Report: PA County Groups Key to Hurting EMS Companies

County authorities designed to coordinate Pennsylvania's emergency medical services, especially at the fiscal level, could help those agencies, a new report says.

The Patriot-News, Harrisburg, Pa.
Ambulance Ems (pby)

A report from the County Commissioners Association of Pennsylvania, drawing on input from ambulance personnel, legislators, county officials and others, suggests that a county-level municipal authority could be the key to saving EMS companies around the state.

It’s an idea that at least some in Perry County are willing to discuss while they search for better solutions for the financial dilemmas facing emergency medical services here.

“It is my belief, that with some political fortitude, a county authority for a county like Perry could be a fantastic solution for our failing system,” said Kraig Nace, operations chief of Duncannon EMS, in an email.

Nace shared the association report with the current and incoming commissioners, as well as other county emergency personnel, in that same email.

The association report goes deeper into issues affecting EMS and fire companies — such as recruiting and retention of qualified personnel. The main component, however, is a county or multi-municipality authority to coordinate EMS units, particularly in fiscal matters.

That was the first of eight priority recommendations included in the report, which built on last year’s SR 6 commission report to the legislature.

“Develop statutory authorization for county or multi-municipal authorities that would be capable of county-wide or regional EMS service delivery, including paid staffing, optimization of service deployment and service areas, and dedicated funding sources,” the report states in its first recommendation.

Some of the biggest things to be discussed would be how to finance a regional EMS authority, according to the report. Dedicated fees, taxes, subscriptions and other funding mechanisms are mentioned. The report notes that centralized fees or tax rates could reduce local taxes. It also talks about the potential to offset costs through subscriptions and recovery of out-of-area service costs.

“Viability and sustainability may be dependent on broad and uniform municipal participation, and the primary objective is to obtain broad-based, voluntary, durable agreement among municipalities and providers,” the report notes.

That cooperative spirit will be important if such a regional effort to improve emergency services is to work in Perry County or elsewhere. While it might sound workable on an idea basis, local buy-in is always going to be important.

“I think the local municipalities need to be surveyed to see in what (if any) kind of authority they would be interested in participating,” Nace said. “I would be surprised if any municipality was not interested, given financial capabilities per-municipality.”

Done correctly, a regional authority for EMS could be better staffed, more efficient and accountable, he thinks. County wide fees or taxing authority for such efforts probably wouldn’t happen right away, but it would likely be a necessity in the future, he said. More immediately, Perry County communities could focus on central coordination and grant writing.

“As we saw with the radio system grant that Blain got for the county, the state and federal governments like collaboration, and it’s clear that our chances with grants are much better when multiple regions and agencies benefit,” Nace said.

In 2016 and 2017, the county was upgrading its emergency radio system and other communications infrastructure. Blain’s firefighters led the way seeking grant money to pay for the local radio upgrades at fire companies.

Multiple EMS companies including Duncannon, Landisburg, New Bloomfield and others have discussed financing options. Many have limited budgets.

“I believe EMS companies and municipalities should work together with a common goal of providing emergency medical care to the residents in our care. This should be the first step,” said Jeremy Fox, chief of Landisburg EMS.

Spring and Tyrone townships have committed to helping the EMS company with financial support, but its namesake borough has not, he said. That’s in part because of the limited fiscal budget the borough has. But if there’s going to robust emergency services across the county, something may need to change, he said.

“The long term solutions require us to build more efficient business practices,” Fox said. “This could include funding at a county level, centralize financial issues across the county, merging equipment, funds, etc., allowing companies to lower overhead and operating costs.”

The commissioners-elect, Brian Allen, Gary Eby and Brenda Watson, have said county discussions about emergency services would be a priority for them.

“That report has some strong points and ideas that may or may not work in this county,” Eby said, noting he wasn’t speaking for the others. “One thing that I am not excited about is creating a funding source without having other areas already in place fixed.”

State and federal legislators should fix how insurers pay claims for EMS, as well as payment levels from Medicare and Medicaid before counties ask residents to pay more in taxes, he said. Even if there was a county tax, he would want the money dedicated to EMS operations, not administration.

CCAP’s EMS Task Force report can be found under the “resources and reports” link of the Government Relations tab on the association’s website,


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