Times Observer photo by Josh Cotton Aaron Rhone, the state’s director of the Bureau of EMS, spoke with a group of elected officials and responders last week at Warren Area High School.

No one would argue with the assertion that the heart of the emergency medical services crisis in Warren County is primarily a decline in volunteers.

But instead of bemoaning those challenges, Aaron Rhone, the state’s director of the Bureau of EMS, brought a different message to Warren County.

He met late last week with a group of responders and municipal elected officials for a discussion at Warren Area High School.

“This is… an ‘us’ problem as a collective whole,” Rhone said. “We are a very strong volunteer state here in Pennsylvania.”

He made the argument up front that there are people in communities that can help solve the crisis but that are being turned away.

“We are very poor at creating pathways and entryways,” he said, explaining that there might be people that have finance, fundraising or event capabilities that don’t want to see blood and guts or drag hose.

“Invite them in,” he said. “Talk to them and get them engaged.”

If there was any single theme to Rhone’s presentation it was this – the importance of relationships and partnerships.

“As an elected official, what I want you ro remember is (you) provide an essential service to your community,” Rhone said. “I want our EMS agencies to come talk to you and explain what they’re doing. Not everyone knows what the cost of readiness is.”

He acknowledged that words like “merger” and “consolidation” are unpopular.

“We need to look at partnerships,” he said, “working together. If you buy in bulk the cost goes down. There’s nothing prohibiting you from working together to grow and work together in a logical way.”

He outlined how that will require a change in philosophy – “we have to look at multiple streams, ways of doing business,” arguing that EMS in the 21st century moved from a social club model to a business model.

He said the Bureaus role is to be “partners in that. Our goal is to be successful.” There are over 1,200 licensed EMS agencies in the state and Rhone said “I want everyone of them to be successful 100 percent of the time. We want to make sure that they’re working together.”

“Our system is trying to move forward,” he stressed. “That change is uncomfortable. Part of that required working to have competent, capable providers.”

To that end, there’s been a fair amount of criticism locally of the EMT licensure test. Clarendon VFD had seven students go through EMT training during the pandemic and all seven failed the test.

Rhone stressed that the problem is the education and training that’s offered, not the test.

“We recognize the process is flawed getting to that test,” he said, highlighting the lack of continuing education required for instructors and how instruction on how to break down test questions is not taught “on a regular basis.”

He noted that the pass rate – 75-77 percent – is similar to the state’s licensure test for registered nurses.

Rhone outlined another key problem that the system faces: Pennsylvania, he said, considers EMS service essential but does not fund it as essential.

He outlined a few potential solutions in that end, one of which is legislation that would permit EMS to be provided by county-wide authorities.

“The authorities model is a great idea,” he said. “It’s optional” but also an attempt to “open up the tool box and find ways to be more successful.”

He also highlighted a proposed $4 addition to vehicle registrations solely for EMS that could generate as much as $48 million.

Rhone said funding now comes into the system from fees on speeding and DUI offenses. The registration fee would “go a long way” but also raise funds in a way that doesn’t result from people’s bad behavior.

He acknowledged, though, that all funding changes won’t fund every agency at 100 percent.

“Sustainable funding does not make you whole,” he stressed. “We can make a difference. It’s just going to require some change.”

He has been in the role as director of EMS for a little over a year and has observed that the “predominant” range where EMS is losing personnel is 30-48. He said family is part of that but that another impactful factor is EMS providers going on to other healthcare careers – physician assistant, nurse, doctor.

“What’s the career ladder in EMS?” he asked, highlighting how someone can go from EMT to advanced EMT to paramedic and then maybe to a leadership position in an agency. But he was highly critical of the lack of training that goes into those leadership roles.

“You get self-trained,” he said. “We have nothing to take you from the start as a clinician to being the person in charge of the office.”

Rhone thanked both the elected officials and the EMS personnel that took the time to meet with him.

“It’s important that you’re here,” he said. “I am here to help. To help, I need to hearse what is happening in your community.

“I want Pennsylvania to be the best in the nation at providing EMS. We need to keep EMS at the forefront,” he said. “If we work together, we’re successful for everybody in the community.”