Barbour County EMS Faces Challenges In Staffing And Funding

For several months, stories have circulated the community about problems with Barbour County EMS. Since being presented with the dire situation, Barbour County Commission has been diligently working in finding the solution to preserve this essential service in the county.

In presentation to the Barbour County Commission last Monday, consultants Dylan Oliveto and Patrick Clark from Scars Incorporated shed light on the current state of Barbour County Emergency Medical Services (EMS). The consultants were hired to review the EMS system and presented their findings based on raw data from 2020-2023, with the assistance of the Office of Emergency Management (OEM) and the County Commission.

The consultants began their presentation by highlighting the average call volume of the two agencies in focus, Barbour County EMS and Belington EMS. The combined average call volume was reported at 3,499, translating to an average of nine calls per day. The consultants meticulously broke down the calls by year, month, day, and even hour, revealing a detailed analysis of the service demands faced by the EMS.

Despite matching national averages in call times, the consultants pointed out a decrease in transport volume, primarily attributed to a lack of staffing. “Transport” is referred to a service where EMS transports people from local healthcare facilities (like Broaddus Hospital) to another nearby healthcare facility for further treatment (like UHC or Ruby Memorial Hospitals). They emphasized that they used base Medicare rate, which is $310.50 for loading plus $7.70 per mile, which is the cheapest rate. The consultants estimated that, based on the number of transports, the EMS should have collected $2,258,021, excluding Medicaid, and this year's projected collection should be $426,041.

To address staffing concerns, the consultants suggested a payroll cost of $1.6 million. This includes rates of $100,000 for a director, $90,000 for an assistant, a paramedic supervisor at $25/hr, paramedics at $20/hr, and EMTs at $16/hr. They recommended the employment of three paramedic supervisors, six paramedics, and 12 EMTs to ensure comprehensive coverage across the entire county. These are all recommendations based on the pay neighboring counties provide.

The consultants expressed confidence in the sustainability of the EMS with the proposed staffing levels, aligning with the nationwide trend. They also recommended renegotiating transport contracts, especially with swing bed transport, which could bring additional revenue. The contracts have not been negotiated in some time, resulting in Barbour County EMS charging less for transport than other providers. A decrease in staffing has also led to a drop in the number of transports, prompting the hospital to rely on outside agencies. Barbour County, despite being fortunate to have a hospital, heavily depends on reliable EMS services due to the hospital's limitations.

One crucial aspect highlighted by the consultants is the need for proper documentation to ensure the collection of funds. Often, untimely and not properly filed documentation results in delayed payments and even non-payments of services.

Belington EMS, facing stretched resources, and handful of Barbour County EMS staffers left and often working 16-24 hour weekend shifts, reflect the challenges in maintaining adequate staffing levels. While previous investments have ensured the availability of equipment, the nationwide problem of EMS staffing shortages persists, with 20-25 agencies closed in the state and over 300 nationally.

The National Registry test, allowing more reciprocity across state lines, has posed challenges for seasoned paramedics and EMTs. State of West Virginia has transitioned to requiring the national test, instead of state one, which has resulted in even the most seasoned paramedics having hard time retaining certifications. With fewer people being able to pass the test, the pool of qualified applicants has decreased drastically, adding another layer of complexity to a situation already complex enough.

Moreover, the consultants noted the nationwide issue of EMS personnel quitting and high numbers of suicide rates during the pandemic, as well as the difficulty in retaining qualified staff due to competitive pay rates in neighboring counties.

The County Commission is actively working to ensure access to quality EMS without burdening taxpayers with additional costs. At this time, there are consideration of merging two county EMS agencies, as well as finding ways to help Barbour County EMS remain stand-alone agency.

Barbour County EMS faces a multifaceted challenge that requires collaborative efforts from the community, the County Commission, and other stakeholders to ensure the provision of quality EMS services despite the prevailing nationwide issues.

At this point there is no one person or issue that can be pinpointed as a single cause of staff shortage, a problem not unique to Barbour County. As of now, between two county agencies, they are able to answer approximately 80 percent of the calls, although with Barbour County EMS operating only on weekends, it does increase the wait time when Belington agency has to respond to calls at the other side of the county. Additionally, with severely limited staff, Barbour County EMS is unable to provide transport services for the hospital, which furthermore decreases the income collected.

Barbour County Commission has been working on this issue since they were first presented with it several months ago, and now, after hearing the hired consultants’ presentation, they are able to better assess the situation and recommend necessary changes and the adjustments in order for the residents of the county to continue to have timely and adequate EMS services.