The nation’s emergency medical services system is facing a crippling workforce shortage, a long-term problem that has been building for more than a decade. It threatens to undermine our emergency 9-1-1 infrastructure and deserves urgent attention by Congress.
The most sweeping survey of its kind – involving nearly 20,000 employees working at 258 EMS organizations – found that overall turnover among paramedics and emergency medical technicians ranges from 20% to 30% annually. With percentages that high, ambulance services face 100% turnover over a four-year period. Staffing shortages compromise our ability to respond to health care emergencies, especially in rural and underserved parts of the country. The pandemic exacerbated this shortage and highlighted the need to better understand the drivers of workforce turnover.
Ambulance crews are suffering under the grind of surging demand, burnout, fear of getting sick and stresses on their families. In addition, with COVID-19 halting clinical and in-person trainings for a long period of time, the pipeline for staff members is stretched even more. Many health care providers have extensive professional development resources, but that simply does not exist for EMS. COVID-19 has put additional pressures on the health care system and added another layer of complexity to the emergency response infrastructure.
EMS professionals are calling upon Congress to take immediate action, outlining a few possible solutions to stop the hemorrhaging of the nation’s medical lifeline and critical safety net.
Although the provider relief funds are essential and helpful to address the challenges of the pandemic, we need funding for EMS that addresses paramedic and EMT training, recruitment and advancement more directly. Congress can provide specific direction and funds to the Health Resources and Services Administration to help solve this workforce crisis.
The funds can be used to pay for critical training and professional development programs. Funding public-private partnerships between community colleges and private employers to increase the applicant pool and training and employment numbers through grants could overcome the staffing deficit we face.
To help ambulance services retain paramedics and EMTs, direct payment to paramedics and EMTs are needed. HRSA earmarked funds could be distributed to each state with specific guidance that the State Offices of EMS distribute the funds to all ground ambulance services using a proportional formula (per field medic).
With capitated payments by federal payers, there are limited funds to transfer into workforce initiatives. Increasing Medicare payments temporarily would be meaningful to compete with other employers and other jobs. Infusing additional funds into the workforce and creating innovative staffing models that take into account hospital bed shortages and overflow can be helpful.
The workforce shortage crisis facing EMS spans several potential committees of jurisdiction. The critical shortage is particularly felt in many rural and underserved communities. EMS urges Congress to organize hearings in the appropriate committees to develop long-term solutions and focus the country’s attention on these urgent issues.
Addressing the EMS workforce shortage is vital to every community across the nation. Without Congress taking immediate action, communities can run the risk of being void of emergency medical services.
Bruce Evans is the chief of the Upper Pine River Fire Protection District.
