Additional funding for ambulance providers included in the biennium budget last year was scrapped in the governor’s proposed budget adjustments released last month, leaving EMS professionals across the state disappointed.
“The state of Connecticut has not really prioritized emergency medical services … We are not an essential service in this state,” said Nicholas Maltby, chief of service at New Hartford Volunteer Ambulance.
Gov. Ned Lamont’s proposed budget said it would be premature to include the additional funding because the state is still studying Medicaid reimbursement rates. New findings are due early next year.
The additional funding comes in the form of Medicaid reimbursement for ambulance providers. Medicaid is the state’s public health insurance, known as HUSKY, which provides financial assistance to people below certain income thresholds. HUSKY was used as payment for EMS services at least 44,000 times each year in 2021 and 2022, according to the most recent annual report from the state’s Office of Emergency Medical Services.
In response to the lack of additional funding, ambulance providers gathered at the Capitol to urge lawmakers to restore funding. Maltby, along with other EMS workers from around the state, testified to the Appropriations Committee, which has until April 5 to recommend any adjustments to the 2024-25 budget.
Lamont’s proposed budget adjustments note that ambulance providers received additional funding in the last biennium, but providers say that removing next year’s additional funding would be devastating to their already-scarce resources. Meanwhile, state data shows that ambulance staff remain busy.
EMS providers across the state responded to anywhere from 55,000 emergencies in April 2020 to as many as 83,000 in December 2022, according to data from OEMS. Data for 2023 will be released later this year in the offices’ annual report.
About 2.6 million emergency responses were made during that three-year period. But some EMS providers' staff numbers dropped by 2022.
"It's almost like a perfect storm," said Maltby.
Forty-one EMS providers saw their number of active crew members decrease from 2020 to 2022, according to data reported to OEMS, with another 59 seeing no change or an increase. Stratford EMS, Newington Volunteer Ambulance Corp and American Ambulance Service Inc all lost over 70 active members. Services in Suffield, Westport, Lyme and Wilton all saw member decreases of 20 or more, along with American Medical Response and Northern Duchess Paramed.
Ambulance providers vary in their structure, with some funded by their town while others are non-profit, commercial or volunteer-based. Some providers say they’re losing volunteers and resorting to hiring paid staff, which further strains their budgets.
“Our ability to help each other has gone down while the number of calls has gone up," said Maltby, referring to mutual aid, which occurs when an ambulance provider assists a patient outside their service area. Calls for mutual aid increased from 4,887 in 2021 to 6,515 in 2022, a 33% increase.
"Let's say we're out on like something small, you know, somebody's just feeling sick. And then we end up with a car versus motorcycle accident. Who comes to that call?" said Maltby. "Right now there are so many times where basically every ambulance in our area is out on a call and there's nothing left. And so far we have not had that nightmare call."
For some rural towns, having more crew members is critical because of the longer time it takes to get to a scene and then to a hospital. Longer response times means having to rely on mutual aid or more volunteers.
Among all towns in 2022, about nine minutes was the average response time from the moment a unit is notified by dispatch of an emergency to the moment it arrives on the scene. But some towns, like Washington, had average response times as high as almost 19 minutes. Another 16 towns had average response times above 15 minutes.
The lowest average wait time was experienced in New London at just over 5 minutes, followed by Windsor Locks and Greenwich.