Rural EMS Issues Discussed at Illinois Summit

The issues regarding rural EMS in Illinois mirror those being seen all around the country, according to Gary Scott, Director of the McLean County Area EMS System. Scott is on the state's rural affairs council and chaired the committee that put together a rural EMS summit held in Springfield on October 8.

The biggest topics were reimbursement and funding, and then recruitment and retention of personnel.

Scott told EMS World that this meeting was the first of its kind. “We’re hopeful that it can become almost an annual event,” he says.

“It offered an opportunity for EMS providers from across the state to come together and hear these ideas and best practices,” he says. The participants also separated into break-out sessions where they compiled feedback to take back to the council, so that future goal-setting can be established.

 “With the healthcare system changing drastically, the greatest concern has been about EMS reimbursement,” Scott says.

Lt. Gov. Sheila Simon told summit attendees that they can count on rural EMS providers being among those who will be adjusting to the Affordable Care Act. According to WBGZ Radio, Simon described the ACA as “version 1.0” and said everyone involved is simply experimenting to see what “version 1.1” will look like. As for how the rural EMS community will be affected, Simon said, “When we have more people who are insured, I think we will have more people who are able to engage in (preventive) care. (There will be) less need to respond to an emergency if you’ve been able to address your health care in advance.”

Following discussions on Medicare and Medicaid, additional topics included best practices in the care of stroke patients, and utilization of 911. They’re seeing both the issues of too many people using it when they shouldn’t, and not using it when they should.

The state recently had an opportunity to evaluate the EMS system when a task force looked at EMS funding and had hearings across the state, about one and a half years ago, Scott says. The findings were written up in a report about EMS in Illinois which has since been used as a launching pad for legislative actions, determining future goals and working with the state department of health.

As a result, legislation has since been passed to ease the burden on rural EMS. This includes an alternative staffing model for communities with populations of 10,000 or less, which says they can have crews of one EMT and a responder, as opposed to two EMTs. It is also now allowable for the two to respond separately and meet at the scene.

Additional changes to assist rural systems include licensing fee waivers for EMTs serving populations of 5,000 or less, and a reduction in the number of CE hours required for all EMTs at all levels. Previously, EMTs were required to have 120 hours of approved continuing education every 4 years. Now that amount is 60 hours for EMT-Basic, 80 hours for EMT-Intermediate or Advanced and 100 hours for EMT-Paramedic.

Scott says legislation currently underway would allow another change for communities with populations of less than 7500; the plan would allow the highest level person staffing the ambulance to do an in-field upgrade of the vehicle, and it is hoped this will be in place by the end of the year.

Despite these changes, “We still have a long way to go,” Scott says.

One of the take-aways was that communities need to start looking at non-traditional service delivery models, including collaborations and partnerships with other agencies.

“I think these are going to be necessary for EMS to survive, especially in these rural areas,” Scott says.

While mobile integrated healthcare did come up at the summit, this is something that will be looked at separately and in-depth by a special committee, Scott says. Look for more on that next month on EMS World.