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October 04, 2015

Volunteer ambulance corps waning in Pa., N.J.

Gradual decline comes as financial pressure and training costs rise

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After generations of volunteer EMTs serving as fixtures in communities throughout the United States, the future of ambulance corps has reached a point of distress as financial uncertainty, intensive training and new alliances wipe out what remains of traditional ambulance services.

While volunteers have long donated their time and skills to rush to the aid of those in need, the crunch has become especially pronounced in Pennsylvania and New Jersey, The Philadelphia Inquirer reports.

"The entire system is just about to collapse," said Scott Phelps, professor of ambulance science at the Emergency Management Academy in New York. "There is not enough money to run the system the way it operates."

Traditionally, ambulance corps were established through local fire companies and operated on donations to train and equip staff who could handle everything from childbirths and heart attacks to car crashes, work injuries and severe burns. 

The patchwork of services has gradually become more of a challenge to keep afloat, however. 

Twenty-five mergers occurred in Pennsylvania between 2008-2014, according to the report, while New Jersey has seen 120 volunteer ambulance companies go under since the mid-1990s.

One key reason for the decline has been the growing cost of training for EMT certificates relative to the pay that these professionals receive when they look to move forward from volunteering. A 12-credit EMT certification costs $3,000 at Delaware County Community College, compared to an average annual income of $16,000-$19,000.

Paramedics, who earn between $25,000 and $33,000, pay $7,500 for a 70-credit, 6-semester associate of applied science degree. Often, those who work in these fields take second jobs, but it can become difficult for them given the unpredictability of emergencies.

Another issue is the trouble of getting insurance reimbursement on a consistent basis. Insurance companies typically direct payments to patients, bypassing those who play an essential part in resolving their crises.

As volunteer corps dissipate under the financial pressures faced by municipalities, communities risk dipping below adequate coverage. Municipalities and hospitals have worked to find alternative solutions driven by large contracts, but the model maintained by Narberth in Montgomery County could represent a time-honored way forward. 

Narberth's 71-year-old Volunteer Medical Service Corps uses a mixed staff of volunteers and employees -- 92 volunteers to 37 EMTS and paramedics -- who serve Narberth, Conshohocken and West Conshohocken. The company, which responds to more than 6,000 calls per year, also employs a small, paid administrative staff to recoup about $2 million insurance claims. The rest of their budget comes through a combination of subscription drives and additional grants.

As a company with a centralized location and a defined culture, Narberth's ambulance corps gives volunteers the opportunity to advance while operating in a manageable territory that keeps them at a sustainable scale. Volunteers are always gifted with a special, service-minded approach, but the practical dimension of ensuring their career development could be equally important to the viability of these services. 

Read more at The Philadelphia Inquirer.

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