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Statewide EMS staffing shortages exacerbated by pandemic

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Emergency medical services are facing staffing shortages statewide.

There are an estimated 1,000 open emergency medical technician and paramedic jobs, according to Angela Madden, executive director of the Michigan Association of Ambulance Services, which serves 70% of Michigan counties.

The shortage, she said, is not new but has been exacerbated by the pandemic.

“Turnover has increased by 10% to 20%, depending on where you are in our state,” Madden said. “But we also have far fewer people coming in to backfill those positions because we were unable to educate and help create new paramedics on the road.”

Madden said Michigan EMTs are paid an average of $13 to $14 per hour while paramedics are paid an average of $16 per hour. The wages are not competitive with service and retail jobs that pay similarly but may not require as much training or intensive labor.

EMTs must go through six months of training. Paramedic training can take six months to two years to complete.

Madden said the shortage is felt particularly in the state’s rural areas whose patients' access to health care is greatly supported by their local EMS agency.

“Every single entity in our state is facing some level of staffing shortage. I would say that that staffing shortage is felt a little bit more strongly in our rural communities.”

But Madden said there has been a total investment of $54 million to EMS in Medicaid reimbursement rates. Next, she wants the state to invest its American Recovery Plan Act dollars into EMS education in order to bring on more staff.

But to solve the shortages that were present before the pandemic, Madden said the federal government needs to recognize EMS as a health care provider.

EMS falls under the Michigan Department of Health and Human Services, but federally it’s a different story. Madden said EMS is not federally recognized as a health care provider, as it is situated within the Department of Transportation under the National Highway Traffic Safety Administration. It was created as a response to road accidents in the 50s and 60s.

An ambulance agency is only reimbursed through Medicaid for transporting a patient, which Madden said doesn’t take into account the cost of being staffed, equipped and ready to respond.

Hospitals, she said, are already overrun, forcing EMS agencies to travel farther in order to transport a patient. She said EMS agencies may have to prioritize 911 calls over scheduled inter-facility patient transfers. This means patients who need to be transferred from one facility to another for different types of care could face longer wait times.

While it has not escalated to EMS agencies leaving a 911 call unanswered, she said it could if the shortage isn’t resolved.

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