AREA — As the nation continues to slowly recover from the aftereffects of the Covid-19 pandemic, Emergency Medical Service (EMS) providers are struggling to find the right way forward amid growing staff shortages and mounting financial challenges.
“If you talk to anyone in the medical community, they’ll tell you that EMS squads are in crisis in almost every municipality in New Jersey,” said Laurie Sheldon, a trustee and former president of the Clark Volunteer Emergency Squad. “We lost a lot of medical professionals to burnout during the pandemic and we still haven’t been able to fully bounce back.”
Volunteer EMS squads like those found in Clark and Westfield have been struggling with retention issues and increased service costs for decades, said Jonathan Delano, president of the Westfield Volunteer Rescue Squad, but not to the same extent that they are now.
“Times are tough for all volunteer rescue squads and volunteer fire departments,” Mr. Delano said. “It takes a really big commitment, timewise, to become a volunteer Emergency Medical Technician (EMT), and these days, not many people are willing and/or able to do that. Combine that with an aging population and a lack of people pursuing EMS as a career, and you’ll start to understand a big part of the problem.”
According to recent statistics provided by the New Jersey Department of Health, the state only has about 70 percent of the certified paramedics and EMTs that it should. The shortage has led to longer response times throughout the state — on average, it now takes about 16 minutes for an ambulance to reach someone who has called for help.
New Jersey also is one of 37 states that does not classify EMS as an essential service, which means that local governments are not required to fund their municipal squads in the same way that they are expected to support fire and police departments.
“I think one of our biggest challenges right now is that people assume that EMS squads are paid for through taxes, but that is not now, nor has that ever been the case,” Ms. Sheldon said. “We rely almost exclusively on community support. Lately, though, it seems like everywhere you look, someone — a sports team, a school club, a non-profit organization, a community club, you name it — has their hand out looking for a donation. There just isn’t as much to go around as there used to be.”
According to recent statistics gathered by the American Ambulance Association (AAA), paid departments, like the one run by Union County, are not fairing much better.
A survey released by the AAA earlier this year revealed that turnover rates among full-time paid EMTs and paramedics across the country rose to between 20 and 36 percent in 2022, a 6-percent increase over the previous year.
“In keeping with prior years surveys, the primary reasons cited for turnover across all positions within EMS agencies is low pay and benefits, followed by a change in career. While many agencies offered stipends and increased wages in an effort to incentivize employees, it has not flattened the turnover curve,” the AAA stated in its report.
The AAA report goes on to note that part-time openings for both EMTs and paramedics skyrocketed by about 55 percent in 2022, “suggesting that those who previously worked EMS as a second job no longer find it an attractive part-time career choice.”
According to information provided by the Bureau of Labor Statistics, the average full-time paid EMT in New Jersey earns between $36,380 and $46,040. Paramedics, whose certifications require more education and training, earn slightly more on average, but still top out at around $52,971.
“A lot of our paramedics are leaving the field to work in nursing because the salaries are better and there are more opportunities for growth,” Ms. Sheldon said. “The cost of living in this state is very high, and the salary ranges for these positions are just not cutting it anymore.”
The Clark squad, like many others across the state, has recently shifted from its long-standing all-volunteer program to a hybrid model that relies on paid EMTs to handle daytime calls. The squad also has had to start billing for its services in order to keep up with rising costs.
“I have been a member of this squad for 40 years, and we have never had to charge anyone anything until now,” Ms. Sheldon said. “But here we are.”
Although municipal EMS squads are not financed through state mandate in the same way that police and fire departments are, individual communities do have the ability to make financial contributions to their squads in other ways.
In Clark, for example, the township donates about $75,000 to the squad each year to help pay the salaries of the daytime EMTs and offset other expenses. Going forward, Ms. Sheldon said, that annual gift also will be used to make sure that residents will not be required to pay any out-of-pocket expenses under the new billing model.
“We’re very lucky to have the support of our community,” Ms. Sheldon said. “Not every squad is that fortunate.” Other local communities, including Scotch Plains and Cranford, also have been forced to search out creative solutions to their growing medical- response challenges in recent years by shifting some of the EMS responsibilities to their fire or police departments.
Earlier this year, the Scotch Plains Fire Department was granted permission to buy a new ambulance to help fill in some of the community’s coverage gaps.
According to information provided by Skip Paal, the Scotch Plains deputy fire chief, the new service is designed to be budget-neutral and self-sufficient. The service will not require taxpayer funding since the additional payroll costs will be covered by health-insurance companies. The program will be staffed by part-time firefighters and EMTs from within and outside Scotch Plains.
“When our volunteer Rescue Squad is available to answer a call, they will respond and answer the call. If they’re not available, because maybe they’re on another call or a second call comes into town, our fire department ambulance will be there to serve as a backup, ensuring that our residents get a timely response and proper care,” Deputy Chief Paal said, speaking at a regular meeting of the mayor and council back in March.
And while some all-volunteer squads like Westfield are still managing to stay afloat, changing demographics, new residential construction projects and other community demands could still pose challenges down the line.
“Like other towns, things are changing in Westfield,” Mr. Delano said. “The population is aging and expected to increase in the coming years with the proposed residential developments in town. This will put increased pressure on EMS, both paid and volunteer, to handle an expected increase of 911 medical calls.”
For the time being, however, Mr. Delano said, “the Westfield Volunteer Rescue Squad will be doing its best to continue to provide 911 ambulance service to the town of Westfield, at no cost to the town or patient.”
At the moment, every volunteer EMS squad in Union County is looking for donations, members and support. These organizations can be contacted directly through their individual social-media pages or through municipal directories.