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Beginning the Conversation to Prevent EMS Budget Cuts, Especially for Rural EMS Providers

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By Allison G. S. Knox
Contributor, EDM Digest 

Emergency Medical Services (EMS) has been the subject of much debate over the past few decades. Various people have debated what emergency medical technicians and paramedics can do in the field and whether agencies should be comprised of volunteer members or paid staff.

In many respects, these debates have to do with a variety of policies and politics at the local and state levels of government. Also, they are affected by a variety of factors. Recently, Arthur Hsieh, an EMS provider in California, stated in an article that “the future of rural EMS may be on life support.”

Emergency medical services typically experience numerous problems when they call on local government officials to consider the budgets for emergency medical services. Beginning the conversation about emergency medical services and the needs of each specific agency is important for EMS leaders to do now, particularly before they face a budget cut.

Rural EMS Providers Often Lack Resources, Compromising Their Services

Rural emergency medical services are ambulance agencies that are based in the country. For many rural EMS agencies, transport times can be particularly long and resources might not be as readily available as they are for agencies in urban or suburban settings.

As explained by Rural Health Information Hub, rural EMS providers also need specialized training for agricultural and oil field emergencies. Without this specialized training, emergency response efforts could be greatly compromised if a disaster overwhelms EMS personnel responding to an incident.

To Avoid Budget Cuts, EMS Providers Must Work with Government Agencies

Budget cuts are often a threat to emergency management and emergency medical services. In these economic times, it is difficult for some local and state governments to adequately pay for all the programs they offer to their residents.

According to Washington Post journalists Emma Brown and Sandhya Somashekhar, many states struggle with their finances and face budgetary constraints. While it makes sense to cut program budgets when a state cannot afford the programs it offers, cutting budgets can be particularly worrying for important public programs like emergency medical services.

Agencies can be compromised when they’re overwhelmed by a lack of resources to manage 911 incidents, and EMS operates in life-and-death matters.

EMS Agencies Are Losing Volunteers Nationwide

Many agencies are now experiencing volunteer shortages, too. In one incident, a county in Virginia dissolved its volunteer agency because the county did not have the trained volunteers to effectively staff the ambulances.

Other ambulance agencies in the U.S. have had numerous problems trying to recruit new volunteers. Volunteer retention has been widely discussed. But it is possible for EMS leaders to keep the volunteers they already have as they work to recruit new volunteers to staff their ambulances.

The issues associated with volunteerism will put significant pressure on local governments and EMS agencies.

Starting Conversations with Government Officials about EMS Resources and Needs

Many local government officials are aware of the importance of emergency medical services. However, it may be difficult for them to understand all the resources and needs associated with handling 911 emergencies.

Government leaders might lose sight of these EMS needs when they’re working on a new budget. They might feel that if all local-level programs receive budget cuts, they should not make an exception for emergency medical services.

EMS leaders should begin conversations with local government officials about their agency needs before their budgets are brought up for discussion. They must be realistic about their agency’s needs and should also be prepared to explain the difficulties that ambulance agencies experience throughout the country – particularly volunteer shortages.

In addition, EMS leaders need to specify that it is difficult to retain volunteers and explain that cutting their budgets could have significant negative effects on emergency patient care. EMS leaders need to be specific and focus on case studies to illustrate their points. It can be difficult for local government officials to understand EMS needs, particularly when they have never worked in emergency medicine or emergency management.

More importantly, case studies can take a budget conversation “into the weeds,” making the importance of a good EMS budget less of a matter of concern to EMS providers. EMS organizations need certain things from their local governments and it is important that EMS leaders are as specific as possible to highlight how budgetary constraints on their agencies hurt patient care in emergency situations.

Budget cuts in today’s economic climate are a reality. Instead of waiting for EMS agencies to be “on the chopping block,” it is important for EMS leaders to get in touch with their local government officials now to begin a conversation about their agency needs. This important step could prevent further budgetary erosion for EMS providers.

Allison G. S. Knox teaches in the fire science and emergency management departments at American Military University and American Public University. Focusing on emergency management and emergency medical services policy, she often writes and advocates about these issues. Allison serves as the At-Large Director of the National Association of Emergency Medical Technicians, Secretary & Chair of the TEMS Committee with the International Public Safety Association and as Chancellor of the Southeast Region on the Board of Trustees with Pi Gamma Mu International Honor Society in Social Sciences. Prior to teaching, she worked for a Member of Congress in Washington, D.C. and in a Level One trauma center emergency department. Passionate about the policy issues surrounding emergency management and emergency medical services, Allison often researches, writes and advocates about these issues. Allison is an emergency medical technician and holds four master’s degrees.

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