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Congresswoman Debbie Dingell (D-MI) and Congressman Richard Hudson (R-NC), co-chairs of the Congressional EMS Caucus, introduced legislation to address critical issues facing Emergency Medical Services (EMS) professionals and patients by strengthening the EMS workforce, increasing available resources, and improving response time.

“EMS professionals are literally lifelines for our communities, and we need to do everything we can to ensure they have the resources they need to do their jobs safely, efficiently, and effectively,” Rep. Dingell said. “This legislation will take important steps to address the needs and concerns of EMS workers and the patients they treat, resulting in better response times, improved care, and a stronger workforce.”

“EMS workers are overworked, understaffed, and too often underappreciated.” Rep. Hudson said. “As co-chairs of the EMS caucus, Rep. Debbie Dingell and I are working to ensure we have all the proper information to update resources for our EMS workers. This is the first step in improving the quality and timeliness of care, medications, and processes for our EMS workers and patients. 

The bill is endorsed by the National Association of EMS Physicians (NAEMSP).

“There are many stressors on our EMS system that affect the patients treated by paramedics and EMTs. The quality and safety of care for these patients depends upon system oversight by an EMS physician, availability of essential life-saving medications, and efficient transfer of care to the emergency department. This bill is a crucial step toward strengthening EMS systems and improving outcomes for the communities they serve,” said Douglas Kupas, MD, NRP, FAEMS, president of NAEMSP.

The Modernizing EMS Delivery and Sustainability (MEDS) Act focuses on three key EMS concerns:

Value of EMS Medical Directors and Professionals

EMS is a critical component of the health care system. It is much more than a ride to the hospital—it is a system of coordinated response and EMS care, involving multiple people and agencies. Physician EMS medical directors supervise all EMS care for many towns, cities, and counties throughout the nation. Unfortunately, under the current EMS system, physician medical directors are not always adequately compensated for this work.  Further, EMS agencies are struggling to attract and retain EMS professionals, exacerbating persistent health workforce challenges seen throughout the field. The bill directs MedPAC to conduct a study on the level and type of compensation needed to attract and retain EMS physicians who oversee the highest level of quality care and EMS professionals delivering life-saving care to patients with emergency medical conditions.

Availability of EEMs, Blood, and Blood Products

Shortages of essential EMS medications (EEMs) continue to plague EMS and threaten the ability to provide patients with the emergency medical care they require. EMS agencies are experiencing shortages of everything from IV fluids to sedatives. When EEM shortages occur, medical directors must continually revise protocols based on the drugs and concentrations they are able to secure, and paramedics must quickly adjust to alternative medications and/or concentrations—greatly increasing the risk of medication errors in a fast-paced environment. While the fundamental problem with drug shortages is that the cost of EEMs is too low, the opposite is true with regard to blood and blood products which are very costly for EMS agencies to utilize even though they save lives, particularly in rural areas where transports are long. The bill establishes a CMMI demonstration program to evaluate a separate payment for EEMs in shortage as well as blood and blood products, aimed to ensure the availability of medications essential to EMS care for patients and better enable the use of blood and blood products—when minutes count for their survival.

Wall Time

“Wall time” refers to the period when EMS personnel are required to stay with a patient at the hospital until the patient is formally admitted and transferred to hospital staff. This time is often spent "against the wall" in the emergency department. Extended wall times can delay EMS units from returning to service, impacting their availability to respond to other emergencies. It can lead to resource strain and affect the overall efficiency and response times of EMS services. It also typically means significant delays in care for patients waiting to be admitted to the hospital. The bill requires HHS to reissue guidance to hospitals to address the “wall time” crisis and report to Congress on how to effectively tackle the persistent issues plaguing hospitals and EMS systems of overcrowding and patient boarding.

View the bill text here.