To reverse the decline in rural emergency medical services, the first thing we must do is admit, formally and informally, that they are essential.
The state does not classify EMS as an essential service, which means municipalities are not required to provide it. Bills have been introduced to change that, but they have yet to pass the Legislature. This makes sense only in a world in which no one suffers a heart attack or stroke, slips into a diabetic coma or falls down the stairs.(tncms-inline)bab2638c-e53b-4069-8016-b0451d069c21(/tncms-inline)
In the actual world, EMS is, after water and heat, a community’s most essential service, and classifying it that way would make it easier for municipalities to obtain state aid for EMS.
The state needs to be brought in to the EMS effort, because it’s overwhelming rural communities like Thurman, where the EMS folded, and rural counties in Warren County, which has made little progress over the past five years in addressing EMS shortcomings.
When you’re talking about a lack of volunteers and the slower response times that result, you’re talking about losing the opportunity to save lives. In a medical emergency, people die in the gap between a five-minute and a 10-minute response.
Five years ago, Warren County political leaders and EMS squad leaders met to come up with ways to improve emergency services. But little has been done. The county and the communities lack the money to launch an ambitious program like a countywide service, and local squad leaders sometimes resist initiatives that could lead to the loss of a local squad’s identity and to the loss of their own jobs.
One option county leaders should consider is the use of bed tax money, and if that seems to be disallowed by the way the local law was written, then change the law. Last year, the bed tax brought in more than $4 million, and the fund balance from that annual revenue has been over $2 million.
The bed tax revenue was initially meant to be used for promoting tourism in the county, but that mandate has already been interpreted broadly with the funding to fight invasive species in Lake George and money for the Glens Falls Civic Center. Emergency medical services are essential for both year-round residents and visitors, but if supervisors are hesitant to stretch the law in this way, they could look at amending it.
All the good ideas that have been suggested — county-funded “fly cars” that would be stationed in central spots for quick response to stabilize patients before local EMS could arrive; a team of emergency medical technicians that would be overseen by the Sheriff’s Office and would help local squads fill gaps in their coverage — are expensive. The “fly car” plan would cost about $1 million a year.
The state has concentrated its efforts in rural New York on economic development through programs like the Downtown Revitalization Initiative and infrastructure funding for things such as water and sewer service. But being able to buy fresh produce at a farmers market funded with a state grant and wash your vegetables in clean water from your tap does you no good if you cut yourself while chopping the zucchini and bleed to death because your community lacks a rescue squad.
Although rural communities have traditionally taken care of their own emergency services, that tradition is becoming harder and harder to maintain. Regional and, perhaps, statewide solutions are needed.
Five years have passed with little more than talking about the problem. What is needed now are solutions that look ahead and anticipate the continued decline of the local services. It’s not enough to patch things up with a little more funding here and some help from a neighboring town there. Larger solutions are needed that will ensure a continuation for many years of what is undeniably an essential service.