CARES funding: The first step in recognizing crisis in emergency medical services

Christi Johnson, president, Ephraim Ambulance Association

I want to express gratitude and thankfulness to the Sanpete County Commissioners that allocated CARES funds to county EMS (Emergency Medical Services) agencies. As Brian Bench and I said in October, our proposal was a big ask but vital to EMS needs. Thank you, Commissioners, for recognizing the needs of EMS.
These funds have provided relief to already stressed EMS agencies in Sanpete County. This money allowed our agencies to purchase new ambulances or equipment that would not be possible or have taken years to obtain.
Ephraim Ambulance Association could not secure a new ambulance by the required deadline, but updated and purchased needed equipment. Mayor Scott and Ephraim City Manager Shaun Kjar were very supportive of allocating CARES funds.
The CARES funds from Ephraim City allowed Ephraim Ambulance Association to purchase and equip a new Rapid Response Vehicle, replacing a 28-year-old Bronco. Mayor Scott has also contacted commissioners, legislators and senators to advocate for funding EMS.
Funding is just one of the significant issues agencies in Utah face in providing emergency medical services. EMS agencies rely on insurance reimbursements and grants to sustain services. In 2019 Utah reported a 37 million dollar deficit in emergency medical service. Declining Medicare and Medicaid reimbursements, lack of insurance, and volunteer hours to staff ambulances contributed to the loss.
Federal funding is not available, and until 2020 no State funding was available. Sen. Derrin Owens was instrumental in passing House Bill 389, which allocated $3.5 million to the Utah Bureau of EMS. Rural agencies were then able to apply for a grant for funding personnel or equipment. Due to COVID-19, the Legislature cut this funding to $1.5 million. We are hopeful to see continued support for EMS in the 2021 Legislative session.
Unlike police and fire agencies that are required by law, EMS is not. Not requiring EMS means your local and county governments do not have to ensure EMS services are available. Can you imagine calling 911 and no ambulance responding?
In Sanpete County, we are lucky to have four agencies respond to residents’ medical needs. Manti Ambulance is the only agency owned by a city government and Gunnison Ambulance is owned and operated by Gunnison Valley Hospital. Ephraim Ambulance is a 501 (c) (3) nonprofit, and North Sanpete Ambulance is a private association.
Each agency is unique in operation, leadership and ownership, but continues to share issues providing services. Each of these agencies responds to the following designated geographical locations in Sanpete County:
North Sanpete Ambulance (not owned by a city or the county) serves Mt Pleasant, Moroni, Fountain Green and Fairview.
Ephraim Ambulance Association (not owned by a city or the county) serves Ephraim.
Manti Ambulance (city owned) serves Manti and Sterling.
Gunnison Ambulance (hospital owned) serves Mayfield, Axtell, Gunnison, and Centerfield.
Another significant issue EMS is facing is the lack of volunteers to staff agency ambulances. Before COVID-19, there was already a substantial decrease in volunteerism. COVID-19 has complicated this issue resulting in a more significant reduction in volunteerism.
Almost all agency volunteers have another full-time job, and those employers have disallowed volunteering with EMS to limit COVID exposure. EMS volunteers receive very little if any compensation for their time. The leadership of these agencies also donate their time and expertise to operate county agencies. EMS in Sanpete County is only surviving because of these volunteers and the time donated.
EMS is in crisis. EMS services will not continue to be sustainable with reliance on volunteerism and the current funding structure. EMS in Utah needs recognition as an essential service, just like the fire or police Departments. EMS is vital; your life could depend on it.

Christi Johnson MSN, BSN, RN, AEMT
President Ephraim Ambulance Association
Rural EMS Directors, Secretary
Vice-Chair Utah EMS Committee