When I compare the emergency services of police/fire and EMS, I compare them to a three-legged stool. And today we need all three legs to maintain public safety.
Coming from a financial background in banking and having been the treasurer for the former Millersville Fire Company (now part of Blue Rock Fire) for more than 40 years, I believe I have a decent understanding of the fire service financial model. Likewise, being mayor of Millersville for the past 15 years and reviewing the borough’s budget, I have a decent grasp of that financial model as well. So when I joined the board of directors of Lancaster EMS, it didn’t take me long to grasp that the emergency medical services financial model in Pennsylvania was headed for trouble — perhaps not tomorrow, but eventually. As a community leader, I believed it was my responsibility to do something about it before it was too late.
As chairman of the Lancaster County Mayors’ Association, I felt it important to educate my fellow mayors about the unsustainable EMS reimbursement model. As a member of the Pennsylvania State Mayors’ Association, I have informed mayors across the commonwealth that they, too, need to be alert to the precarious fiscal situation of the EMS providers in their communities before it’s too late. In addition, I have been informing my other municipal neighbors that we need to pay attention to this impending financial crisis that is brewing in our various EMS organizations throughout the state.
It has nothing to do with the mismanagement of funds. It has to do with simple math and reimbursement rates. Ambulance Association X and Ambulance Association Y are both impacted by the same rules and same reimbursement rates, some of which have not been changed since 2004.
The fact is that the ambulance associations of 25 years ago — even 10 years ago — were not the same as they are today. Today, the EMS system is a health care provider, not just a transport system, and yet the reimbursement models have not changed to reflect the health care component.
Recently, when I did an EMS ride-along, the first two calls were ones for which there would be no reimbursement for EMS, because the emergency medical technicians did not transport the patients, but rather treated them at the scene. This made the calls ineligible for any type of reimbursement, despite the outlay of staff resources and time. This simply doesn’t make sense to me.
It saves insurers money if EMS providers treat patients without transporting them to the hospital. So why won’t insurers reimburse the EMS providers in these cases? This is just one example of how the EMS system needs to change to reflect today’s realities.
Sure, there can be finger-pointing and excuses, but the reality is that our communities are going to be facing some difficult circumstances in the very near future. As with police and fire services, the writing is now on the wall for EMS. These providers need greater financial support, and the current financial model cannot support the EMS system.
This has serious implications for the health and well-being of community residents. And as local leaders, we ought to be concerned about what it will mean if EMS providers no longer are available to serve our citizens.
I also know that our municipal budgets are strapped already, so where are we going to get the funds? I can venture a guess that we at the local level are going to be left to figure it out for ourselves, which is what we do best. If you look at history, you’ll see we’ve had no other choice.
Richard Moriarty is the mayor of Millersville Borough.