Maine EMS, and the nation in general, is experiencing a critical EMS provider shortage that is impacting our ability to respond to emergency calls and provide transfer service for the hospitals. We can no longer afford to wait for the situation to resolve itself, and we need to reach out to our representatives and Governor to encourage their help in formulating a definitive plan to address this crisis. We cannot do this ourselves, and we need help from both our state and federal representatives.
How did we get here?
While there may be those that blame the vaccine mandate, the public safety workforce problem has been developing for many years.
- Increasing training and recertification requirements, along with an increase in CDC, OSHA, and Maine EMS regulations, have made it increasingly difficult to be an EMS provider. While medical education and safety regulations are important, these changes have been implemented with little or no support for the providers and organizations to implement the changes.
- Medicare and MaineCare represent the majority of the payments (70%+) to ambulance services in the State of Maine. While we realized an increase in MaineCare in 2020, the Medicare/MaineCare payments are still below what it costs to actually deliver services, and DHHS is holding off implementing the Medicare add-ons until April 2022. The Federal Government is in the process of conducting a cost assessment, but that survey won’t be done until at least the end of 2025, with additional time necessary to evaluate the data and propose an updated reimbursement plan, probably 2026. We are in trouble now.
- Pay for EMS providers (for those organizations that can afford to even pay their providers) is historically low, with EMT’s making around minimum wage and paramedics starting in the high teens, low 20’s. Most EMS providers work multiple jobs to be able to support their families. We can’t pay more because reimbursement is so low and the organizations/municipalities can’t afford to subsidize and increase in pay.
- Many communities in Maine rely on volunteers to provide EMS in their area, and would not be able to support a full-time paid service. The volunteers give freely of their time, and many pay for their own education, equipment, and uniforms, with little incentives other than to be of service to their residents.
- Because of the staffing shortages we are experiencing:
- Many EMS providers are routinely working 80 – 100 hours per week, many times 48 – 72 hours consecutively.
- EMS services are regularly not able to staff the number of ambulances that they normally put in service, or are staffing a lower license level than normal.
- Hospitals in Maine facing tremendous difficulty find ambulances to transport their patients, which backs up their ED’s and doesn’t allow them to put new patients in beds. Hospitals are losing receiving beds because they can’t find an ambulance for transport in a timely fashion. Regularly, we have services traveling 2+ hours to pick up a patient because they were the only ambulance available.
- A recent motor vehicle accident in Maine with 5 patients injured and the closest mutual aid service that had a crew to respond was 1 hour away.
What do we need?
Our current EMS staff are reaching their breaking point. We need help from the State of Maine to immediately develop and implement a plan to address this critical shortfall. Some potential ideas to consider:
- Commit to a comprehensive media recruitment and retention campaign for public safety which will include EMS, Fire, Police, Corrections, and Dispatch.
- Convene a Legislative Blue-Ribbon commission to study the delivery of EMS in the State of Maine and make recommendations to improve the system.
- Explore immediate ways to increase reimbursement for EMS. We cannot wait until 2026.
- Provide funding to the Community Colleges so they can offer free EMS programs for at least the next 10 years.
- Implement an apprentice program to pay participants in EMS classes a wage while taking class, and reimburse EMS organizations for cost to mentor new employees.
- Explore incentive programs for active Public Safety providers (property taxes, payroll taxes, LOSAP, etc.)
- Offer anyone working in public safety and members of their immediate family 1-yearfree tuition at a state college for every 5 years worked in public safety.
- Allow public safety personnel access to participation in the state retirement system and state health insurance.
- Establish that Public Safety Personnel are eligible for low-interest loans.
What can we do?
We need to get the word out about this crisis right now! We desperately need you to reach out (calls and emails/letters) to the Governor’s office and your local representatives. Look this document over and use the talking points to make your case. But, make sure you also relate how this shortage is affecting your service, their constituents. If you have additional suggestions on what the state could do to help, please add it to your communication and let us know so we can add it to our requests. Here is the link to the listing of Maine
House of Representatives: