A recent report by state Comptroller Tom DiNapoli confirmed what local fire and ambulance departments already knew: It’s becoming increasingly more difficult to recruit and retain EMS workers to serve their communities on a volunteer basis.
“EMS agencies and other stakeholders certainly see staffing as a major obstacle to providing adequate services,” DiNapoli reported. “Frequently cited staffing issues include declining volunteerism, difficulties recruiting qualified staff, and low pay for EMS staff compared to other occupations in health care and public safety.”
DiNapoli referred to a New York State Emergency Medical Services Council study, which found that 52% of agencies relying on volunteers said their ability to respond in a timely manner was moderately or severely impaired by shortages in certified volunteer staff. Nearly 30% indicated that they frequently delayed responses or missed calls due to the shortage.
Forty percent of agencies relying on volunteers reported that their staffs decreased by 11% or more over the previous three years, and for 16% of agencies, the decline was greater than 25%, DiNapoli said.
“Comptroller DiNapoli's report provides important data that highlights the accelerating deterioration of the EMS safety net in New York State,” noted South Country Ambulance Chief Gregory Miglino, Jr. “He points out that ‘Reliable ambulance services are a public health imperative’—we couldn't agree more.”
Miglino continued: “The Comptroller does a great job identifying that EMS is in crisis mode right now and mentioned some causes and remedies needed. What is not mentioned is that at a time when things are the worst they have been in decades, state agencies are passing regulations that will make it worse and endanger lives while driving up costs.
Recently, the State Emergency Medical System Committee voted to eliminate an entire Advanced Life Support credentialed position that has been providing EMS services for over 45 years, according to the ambulance chief. “This despite, as the report points out, New York having lost 3,510 (31%) of its ALS Providers since 2019.”
Assemblyman Joseph DeStefano, a Medford Fire Department Commissioner who’s been in the volunteer service for more than 40 years, noted another Albany mandate being considered that will severely impact the ability of local departments to recruit and retain volunteers. According to DeStefano, the state Department of Labor is looking to almost double the hours needed for a volunteer to become a trained firefighter. “If they get away with doing this, volunteer departments will go extinct with costs for paid responders going up about almost $5 billion,” said the assemblyman, who vowed to fight against the mandate.
“Most communities take for granted that when they press 911, an ambulance will show up,” Miglino continued. “If corrective action isn't taken in the next year or two, it may be a reality that you press 911, and there is nobody to respond.”
Miglino says the state should identify EMS as an “essential service,” which would make it easier for EMS agencies and communities to sustain ambulance coverage.
“Lawmakers on Long Island and in Albany need to meet with actual industry leaders in EMS and fire services to develop a workable plan that addresses problems while keeping costs in check. Right now, we are on course to lose services and increase costs by billions of dollars statewide. I don't believe anyone wants that,” Miglino concluded.
One initiative that would help departments keep volunteers is reimbursement of college costs, pointed out Bill Theis, chairman of the Long Island Firefighters Legislative Committee. Using a sliding scale depending on their grades, the federally-funded program helps pay tuition for schools in Suffolk or Nassau counties. The state Association of Firefighters, under the direction of David Dennison, is also lobbying Albany to not put training requirements out of the reach of the average volunteer.
“In many cases, declines in volunteers lead to lack of service availability, which drives local governments to look to paid providers to meet their service needs,” DiNapoli’s report stated. “Yet even agencies using paid responders exclusively report staffing shortages. In the survey just cited, 62% of agencies using only paid responders reported that insufficient qualified paramedics diminished their ability to cover their calls and shifts, and 38% reported that a shortage of qualified EMTs diminished their ability to cover calls.”