EMS Response Times as High as 25 Minutes in Rural Connecticut

National response time standards for EMS show that nine minutes can significantly impact patients’ chance of survival.

In Connecticut, there are large sections of rural parts of the state in the northeast and northwest corners where the response times are longer than nine minutes and in some places as high as 25 minutes.

“The research shows that there are worse outcomes for car accidents in places that have long response times,” said Ben Zura, an EMS consultant with Holdsworth Group, and an appointed member of the state’s EMS Advisory Board. Zura said he is sharing his opinion and not speaking for the board.

Several lawmakers are troubled that EMS response times are not more readily accessible, as they are published in a yearly report issued by the Office of Emergency Medical Services. But the data is two years behind.

Those lawmakers are calling for more transparency for reporting of EMS response times, advocating for a proposed bill that would require the state’s Department of Public Health to “create and maintain an EMS response time dashboard that collects and displays EMS response time data to the public broken out by geography, call type and time of day,” according to an analysis of SB 238.

The Public Health Committee passed the bill in a 23-8 vote mainly along party lines with most Republicans against the bill.

“I think what this bill is going to do is make it much easier for everybody to see what’s going on within the EMS system,” said Zura. “In every town the statewide EMS system affects all of us. And right now, it’s very hard for anyone to understand or visualize what is a massive, invisible problem.”

Opponents of the bill including several lawmakers concerned about adding another state mandate and that implementing such a system would be costly.

But proponents of the bill say that such a dashboard would enable public health officials to have a better understanding of response times so they can provide more resources to an EMS system they say is bogged down by high costs and retention issues due to the system’s  heavy reliance on volunteers. They say a better understanding could lead to better outcomes for patients.

“Fellow legislators and municipal leaders have expressed concerns about EMS planning and response times throughout the state,” said Rep. Cristin McCarthy Vahey, a Fairfield Democrat and co-chair of the state’s Public Health Committee. “We recognize this is a workforce issue as well as an access issue. While the dashboard will not immediately resolve these discrepancies, it will shine a light on the issue and inform us of next steps.

“The goal of this bill is ultimately to help improve transparency and EMS response times,” McCarthy Vahey said. “The proposed dashboard will give stakeholders a better sense of where needs exist within the system. If we can more fully assess the situation, we’ll be better equipped to address the situation.”

Sen. Saud Anwar, a South Windsor Democrat and co-chair of the Public Health Committee, said “in an emergency, time can mean the difference between life and death.

“Right now response times in our state vary depending on where someone lives,” he said. “We need transparency, not to blame anyone but to understand where help is needed so we can invest wisely and make sure every person gets timely care when it matters most.”

‘Response times continue to climb’

Zura said “a clear view of where the system is working and where it is struggling is the first step toward understanding what will be needed to fix it.

“In the absence of that clarity we have seen response times continue to climb, particularly in the state’s rural northeast and northwest corners,” he said.

Zura said Connecticut is far behind other states including New York in addressing the issue of its long response times by studying, funding and supporting EMS.

“Whereas here we haven’t even started,” he said. “This bill is going to help us see the scope of the problem and the urgency of coming together at the state level, and at the municipal level within the industry itself to actually start to fix these problems. This is a simple bill that I think could have a huge impact on making people see the scope of the problem and why we need to be doing much more to address it.”

There is no state funding for the provision of EMS and no set funding for the oversight and regulation of EMS.
The National EMS assessment found that Connecticut spent $250,000 on EMS in 2020, the latest report on the issue, far below other states.

The latest OEMS report found that urban towns had the most emergency responses and shortest average response time of “7.02 minutes” while suburban towns had an average response time of “8.03 minutes, and rural towns had the fewest calls and longest average response time of 9.74 minutes.”

But in the same measure, there is conflicting data in the report. The report shows the average response time in rural towns exceeding 9.74 minutes such as in the towns of Chester, Chaplain, Goshen, Hampton, Hartland, Kent, Killingworth, and Washington, which had an average response time over 14 minutes.

Zura said there is additional data that could better inform response times.

The response times are recorded when the ambulance is first given the call, but if there is not an ambulance available at that time, it is not being counted.

“DPH only has half of that data, and DESPP has the other half,” Zura said. “DPH’s response time data comes from the reports filed by the EMS providers who arrived on scene and treated the patient. These reports are blind to any of the parts of the response process that happened before that ambulance was assigned to the call.”

Sen. Heather Somers, a Woodbury Republican and a ranking member of the Public Health Committee, who voted in favor of the bill, said she likes the concept of the bill but that it needs  work.

“I can tell you that in some of my rural towns even though we have shared coverage, sometimes the response time is significant,” she said. “I do think that we need to get more data and more information from our municipalities to have them report to DPH, because if you’re having a heart attack the difference between a 3 minute response and a 10 minute or 15 minute response can literally be life and death.”

Some of the smaller towns may have one or two people in EMS who are paid and the rest are volunteers, Somers said.

“It’s harder and harder to get volunteers,” she said. “If that one ambulance is off on another call you have to rely on a surrounding town to answer your emergency and those towns, especially in our rural areas sometimes they’re not close, so it can take a significant amount of time.”

Peter Brown, president of the Uniformed Professional Fire Fighters Association of Connecticut, which represents under 4,000 career firefighters, also shared concerns about response times.

“A lot of our fire departments are providing the first level of care,” Brown said. “So in many cases it’s our firefighters that are on scene for extended periods of time, 15, 20, 25 minutes, waiting for an ambulance to show up. And you know, that’s time that is critical. You know they’re stabilizing the patient, making sure things don’t get any worse. But that’s the time that they’re out of service and not able to respond to any other incidents while they’re locked up on that call.”

Brown said he hopes a dashboard system would shed some light on response times and provide everyone the information so improvements can be made to the overall system.

“There’s definitely pockets of the state that do not have the same level of emergency medical protection that some of the more densely populated areas have,” he said. “I think the state needs to do everything it can to make sure that we’re giving adequate medical attention to all residents no matter where they live.”

Coventry Council Chair Lisa Thomas said EMS in general has been a big red flag for a number of years now, not because “departments aren’t doing their jobs but because there are no EMTs to hire.

“That’s why Coventry is fortunate our fire EMS department and especially Chief Bud Meyers figured out a way to move to paid staffing, which has led to us being able to get increased volunteer hours, and he established within the department a student living program,” she said.

Meyers said in an email that a dashboard “will definitely increase transparency.

“It may help to improve response times, however only if the state and EMS services use the data as a management tool rather than just a scorecard,” he said. “It also needs to make sure it is paired with other indicators that distinguish truly life-threatening rapid response from calls where the appropriate action is for the ambulance to stage until the scene is safe.”

Costs and opposition

The state Department of Public Health Commissioner Manisha Juthani said in her testimony that the Department of Public Health could not support such a bill “since the cost of developing the website is not included in the governor’s proposed budget.”

“An online dashboard with more frequent reporting would require changes in statute on the frequency of reporting that EMS providers are required to give to the department and would result in a cost to the department for the development of an interactive public-facing website,” Juthani wrote in her testimony.

Rep. Anne Dauphinais, a Danielson Republican, also was not in support of the bill.

“It’s a mandate and I’m always concerned about mandates and the burden it puts on people…,” she said. “All these things make our state more and more expensive. Every time we add a mandate that costs money for a service, it comes back to the consumer at some point.”

The Office of Fiscal Analysis reported that the dashboard would cost DPH $90,000 in fiscal year 2027 and $10,000 annually thereafter.

“This includes a one-time cost of $80,000 in FY 27 to support the work of a Data Engineering Consultant to develop the EMS data pull from the source system into the existing DPH system,” the Office of Fiscal Analysis said.

Sen. Jeff Gordon, a Woodstock Republican, also shared concerns about whether the bill would require response times be reported every month. He said he did not get an answer on whether that would be required, leading him to vote against the bill. He said he was not opposed to the dashboard but was concerned about the added responsibility to small towns with volunteer EMS.

“There’s a lot of small towns with volunteer EMS,” he said. “They are spread for time, resources and money as is.”

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