During the annual fall meeting of the New York State Association of Counties (NYSAC), county officials adopted a resolution calling for Governor Hochul to sign legislation sponsored by Senator Hinchey and Assemblymember Kelles that would allow EMS agencies and ambulance networks to be reimbursed for treating patients at the scene of the incident and/or transporting them to non-emergency room-based care facilities for treatment and triage. This legislation has been a top priority for counties and is critical to ensuring EMS providers are financially stable and can properly operate and serve our state’s residents and visitors.
Under current law, EMS agencies are only reimbursed when transporting a patient to a hospital emergency room. This arrangement is not only financially challenging for EMS agencies, but it also contributes to patients being transported to healthcare settings when a hospital emergency room may not be the most appropriate setting to administer treatment. Additionally, hospital emergency rooms across the state are already beyond capacity, with extraordinary wait times for admission to a hospital bed and is often the most expensive care setting possible for the patient.
Orleans County Legislature Chairman Lynne Johnson attended the conference with Legislators Bill Eick, Ed Morgan, John Fitzak and Skip Draper, along with Chief Administrative Office Jack Welch. All are in support of this legislation.
“Orleans County is just one of many counties across the state faced with the challenge of looking for ways to supplement our volunteer EMS services, and one of the big hurdles in moving forward is how would we pay for this supplemental service,” said Chairman Johnson. “This legislation would provide a mechanism for reimbursement that is a step in answering that question.”
During the COVID pandemic, the Centers for Medicare and Medicaid Services (CMS) allowed waivers for ambulance services to be reimbursed for treatment in place (TIP) and transportation to an alternative provider (TAP), but these ended in May 2023. Data from these waivers indicates that reimbursing EMS for TIP and TAP would save the federal government around $2 billion annually, with commensurate savings at the state level.
Furthermore, allowing EMS practitioners to treat patients at their homes or the scene of the incident and receive reimbursement for delivering those services enables EMS agencies to return to action immediately—rather than waiting for a hospital to admit their patient.
Many patients dial 9-1-1 to seek emergency medical treatment when they are experiencing a mental health crisis. Allowing EMS agencies to transport a patient immediately to a behavioral healthcare facility not only expedites the patient’s mental health treatment but also relieves inpatient hospital mental health units from having to respond to every mental health incident.
Justin Niederhofer, Director of the Orleans County Emergency Services Office said, ““We thank NYSAC for bringing all the counties together to push for this legislation and we hope Governor Hochul will do the right thing and sign the bill. Our volunteer EMS personnel in Orleans County are top-notch but with dwindling numbers and increased regulations, the burden on them is overwhelming. We need to look for ways to support them and this legislation would greatly help that effort.”
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