IDAHO, USA — There are a number of EMS agencies in Idaho that get by year after year on bake sales, they literally don't have the budget to keep diesel in the ambulance.
Wayne Denney, the chief of Idaho's Bureau of EMS and Preparedness laid it out for KTVB last summer. Idaho's Emergency Medical Services agencies, especially in smaller counties, are struggling to stay staffed, updated and supplied.
A bill which just cleared the Senate could change that. Senate Bill 1416 would label EMS in Idaho as essential services, which would enable more funding.
Here is what EMS faces in Idaho. By law the state does not designate EMS as an essential service, like police and fire. Therefore, the state is not required to fund it. So, many EMS agencies, of which there are 44, (one in each county) face a never-ending string of bake sales trying to fund their services.
How many lemon bars would one have to sell to cover the cost of a $200,000 ambulance?
And that's just for the updated equipment.
What about the people you expect to drive that ambulance and possibly save your life?
Well, a recent report by the Office of Performance Evaluations found about 7 out of 10 of those are volunteers.
This Emergency Medical Services issue didn't just emerge. It can be traced back nearly two decades.
In 2006, the state legislature decided it would be a good idea to look into how EMS services were handled in Idaho, how it was governed and funded.
They created the EMS Code Task Force, which spawned four years of trying to address the issue at the statehouse.
Nothing came of it.
Then in 2010, the Office of Performance Evaluation released a study where they found gaps, and sometimes duplications in EMS coverage, because of a lack of clarity about who is responsible for what.
They found such services are quilted together across the state with a patchwork of agencies and resources, threaded together by outdated state codes.
They also found a need to have a governing body which would have the authority and the funding to develop, maintain and consistently deliver quality Emergency Medical Services.
They made it clear how policy makers can establish an effective system that would place patient care as the top priority.
Basically, someone has to be in charge.
Eleven years later, another task force was created, the Idaho EMS Sustainability Task Force, to figure out how to fix it.
Senate Bill 1416 would move EMS out from the Department of Health and Welfare, and put it under the Office of Emergency Management.
Thus establishing Emergency Medical Services as essential, and making it more consistent.
A better system according to the experts. Like those in Lincoln County, who told KTVB last August it was better than their system, where starting pay for an EMT is less than $11 an hour.
Their equipment is more than a decade old, and if they have to go out on two ambulance calls in one day, they have to call in a volunteer who then has to have the ability to just leave their job at a moment's notice.
These agencies aren't required to respond to every call for help and EMS in Idaho, especially in rural areas, need more funding.
However, during debate at the statehouse over the bill there were several members of the Senate who were worried about what it would cost.
Like Senator Chris Trakel (R), when he learned patients would still have to pay for a ride in an ambulance.
"To call something an essential service but then still require the taxpayer to pay for it out of their own pocket when they utilize said service, we don't' do that with fire, we don't' do that with law enforcement. So, I have a hard time increasing the size of government and more spending with no cost reduction to the individual that requires the services," Trakel said.
Or Senator Brian Lenney (R).
"Everybody complains all the time about the federal debt, and all that kind of stuff, we're at something like $34-trillion right now. Well, this bill, which I said has kind of baked into the cake a lot of federal money over several years, is going to further inflate that federal debt balloon," Lenney said.
To be clear, this bill would only offset the cost of staff and equipment, by bringing it up to date and making it more centralized and consistent.
As for what it would cost, nothing for fiscal year 2025.
The move to OES would be a transitional, not immediate. Making this a law in Idaho would be the first step in a five-year process.
The Office of Emergency Management will set the budget in September for fiscal year 2026, and it is expected to be $2.2 million.
Then, based on what is needed locally, more funds could be allocated, and even federal money could be used.
Conversely, the other side of this argument came from Senators Carl Bjerke (R) and Geoff Schroeder (R), who said this bill isn't about growing government.
"What is your level of expectation in the state of Idaho?," Bjerke said. "Is your level of expectation that you call 911 and you don't believe someone is going to be there knocking on the door within four minutes? Or are you ok with an hour, hour and a half? A body recovery versus somebody that has actually been saved?"
Senator Schroeder agreed.
"This has to do with how you allocate and how you create a functional system that saves idahoans lives no matter where they are and not have that ability to have your life saved be a function of the property value and the levy rate in the county in which those services have to be bought," Schroeder said.
This is about an essential service, as defined by Idaho's Department of Health and Welfare, a function that is required to maintain the health and safety of a community. It is also not something based on location.
Senate Bill 1416 is now headed to the House, after passing the Senate 29-9.
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