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'It's a broken system': EMS leaders outline legislative hopes this session

The Idaho EMS Sustainability Task Force is working on legislation to make EMS an essential service.

BOISE, Idaho — "Think about a time when you or a loved one had to call 911 for a medical emergency. What happened and did help arrive?" — was the first question posed to lawmakers and community members sitting in the audience of Monday's Emergency Medical Services 101 panel

Worryingly enough, EMS leaders said help arrives slower and slower, especially in rural areas, because of population growth and other strains on Idaho EMS. That is part of why the Idaho EMS Sustainability Task Force is working on legislation for this session in hopes of making EMS an essential service. 

"If we don't do something to increase funding, to help with recruitment, retention, we're going to see this system fall in the next 5 to 10 years," said Rick Funk, Payette County EMS chief. 

Right now, some parts of Idaho, especially the rural areas, do not have EMS. If EMS becomes essential, Shawn Rayne, Ada County Paramedics chief, said it would put the authority and responsibility on county commissioners to ensure EMS is provided within their borders. 

However, that means lawmakers need to develop a more sustainable funding system. Rayne called current funding for Idaho EMS a "hodgepodge." 

"There are agencies in the state of Idaho that helped fund their agency through, believe it or not, bake sales and spaghetti feeds, all the way up to EMS districts like Ada County that have a taxing district," he said. 

Funk said they get most of their money through patient insurance. 

"It's Medicaid, Medicare," he said, "but the reimbursement rates aren't the greatest. We have a whole lot of write-offs each year."

Payette and other rural EMS agencies also keep losing staff to places able to offer large sign-on bonuses, which Runk said can lead to slow response times of 30 or 40 minutes. 

Funk said inflation is not helping matters, either. The cost of a new ambulance, which lasts 7-10 years, is nearly $280,000. It costs another $229,000 in equipment to get the vehicle up and running. 

Fremont County Commissioner Blair Dance encourages lawmakers to create an EMS fund to help address the systemic funding issues because "counties struggle when they are given an unfunded mandate."

[The State of Idaho needs to] feed that fund with funding from other resources through the state to establish a base of support for EMS that we can get, salaries, pay benefits and keep people full time," he said. 

Last year's legislature passed a resolution asking the Department of Health and Welfare to draft legislation around making EMS an essential service. EMS leaders said their legislation is a work in progress, and there is no set date for when it will be introduced. 

"This is really the first step," Rayne said. "I think this is going to be a multi-year process to really find the ways to find and sustain EMS long-term in the state of Idaho." 

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