Sanders Introduces Legislation to Address Major Staffing Crisis Across EMS Departments

With the third year of the coronavirus pandemic straining every level of the U.S. health care system, Sen. Bernie Sanders (I-Vt.) on Wednesday, joined by Sen. Tina Smith (D-Minn.), introduced legislation to address the major staffing crisis affecting Emergency Medical Services (EMS) in Vermont and across the country. The EMS Staffing and Support Act follows legislation Sanders introduced last month to address a similar workforce crisis afflicting fire departments across the U.S.

"In too many communities across our country, ambulance and emergency medical services are not getting the support from the federal government that they need to do their jobs," said Sen. Sanders. "It is time for that to change. Simply put, EMS and firefighters are the first responders to some of people's most difficult moments, and often are the difference between life and death. We must do all we can to ensure that they are fully staffed, equipped, and able to respond to emergencies in a timely manner."

"EMS and fire department calls have skyrocketed during the pandemic. Yet too often, these emergency services are understaffed and underfunded," said Sen. Smith. "Everyone deserves a timely, fully-equipped response in times of crisis. I will continue working to get this bill across the finish line and ensure our first responders have the resources and staff they need to do their jobs."

Over the last 30 years, emergency call volume has tripled in the U.S., yet fully staffing fire and EMS departments has become increasingly more difficult, severely affecting the safety of communities. The strain of the COVID-19 pandemic has only deepened the crisis for EMS and fire departments alike. Among paramedics and EMTs, turnover ranges from 20 to 30 percent annually, leading to 100 percent turnover every four years. In 2020, nearly a third of the workforce in ambulance services left after less than a year. Eleven percent left within the first three months. Despite staffing shortages, local EMS departments respond to nearly 28.5 million 9-1-1 dispatches every year across 41 states, according to the 2020 National EMS Assessment.

Across the country, and particularly in rural areas, EMS departments face many of the same challenges as fire departments, from high turnover to issues around recruitment and retention, equipment, and expensive out-of-pocket training. However, while fire departments have access to already underfunded Federal grants, EMS agencies that are not affiliated with a fire department - about 60 percent of all EMS departments in the country - are largely shut out of federal funding altogether. EMS responders who work in rural areas are particularly underfunded, often relying on reimbursements from Medicare or Medicaid. However, Medicare and Medicaid will not cover anything if a patient is treated on-site, and often will only reimburse 75 percent of what it costs to transport a patient.

Sanders' EMS Staffing and Support Act would provide $500 million to establish a grant program in the Health Resources and Services Administration. These grants would exclusively fund EMS needs, strengthening departments' capacity to hire personnel; recruit and retain volunteers; provide training or reimbursement for training; implement apprenticeship programs; purchase new equipment, vehicles, and medical supplies; support the well-being of EMS personnel; improve station facilities; establish community paramedicine initiatives; and improve regional coordination. The legislation would also:

• Require the Secretary of the U.S. Department of Health and Human Services (HHS) to provide Congress a report detailing the challenges, disparities, and inadequacies in ensuring Federal and private reimbursement for emergency medical services, as well as a recommendation for action;
• Require the Secretary of HHS to provide Congress a report detailing the challenges specific to rural EMS departments and to nonaffiliated EMS departments, and develop an action plan to address those challenges through grants and other administrative action.

Sanders recently introduced the Firefighter Staffing and Support Act, which would more than triple federal support for fire departments over the next five years and begin to address the major staffing crisis affecting both career and volunteer fire departments in rural communities and across the country.

Read the bill text, here.
Read the bill summary, here.