GARDENDALE, Ala. (WIAT) — A shortage in paramedics across Alabama is impacting response times and safety, according to ambulance service providers.

Currently, industry leaders estimate there is a 30% shortage in EMTs throughout the state.

In central Alabama, Regional Paramedical Services is down about 80 employees across 8 counties.
“We need to handle the emergency we have now, we are actually calling this a crisis,” said Co Owner, and Director of Operations Eric Pendley.

Pendley said RPS runs about 12 to 15 fewer ambulances than it did before COVID-19.

“We simply don’t have enough EMTs or paramedics to cover the calls that we have,” said Pendley.

As a board member of Alabama Association of Ambulance Services, Pendley said he hears from other providers across the state. He said larger and smaller services are feeling the pinch.

“We’ve had instances where we just didn’t have enough ambulances at the time of an emergency.

We’ve had a gunshot wound that had to have been taken by private vehicle to the hospital. We’ve had calls that’s took over an hour to get an ambulance to that used to take less than 20 minutes,” said Pendley.

While industry leaders are trying to address short and long term issues, fire departments like Hoover and Gardendale are trying to help by avoiding unnecessary ambulance calls that can tax first responders.

“How we’ve changed is by triaging the calls we run. Now instead of always getting a paramedic, we might get an advanced EMT truck for some of our basic calls,” said Chief Joe Thomas with Gardendale Fire Department.

Thomas said GFD works well with RPS to identify and work around any potential issues, but he said there is a real need for more paramedics.

“We want rapid transport. As soon as there’s a need identified to transport, we want that to happen as soon as possible and the more ambulances they have in service, the faster we can get the patient transported to the hospital,” said Thomas.

Reasons for the lack of available paramedics

Many EMT workers are burnt out from the pandemic and have found other positions with higher pay, Pendley said. He admits pay needs to go up and estimated the average starting salary to be around $17 in Alabama. Pendley believes that number needs to be above $20.

According to Pendley, rising insurance costs and low reimbursement rates from Medicaid make it difficult for ambulance companies to afford higher pay.

In Alabama, transport providers are reimbursed around $170 from Medicaid after transporting a Medicaid patient, Pendley said.

“We did a study in the states surrounding us, Mississippi is at $385, Georgia and Tennessee are close to $400,” Pendley said.

Pendley said said ambulance companies must respond to Medicaid calls, but can lose anywhere from $150 to $200 on each transport.

With higher Medicaid reimbursement, he believes ambulance companies will be able to use the money to pay better wages.

“We’ve got to get that reimbursement up to get these guys an attractable salary to get in this industry,” said Pendley.

There are some areas of Jefferson County where Pendley said the ambulance company could lose hundreds of thousands of dollars per year.

“There’s areas over there that have 27% Medicaid patients and then you have another 12 to 15% that is indigent care that has no insurance,” said Pendley.

There is hope that Alabama lawmakers will support putting pressure on Medicaid to increase reimbursement payments to transport providers, Pendley said.

Short term solutions

To combat current shortages, Pendley said the Alabama Association of Ambulance Services is working to offer more telemedicine options.

Leaders are meeting with the Alabama Department of Public Health in hopes of changing some state requirements in order to free up more resources, such as limiting hospital preferences.

“If you had just a general illness and you preferred to go to a hospital 40 minutes away, but that hospital 8 minutes down the road could take care of your needs, we want to be able to transport you to the closest available facility,” said Pendley.

Pendley said they are also meeting with hospital leaders to try to reduce the turnaround times for ambulances after dropping off a patient.

Telemedicine is also being explored as an option for patients to avoid calling an ambulance prematurely.

In order to help hire more people, RPS is offering training to anyone interested in a career in the medical field.

“We are putting them through all the training, paying for it. We’ve got in house instructors, so we get them the training here. We get them to get their state test and get them their certification and then we put them on a truck,” said Pendley.

For more information, you can visit the RPS website here.