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Chip Curry, D-Belfast, represents District 11 in the Maine Senate.
Imagine a loved one has suffered a serious medical event, possibly a heart attack, a stroke or trauma from a car accident, so you call 911 for help. What happens next really depends on where you live. Most people assume that when they call 911, all the advanced emergency medical care that we see on TV dramas will be there within minutes.
However, in rural communities this assumption is increasingly false. Emergency dispatchers will call the closest service, then wait. If they are on a call already or can’t staff that shift, they call the next closest service — and then the next and the next. All the while, minutes are slipping away, and the distance the responding ambulance must travel is growing.
In too many rural communities across Maine, this part of our public safety net is fraying. It’s being held together by dedicated local EMS leaders who are being pushed to the brink and need our support. To make our EMS system sustainable, the state of Maine and municipal governments need to come together.
Underfunded, understaffed and stuck in a fractured health care system, emergency medical services have felt the crunch for years. As of 2021, of the 272 EMS departments in Maine, less than 70 are paid and staffed full-time. The remaining 202 are a mix or entirely volunteer. Part of the problem is that the work is incredibly hard. Shifts can be a full consecutive 24 hours. Responsibilities range from being the first on the scene to a horrific car accident to reviving a patient overdosing.
Another part of the problem is that the pay hovers near minimum wage. Workers in one locale could choose between making $17.50 an hour in EMS or making the same wage down the road at Walmart. According to Maine EMS, Maine has lost nearly 1,500 EMTs and paramedics between 2013 and 2021 — nearly a quarter of the workforce. All while the average number of calls each year continues to rise, with over 22,000 in 2021. Growing the workforce is a major step in the right direction to uplift our emergency medical services.
Far too often, these decisions must be made under duress when a volunteer ambulance service unexpectedly closes or when a town must increase its EMS contribution to maintain services.
It’s beyond time for the Legislature to step up. That’s why I introduced legislation to help our rural communities strategically plan for the sustainability of our EMS. My bill, LD 1859, An Act To Build More Sustainable Ambulance Services in Communities, lets towns and local EMS agencies apply for grant funding to undergo a strategic planning process to identify their strengths, weaknesses and challenges for long-term viability. I’m proud to share that the Criminal Justice and Public Safety Committee passed my bill with unanimous, bipartisan support. It now faces votes in the Senate and the House.
The facilitators of this process, who are leaders in Maine’s rural emergency medical service community, share this information in multiple public forums to help town leaders and residents know what they have when it comes to EMS, what alternatives exist for strengthening their services and how much it costs. This planning process, known as Informed Community Self-Determination, or ICSD, has been applied in Franklin County, St. George, Jackman and the Camden area already. My bill will allow more towns or regions to engage in long-term sustainability planning. I’m proud to work on this issue and to support our frontline workers.
The COVID-19 pandemic has only underscored the ways our health care system is suffering; however, our rural emergency medical services have been overlooked for decades. Back in the 1980s, the federal government eliminated all dedicated funds for EMS systems in favor of block grants that were not earmarked for EMS. Across the U.S., a rift grew between rural and urban EMS because larger communities have the call volume, and therefore more reimbursements to support full-time staff coverage. In contrast, rural communities that historically relied heavily on volunteers, have seen a significant drop off in new volunteers and fewer who could fit the requirements of training and long shifts into their busy lives. Overcoming these challenges is possible, and we need to face them.
When we call for an ambulance, we should be able to trust that there will be a speedy response from highly trained team of EMS practitioners, who have the equipment they need and are prepared to provide emergency care and transport to nearest ER. This should be a guaranteed standard for Mainers no matter wherever you live — today, tomorrow and decades down the line.