After two deaths linked to ambulance shortages, lawmakers call on Justice to fund EMS

Wayne Williamson, assistant fire chief at the Kermit Volunteer Fire Department, hopes state lawmakers will address EMS funding shortfalls. (Amelia Ferrell Knisely | West Virginia Watch)

In February, on Valentine’s Day, a Wayne County teenager died after waiting for CPR and other emergency care because his local ambulance service didn’t have a crew to respond.

A little more than two weeks later, a 911 dispatcher said an ambulance wasn’t available to help a 41 -year-old mother in Mingo County who was having chest pains. She died as her mother drove her to the nearest hospital. Her teenage daughter and her husband — a local assistant fire chief — had attempted CPR.

The deaths, 26 days apart, highlight a dire problem in West Virginia, particularly in the state’s rural counties: there is an emergency medical services shortage spurred by tight county budgets, a worker shortage and more.

Wayne Williamson is a long-time volunteer firefighter in Mingo County who lives in nearby Wayne County. He has seen first-hand two communities dealing with grief and fear for the future.

“People are scared. People are worried that if they all call 911, they’re not going to get that help,” he said. “There are more than just those two instances that concern us here.”

Emergency medical service personnel sit in the House of Delegates gallery on Jan. 15, 2024. (Will Price | West Virginia Legislative Photography)

There is no permanent statewide funding for EMS, and counties are required to provide the services to the best of their financial abilities — typically relying on a combination of levies, grants and volunteers to keep the ambulances running and workers paid. The hodgepodge of funding has fallen short in many counties, and the West Virginia EMS Coalition predicted more closures without adequate state funding.

At least 18 organizations licensed by the West Virginia Office of Emergency Medical Services to provide 911 response have ceased operations since 2022, according to the WV EMS Coalition. EMS crews regularly leave their home county to fill in gaps.

The wait time for an ambulance can be 50 minutes or longer in Clay, Pendleton, Summers, McDowell and Wirt counties, according to a presentation the state health department presented to lawmakers in November.

“ You’re really playing a very risky game with people’s lives … If you had a severe emergency, could you wait 50 minutes for an ambulance? ” asked Chris Hall, executive director of the WV EMS Coalition.

“The state of West Virginia is going to have to step up and help our local governments that don’t have the funds to run the ambulance services for years and years,” said Williamson, who serves as assistant fire chief at the Kermit Volunteer Fire Department.

Some lawmakers are hopeful that Gov. Jim Justice will prioritize EMS funding in the expected special session next month.

Del. Joe Statler, R-Monongalia

Del. Joe Statler, R-Monongalia, serves on the House Committee on Fire Departments and Emergency Services.

“We’ve got to identify money to help across the state,” he said. “It’s getting worse and worse, and sooner than later people are going to have to wake up.”

House Democrats already called on Justice to prioritize funding county medical services.

“Flat budgets are a joke. We have to think about how we’re going to fund the most basic duties of government, which includes keeping people safe,” said Del. Joey Garcia, D-Marion, who serves as minority chair of the House Committee focused on emergency services.

He continued, “It would be a tragedy to think if we don’t fund the services we need … That’s something I wouldn’t want to live with on my conscience.”

A mixture of state and local funding needed

In 2023, a bill that would have provided permanent funding to EMS agencies didn’t make it to the governor’s desk as lawmakers squabbled over how they’d pay for it.

EMS workers unsuccessfully tried again this year, visiting the State Capitol in January in hopes of securing financial help. One ambulance can cost about $950,000 to operate annually.

Justice did, however, recently sign a bill creating a permanent funding source for volunteer fire departments.

The governor’s original budget included $20 million to be split between volunteer fire departments and EMS for equipment and training. It was taken out due to late-in-session budget concerns that overshadowed the second half of lawmakers’ time in Charleston.

Hall would like to see that line item come back during the special session, where lawmakers are expected to hash out remaining issues with the budget.

Del. Buck Jennings, R-Preston, a former paramedic, speaks on the House floor Aug. 8, 2023. (Perry Bennett | West Virginia Legislative Photography)

“We’re hoping that when they come back for the special session that they look at the circumstances — we have counties that can’t meet the needs of the citizens,” he said.

Because counties differ in how they fund EMS and the amount they contribute, lawmakers have cautioned that a “one size fits all” funding approach won’t work.

“You have counties that do a good job, and you have counties that do nothing,” Statler said.

Wayne County residents voted down a levy to fund emergency services in 2018. A WSAZ investigation published in January detailed how the county had inadequate EMS and relied on neighboring Cabell County for help. Another levy attempt is on the November ballot.

In Mingo County, commissioners are trying to figure out how to fund EMS. They’ve considered using opioid settlement money to pay for it; that money would be a temporary solution.

Kermit Volunteer Fire Department Chief William Preece hoped commissioners would find a permanent solution.

“ Our funding is limited, and we really struggle,” he said. “Our whole community is talking about it if they call in and they don’t have an ambulance available. It’s a bad situation, it really is.”

Hall explained that lawmakers need a plan that includes county contributions. He has proposed a grant program that would allow every county to apply for up to $125,000 in state funding for EMS and equipment. He estimated that it would take around $6.8 million in state funding to serve all 55 counties under that proposed formula.

“We’re proposing there’d be a 30% local match that either comes from the county or an EMS agency,” he explained. “We’re trying to do something that benefits everyone.”

Del. Joey Garcia, D-Marion

Garcia also proposed short-term, needs-based funding that would address urgent needs in counties while they’re attempting to raise money or get a levy on the ballot to fund EMS.

“I think the state really should be able to come in and help connect those gaps and services,” he said.

In an attempt to address the financial strain, lawmakers did pass a measure that will require private health insurance companies to ensure EMS workers are paid for services rendered even if a patient is not admitted to a hospital for care.

“They can at least put in a bill and recoup as much as they can,” Statler explained, adding that he hopes future legislation can require reimbursements from Medicaid and PEIA.

EMS staff shortages persist

Del. Buck Jennings, R-Preston, spent more than 30 years working as a paramedic before retiring a few years ago.

He’d like lawmakers to first focus on addressing EMS staffing shortages.

“We’re still losing EMS, and it’s getting worse and worse,” Jennings said.

A spokesperson for the West Virginia Department of Health declined an interview request for Jody Ratliff , director of the Office of Emergency Medical Services.

A 2022 Justice initiative to bolster the EMS workforce — funded by pandemic relief dollars —  has added hundreds of paramedics to the workforce, but shortages still persist.

EMS workers can often earn $2-3 more per hour in neighboring states.

Jenning sponsored a bill , recently signed into law by the governor, that will allow EMTs with three years of service to receive state assistance to become a paramedic. Funding for the program would come from the EMS Equipment and Training Fund if an allocation is made within the budget in the upcoming special session.

“What we’re trying to do is get a pathway for a career. EMS is not a career to grow old in unless you’re going into management,” he said.

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