After helping with the baby delivery and answering a few other 911 calls, Feldman turns back to a trauma center in the heart of New Orleans.
There, about half a dozen ambulances from all across the state — some who traveled from hours away — are lined up. All of them are waiting to transfer patients to the hospital so they can go back into service. It’s another reminder that this problem isn’t going away anytime soon.
To adapt to the current medical landscape, EMS agencies are looking for ways to collaborate with hospitals and partners to ease the load as best as they can. Some solutions are as simple as making sure they don’t take every patient to the same hospital, Feldman said.
EMS agencies are also working with other medical providers, too. For example, if a patient isn’t experiencing a true emergency, the ambulance could take them to an urgent care or other outpatient facility.
They’re also looking at ways they can expand their workforce. In Louisiana and other southern states, Acadian Ambulance has started offering to pay for school, training, and certification for people interested in becoming an EMT.
“We have been able to identify and remove certain barriers to entry, which include financial barriers and technological barriers to entry for people starting EMT school with us,” said Justin Back, Acadian Ambulance president.
Back says the company’s academy is one of the larger producers of EMS crew members in the nation. Acadian is also trying to recruit EMTs from other countries, like Back’s native Australia.
“We’re working on that with different elected officials in the hope that we can open up Mexico and Canada, for example, to be able to bring talent in and train them as crewmembers,” he said.
Ramotar says Global Medical Response is implementing many of these immediate solutions but also looking for long-term options by advocating for itself at the federal and state level. The hope is for policymakers to increase Medicaid and Medicare reimbursement rates for ambulatory care, for both emergency and non-emergency patient transports since reimbursement rates are below costs.
These government payers are a main source of revenue for ambulances, especially in underserved areas.
“Our costs over the past couple of years have increased because of supply chain issues, fuel, and of course the cost of recruiting and retaining a workforce,” he said, adding that higher reimbursements could help them hire and retain staff at higher salaries.
“We’ve been pleading at the federal level and at the state level since this impacts the ambulance system’s ability to get to the next patient,” he continued. “And if that patient is, in fact, in a true life and death emergency, those minutes matter.”
Feldman — who will stay on in New Orleans EMS’ reserves but has ultimately decided to leave his post with the agency to become a physician assistant after the Gulf States Newsroom’s ride along — says progress will depend on recruiting people and setting them up to thrive so they decide to stay and take those 911 calls.
This story was produced by the Gulf States Newsroom, a collaboration among Mississippi Public Broadcasting, WBHM in Alabama and WWNO and WRKF in Louisiana and NPR.
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