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NAEMT President Evans Provides Written Testimony to FY2022 Appropriations re: SIREN Funding

May 13, 2021

Bruce Evans – National Association of Emergency Medical Technicians (NAEMT)

Written Testimony For the Record – FY2022 Appropriations

House Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies

Thank you, Chairwoman DeLauro, Ranking Member Cole, and distinguished members of the Subcommittee. My name is Bruce Evans, and I am the President of the National Association of Emergency Medical Technicians (NAEMT). I am also a fire chief leading a fire-based EMS organization in a super rural area of Southwest Colorado--12,000 residents in 264 square miles.

Founded in 1975 and over 70,000 members strong, NAEMT represents our nation’s frontline EMS practitioners, who provide critical, lifesaving services to communities nationwide, especially in rural, frontier, and other hard-to-reach areas. On behalf of our organization, thank you for your ongoing support of EMS professionals. NAEMT would like to offer our views on the Subcommittee’s FY 2022 bill. At the outset, we write to ask the subcommittee to provide robust funding for the SIREN Rural EMS Equipment and Training Assistance (REMSTEA) program within the Department of Health and Human Services’ (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA) Fiscal Year (FY) 2022 Labor, Health and Human Services, Education, and Related Agencies (LHHS) Appropriations.

This written testimony coincides with an important week for our membership and profession: the 46th Annual EMS Week is May 16 – May 22. The goal of EMS Week is to thank paramedics, EMTs, and the entire EMS workforce for their services and sacrifices. However, EMS professionals do not just want a pat on the back – I, like the rest of our members, am writing to continue to raise public awareness about the critical funding shortfall of EMS in the communities we serve. This urgent request aligns with the spirit of EMS Week.

Passed in the 2018 Farm Bill, the SIREN/REMSTEA grant program supports rural public and nonprofit EMS agencies in their efforts to complete their mandate to provide critical emergency medical care to all of the residents in the communities they serve. The grants help rural EMS agencies train and retain staff and purchase equipment, among filling other needs. Community demands keep growing: each year, fire departments and EMS agencies respond to more than 20 million calls for emergency services. While the COVID-19 pandemic exacerbated the plight of these agencies, EMS practitioners and agencies were facing severe challenges before the virus’ outbreak. This can be attributed, in part, to greater distances between health care facilities and low reimbursement rates. The most pressing impact is the decline of available medical care in rural communities, which has heightened the need for already-stretched EMS agencies to perform these lifesaving services. Again, this foreboding and bleak landscape existed even before the onset of the pandemic, which has strained the social safety net that EMS professionals provide.

COVID-19 made an already growing problem much worse. In FY2020 and FY2021, your Committee provided $5 million and $5.5 million for SIREN grants, respectively. However, the program requires a substantial increase in funds to make sure our personnel have the equipment and training they need. Social distancing and “stay-at-home” protocols because of the pandemic complicated income streams for these agencies. Many rural EMS agencies rely heavily on community fundraising efforts, such as bingo, raffles, and community barbeques. At the same time, support from localities whose tax revenue base has dramatically declined, further hindering EMS agencies’ ability to fill their coffers. Beyond smaller revenue streams, costs have gone up, especially as EMS agencies have been paying higher prices for personal protection equipment (PPE) throughout the pandemic.

 Rural EMS organizations, like mine in Colorado, have disproportionately suffered from shrinking revenue streams and increased demand before the pandemic and now, especially as it relates to synthetic opioid overdoses, which have skyrocketed and do not seem to be slowing down. Ambulance crews that support the most far-flung areas of our country are running out of money and personnel. Because of the especially demanding work that rural EMS organizations shoulder, they are struggling to stay afloat at a much higher rate than their more urban counterparts. This challenge is not limited to one region of the country; rather, rural EMS organizations across the board are more likely to shut their doors, leaving their residents without reliable access to local ambulance service. Ultimately, without the support this grant program provides, many more local EMS operations will likely have to close their doors.   

The result is, unfortunately, predictable: increasing workforce shortages as EMS personnel become increasingly burnt out, face shrinking compensation, and are constantly exposed to unpredictable and dangerous environments.  In short, more money is needed to bring more people aboard to ensure that our professionals are provided a safe, healthy, and respectful work environment, and that their EMS agency can effectively serve their communities. The enhanced funding for the SIREN/REMSTEA program will go to good use, especially as our country and economy recover from the economic and health care crisis brought on by the pandemic.

Beyond the demonstrated need, EMS personnel made good use of the funds allocated under the FY2020 and FY2021 spending bills. For FY2020, SAMHSA awarded REMSTEA grants ranging from $92,000 to $200,000 to approximately 27 EMS agencies across the country for recruitment and training purposes. In December 2020, SAMHSA announced the potential to grant awards to another 27 rural EMS applicants. Rural EMS agencies are in dire need for additional support – we can assure you that our organization’s members will not leave money allocated by Congress on the table.

On behalf of our 70,000 members who live and work in hundreds of Congressional districts across our country, thank you again for supporting our brave men and women who provide important roles in the health care ecosystem. SIREN/REMSTEA grants will certainly help them do their jobs to their fullest ability.