A pilot program to help emergency medical services across the state get what they need to operate effectively was approved Wednesday by the county commissioners — including by the one who started it.

Commissioner Kevin Boozel initiated a task force at the County Commissioners Association of Pennsylvania (CCAP) before he became president of the organization this year.

Boozel now heads that task force, which is preparing to participate in a pilot project to study EMS service and develop recommendations to address concerns.

Five counties are involved in the pilot program.

Butler and Mercer counties will work together in the program, Boozel said.

Boozel stressed that the program's goal is not to determine EMS providers' insufficiencies, rather, the idea is to gather information on their needs and how they could more effectively operate their ambulance services.

He said the program is in response to discussions between CCAP, the state borough and township associations, the state Municipal League and several state legislators on introducing legislation related to EMS and first responder operations.

“We have heard from many ambulance services about the financial struggle,” Boozel said.

He said many have advised him that the Medicare reimbursement received by EMS providers is insufficient.

Nathan Bacher, operations supervisor at Butler Ambulance Service, said issues with reimbursement from insurance companies and Medicare affects the pay rate of the 95 employees at his company.He said people considering a medical career look at the training that goes into becoming a nurse versus a paramedic and the pay scale of both.“People say if I've got to do that much (training), I might as well be a nurse,” Bacher said.He said transporting non-emergency patients is the more lucrative end of his family's business because employees can be scheduled for each day and no patients are going to refuse services, which is a situation faced in emergency calls.“It's always been a problem on the EMS side,” Bacher said. “Whenever you go on a call and treat and assess a patient and they decide not to go to the hospital, we do not see reimbursement for that.”He said a few insurance companies do permit billing for refusals, but most do not.Regarding ambulance service coverage, Bacher said Butler County is in pretty good shape.He said ambulance services overlap in certain areas of the county, compared to many counties, where three or four EMS providers must be called to get an ambulance to a patient.“We don't have areas that aren't covered,” Bacher said.For his business, Bacher said the main problem is the decrease in emergency medical technicians and paramedics coming into the field.“The main thing in Butler is staffing at this point,” he said.

Bacher is cautiously optimistic about the EMS pilot program.“I think Butler County could benefit from some aspects of it,” he said.Bacher hopes any state rollout of practices and procedures to the EMS industry will be specific to each county's needs and not a blanket mandate.“I think there is a long and healthy future ahead for EMS in Butler County,” Bacher said. “There are things that need to change, and obviously we prefer sooner rather than later, but the model as it stands now isn't sustainable.”Boozel said the goal of the pilot program is to gather information and create a toolbox that counties can use to improve their EMS services.He said in addition to financial concerns, EMS providers struggle with the amount of training required to keep a paramedic or emergency medical technician certified.The pilot program will include discussions from both paid and volunteer EMS entities, Boozel said.“Some are paid and some are unpaid, but they're all professionals,” he said.The state Department of Community and Economic Development will provide a facilitator for the program who will ask the right questions of EMS providers, Boozel said.The end goal is to provide the EMS toolbox so all of Pennsylvania is sufficiently covered by EMS service and providers are able to run their services efficiently.“EMS is in crisis,” he said. “We want to move from crisis to highly functioning.”