NSCOG hears presentation on EMS crisis
MAHANOY CITY – Emergency medical providers are continuing to struggle with funding and staffing issues, and that is leading to longer response times, if an ambulance can get on the road at all in some cases.
That was part of the message given to municipal leaders at the Northern Schuylkill Council of Governments’ meeting on March 27.
Just this year, Greater Hazleton Ambulance announced they were closing, the latest in a string of closures in our area and throughout eastern Pennsylvania.
Stephen Bohr, a paramedic and emergency management coordinator, told the council that it is not uncommon to have two paramedics, total, covering the entirety of Schuylkill County, one of which is based in Shenandoah. Paramedics staff Advanced Life Support (ALS) ambulances, which are called to critical medical calls like cardiac arrests.
Both ALS and Basic Life Support (BLS) services have dwindled.
Working with Minersville EMS, Bohr said he’d been to Sheppton, Delano, Mahanoy City, and the Strausstown area in Berks County.
“Just covering calls. There has been no one,” Bohr said. “There’s a good chance you’re not going to see your local EMS unit.”
Shenandoah has full-time ALS service, but is often called all over Schuylkill County and to Northumberland or Luzerne County. Geisinger helps staff ALS units in Minersville and Tremont, though Tremont ALS is not full-time. Schuylkill EMS has also had troubles maintaining full-time ALS staffing.
“It’s not a question of if [the system] will collapse, but when,” Bohr added.
Agencies have closed, staff have either retired or left the field, and they are not being replaced at a sufficient rate.
Volunteer fire companies have attempted to fill the void, launching Quick Response Services, such as in Sheppton, to have an EMT-certified firefighter provide emergency medical care while a more distant transport unit is en route.
Training issues also exist, Bohr told the group, as classes are often inconvenient, inaccessible, or unaffordable.
For those who are trained, Bohr said that the convenience store chain Sheetz pays more than many EMTs are paid.
The ambulance services, though, do not have the funding to pay more as insurance reimbursements are far lower than the actual expenses incurred on calls. Bohr also said that funds from the state’s Emergency Medical Services Operating Fund have been used to fill state budget gaps and have not been given to services.
When the funds to make their way to services for equipment, the costs of said equipment outpace the allowances through the fund.
“It’s not one group that’s going to fix [the crisis,]” Bohr said. “It’s going to take a massive effort. Everybody’s going to have to work together to do it. Municipalities need to be more involved.”
Bohr suggested that the leaders go back to their councils and ask ,”What is something at the municipal level that we can do?”
“Is there a municipal scholarship that we can put out? Is it ‘Hey, can we pick up some of your insurance,'” Bohr said, noting that municipalities often help fire companies but not EMS services.
In November, Shenandoah Ambulance requested assistance from the municipalities where they provide primary coverage.
In a letter to those municipalities, Rick Examitas, ambulance chief, said the ambulance has begun expanding their paid staff and estimate they will respond to 4,000 calls a year.
Rising costs, including a $12,100 hike in station and vehicle insurance costs over the past two renewals, are taking a toll, he said.
“All of this occurs without our organization seeing an increase in the reimbursable amounts for services rendered,” Examitas wrote. “Our primary population served are covered by government insurance (Medicare or Medicaid) who have fixed rates for reimbursement that have not increased to keep up with the expenses.”
Since 2016, numerous ambulance services in northern Schuylkill County have either closed or merged with another service.
Nuremberg Ambulance ceased operations in 2016 after 48 years of operation.
The next year, Shenandoah Ambulance merged with Lost Creek and Ringtown. The combination of mergers and Nuremberg’s closure ballooned Shenandoah’s first-due basic life support (BLS) response area from the immediate Shenandoah area to include much of the Ringtown Valley and patches west of town.
In 2021, Girardville Ambulance became a quick response service — providing emergency medical services but without transportation to the hospital — and closed shortly after.
Regionally, the Kutztown area lost both of its ambulance providers since 2018. Start-up Northeastern Berks EMS closed in 2018, just over a year after it launched.
In August, the longtime EMS provider there, the Kutztown Area Transport Service, also folded.
Following that closure, State Senator Judy Schwank told Allentown’s WFMZ-TV, “Right now, all over the Commonwealth of Pennsylvania, EMS services like Kutztown Area Transport Service are experiencing financial difficulties, and it’s becoming increasingly clear that this is something the state legislature needs to address.”
About Author
