EMS Crisis Meeting Held at Center Brunswick Fire Company

By Ashleigh Morris

On March 19, a packed house filled the Center Brunswick Fire Department as Dr. Warren Hayashi presented a detailed analysis of the financial and operational challenges facing the EMS system in Rensselaer County. EMS billing revenue currently covers only about 50% of operational costs, meaning municipalities must fund the remaining expenses. To sustain a paramedic-level ambulance service, fair cost-sharing agreements are essential. However, leadership disagreements and the historical independence of various agencies have slowed progress toward a unified system. Additionally, the relationship between paid paramedics, EMTs, and volunteers remains a crucial factor. Volunteers have long been the backbone of EMS in the county, and it is essential to integrate them effectively into any new system to continue their vital contributions.

Financial Breakdown and Cost Analysis

The average billing revenue for EMS calls in the county is around $450 per call based on 2023 data. However, non-transport calls often generate little to no revenue, as insurance companies typically do not reimburse these services. Meanwhile, the operational cost of a single ambulance service is between $850,000 and $900,000 per year. If an ambulance handles 1,000 calls annually, it will generate about $400,000 to $450,000 in revenue, leaving a funding gap of approximately $400,000 to $500,000 per ambulance. Various funding models were considered, including distribution based on population, call volume, or total market value of properties. Dr. Hayashi determined that total market value was the most equitable method, as it aligns with existing tax structures and ensures accountability for service utilization.

Proposed Expansion and Job Creation

Dr. Hayashi outlined a plan to increase the number of active ambulances from five to thirteen. This full implementation would add approximately 50 new jobs in the county, providing a significant boost to the local workforce. Many of these positions would be filled by paramedics and EMTs currently commuting to other counties due to the lack of competitive opportunities within Rensselaer County. With a stronger EMS system, these skilled professionals could remain in the area, improving both retention and response times.

Staffing and Mutual Aid Considerations

The county currently lacks a dedicated ambulance in some areas, such as Brunswick, making mutual aid agreements difficult. Establishing regional partnerships between municipalities could improve response times and efficiency. However, another key challenge is ensuring there are enough trained paramedics to meet the growing demand. Many EMS providers in the county work second jobs at lower pay rates because they enjoy the work environment, but expanding services would require a more sustainable employment model with appropriate salaries and benefits. Dr. Hayashi emphasized that improving work conditions and offering competitive compensation would help retain local talent and build a stronger EMS system.

Cost Efficiency and Future Funding

While EMS expansion would require significant investment, consolidation and shared services could create cost efficiencies. For example, combining services would reduce the need for excess backup ambulances and gear. Dr. Hayashi estimated that some of these efficiencies could offset additional costs, though he acknowledged that expenses may still exceed projections. To fund the expansion, potential sources include municipal cost-sharing agreements, fundraising efforts, and grants such as the Local Government Efficiency Grant. Although the deadline for this grant recently passed, there is potential for future applications if the county organizes a comprehensive EMS proposal.

Next Steps and Community Involvement

Dr. Hayashi encouraged continued discussions among EMS agencies, local leaders, and community members to refine the proposed EMS models. He urged residents to stay engaged, review the financial breakdowns, and advocate for a sustainable EMS system that meets the county’s growing needs. By working together, the county can create a more effective and equitable emergency response system that benefits all residents.