Author: Matt Zavadsky

Kathy Hochul vetoes legislation aimed at helping EMS providers. Here’s why

Jillian McCarthy

Binghamton Press & Sun Bulletin

Dec. 24, 2025

https://www.pressconnects.com/story/news/public-safety/2025/12/23/first-new-york-state-bill-in-rescue-ems-package-vetoed-by-hochul/87897086007

Key Points:

• New York Governor Kathy Hochul vetoed a bill that would have allowed local governments to fund emergency medical services outside of the property tax cap.
• The governor cited concerns that the bill could lead to substantially higher property taxes for homeowners and businesses.
• The vetoed bill was part of a legislative package aimed at addressing funding and service gap issues for EMS providers across the state.
• State Assemblymember Donna Lupardo, who introduced the bill, expressed disappointment that the governor did not offer alternative solutions to the EMS funding crisis.

Gov. Kathy Hochul has vetoed a bill designed to provide financial support to emergency medical services across New York state.

On Dec. 23, State Assemblymember Donna Lupardo (D-Endwell), who initially introduced the legislation as a part of her “#RescueEMS” legislative package, announced that it had been vetoed despite bipartisan support and receiving almost unanimous approval when it passed through both houses.

The bill would have removed expenditures for EMS from the limit on real property tax levies issued by local governments, allowing municipalities to fund EMS outside of the tax cap.

This, Lupardo said, would have given local governments the “flexibility needed to better support these vital services.”

Hochul: EMS bill vetoed to avoid higher property taxes

Hochul issued a statement after vetoing the bill, citing the potential for higher property taxes as a result of the legislation:

“This bill would exclude the costs of Emergency Medical Services from the calculation of the limit upon municipal property tax levy increases imposed by the General Municipal Law. The property tax cap, enacted in 2011, restricts the annual increase in local property tax levies by local governments and school districts to two percent or the rate of inflation, whichever is less. The tax cap has been effective in limiting local property tax growth, resulting in considerable savings for taxpayers. This bill, as written, could lead to substantially higher property taxes imposed on homeowners and businesses in communities throughout the state. Therefore, I am constrained to veto this bill.”

The “#RescueEMS” legislative package

In July, Lupardo and state assemblymember Joe Angelino (R-Norwich) joined Broome County EMS Coordinator Dave Tinklepaugh at a press conference to discuss the status of several bills within the legislative package.

Together, they looked to address issues with EMS ranging from underfunding to the Medicaid reimbursement rate, a decrease in volunteers, and the slow decline of access to EMS, especially in rural areas.

The second bill in the “#RescueEMS” legislative package initially designated general ambulance services as an essential service, an issue that first arose in 2020 during the COVID-19 pandemic. An amended version of the bill passed without that provision, but it does require every municipality to conduct “an exhaustive planning process” related to emergency medical system plans.

This bill was approved and signed by Hochul.

The process will require counties, cities, towns and villages to work together to assess current service levels, identify existing service gaps and estimate costs for providing such services.

The third and final bill in the package requires the Thruway Authority to issue emergency services permits to ambulance and fire vehicles, making them exempt from roadway tolls.

This bill, like the first, was also vetoed by Hochul.

EMS has ‘dangerous service gaps, especially in rural areas’

In the wake of the first bill being vetoed, Lupardo said she is disappointed that the veto message from Hochul did not include any “alternative suggestions” regarding the EMS “funding crisis.”

“For the last few years, we have worked tirelessly across party lines to raise the alarm about the need to #RescueEMS,” she wrote in a statement. “But in spite of our best efforts, there remain dangerous service gaps, especially in rural areas, and an uncertainty about what the future holds. The bottom line is that New Yorkers expect EMS to come to the rescue whenever needed − ironically, they are the ones in need of rescue now.”

New York State Senator Rachel May also responded to the veto, emphasizing the bipartisan agreement that the “need to fund emergency medical services was more important than an arbitrary tax cap.”

“I am disappointed that the Governor chose not to empower local municipalities, including many rural villages and towns in my district, to fund EMS as they see fit and as current economic realities demand,” May wrote in a statement.

The Academy of International Mobile Healthcare Integration (AIMHI) Excellence in EMS Integration Awards celebrates and promotes high-performance, high-value EMS, its partners, and leaders.

Nominations for the 2026 Awards will open on January 26, 2026, and run through February 20, 2026.

Start thinking about your nominees now for the following categories:

Excellence in EMS Integration

Recognizing a non-EMS organization that has developed and implemented a partnership with EMS organizations that have demonstrated enhancement of patient experience of care, improved patient outcomes, or reduced the cost of healthcare.

Advocacy in Integrated Healthcare

Recognizing a legislator or regulator who has made significant impact on the integration of EMS, or the advancement of the integration of EMS into the healthcare system.

Excellence in Public Information or Education

Recognizing an EMS or non-EMS organization that has developed and implemented an effective public information or education campaign designed to encourage patients, members, or the public to develop or maintain healthy lifestyles, or to more effectively utilize healthcare resources.

Excellence in Value Demonstration or Research

Recognizing an EMS or non-EMS organization that created and implemented an analysis of data and/or research project to demonstrate the value impact of the services provided by the organization.

Leadership in Integrated Healthcare

Recognizing an individual who has made significant impact on the integration of EMS, or the advancement of the integration of EMS into the healthcare system.

Excellence in Medical Direction

Recognizing a physician Medical Director who has made significant impact on the integration of EMS, or the advancement of the integration of EMS into the healthcare system.

The Advocacy in Integrated Healthcare awardee will be recognized during NAEMT’s EMS on the Hill Day March 25-26, 2026 in Washington, DC. Other awardees will be recognized at the AIMHI Board Meeting during the American Ambulance Association Conference & Trade Show April 20 – 22, 2026 in Las Vegas.

Information about the 2025 Excellence in EMS Integration award winners can be found here: https://aimhi.mobi/awards/

Ambulance fleet management plays a critical role in ensuring operational efficiency, responder safety, and patient care reliability. High Performance/High Value agencies comprising the Academy of International Mobile Healthcare Integration (AIMHI) must employ state of the art practices to assure exceptional fleet reliability, as well as cost effectiveness.

In this webinar, an expert panel of fleet managers from AIMHI member agencies will explore proven strategies and innovative practices for managing emergency vehicle fleets—from procurement and maintenance to sustainability, technology integration, and lifecycle replacement planning.

Participants will gain practical insights into balancing cost control with performance, optimizing vehicle uptime, and leveraging data-driven decisions to enhance fleet operations. Whether your agency manages five ambulances or fifty, this webinar will provide actionable takeaways to strengthen your fleet’s reliability and readiness.

Join industry experts as we explore:

✅ Key components of an effective ambulance fleet management program, including maintenance scheduling, vehicle tracking, and lifecycle planning.

✅ Evidence-based strategies to reduce downtime and extend vehicle service life through preventive maintenance and data analytics.

✅ Procurement and replacement options to achieve the best balance between cost, performance, and long-term operational sustainability.

✅ Policies and performance metrics that support safety, compliance, and environmental stewardship within EMS fleet operations.

📅 Date: Wednesday, January 21, 2026
🕒 Time: 2p ET
📍 Location: Zoom Webinar
 
Register now to gain insights on how to better manage your ambulance fleet for maximum performance and reliability!

EMSA earns perfect score among EMS providers in CAAS accreditation

Terré Gables

12/4/25

https://kfor.com/news/local/emsa-earns-perfect-score-among-ems-providers-in-caas-accreditation/amp

OKLAHOMA CITY (KFOR) – EMSA officials are celebrating a rare distinction after landing a perfect score, placing it among the nation’s most elite emergency medical service providers.

According to EMSA officials, it has earned national accreditation from the Commission on Accreditation of Ambulance Services (CAAS), a distinction only 1% of all EMS agencies nationwide achieve.

“Earning CAAS accreditation is an incredible achievement, reflecting the skill, professionalism, and dedication of our entire organization,” said Johna Easley, EMSA President and CEO. “A perfect score demonstrates our unwavering commitment to setting the highest standards in patient care, quality, and continuous improvement across every aspect of our service.”

EMSA says CAAS accreditation represents the gold standard in the ambulance industry, and the process involves self-assessment and independent and external reviews of all areas of an organization’s operations.

“CAAS accreditation is the most respected benchmark in the EMS industry,” said Tammy Powell, Chairperson of the EMSA Board of Trustees and President of St. Anthony Hospital. “Earning a top score in such a rigorous independent evaluation of all areas of EMSA’s operation reinforces that our communities can trust they are receiving excellent EMS care every time EMSA responds.”

Only two ambulance services in Oklahoma currently hold CAAS accreditation, said EMSA officials.

EMSA is Oklahoma’s largest provider of pre-hospital emergency medical care and has held CAAS accreditation since 2010. 

We’re excited to share that the Ready, Next LIVE Operations Tour, held October 13-17, 2025 on the East Coast, was a tremendous success! Thank you to the active participation of our members and the generous support of our sponsors. The tour delivered insightful discussions, valuable education, and meaningful connections that continue to strengthen our industry.

Watch a short video of the MEDIC site visit here.

Watch a short video of the Richmond Ambulance Authority visit here.

Some pics from the event:

Nice to see more communities moving toward basing their ambulance fees on the cost of service delivery.

This is something we encourage to help with EMS system sustainability. Medicare and Medicaid patients are essentially unimpacted by changes in fees, and the reality is that collections from self-pay patients are very low (our soon to be released December 2025 EMS Financial Index will show a 7.3% self-pay gross collection rate for public providers). Self-Pay patients can be shielded from large out of pocket expenses through compassionate care billing practices.

Here’s a link to a recent PWW Advisory Group webinar on this topic: 𝐖𝐡𝐚𝐭 𝐀𝐫𝐞 𝐘𝐨𝐮 𝐖𝐨𝐫𝐭𝐡? 𝐄𝐬𝐭𝐚𝐛𝐥𝐢𝐬𝐡𝐢𝐧𝐠 𝐚𝐧 𝐀𝐩𝐩𝐫𝐨𝐩𝐫𝐢𝐚𝐭𝐞 (𝐚𝐧𝐝 𝐂𝐨𝐦𝐩𝐥𝐢𝐚𝐧𝐭) 𝐅𝐞𝐞 𝐒𝐜𝐡𝐞𝐝𝐮𝐥𝐞: https://info.emsmc.com/webinar-what-are-you-worth

Feel free to contact us if you would like to learn how to model the impact that fee schedule changes could have on your EMS system.

𝐊𝐞𝐲 𝐐𝐮𝐨𝐭𝐞𝐬 𝐟𝐫𝐨𝐦 𝐭𝐡𝐞 𝐑𝐞𝐩𝐨𝐫𝐭:
“The city plans to raise ambulance rates from $735 or $1,065 to $2,324 for advanced life support calls, and $620 to $1,162 for basic life support calls.”

“The new rate is based upon the “true cost” of the service as determined by a third-party auditor, a rate the city already uses to get additional federal reimbursement for Medicare and Medicaid clients.”

“Dubuque’s current ambulance rates are comparable to charges levied by other cities in Iowa, but cities in other states, particularly Illinois and Wisconsin, have already moved to charging ambulance users the full cost of the service, rather than falling back on property taxes.”

“These communities have also shifted the burden of paying for fire departments away from the community at large and onto the person who uses the service.”

“For that self-pay group, the city offers a hardship waiver both for residents and non-residents, which Scheller said would be extended to people charged for other Fire Department services.”
—————
𝐂𝐢𝐭𝐲 𝐨𝐟 𝐃𝐮𝐛𝐮𝐪𝐮𝐞 𝐬𝐞𝐞𝐤𝐬 𝐭𝐨 𝐫𝐚𝐢𝐬𝐞 𝐚𝐦𝐛𝐮𝐥𝐚𝐧𝐜𝐞 𝐟𝐞𝐞𝐬, 𝐜𝐡𝐚𝐫𝐠𝐞 𝐟𝐨𝐫 𝐬𝐨𝐦𝐞 𝐅𝐢𝐫𝐞 𝐃𝐞𝐩𝐚𝐫𝐭𝐦𝐞𝐧𝐭 𝐬𝐞𝐫𝐯𝐢𝐜𝐞𝐬
BY CHRIS GRAY
Nov 29, 2025

https://www.telegraphherald.com/news/tri-state/article_3e7caa05-8fb1-453b-8545-f3cb943dbbbd.html

City of Dubuque leaders seek to sharply increase ambulance fees and begin charging for a menu of Fire Department services, including dousing vehicle fires.

The new user fees and increased ambulance rates would allow the city to recruit and hire five new firefighter-paramedics as early as April.

The Dubuque City Council will consider a proposal for the new fees and added positions at its Monday, Dec. 1, meeting.

The city plans to raise ambulance rates from $735 or $1,065 to $2,324 for advanced life support calls, and $620 to $1,162 for basic life support calls.

“We are looking to charge the full cost of our service to all pieces of our payment mix,” said Fire Chief Amy Scheller, explaining the new ambulance rates.

Current rates have been billed based on what major insurers were willing to pay for the ambulance services and then spread out across other insurers and residents who self-pay.

The new rate is based upon the “true cost” of the service as determined by a third-party auditor, a rate the city already uses to get additional federal reimbursement for Medicare and Medicaid clients.

Dubuque’s current ambulance rates are comparable to charges levied by other cities in Iowa, but cities in other states, particularly Illinois and Wisconsin, have already moved to charging ambulance users the full cost of the service, rather than falling back on property taxes.

“It’s not just an Illinois model, it’s across the country,” Scheller said. “Fire departments will look at the user to cover the cost of the service.”

These communities have also shifted the burden of paying for fire departments away from the community at large and onto the person who uses the service. Some communities charge for house fires, but Scheller’s recommendation declined to add a fee for this service.

New Dubuque Fire Department charges have not been set, but a third-party fire cost recovery recommended $520 per auto crash, $605 per vehicle fire, $700 for hazardous material cleanups and $400 for rescues.

The new ambulance rates are expected to net an additional $1 million per year, and the new fire charges would bring in about $120,000. A renegotiation of an auditing contract reaped $78,000 in savings, leaving about $1.2 million to hire five new firefighters. The cost estimate for a new firefighter is $108,000, with a starting salary of about $70,000.

City Manager Mike Van Milligen has the authority to raise ambulance rates, but he would need authorization from the City Council to create five new firefighter positions as well as impose the new Fire Department cost recovery fees.

Mayor Brad Cavanagh said he was still working out his position but noted that ambulance rates had not been raised for 10 years, and an increase was overdue to cover the rising costs of the service. He also said there should be some balance between property taxes and user fees.

“We all have a desire to add these firefighters,” Cavanagh said. “This is a conversation about how we do it.”

Outgoing Council Member Ric Jones, a retired firefighter, said he is glad Scheller came forward with a concrete proposal to bring the city closer to its hiring goals for the Fire Department. He thought insurance companies would pick up many of the increased fees and new charges, but he drew the line at charging to extinguish vehicle fires.

“I’m not sure I agree with charging for putting out fires. I think that’s a basic tax-supported service,” Jones said.

But both incoming council members — who will be sworn in in January — rejected the plan and one sitting council member, Danny Sprank, said he was opposed to shifting so much of the burden for paying for the Fire Department to citizens who need its services.

“I don’t agree with that much of an increase,” he said. “That’s a pretty big jump — $2,300 to $2,400, that’s not exactly affordable for those who need it.”

He also thought auto insurers would balk at paying for the Fire Department to respond to crashes and put out fires.

“Citizens already pay taxes for our Fire Department,” he said. “I don’t think additional fees for a service that is out of your control is fair for our citizens.”

Council Member-elect Chris Staver agreed: “That seems like a bad idea. That seems like a way to promote people not to call the Fire Department. I think that’s what our taxes are for. They need to find it in the budget.”

Staver said he understood that ambulance fees might be overdue for an increase but opposed the sharp rise.

Council Member-elect Tyson Leyendecker said money for the Fire Department should come from a reprioritization of spending rather than heaping new fees on citizens.

“It’s double taxation, right?” he said. “I would think there’s a better solution than that.”

The new ambulance rates would primarily affect patrons who self-pay for the service, who are either uninsured or underinsured with a high deductible to pay before their insurance kicks in for the coverage.

The city might recover more money from insurance companies, but it cannot balance-bill the patient and seek more money than the insurer agreed to pay. People with insurance from Medicare or Medicaid would not see a bill, and the department already has a method to extract the actual cost of services from the federal government.

For that self-pay group, the city offers a hardship waiver both for residents and non-residents, which Scheller said would be extended to people charged for other Fire Department services.

The waiver works on a sliding scale. Households below 150% of the federal poverty level get a complete waiver, while those up to 300% of the poverty level can receive a reduction. The higher figure works out to $47,000 for a single person or $96,000 for a family of four.

Under the current fee schedule, the hardship waiver has rarely been used; Scheller said the department is currently processing one application, which would be the first sought and granted since 2022.

Scheller is also supporting a federal grant proposal that would help the city staff up to nine more firefighters over three years, helping to make good on a top council priority of increasing minimum staffing on all fire rigs to three firefighters, up from two firefighters currently.

The grant would have a 25% local match for the first two years and a 65% match for the third year, allowing the local government to ramp up budgeting for the added cost of the new employees so it would be sustainable when the grant ends, Scheller said.

Clarkston (WA) Looks Ahead After EMS Levy Fails at the Ballot Box

Sanders Kennedy

November 6, 2025

https://klewtv.com/news/local/clarkston-looks-ahead-after-ems-levy-fails-at-the-ballot-box

Clarkston, WA – Clarkston voters on Tuesday rejected a proposed emergency medical services levy that city officials say is crucial to keeping the community’s ambulance program running past next year.

The measure needed 60% voter approval to pass but received just 42% “yes” votes, according to preliminary election results.

The proposal would have increased the city’s EMS levy rate from $1.50 per $1,000 of assessed property value in 2025 to $2.64 in 2026 — roughly a 76% jump.

With the levy failing to pass, the EMS service could end in 2026.

“The current tax dollars will cover the department through the end of the year,” said Fire Chief Darren White. “And there is reserve set aside in the EMS budget that could possibly be carried over into 2026.”

White said the department is already preparing for budget discussions and next steps.

“We are in the process of budgeting for 2026,” he said. “We’re meeting Monday night at a normal council meeting, and we do plan to have at least a workshop or something to discuss future plans for what services we’ll be providing.”

If funding does not improve, up to six of the department’s 13 full-time employees could lose their jobs, White said.

“That would come through talks with city council,” he added. “The ultimate decision on the future relies on them.”

Despite the setback, White remains hopeful voters will reconsider next year.

Austin-Travis County EMS faces $6.2 million cut in newly revised proposed city budget

Daniel Perreault

November 8, 2025

https://www.kvue.com/article/news/local/austin-ems-faces-cut-newly-revised-proposed-city-budget/269-048536d7-c8c8-4c58-880c-601b7fce84d9

AUSTIN, Texas — The city of Austin has released an updated budget proposal, after having to rework the budget for the current fiscal year after voters rejected Prop Q at the ballot box earlier this week.

Prop Q would’ve raised property taxes by about 20% compared to the last fiscal year, and the newly proposed budget is already meeting opposition from some Austinites.

After voters rejected Prop Q, the city now has to balance a budget without more than $109 million in property tax revenue.

To meet that shortfall, they are taking an axe to the budget, cutting $5.2 million from Parks and Recreation, $3.7 million from the Municipal Court, $38 million from social services contracts and $1 million from Austin Fire Department.

“This initial budget does not meet the moment,” said Matt Mackowiak, co-chair of Save Austin Now, the organization that led the opposition to Prop Q. “It does not honor and respect the message voters were sending.”

One of the most significant slashes is a more than $6 million cut to Austin-Travis County Emergency Medical Services (ATCEMS).

James Monks, president of the Austin EMS Association, said he was shocked and disappointed by the proposed budget.

“We’re solving a lot of problems for the city, and it just kind of makes us feel a little bit unappreciated, honestly,” Monks said.

It is already a struggle for the department, Monk said, because they have only been able to secure small budget increases over the past few years, even though they are increasing the amount of money they bring into the general fund.

“I feel like the city always wants to demand that we run lean, but they don’t, and I think that’s a problem,” Monks said. “I hope that they can address that by reopening the budget next time.”

Monks said if the cuts stay as is, they’ll have fewer medics on the streets, which means slower ambulance response times to calls.

“We’ve tried different mechanisms to try to shift, shuffle things around, but this is getting to the point where that’s not working,” Monks said. “It’s actually just making people who are already here have to work harder.”

Earlier this year, the city launched a pilot program to help determine which calls do not require an ambulance staffed with two paramedics. Instead, one paramedic would respond in an SUV equipped with the same equipment as an ambulance, taking some ambulances out of service. This would help the department save money on gas, maintenance and overtime as they worry about going over the budget.

“We’ve been dealing with rolling brownouts for years now. We finally got to a point with our staffing where we were hoping that maybe we weren’t going to have to be brownout trucks anymore, and then we got hit with the budget crisis,” Monks.

They tried to find funding through the council and other avenues, but Monks said they were told none was available. He says these cuts would exacerbate the issue.

“The medics that are here, they’re going to have to work harder, they’re going to have to do more work, and we’re already kind of stretched thin,” Monks said. “People are already facing burnout, they’re already overworked, they’re already tired, and now this is just another blow to that.”

Mackowiak said he knows the city is in a tough spot with the budget, but he will fight any cuts to public safety.

“The message voters delivered on Tuesday night with Prop Q going down handily was not to cut public safety,” Mackowiak said. “If the first thing you want to do, after Prop Q, is to cut public safety, city leaders have another thing coming.”

Mackowiak said if public safety isn’t adequate in a city, almost nothing else matters.

“When you’re in a crisis or someone you care about is in a crisis, you expect EMS to be there, and those response times are absolutely critical,” Mackowiak said. “If a response time is 5 minutes or 10 minutes, that may not sound like much of a difference, but it’s the difference between life or death and a critical incident.”

Mackowiak called on city council members to fully fund public safety and said if they don’t, “all political options are on the table.”

“The charter election [is] in May, which will be occurring in our city, and half of our city council is on the ballot in November,” Mackowiak said. “Those are things we’re keeping a very close eye on.”

“City Hall will hear from our activists all across the city, across all demographics, across all parties starting on Monday,” he added.

In the new proposed budget, the Homelessness Strategy Office would get a roughly $3.7 million increase.

“Other states invest in homeless services. The state of Texas doesn’t do that,” Councilmember Ryan Alter said on Tuesday. “So it’s up to us to deliver those services because we’re on our own.”

City leaders are expected to move ahead with a 3.5% property tax increase next year, the highest rate they can implement without voter approval. The proposed new budget includes $5.25 million in additional property tax revenue.

Alter acknowledged that city leaders are now facing tough choices as they must find a way to account for the missing revenue the tax rate increase would have generated.

“We are going to try to minimize the damage, but it is going to hurt real people,” Alter said.

There is a $7.1 million increase in General Fund expenditures in the proposed new budget, including:

• $50,150 to provide employees who earned less than $53,000 per year in FY 2025 with a wage increase of $2,120 per year in FY 2026, in lieu of the 4% civilian wage increase.
• $5 million in ongoing funding for Austin Homeless Strategies and Operations to continue emergency shelter operations at the Marshaling Yard. An additional $3 million in one-time funding would be provided through the Housing Trust Fund in order to ensure total funding of $8 million in FY 2026.
• $2 million, including 20 new positions, for Austin Parks and Recreation to address parkland and grounds maintenance needs.

When the system SNAPs: How food and policy uncertainty will reshape EMS

“The next evolution of EMS leadership will not be measured by how many calls we answer, but by how many crises we prevent.”

November 05, 2025

Shannon L. Gollnick, DBA, NRP, FP-C

Matt Zavadsky, MS-HSA, EMT

PWW Advisory Group (PWWAG)

https://www.ems1.com/community-awareness/when-the-system-snaps-how-food-and-policy-uncertainty-will-reshape-ems

The Supplemental Nutrition Assistance Program (SNAP) is the cornerstone of America’s fight against hunger, serving over 41 million people every month. Administered by the U.S. Department of Agriculture, SNAP provides electronic benefits that help low-income households purchase food; a safety net that stabilizes families, communities and, indirectly, our healthcare system itself.

When this safety net is weakened, or worse, fails, the ripples are felt far beyond the grocery aisles.

They show up on 911 screens, in the patterns of repeat calls, and in the strained hands of the EMS clinicians who respond.

The impact of SNAP uncertainty

On Nov. 1, 2025, a federal funding lapse delayed SNAP benefits for the 41 million Americans who rely on this benefit. States have been left scrambling, contingency plans are uncertain, and families are being urged to stretch what remains on their Electronic Benefit Transfer (EBT) cards. For those living paycheck to paycheck, that uncertainty is destabilizing, but for EMS, it is predictive.

When people lose access to food, utilities or housing support, their health and stability erode in quiet ways that eventually become loud emergencies. Delays or reductions of SNAP don’t just affect the poor — they reshape local acute care and emergency response demands. The pandemic-era of SNAP had measurably reduced food insecurity. When those benefits expired, Health Affairs reported an 8.4% increase in food insecurity nationwide. That is not an abstract data point — it’s a stress test for the social systems that surround us, including EMS.

“ SNAP, like healthcare itself, is a social contract. When that contract wavers, it exposes the fragility of our social infrastructure, and the degree to which EMS has become both responder and witness to the nation’s inequity.”

The social determinants behind the sirens

Emergency medicine often deals with the symptoms of social distress. Behind many of our calls lies a social determinant: food, housing, transportation, education, medication or safety. In other words, what we often document as “chief complaints” are really the downstream effects of social challenges.

EMS professionals now find themselves again at the front line of public health, population health and social care all at once. Our ambulances increasingly serve as mobile observation posts for community well-being. The end of SNAP benefits and the uncertainty surrounding their renewal have underscored this realty: clinical emergencies are rarely isolated medical events — they are the social ledger of community health.

This recognition should not burden EMS — it should empower it. The growing intersection between health and policy means that emergency services must evolve into more adaptive, data-driven systems, capable of responding to — and not just transporting — social need.

While SNAP faces uncertainty, the much discussed “One Big Beautiful Bill Act” (OBBBA) proposed to redefine how healthcare and social policy interest. While its legislative fate remains uncertain, the intent is clear: to consolidate and modernize the funding streams that address the social determinants of health — from nutrition and housing to behavioral health and care access.

For EMS, this represents a profound transition. For decades, reimbursement has been tied almost exclusively to transport. The OBBBA and similar policy changes aim to incentivize outcomes over outputs and recognize that preventing crises and connecting people to social supports is as valuable a service as the lights-and-siren response.

This shift has the potential to reshape the financial and operational DNA of EMS. Systems that demonstrate community impact, integrate with public health and collect meaningful SDOH data will be best positioned to thrive in this new environment. Agencies that remain narrowly focused on transport alone may find themselves increasingly marginalized.

MORE: How ‘One big beautiful bill’ could break EMS

Redefining our role

EMS has always been adaptive. From wartime roots to today’s mobile integrated health (MIH) models, the profession has evolved with each new social reality. The current SNAP uncertainty is another inflection point. The lines between healthcare delivery, social care and emergency response are blurring faster than ever — that creates both risk and opportunity.

The opportunity is clear: evidence demonstrates that EMS can lead the integration of social determinants of health (SDOH) into emergency care. By tracking food insecurity, housing instability and other social factors in our electronic patient care records, we can offer real-time insights into community rends that hospitals, policymakers, and public health department may not see.

Preparing for the next iteration of EMS

The convergence of SNAP instability and transformative healthcare legislation is more than a political story; it is a leadership challenge. EMS leaders must start preparing for systems that are rewarded not based on process measures, like response times, but on measurable community outcomes.

To thrive in this new era, EMS must:

1. Embrace data as a social diagnostic tool. Aggregate and analyze SDOH indicators from field documentation to identify emerging vulnerabilities
2. Build partnerships beyond healthcare. Engage local food banks, social services and community health networks as part of coordinated care pathways
3. Invest in workforce stability. Recognize that some EMTs and paramedics face the same social vulnerabilities as their patients; addressing those needs strengthens organizational resilience
4. Prepare for reimbursement reform. Anticipate how the OBBBA and related initiatives will align payments with prevention, integration and social impact

The road ahead

The uncertainty surrounding SNAP is more than a budget hiccup — it’s a mirror reflecting the fragility of America’s safety nets. Peering into that reflection, EMS can see its future roles more clearly. The profession that once defined itself by rapid response must now define itself by relevance — by its ability to understand, measure and mitigate the social conditions that generate emergencies in the first place.

In the months and years ahead, as food assistance, healthcare and social policy become more interconnected, EMS will no longer be just an emergency service. It will be a social stabilizer, a public health partner and a community intelligence system.

The next evolution of EMS leadership will not be measured by how many calls we answer, but by how many crises we prevent.

We LOVE this idea!  A great way to serve the community, especially with local animal shelters in many communities reporting they are over capacity!

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OKC Animal Welfare, OKCFD partner to reunite lost pets

Oklahoma City fire stations 25 and 30 are now equipped to scan stray animals for microchips, aiming to reunite lost pets with their owners and reduce shelter intake.

11/3/25

https://www.okc.gov/News-articles/OKC-Animal-Welfare-OKCFD-partner-to-reunite-lost-pets

Oklahoma City Animal Welfare is partnering with the Oklahoma City Fire Department to make it easier for families to reunite with their lost pets without the pet ever entering the shelter. Beginning in November, two Oklahoma City fire stations will be equipped with microchip scanners, providing the community with more flexible options to help a found pet return home.

Residents who find a stray pet can take it to one of the participating stations, where firefighters will scan the animal for a microchip. If a chip is found, the finder will receive the microchip number and instructions on how to look up the owner’s information, allowing them to quickly and directly reconnect the pet with its family.

Participating Fire Stations:

Station 25: 2701 SW 59th St.

Station 30: 4343 S. Lake Hefner Dr.

“It’s always better for a lost pet to go directly back home rather than spend time in the shelter,” said Ronnie Schlabs, Superintendent of the Oklahoma City Animal Welfare. “By working with the Fire Department, we’re making it easier for neighbors to help neighbors and giving families more opportunities to be reunited quickly. This partnership saves time, reduces stress on the animals, and ultimately saves lives. We are grateful to the Oklahoma City Fire Department for their support and commitment in helping make this program possible.”

The program provides a convenient alternative to shelter intake and extends microchip scanning hours beyond the traditional operating times of veterinary clinics and the OKC Animal Shelter. This not only speeds up the process of reuniting pets with their owners but also helps reduce overcrowding at the shelter, conserve city resources and limit the stress that animals experience when separated from their families.

Pets cannot be left at the fire stations, as they are not equipped to house or care for animals. If a finder is unable to hold onto the pet or needs further assistance, they may contact OKC Animal Welfare dispatch at (405) 297-2255.