Report: EMS in Idaho underfunded, rural patients left to feel the impacts

EMS considered  not "essential" under Idaho law
Posted at 6:15 PM, Dec 15, 2021
and last updated 2021-12-15 20:42:44-05

BOISE, Idaho — A recent state report showed Emergency Medical Services are widely underfunded because it is not considered an essential service by the state.

EMS providers across the state are facing an array of challenges, regardless of whether they are volunteers or paid staff, jeopardizing patients who rely on the services. Those who live in rural areas may feel the most impacts of strained EMS workers.

A recent 92 page report by the Idaho Office of Performance Evaluations looked into volunteer providers of Emergency Medical Services (EMS).

Only 11 states nationwide have laws designating EMS as an essential government service like fire and police guaranteeing those services to all municipalities.

States with Essential EMS

Staffing and funding are two areas of concern, which a majority of providers say will impact the service they provide.

In north Idaho where the state continues to be under crisis standards of care, Kootenai County EMS Chief Bill Keeley said services are already impacted.

"Our length of time, at times, to get there is increased because when we're really busy units have to come from further away then they normally would," Keeley said.

Staffing issues caused delays for 65% of providers surveyed.

"We have had people just resign for a number of reasons, COVID being one of them," Ada County Paramedics Chief Shawn Rayne said. "Pay continues to be an issue for EMS in Ada County our human resources department has determined that our starting salary for paramedics should be higher than what it is today, but unfortunately the way that we're funded currently we just can't afford to make that pay raise as it stands today."

EMS providers across Idaho are responding to more calls due to growth. Ada County Paramedics report the agency saw an increase in call volume over the last few years. They reached the projected number of calls for 2021 on Nov. 30.

Ada County Paramedics Call Volume

EMS is funded through a patchwork consisting of billed for service, sales and property tax. In Ada County the percentage given to EMS through collected property tax has not changed since the 1990's. Volunteer EMS rely on similar funding but depend more on counties and the state.

"The smaller rural districts may have no ability to provide service for a day or two. You look at the funding for some of the volunteer agencies it's so small right now. If their ambulance goes down, the don't have an ambulance for the community. Luckily, we don't face that here in Ada County."
Shawn Rayne, Ada County Paramedics Chief

Idaho lawmakers from both parties say more needs to be done to address EMS funding.

"I represent a lot of rural folks. I represent 5 rural counties and that's the last thing I want for my people to have to do is call and have someone tell them no, an ambulance can't come." said Sen. Mark Harris, R-Soda Springs.

Rep. Ilana Rubel, D-Boise, said funding EMS should be a core expectation of local officials.

"It really shocked me that's not something that's considered a vital government service because certainly in my mind that's one of the bed rock things that citizens expect from their government, they expect someone to come fast when they call 911 and are having a heart attack or a major medical emergency. And if we're not meeting that expectation and we have $1.5 billion in the bank then there's something wrong with our priorities," said Rubel.

Related: Idaho's projected budget surplus climbs to $1.6 billion

All eyes now turn the legislature and to the upcoming session to see if they will act to fund EMS, especially for volunteer providers, and if they make EMS an essential government service.

"I really think the legislators need to take a look at that (OPE report) and see what they can do to help EMS in the state of Idaho probably the number one thing they can do this year is make EMS an essential government function," said Rayne. "Right now, it isn't so there are places in Idaho that don't have ambulance coverage and I don't know how many people in the public are aware of that."

Harris and Rubel both serve on the Legislative Oversight Committee that reviews these reports. Rubel said she has already begun discussions with the Joint Finance-Appropriations committee to see what can be done within the budget.

Harris said he has had some conversations but nothing concrete, and expects the full Legislative Oversight Committee to begin conversations once they hear the full report from OPE in January or February.