EMS Challenges


This is not intended to be an exhaustive list or analysis of the challenges faced by EMS organizations, but instead an overview or starting point.

Unsteady Funding Sources

West Virginia does not have a dedicated, permanent funding source for EMS at the state level. The result has been mixed, often unsteady excess levies, ambulance fees, and other financial support out of (some) county budgets.

Insurance Reimbursement

Medicare and Medicaid patients make up the largest share of ambulance transports. But the government reimburses EMS organizations at a rate below their cost of providing service. Additionally, some calls for service are non-billable, resulting in an additional financial burden on EMS organizations.

Declining Volunteer Participation

Volunteer EMS personnel save lives, but also provide millions of dollars in unpaid labor each year. This is known as the “volunteer subsidy.” As volunteer participation slips, EMS organizations are faced with closure or navigating the cost of paying personnel.

Rural Coverage Areas

West Virginia’s roads are often bumpy, windy, and slow. These conditions aren’t conducive for a fast EMS response or transport. Transporting a patient over these large areas is time-consuming, and often leaves a community’s primary EMS crew out of service for potentially hours at a time.

Workforce and Staffing

Given the sector’s reimbursement and funding challenges, EMS organizations are finding it increasingly difficult to pay competitive wages. A report from the WV EMS Coalition showed EMTs & paramedics were among the lowest-paid healthcare and public safety professionals in the state.

Support and Coordination

Navigating these issues is not easy – especially when EMS leaders often have other full-time jobs in rural communities. The state government provides very limited technical support to counties, and they need support. Additionally, the state’s Office of Emergency Medical Services’ capacity is limited given its funding.