Dozens of emergency medical providers gathered in Hartford Monday with state and town officials to warn of worrying shortfalls in Connecticut’s EMS system driven by a number of factors including short staffing and inadequate reimbursement rates.
Men and women in first responder uniforms crowded a conference room in the Legislative Office Building to sound an alarm. Connecticut residents experiencing medical emergencies in some areas of the state may be waiting more than 40 minutes before an ambulance arrives to treat them. The problem, they said, will only get worse unless something is done about it.
“The challenges are acute,” New Britain EMS Chief Bruce Baxter said. “We don’t have the staffing, costs have grown, insurance reimbursements, in some cases, have gone down or remained flat and the only way we can change them is to go to the legislature… The patient will be in peril if we do not act today.”
The situation reflects a long-stressed patchwork of EMS and ambulance coverage systems that has grown more strained in recent years. Commercial ambulance services have increasingly been bought up by a small number of hospital networks. Meanwhile, many volunteer departments that serve some of Connecticut’s more rural towns have struggled to recruit.
During the press conference, Coventry Town Manager John Elsesser described merging two volunteer fire departments and eliminating one of the town’s ambulances in an effort to maintain 24/7 coverage. When the pandemic hit and volunteer ranks shrunk further, the town used federal funding to pay for temporary staffing. Eventually the funding dried up and voters rejected a tax increase to fund the paid responders, Elsesser said.
“Even the town can’t get the public to agree for a property tax increase,” Elsesser said. “The towns are now dialing 911 and calling on the state to step up and address the most basic service to our citizens: emergency medical care.”
Lawmakers on the Public Health and Human Services Committees will seek to take action this year on at least two fronts to address the problem. One proposal will attempt to boost Medicaid ambulance rates over time until they match Medicare rates.
“The Medicaid payments in the state of Connecticut for EMS services can not be less than 90% of the Medicare payments,” said Sen. Saud Anwar, a South Windsor Democrat who co-chairs the Public Health Committee. “That is one thing that can solve quite a few of the problems because financially, these organizations are no longer viable in the current form… This is going to save lives if we fix this.”
Another proposal would task the Office of Emergency Medical Services and Office of Health Strategies with aggregating data pertaining to Connecticut’s emergency medical calls. The “dashboard” would be used to track information like call response times, which services transported patients and which hospitals accepted them.
That data is critical to modernizing the state’s EMS systems, according to Ben Zura, a member of the Connecticut Association of Paramedics and EMTs and director of innovation and strategy for Emergency Resource Management.
Zura said two pending bills related to the data collection would help to close a decades-old information gap that has complicated the management of Connecticut’s EMS system.
“We’ve begun a conversation about the future of EMS in Connecticut and as we start to delve into the specifics, the importance of those two bills and the lack of this data is going to become apparent to everybody involved,” Zura said.
Another area where lawmakers hope to boost the state’s EMS system is through workforce development. Connecticut has struggled to recruit and train new EMS providers to replace those who have left the field, according to paramedic Nicholas Paproski, a paramedic and director of external affairs for the Connecticut Association of Paramedics and EMTs.
Paproski said it is common for medics and EMTs to work more than 80 hours a week or at two or three jobs.
“The brave men and women who wear Connecticut paramedic and EMT patches are tired and the recruitment and retention data reflects that,” he said.