Assistant Editor for the International Journal of Paramedicine. Prior to teaching, Allison worked for a member of Congress in Washington, D.C. and in a Level One trauma center emergency department. She is an emergency medical technician and holds five master’s degrees.

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