Leaders of EMS agencies throughout the state expressed concern and frustration about a lack of resources with a small group of West Virginia lawmakers during a roundtable discussion at the West Virginia EMS Coalition 2023 Annual Membership Meeting on June 15.
The coalition was reorganized about a year and a half ago, and now the board has representation from all types of agencies, in every corner of the state.
The lawmakers who joined in the discussion were Lewis County Delegate Adam Burkhammer, Monongalia County Delegates Evan Hansen and Joe Statler, Marion County Delegate Phil Mallow, and Preston County Delegate Rolland “Buck” Jennings.
EMS directors and personnel told the legislators they increasingly are being stretched thin with decreasing human and financial resources to dedicate to caring for their communities, a report from the meeting said.
During the discussion, it was estimated that staffing shortages caused around 17 EMS agencies to close throughout the state in 2022, and at least two or three more in 2023.
Different versions of a bill that would have provided a little more than $12 million to EMS agencies and volunteer fire departments throughout the state was adopted by members of the Senate and House of Delegates during the 2023 regular Legislative session, however the measure died during the last day of the session because of a disagreement about how to fund the measure – through a surcharge on homeowners’ insurance or using surplus state revenue.
According to the report, EMS representatives at the meeting told the lawmakers they (the coalition) had done the work of identifying their issues and even drafting legislation for lawmakers, and they are expecting to see results in the form of funding from the state and broader access to EMS retirement plans.
“A lot of bills went in,” Dylan Oliveto, with Atlantic Emergency Solutions, said at the meeting. “Not many of them came out. Obviously, the coalition is trying to do what it can do, and you guys are doing what you can do. Where do we need to apply the resources from our perspective for agencies, for personnel?”
Most of the discussion dealt with how to get state funding to support EMS agencies to help them restore staffing and service levels, the report said, including changing the existing laws to make it so all EMS workers are eligible for benefits in the EMS Retirement System.
Currently, EMTs and paramedics can cross state lines to any of the states that border West Virginia and make between $2 and $3 more an hour, the report said. State governments for each of West Virginia’s bordering states provide some sort of funding to support EMS agencies in those states. West Virginia is the only state that does not provide direct funding to EMS agencies.
While the state does provide funding to community and technical colleges to train people to be EMTs or paramedics, EMS directors increasingly say West Virginia is paying to train people to leave the state for better paying jobs.
Limitations on access to retirement benefits was also a concern discussed with the lawmakers.
According to Monongalia Emergency Medical Services Executive Director Forest Weyen, many agencies, like Mon EMS, privately have retirement benefits for their employees.
Weyen said there is an EMS retirement system that was built years ago to allow EMS providers in the state to have access to certain benefits after a few criteria are met, but the issue is that the definition of who can participate in the state system is limited. Mon EMS and many other agencies in the state are not eligible.
The EMS coalition is working with state legislators to broaden the definition to ensure access to more providers, Weyen said.
Worker burnout or fatigue, Weyen believes, is one of the biggest problems facing the state’s EMTs and paramedics.
“If there was a warning light for an ensuing problem, this is it,” Weyen told The Dominion Post. “EMS providers around the nation are dealing with a myriad of issues and it is threatening the EMS system as a whole. In addition to the normal scope of work, EMS professionals face compassion fatigue, patients who are chronic utilizers, mental and behavioral health issues, substance abusers, etc. “
Noting that worker fatigue is a far deeper issue, Weyen gave two predominant reasons for provider burnout.
“EMS providers are used to dealing with the bad and super taxing stuff – we have programs for that,” he said. “However, that has morphed in the last 20 years into this fatigue of seeing the same patient multiple times a day or week, the same problems, the same overdoses…and you can get desensitized to it. It’s taxing to providers, because you can feel like there is no end in sight.”
There is still a stigma that asking for help is a sign of weakness or defeat, which prevents many of those struggling from asking.
Weyen said Mon EMS and other agencies in the state have multiple resources at hand, and promote and encourage the use of them, but are trying to do something different.
“We are trying to make sure that people know it is OK to not be OK,” he said. “It takes a while to change a culture like that, but Mon EMS and the entire EMS industry need to do that.”
According to the meeting report, each of the lawmakers who took part in the discussion with the coalition, in their own way, encouraged those present to engage with their respective representatives to increase lawmaker’s understanding and garner broader support for getting their needs met.
In May, a resolution was adopted encouraging House Speaker Roger Hanshaw and Senate President Craig Blair to recommend that Gov. Jim Justice include the bill in a special session call later this year.
Weyen said he believes the legislators need to realize they have to find a way to sustain their safety nets.
“Their EMS, police, fire, and the 911 centers that service them are their safety nets. There is no one after us. No matter what happens with any other social service, project, facility, operation … when it goes south, you dial 9-1-1,” he said.
While there is no “silver bullet” to solving the problem, Weyen said, he thinks creating a work culture and addressing provider mental health will be a huge step in saving EMS, and all first response agencies, by ensuring they can do the job.