EMS Budgets May Be Impacted by Hochul Budget

Providing emergency medical services has been in critical condition for a while and Governor Kathy Hochul's proposed budget, along with a series of bills being introduced in the state Legislature could help get EMS off the critical list and provide much-needed EMS services to everyone. 

There will be a lot of debate over the budget in the coming weeks and local officials are hoping it leans toward providing relief or as some are calling it "Rescuing EMS"

Delaware and Schoharie counties have been dealing with the difficult ins and outs of establishing ambulance services, as local fire districts and ambulances have been seeking relief for several years, due to lack of personnel. The counties have established county ambulance services to back up volunteer agencies. However, it is a difficult, time-consuming, and complicated process, due to the fact EMS is not considered an essential service like fire and police services.

Making EMS an essential service, will require every county, city, town, and village, acting individually or jointly, or in conjunction with a special district, to ensure that an emergency medical service, a general ambulance service, or a combination of such services are provided. It allows them to establish a special district for the financing and operation of general ambulance services.

That one step will allow EMS districts to be established and provide ways for municipalities to fund ambulances and EMS. 

The state has private, public, or not-for-profit providers attend to demand across the state in a scattered, patchwork approach. It has left residents uncertain whether an EMS provider will be available in their locality, let alone in a time of need. 

Another issue is the existing framework for the provision of EMS. The Governor's budget provides “a coordinated system of healthcare delivery that responds to the needs of sick and injured individuals, by providing: essential emergency, non-emergency, specialty need or public event medical care; community education and prevention programs; ground and air ambulance services; emergency medical dispatch; training for emergency medical services practitioners, medical first response; mobile trauma care.," according to testimony provided by the New York Association of Counties (NYAC)

The Executive Budget provides investments to enhance the EMS statewide, including Ensuring emergency transportation providers are appropriately reimbursed for trips, by increasing Medicaid reimbursement for more complex patients; Establishing a working group to recommend ways to expand access to non-emergency medical transportation; Establishing nine regional EMS organizations that can better coordinate all the EMS agencies and providers operating within their region;  The budget proposes establishing a statewide EMS disaster response system that can rapidly deploy personnel and equipment when and where it is needed during an emergency; Allowing EMS providers to perform expanded clinical care in the community; and,  Permitting ambulances to treat patients in place or take patients to urgent care clinics without sacrificing payment for the trip, decreasing the number of unnecessary emergency room visits. The proposed budget reforms the delivery of public health, including an investment in emergency medical services that increases to an average annual value of over $30 million per year and new improvements to the certificate of need process.

There are also bills introduced in the state Legislature to help facilitate EMS. Those six bills include. special taxing districts, removing EMS services from the municipality's tax cap, making it easier for them to fund expanded services; providing state and local tax credits; increasing the state's personal income tax credit for fire and ambulance workers from $200 to $800 and creating a methodology for Medicaid reimbursements that more closely match the cost of the services.

Stamford Fire Commission Bill Sharick provided a rundown of these proposals during a department meeting this week.

The Stamford Fire Department moved to a first responders unit a few years ago and three towns have been working to establish a non-profit ambulance service, Headwaters EMS, to serve the towns of Harpersfield, Stamford, and Kortright. It is a lengthy, ongoing process. The new ambulance service has resulted in much faster response times, but it is still working towards its advanced life support certification through the state Department of Health. Those involved say it has not been an easy process.

As budget negotiations get underway, it is hoped state Legislators will rescue EMS.