Many rural areas rely on volunteers to man ambulances and run emergency medical services, but sometimes that's not enough. "Today, that system faces collapse. As these communities become grayer
and less populated, there are fewer people left to drive ambulances, and
fewer people left to pay the taxes that keep the ambulances in service," Nathan Kohrman reports for The New Yorker.
Sometimes EMTs from nearby towns have to come help counties with no ambulance service, meaning sometimes dangerously long waits and rides for patients and medics who are stretched too thin. "We’re facing a crisis in rural America. Someone needs to do some planning or one day we’re going to call 9-1-1 and nobody’s going to come," said Andy Gienapp, director of the Wyoming Office of Emergency Medical Services.
The modern era of emergency transport services began in 1973 when Congress passed the EMS Systems Act, giving states more than $150 million to create or improve their emergency medical service systems. When President Reagan stripped EMS money from the federal budget in 1981, emergency services in many rural areas were only able to limp along with volunteers or by pooling resources with local volunteer fire departments, and some rural areas had to shutter their emergency services, Kohrman reports.
Dia Gainor, the executive director of the National Association of State EMS Officials, said better federal funding would be a big help for rural emergency services. "Fire departments get the love because of community insurance ratings," Gainor told Kohrman, since it's cheaper for people to insure their homes in rural towns with fire stations.
Gienapp agreed that better federal funding would help augment state and local funding. "Do we have a right to an ambulance within five minutes of our home? Within forty minutes? The answer isn’t going to make everybody happy. Cities are going to have to help write the checks, and they can’t just say, 'Tough nuts, hillbillies,'" Gienapp told Kohrman.
Structural changes could also help: "Congress could let rural ambulances make more money by billing for the care they provide. It could legislate higher reimbursement rates for Medicaid and Medicare, the way it did with the Critical Access Hospital program, which has helped rural hospitals increase their revenue," Kohrman reports. "Federal lawmakers could also establish grants to help fund EMS volunteers and full-time medics, and commission national-scale research on EMS. In states that have not expanded Medicaid under the Affordable Care Act, lawmakers could vote to do so."
Sometimes EMTs from nearby towns have to come help counties with no ambulance service, meaning sometimes dangerously long waits and rides for patients and medics who are stretched too thin. "We’re facing a crisis in rural America. Someone needs to do some planning or one day we’re going to call 9-1-1 and nobody’s going to come," said Andy Gienapp, director of the Wyoming Office of Emergency Medical Services.
The modern era of emergency transport services began in 1973 when Congress passed the EMS Systems Act, giving states more than $150 million to create or improve their emergency medical service systems. When President Reagan stripped EMS money from the federal budget in 1981, emergency services in many rural areas were only able to limp along with volunteers or by pooling resources with local volunteer fire departments, and some rural areas had to shutter their emergency services, Kohrman reports.
Dia Gainor, the executive director of the National Association of State EMS Officials, said better federal funding would be a big help for rural emergency services. "Fire departments get the love because of community insurance ratings," Gainor told Kohrman, since it's cheaper for people to insure their homes in rural towns with fire stations.
Gienapp agreed that better federal funding would help augment state and local funding. "Do we have a right to an ambulance within five minutes of our home? Within forty minutes? The answer isn’t going to make everybody happy. Cities are going to have to help write the checks, and they can’t just say, 'Tough nuts, hillbillies,'" Gienapp told Kohrman.
Structural changes could also help: "Congress could let rural ambulances make more money by billing for the care they provide. It could legislate higher reimbursement rates for Medicaid and Medicare, the way it did with the Critical Access Hospital program, which has helped rural hospitals increase their revenue," Kohrman reports. "Federal lawmakers could also establish grants to help fund EMS volunteers and full-time medics, and commission national-scale research on EMS. In states that have not expanded Medicaid under the Affordable Care Act, lawmakers could vote to do so."
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