EMS providers are used to responding to alarms. But now, they’re the ones sounding it.
“We're really in a crisis mode right now in terms of staffing vehicles, and even though it might be in some areas more pronounced, the staffing problem and the crisis problem is a regional issue, it's a state issue, it's a national issue," said Michael Woronka, President and CEO of Wilmington-based Action Ambulance Service, which has been providing EMS across Massachusetts since 1977. “We’re seeing it all around the state. It's not just happening in the Berkshires. It's happening in Springfield, it's happening in Worcester, it's happening in Boston. So, our large cities are experiencing staffing shortfalls and labor shortfalls.”
In smaller communities with even less access to life-saving resources, EMS that have relied on volunteers are seeing their staff age out of the job.
“So as a result, the amount of people that are out there that are able to respond to incidents in these smaller communities are just not there anymore, and there's not enough people who work within these local communities that can backfill these lifesaving roles,” Woronka continued.
He fears that there aren’t enough incentives to attract new blood into the EMS world.
“We're also starting to see less availability of the paramedic level or advanced life support provider that exists out there because less people are coming into the field as a whole," said Woronka. "And so, providing advanced life support services is becoming more difficult in these types of smaller and regional type of settings.”
The crucial metric in the world of EMS is response time. Woronka says that’s where the commonwealth’s system is already starting to show its strain. Left unaddressed, he says it could get even worse.
“Very simply that when you call for an ambulance, an ambulance is not going to come, or it's going to be extremely delayed into the 20, 25, 30, 35, if not longer period of time for an ambulance to arrive, which would mean that police officers could be sitting there that whole time trying to do the best they can," he told WAMC. "And it also means that those critical patients that require this advanced level of care might not get that care at all prehospitally, and are going to have to wait until they arrive at the emergency room to get that level of care.”
That’s if an ambulance appears at all.
“There's another concept that we have which we call Level Zero, and that means that all the ambulances in communities are not available," Woronka explained. "So, there's no ambulance available to respond in that community. And so, what we're starting to see is that Level Zero happen not just in a particular community, but in multiple communities simultaneously. And as we see more Level Zero status within these systems, that's when the response times start to get elongated. So, we're seeing more and more of it. It's becoming more of a common practice every single day, instead of it being once or twice a month.”
At Dewey Memorial Hall Friday, Woronka will be joined by State Representative Leigh Davis of the 3rd Berkshire District to talk about the EMS crisis.
“I'm seeing the dedicated professionals who save our lives every day, and these people are overworked, they're underfunded, and they're facing an uncertain future," she told WAMC. "So, we can no longer treat EMS as an afterthought.”
The first-term Democrat who serves Southern Berkshire County says she doesn’t have to try hard to find evidence of the problem locally.
“I'm certainly seeing it with Fairview Hospital, they're struggling to find ambulances often," said Davis. "I'm seeing that with funding, Southern Berkshire Ambulance Squad, for instance, is coming to Great Barrington again, another year, looking for over $350,000 to keep afloat. And when you think about how our municipal budgets are already strapped, where are we going to get the funds?”
Davis has five bills in the Massachusetts House aimed at shoring up EMS in the commonwealth. They include measures to increase funding for EMS, designate it an essential service, form a special committee dedicated to the field, and more.
“The fact is that the reimbursement rates are not what they should be," said Davis. "Today, the EMS system is very different than it was years ago, 25 years ago. It's not just a transport system. It's a healthcare component, and the reimbursement models have not changed to reflect that it's a healthcare component.”
One of the bills would require CPR training in schools and invest in promoting the career path to young people.
“We have very, very low recruitment and retention," Davis told WAMC. "EMS providers struggle with low wages and burnout often, and we need more competitive wages, we need benefits, and we need more incentives to help retrain and train skilled professionals.”
Woronka welcomes Davis’s efforts.
“We need some guardian angels out there, like we need some high-level guardian angels to stand up and to go along this journey with us, to be able to help us a navigate some of the processes here from a regulatory perspective," he said. "And we need some guardian angels to be more or less pounding some fists on some desks saying, this is a critical issue, we need to come up with solutions, we need to work collaboratively. But we can't take no for an answer.”
The panel discussion is set for 1 at Dewey Memorial Hall in Sheffield Friday.
