News10NBC Investigates: Some counties moving to countywide EMS system

ROCHESTER, N.Y. The EMS crisis continues across our community and has forced some of our counties to take things into their own hands.

News10NBC has been investigating the state of the EMS system in Monroe County. Between staffing shortages and Medicaid and Medicare reimbursement rates, a number of ambulance agencies are concerned about how long they can stay afloat.

“We are in a situation where there’s not that light at the end of the tunnel,” says Mike Hoskins, the chief of Perinton Ambulance and a member of the Monroe County EMS Chiefs Association. “We’re losing money for every Medicare and Medicaid patient that we care for and that accounts for about 60-70% of all of our patients.”

The ambulance agencies still operating in Wayne County are a combination of paid and volunteer. They have been struggling to cover for the agencies that have closed over the past several years.

“There were response time issues where it was taking an inordinate amount of time for ambulances to respond,” says Wayne County Administrator Rick House.

So, come July 1, Wayne County will start its own ambulance service. It’s taking over the current Lyons Ambulance and building two new stations, one on each side of the county. It has already purchased two used ambulances and has two new ones on order. When all is said and done, House expects to have a staff of 50.

“We’re using a little over a million dollars of ARPA money, federal money to augment this,” House explains. “The rest will be solely on taxpayers through our general fund balance. Our initial start-up, we’re looking at … could be up to $15 million.”

When asked why he thinks that is a crucial investment, House said, “Because you can’t put a price tag on human lives and we definitely have an issue here.”

The EMTs and paramedics that Wayne County will hire will be civil servants who are eligible for a state pension. House says his intention isn’t to poach from the ambulance companies still operating in Wayne County or force them to close but to cover the more remote areas that are currently underserved and be available when the smaller agencies are tied up.

Livingston County began a countywide ambulance service a few years ago that covers for towns that don’t have service and backs up local fire departments. The Erie County executive also announced plans to set up a county-run EMS system to fill the gaps left by ambulance companies that have closed in the more remote areas of his county over the last several years.

Jennifer Lewke: Would a countywide system work in Monroe County?

Mike Hoskins: It’s not really for me to say. Right now, my focus is on the Perinton and Fairport community, but we do know that some studies suggest there could be efficiency and economies of scale by having a larger service area where you can more efficiently put your resources.

Monroe County Executive Adam Bello tells News10NBC he is well aware of issues that local EMS agencies have been facing.

Jennifer Lewke: Is a countywide system something you’re looking at?

Adam Bello: Monroe County taking over and creating its own thing isn’t going to solve that staffing issue. The issue isn’t how many providers we have. The issue is how much staff do those providers have to be able to meet the needs of the community.

Jennifer Lewke: In Wayne County, they’re able to pay a higher rate for those employees and they’re able to offer them a pension and that seems to be drawing people in, so there could be some benefits to a countywide system. It’s just not on the table right now?

Adam Bello: No, not here in Monroe County, no.

Bello says for the time being, the county is using about $6 million in federal funding to provide grants to local EMS agencies to help them with recruiting, retention and equipment. At the same time, he says, he’ll be lobbying state and federal lawmakers to up reimbursement rates for ambulance transports.