- Report Published -
|Review of Emergency Medical Services in Virginia|
|Joint Legislative Audit and Review Commission|
|HJR 133 (Regular Session, 2004)|
|House Joint Resolution 133 of the 2004 General Assembly called for the Joint Legislative Audit and Review Commission (JLARC) to conduct a comprehensive review of pre-hospital emergency medical services (EMS) in Virginia. The mandate directed JLARC staff to address several broad areas, such as reviewing and assessing emergency care services in Virginia, identifying emerging issues and problems in the EMS system, and considering the effect on the EMS system of issues such as health care costs, funding for emergency medical care, and third-party reimbursement.|
JLARC staff found that Virginia’s EMS system is currently in a state of transition. Training requirements for EMS staff are increasing, and in many areas of the State, EMS is moving from a free service provided by volunteers to a service that bills for the care it provides and uses paid staff to ensure the availability of a high level of emergency medical care 24 hours a day, seven days a week.
Overall, this report found that all Virginians have access to some level of emergency medical services. However, the availability of advanced life support providers, particularly paramedics (the highest skill level of EMS provider), varies substantially across the State. The time it takes for an ambulance to respond to a 911 call also varies across the State; response times are longer in some parts of the State due to factors such as terrain, population and traffic densities, and EMS agency staffing levels.
Other issues are also affecting the EMS system. For example, agencies are having difficulties recruiting and retaining providers, both volunteer and paid. Access to advanced life support training has been reduced because of new accreditation requirements. In addition, many EMS agencies do not bill patients’ health insurance for emergency medical services, forgoing a substantial revenue source.
This report makes several recommendations to address these issues, including amending the Code of Virginia to require local governments to ensure the provision of EMS, requiring EMS agencies to have response time goals, requiring new squad captains to take leadership and management training to improve recruitment and retention, improving access to advanced life support training, and encouraging agencies to bill patients’ health insurance for services. Several organization and management recommendations are also presented to help improve services.