PITTSBURGH — Emergency Medical Services Agencies in 44 counties in Pennsylvania joined forces and sent a letter to Gov. Josh Shapiro and Acting Health Secretary Debra Bogen expressing concerns about the Bureau of EMS and the effects it’s having on an already fractured system.
“EMS has gone through a number of changes over the years,” said EMS West Board President Greg Porter. “Most notably in the last three years has been COVID-19, which increased the risk to providers. It increased the call volume. Increased the protective demands on them per call. Meanwhile, all of our expenses are going up. We can’t really compete with wages in any of the other markets. We’re losing people at an impressive rate. And then fast forward to about a year ago, we got a new EMS director.”
Greg Porter is the President of EMS West, which serves 16 counties in Western PA. The new Bureau of EMS director is Aaron Rhone.
Rhone has been overseeing all the EMS agencies at the state level under the Department of Health for a year now, which includes certification, licensing and coordination of 13 regional councils, about 1,3000 EMS agencies and more than 40,000 EMS providers.
“Very educated,” said Porter. “Very well-spoken but has a very heavy-handed management approach to how he wants EMS to be run and regulated.”
Because of some noticeable changes implemented by Rhone over the last year, EMS agencies across the state have sent letters to the Governor and the state’s Acting Health Secretary outlining their concerns. They fear if these concerns aren’t addressed more and more EMS agencies will close, forcing ambulances to travel longer distances to calls increasing response times.
“We’re going to see less providers, less services,” said Porter. “Longer response times in a system that already has some significantly delayed response times.”
Porter says the Bureau has launched hundreds of investigations into local agencies, more than ever before.
“I had heard 12 last year, compared to 300 so far this year,” said Porter. “Now I don’t have firsthand knowledge of that. I can’t attest to that.”
Porter says a right-to-know request has been submitted to find out an exact number.
In Porter’s letter to Governor, he wrote, “These investigations are often based on incomplete, unconfirmed and unvetted information, including reacting to random social media posts.”
Porter says individual paramedics have had to pay fines, and in one instance an investigation was opened after a fire department responded to a medical call to assist EMS.
“A fire department that was requested by the paramedics on the scene to come help, and they received a letter from the Bureau of EMS that they were functioning outside of their scope and needed to stop that immediately,” said Porter. “Some time today, we’re going to go on a call with the police officer that has an AED. And according to the Bureau’s interpretation, he’s functioning outside of the scope of EMS by trying to apply that AED and help somebody which is exactly what the fire department was doing at the request of EMS, and we’re sanctioning them for doing that.”
These investigations have then led to restrictions on agencies operating licenses.
“While there is value in that system that we’re holding people to some regulation, the provisional license also comes with some risk to that ambulance service because it’s a tarnishment on their service record,” said Porter. “Their funding from their communities is at risk. Their funding from insurance companies is at risk. Employees are less likely to want to go work at a service that has a sanctioned license because their employment could be at risk.”
Porter says it really hurts recruitment and retention, which in the end hurts the people they’re trying to help.
“It takes a system that is already struggling, and defined by some as in crisis, and really pushes it to the breaking point,” said Porter.
Channel 11′s Alyssa Raymond spoke to several chiefs who did not want to do interviews in fear of retaliation. That’s one of the reasons State Senator Lindsey Williams says she’s getting involved.
“I used to work for the National Whistleblower Center,” said Williams. “So I worked for employees who were in fear of retaliation, and I don’t want that for my EMS agencies. So if they’re afraid, I’m going to be here speaking up for them.”
She says her job right now is to echo the agencies’ concerns and get the state to listen so the people who call 911 for a medical emergency get the help they need.
“When I’m hearing concerns saying this is going to make what we’re under worse, that’s a red flag for me,” said Williams
“Our senators and representatives have been incredibly supportive, and EMS has become a topic at the state level like never before,” said Porter. “So we just want the Bureau of EMS to have that same mindset. Certainly, regulate. Certainly, make sure we’re doing good EMS but help us bring people into the system. Help services succeed. Help us figure out innovative ways to create an EMS system that people want to be a part of and our community relies on and not one that builds barriers.”
Williams says she did get a response from the Health Department and is currently working on scheduling a meeting with them to discuss all these concerns.
On May 3, Auditor General Tim DeFoor released his findings from a performance audit. He noted a lack of internal controls continues to be an issue for the Pennsylvania Department of Health when it comes to the distribution of money from the Emergency Medical Services Operating Fund (EMSOF) to regional EMS councils and the State EMS Advisory Board. According to a release, this is the fourth performance audit of DOH’s administration of EMSOF since 2010 and the fourth time we found significant internal control issues that remain uncorrected.
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11 News received the following statement from the Department of Health:
“The Department of Health’s Bureau of Emergency Medical Services is responsible for ensuring that approximately $10 million annually is appropriately distributed to 13 Regional EMS Councils and the State EMS Advisory Board to support training and certification of personnel, quality patient care, and data collection and licensing of all EMS agencies and providers across Pennsylvania.
“Several audits conducted by multiple state auditor generals — the most recent released this week — found deficiencies with the EMS operating fund. The Department of Health is eager to work with the 13 regional councils to address these recurring audit findings and ensure that every available dollar goes toward protecting and serving the public.
“Governor Josh Shapiro’s proposed 2023-2024 budget includes critical investments that would provide assistance for EMS and fire services, including $36 million for equipment, training, and salaries to support first responders and help grow the necessary workforce to keep communities safe across Pennsylvania.
‘Patient safety and fiscal accountability in the EMS system is possible if we work together to implement the recommendations in previous audits.
“We have heard the concerns raised by regional EMS council leaders and we are committed to work with them to help improve accountability by implementing common-sense procedures to ensure that funds they receive are appropriately spent. We are currently developing education and training materials for regional council staff to provide clear guidance on any procedures to help improve their accountability.
“The Department of Health has the regulatory responsibility to protect people receiving EMS services within the Commonwealth in a consistent, reasonable, and uniform approach. While the EMS system faces serious challenges, we share the goal of improving and strengthening it for the benefit of all. We look forward to working collaboratively with the regional councils to improve the system.”
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