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by David Beard, The Dominion Post
MORGANTOWN – Forest Weyen, executive director of Monongalia County EMS, gave legislators a look at the plight of EMS systems locally and across the state.
“It’s become a crisis around the state,” he told members of the Joint Committee on Volunteer Fire Departments and Emergency Medical Services on Sunday. Legislators were in town for May interim meetings.
Systems are shutting down across the state, he said. Locally, the Star City Volunteer Fire Department has suspended EMS services due to budget constraints. And two Preston County operations have closed.
The problem is nationwide, he said. With closures and understaffed services, some areas are seeing two- to four-hour waits for an ambulance to arrive.
The reasons are several, he said. One is barriers to entry and retention, including the cost for a potential EMS worker to get trained and certified.
Another is reimbursement for EMS services. A system gets reimbursed only for transporting someone to a hospital. There’s no pay for readiness, refusals and cancellations, even though those also cost the system money.
Reimbursement structures also play a role, he said. Medicaid and Medicare transports have a contractual allowance – a reimbursement cap where more than half the cost gets written off, leaving less than half to be paid through patient copays and the government check. He showed an example of an approximately $950 bill, where Medicaid would write off $584 and Medicare would write off $617.
He offered several suggestions. One, the state has a new Emergency Medical Services Advisory Board and he encouraged the board and the Legislature to think system-wide, beyond arbitrary county borders.
Two, provide money for volunteer services. “For goodness sakes, please give it to them.” He said 60% of West Virginia counties provide EMS funding, but the amount per capita varies widely. The average is $47.94 per person, but it ranges from 22 cents to $221.
“Raising EMS rates to proper amounts is the right thing to do,” he said. But rates for state-funded care – Medicare, Medicaid, PEIA and such – also need to go up.
Legislators should also consider readiness funding, state match funds, incentives for underachieving agencies to improve, group purchasing power, prioritizing dispatch to make sure the sickest get served first, and eliminating the $250 certification fee for EMS workers.
Committee co-chair Delegate Joe Statler, R-Monongalia, told the members, “I don’t think there is any doubt about it, we’re losing services around the state. We have to buckle down as a committee during the upcoming session. We’re hearing the cries from the field.”
Members talked about $10 million in CARES Act money that is devoted to a new Emergency Management Crisis Fund.
MTEC Director Greg Dausch told members that his school received a grant through that fund and is working with WVU to offer free EMT training. Within two days of announcing the program they had 100 applicants and are setting up two course sessions to train 50 applicants they’ve selected. One course will start in June, the other in September, and handle 25 people each.
There also will be a high school EMS program starting in fall – a two year course offering high school credit. Students who complete it and graduate will receive a high school diploma and an MTEC certificate.
Statler mentioned that some of the money is funding five mobile training units, made from “souped up ambulances.” They will be deployed around the state at schools that have EMS training programs.