Guest commentary: EMS at breaking point across Illinois
By MIKE HANSEN
If there's one thing everyone in Illinois can agree on when it comes to services provided by the government, it's that we should all be able to count on fast and effective emergency response when we call 911.
We all hope we'll never have to make that frantic call, but the odds are that you or someone you're close to eventually will, which is why it's comforting to believe that a well-equipped ambulance with a well-trained crew is never more than a phone call and a few minutes away. Unfortunately, that comforting thought is increasingly misplaced in Illinois, as our Emergency Medical Service (EMS) has been stretched to the breaking point across the state.
The problems facing EMS in Illinois today are unforgiving: thanks to a bad economy and years of neglect, many EMS providers are closing their doors or not having the number of ambulances and emergency medical technicians (EMTs) they need available for the public. As a result, the remaining EMS providers are forced to stretch further out geographically, covering more miles and more people with fewer ambulances and EMTs. The resulting impact on the health care outcomes for Illinoisans suffering serious trauma or acute medical events such as a heart attack or stroke are not hard to figure out.
How did we get here? It started 40 years ago, when EMS services were first formally recognized in the state. After decades of people having to make their own way to the hospital in an emergency, EMS was added as one-third of the 911 emergency-response system. Unlike the equally important police and fire services, however, EMS was never legally designated an "essential service" in state law. Thanks to that oversight, EMS has seen its state funding repeatedly "swept" away in recent years, while funding for police and fire services have rightly been afforded some protection from these funding sweeps.
Such underlying problems have been compounded by the recent recession, as 911 EMS agencies are largely run by property-tax-dependent county and municipal governments, many of which don't have the tools or the credit rating to make it through tough times without help from the state. The state and federal governments, however, have not been much help to EMS in recent years. A good example of how support for EMS has fallen short: Illinois' Medicaid reimbursement rate for ambulance transport is actually lower now than it was 12 years ago, while the cost of gas alone has almost tripled. So now an ever-shrinking number of ambulance services are going further into the "red" when they answer our calls for help, especially in rural areas where they're driving farther and farther to cover new gaps in service created by other EMS agencies closing their doors entirely. This is obviously not sustainable, despite the incredible efforts of dedicated EMTs across the state, many of whom are in fact unpaid volunteers.
So how do we fix it? The good news is, there are already efforts under way to help EMS stay viable and effective. Over the past year, the bipartisan House EMS Task Force has held hearings across the state to hear firsthand just how bad things are getting, and it has just released its final report. There are a lot of recommendations in the task force report, but they boil down to this: 1) legally designate EMS as an essential service; 2) raise reimbursement rates and provide additional resources to struggling EMS agencies to maintain our emergency medical network; and 3) introduce smart reforms to allow the men and women of EMS do more with less in these resource-strapped times.
It's easy for good ideas to gather dust, however, so a growing coalition of EMS providers, hospital representatives, and patient advocates like the American Heart Association have recently formed the Illinois EMS Alliance to push the task force report recommendations forward. That's a good start, but a problem that affects all of us is going to take all of our help to fix. We all need to stand with the brave men and women of EMS and tell our elected leaders that EMS is essential to us, our families and our communities.
Mike Hansen is chairman of the State of Illinois EMS Advisory Council.