Penn. disbanding an EMS service in line with national trend

By Sarah M. Wojcik
The Morning Call

BATH, Penn. — Facing mounting financial losses and a burned-out volunteer staff, Bath is prepared to end its EMS service for good.

Instead, the borough's roughly 2,700 residents will be served by Bethlehem Township EMS, an agency that's no stranger to the borough, having served as the advanced life support service for more than 35 years.

"All the way around, no matter how you look at it, this was better for residents," Bath fire Chief Emilio DeNisi said. "But it was very hard to let go because there were members in the organization who'd been there for 30, 40 years."

A resolution to make the transfer official is still in the works, but the plan is to switch to Bethlehem Township services starting in October. The township EMS will work out a leasing agreement with the borough to operate out of the Bath Firefighters and Ambulance Corps' facility on Center Street, according to Borough Manager Brad Flynn.

Bath Firefighters is a purely volunteer organization made up of about 35 members, according to DeNisi. Of those members, only about seven are trained emergency medical technicians, he said. The department, DeNisi said, only had the capabilities to provide basic life support services and was so small that a half-dozen staffers were working five days a week from 6 p.m. to midnight covering calls.

This put them in the untenable position of having too many calls for the staff available, but not enough to bring in the money needed to keep up with equipment and training, the chief said. He estimates that the fire department has had $125,000 in losses over the past four years and roughly $100,000 of that can be tied to EMS.

"You can't work with that," Flynn said. "That's a losing composition. If it's not working, then it can't stick around. No one wants to see a tax increase."

Flynn said the borough asked DeNisi, who is relatively new to the post, to take a hard look at the borough's EMS and decide how to move forward. DeNisi said after six months of review, he determined the department simply could not support the service any longer.

It's a tale that rings familiar not just in Pennsylvania, but all over the country, according to Heather Sharar, executive director for the Ambulance Association of Pennsylvania.

Emergency medical agencies, especially those in smaller municipalities, are having a difficult time staying afloat in an era that requires serious training and high-tech equipment, but offers very little in terms of dependable income, she said.

"Basically, they need a mobile ER, but no one wants to pay for it," Sharar said.

Medicaid reimburses EMS companies hundreds, if not thousands, of dollars below the cost of the services, according to Sharar. A typical BLS call is reimbursed at $120 and an ALS call at $200, she said.

Medicare also falls below the threshold, though not as dramatically. Commercial insurers — when they do pay — pay better than the two publicly funded coverage plans. An EMS agency has limited resources to collect bills, she said, but state legislation passed in December could help make that easier when it comes to commercial insurers.

"There's hopefully going to be some relief with that," Sharar said. "But that's not a cure-all. Right now, we're trying to work all the angles."

The reality is harsh, however. Sharar said EMS faces a different world than it did decades ago when the local, small provider was the norm. Acknowledging that truth doesn't lessen the sting, however.

"You have people who are very passionate and dedicated to what they do. They are caregivers," Sharar said. "They feel like a part of the community and I'm sure it can feel like a failure on their part. It's sad."

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