State Sen. Saud Anwar (opinion): Ensuring the future of CT’s EMS services

Both before and during the COVID-19 pandemic, the issues straining EMS services continue to put more pressure on the workers and systems we rely on, state Sen. Saud Anwar says.

Both before and during the COVID-19 pandemic, the issues straining EMS services continue to put more pressure on the workers and systems we rely on, state Sen. Saud Anwar says.

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For decades, independent EMS departments, and individual EMS workers and volunteers, have played a huge role in protecting our cities and towns, ensuring proper and effective emergency response in response to all sorts of events. We cannot thank them enough; they have been instrumental in responding to the broad spectrum of acute medical and nonmedical issues faced by individuals in our communities.

Their hard work has come at a price, though. Both before and during the COVID-19 pandemic, the issues straining EMS services continue to put more pressure on the workers and systems we rely on. No two parts of Connecticut rely on the same model of EMS services, but all of Connecticut relies on EMS services — and without addressing growing strain on workers, our state could struggle, both in the short- and long-term.

In late July, the Public Health Committee held an informational forum discussing and considering Connecticut’s needs; my takeaway is that we must act now, not later, to correct both short-term and long-term trends. In conversations with stakeholders and leaders across the state, we found areas of opportunity and improvement for EMS that can address both the immediate future and years to come beyond them.

As is common in many fields these days, pay is becoming an increasingly pressing issue for EMS systems around the state, adding to already significant financial strain in a number of departments. Most prominently, in some locations, hospital-owned EMS systems pay EMTs and paramedics at rates volunteer-based systems cannot afford. What’s more, the reimbursement rate for transportation of acute medical and nonemergency cases has decreased; it is not keeping pace with salaries and worker needs.

If this issue is not addressed, our systems run the risk of attrition on top of what has already been, placing more strain on fewer workers in a downward spiral; it has already led to a reduced workforce and reduced services in some locations, especially so-called “EMS deserts” where systems are struggling and residents experience the worst consequences.

Above all else, a comprehensive strategy for workforce development in the EMS field would pay strong dividends to meet this pressing concern. Among its many advantages, a strategy would allow state leaders to better align their focuses and efforts in fighting degradation of service quality. Further, it would provide incentives to workers, allowing them to choose EMS as a profession — even better, it would connect the industry with increased standardization of treatments and training. This would provide reduced costs of education, which could be compounded through municipal teamwork and collaboration. Such a strategy, once developed, could even provide tax exemptions and stipends, among other financial supports, to incentivize provision of services across the state.

Additionally, to address further issues, reimbursement rates in EMS should be raised to be placed on par with the rest of the country. Whether this reimbursement comes through insurance, use of Medicare or use of Medicaid, it should have a balance, keeping the needs of organizations and the sustainability of existing systems in perspective. This would likely require some increased costs, but would also allow for better competition in our state for services and workers alike.

Addressing these issues would help address the short-term needs of the state, hopefully buying us time to meet long-term ones. Connecticut has one of the oldest populations in the United States — the seventh-oldest, as of 2021. Older residents will need more consistent and effective access and transportation to care — with some medical emergencies being life-threatening if left unaddressed for too long.

To understand this and other shifting realities that will impact how care is considered in our state, we must create a dashboard and plan of vulnerabilities in the EMS system across the state. Readily available data on response times, mutual aid needs, distance served, number of people served, disease patterns, distances to acute care facilities and types of services administered — among many other potential data points — can provide significant improvements in community-level and state-level response to EMS service upgrades, and guide state and local responses to guarantee best quality of service for all.

To meet the needs of the future, collaboration will likely be necessary, as well. Whether it’s data being shared or, on a larger basis, EMS systems co-existing and aiding each other, such efforts would be a boon for many towns and cities, providing more resources and information to guide and improve best practices, and allowing for adaptive and forward-thinking approaches to meet issues such as pay inequity and an aging population putting more strain on needed services. While there may be some issues with such collaborations, working together would allow all stakeholders better opportunities to meet the public’s needs.

Without EMS services available to all citizens of our towns, our state will suffer significant impacts, from fewer people receiving aid when they need it to a potential migration of residents to other communities. We must not allow this to happen. With a renewed focus on what needs to happen to aid the industry — fair pay and financial restructuring in the short-term, a plan for Connecticut’s aging population and service collaborations in the long-term — we can rise to this occasion and ensure effective EMS services for years to come.

State Sen. Saud Anwar, a Democrat, represents the Third District, which includes the towns of East Hartford, South Windsor, East Windsor and Ellington.