An editorial in The Daily Republic titled OUR VIEW: Rural EMT Crews Need More Help reports that South Dakota legislation to lower ambulance staffing standards is making it’s way through state government. From the editorial:
South Dakota’s senators voted unanimously on Tuesday to soften the state’s standards for ambulance crews because of shortages of emergency responders in many rural areas.
The proposed bill, which now heads to the House of Representatives, allows crews to be operated with an EMT and a trained driver, rather than two EMTs, which is the current requirement.
The proposed legislation will repeal South Dakota Administrative Rule Article 44:05:03:06.02 that requires both the driver and attendant be certified Emergency Medical Technicians. This move is very similar to the state of Wisconsin’s lowering of ambulance staffing standards last year. Governor Walker signed the legislation in November of 2015 after being petitioned by the EMS Taskforce of Northern Wisconsin.
Unlike Wisconsin, South Dakota allows agencies to file for a Hardship Exemption as outlined in South Dakota Administrative Rule Article 44:05:02:03. Reportedly according to Senator Corey Brown (R-Gettysburg) there are 33 out of 120 agencies currently under the exemption, but in the politician’s opinion there should be dozens more.
However, it appears the real issue reveals itself yet once again a little further down in the editorial. Here is the revealing snippet with my own added emphasis:
And while many crews as a whole are struggling, the workload is taking a toll every day on individual EMTs, many of whom work long hours on a volunteer basis and only get paid when they respond to a medical call.
That’s another reason this legislation should pass: We believe it will entice more people to help ambulance crews by becoming a trained driver and, in turn, give more support to the overworked EMTs.
I believe that the true issue in South Dakota has been identified.
MY VIEW: Pay Your EMTs
Whenever I hear about the lowering of ambulance staffing standards it makes me question the true motive behind it. Similar to the response I gave on the issue in Wisconsin to one of the members of the EMS Taskforce of Northern Wisconsin, I believe the issue in South Dakota has more to do with there not being an incentive to be an EMT or Paramedic in the state. In this case, the incentive I am referring to is financially. A simple fix, although perhaps not financially viable to the agencies, is to simply pay their EMTs for the hours they work. According to the emphasized part of the editorial, this does not seem to be the case. The editorial refers to the proposal as a “no-brainer”, but to me paying people to provide a service that you supposedly want is the no-brainer. I’m not even getting into how much to pay them, but rather just pay them.
What I think is even is worse is the absolute horrible spin the editorial puts on about how bringing people in who are not trained is actually helping the EMTs. In actuality, the EMTs will need to be doing more work. They will be the ones who will now have to solely inspect their equipment, clean their vehicle, attend to the patient, provide potentially life extending interventions (including CPR), do the paperwork for reimbursement, AND oversee their drivers who apparently will only be qualified to operate the vehicle. If they were truly interested in helping the EMTs they would find ways to get more qualified assistance (perhaps in the form of other EMTs) rather than unqualified individuals.
Considering there is already a process to get an exemption from the rule, and it doesn’t seem too hard if over 1/3 of the agencies were able to do it, the reasoning behind the permanent downgrade is mystifying to say the least. I hope lawmakers realize the importance of having a standard. If they were truly interested in helping EMTs, then they would find a way to incentivize people to pursue the career rather than simply lowering the standard that honestly is not set all that high to begin with.
My expectation is this will result in morale plummeting, EMT retention decreasing, an increase in Quality Assurance issues (assuming they haven’t done away with Quality Assurance too), and South Dakota finding themselves in a worse situation than they are now.