BOISE, Idaho — During medical emergencies, we all depend on paramedics and EMTs to be on the scene within minutes - in situations where minutes can make all the difference.
However, the increase in demand without more support has been stretching EMS services thin across the state.
Ada County Paramedics respond to just over a quarter of EMS for the state of Idaho. As our Gem State continues to grow, so do the costs associated with running emergency medical services.
"That's very costly," Ada County Paramedics Chief Shawn Rayne said. "It's not the cost of the call when it comes in - the cost is truly being ready 24 hours a day, seven days a week."
Chief Rayne said only a few years ago, ambulances cost around $180,000 to purchase. Now, they cost around $250,000 before installing any equipment.
Last year, Ada County Paramedics shifted from a 48-hour work week to an average of 56 hours, something their chief said the change is not sustainable for the long term.
"Every day at Ada County, we have 14 ambulances on duty 24 hours a day," Rayne said. "The reality of today is that I need really 17 ambulances to provide that base of coverage, but then also to not work my people as hard as they're being worked right now."
Those are problems being have been scene across the state - in both urban and rural areas.
"Many agencies in the state, including my own, we're looking at maybe in two to three years, of potentially having to decrease our level of service," Rayne said.
To avoid a situation like that, the state legislature's Office of Performance Evaluations created the EMS Sustainability Task Force to look at issues impacting EMS services.
Over the past 50 years, a lot of things have changed with how EMS services provide care, with new advancements and equipment - but the way those services are funded hasn't changed.
"The funding model is really based on what we were doing in the 70's," Rayne said.
A number of different sources fund EMS services, including county taxes and insurance - but their largest source of money is from Medicare, a source that isn't providing as much as it used to.
"At the end of it all, we get about $340-$350 from Medicare on a bill that might be $800," Rayne said. "So that portion of our budget that was that fee for service has continued to kind of shrink. So we're really dependent on increased call volume to bring more revenue through the door, but as the call volume increases - we don't have the ability to put more resource on the road to address the increase in call volume."
To try and come up with a plan that will work for these agencies, the EMS Sustainability Task Force recommended three things they would like to see in the proposed 2024 legislation.
The first step is to officially designate EMS as an essential service in Idaho.
"By doing that, it puts the onus on the county commissioners in each county - not to provide it themselves or to have a county service provide it - but to ensure that it is provided within the borders of the county," Rayne said.
The recommendations also ask for developmental money to help counties establish EMS services, to make sure people have life-saving resources anywhere in the state.
"If we continue to see the increase in call volume like we have been, it's just gonna get worse," Rayne said. "So we really need to find these things that make EMS sustainable. Not only here in Ada County - that's certainly important to me and my agency - but across the state."
Rayne said they are not sure when the proposal will be discussed in committee, or if it will be during this legislative session. But they have received interest from some legislators.
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