Senators Smith and Sanders introduce legislation to address major EMS staffing crisis


The legislation represents a significant effort to address first responder labor shortages in rural areas, Indigenous lands and communities across the country.

WASHINGTON [3.23.22] – Today, Senators Tina Smith (D-Minn.) and Bernie Sanders (I-Vt.) introduced a bill to address the major staffing crisis affecting emergency medical services (EMS) in the Minnesota and nationwide.

“Calls from emergency services and firefighters have skyrocketed during the pandemic. Yet too often these emergency services are understaffed and underfunded,” said Senator Smith. “Everyone deserves a timely and fully equipped response in times of crisis. I will continue to work to get this bill across the finish line and make sure our first responders have the resources and personnel they need to do their job.

“In too many communities across our country, ambulance and emergency medical services are not getting the federal government support they need to do their jobs,” said Senator Sanders. “It is time for that to change. Simply put, EMS and firefighters are the first responders in some of people’s toughest times and often mean the difference between life and death. We must do everything possible to ensure that they are fully staffed, equipped and able to respond to emergencies in a timely manner.

Over the past 30 years, the volume of emergency calls has triple in the United States, it has become increasingly difficult to fully staff the fire and emergency services, seriously affecting community safety. The strain of the COVID-19 pandemic has only worsened the crisis for emergency services and firefighters. Among paramedics and paramedics, turnover ranges from 20 to 30 percent per year, leading to 100 percent turnover every four years. In 2020, nearly one the third of ambulance service personnel left after less than a year.

Across the country, especially in rural and Indigenous communities, EMS services face many of the same challenges as fire departments, from high turnover to problems with recruitment and retention, equipment and expensive training. However, while fire departments have access to already underfunded federal grants, EMS agencies that are not affiliated with a fire department – approximately 60 percent from every EMS department nationwide — are largely excluded from federal funding. EMS responders working in rural areas are particularly underfunded, often relying on Medicare or Medicaid reimbursements. However, Medicare and Medicaid will not cover anything if a patient is treated locally, and often only reimburse 75 percent what it costs to transport a patient.

of Senator Smith EMS Staffing and Support Act would provide $500 million to establish a grant program within the Health Resources and Services Administration. These grants would fund EMS needs exclusively, building the capacity of departments to hire staff; recruit and retain volunteers; provide training or reimbursement for training; implement learning programs; purchase new equipment, vehicles and medical supplies; support the well-being of EMS staff; improve station facilities; establishing community paramedicine initiatives; and improve regional coordination. The legislation would also:

  • Require the Secretary of the U.S. Department of Health and Human Services (HHS) to provide Congress with a report detailing challenges, disparities, and inadequacies in ensuring federal and private reimbursement for emergency medical services, along with a recommendation action;
  • Require the Secretary of HHS to provide Congress with a report detailing challenges specific to rural EMS departments and unaffiliated EMS departments, and develop an action plan to address those challenges through grants and other administrative measures.
  • Designate 5% of the bill’s funding for tribal nations, which are particularly affected by underfunded and understaffed EMS services.

You can find a summary of the invoice here.


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