To the Editor:

The nation’s EMS [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 EMTs [emergency medical technicians] ranges from 20 to 30 percent 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 areas. The pandemic exacerbated this shortage and highlights the need to better understand the drivers of that 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 delaying clinical and in-person training, the pipeline for staff is stretched even more — adding another layer of complexity to the emergency response infrastructure. Many health care providers have extensive professional development resources, but that does not exist for EMS.

EMS professionals are calling upon Congress to take immediate action. Below are a few possible solutions to stop the hemorrhaging of the nation’s medical lifeline and critical safety net.

HRSA EMS Training Funding: 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. The Congress can provide specific direction and funds to the Health Resources and Services Administration (HRSA) 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.

Paramedic and EMT Direct Pay Bump: 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).

COVID-19 Medicare Reimbursement Increase: With capitated payments by federal payors, 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.

Congressional Hearings on EMS Workforce Shortage: 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.

Andrew Cohn

Redding