Lewis County EMS leaders warn of workforce collapse; propose countywide four-crew model and ask for study

Lewis County emergency medical services leaders told county legislators the local EMS system is strained by falling volunteerism, low reimbursement rates and retention problems — and presented a proposed countywide model that would require significant new local funding.

Josh Bevec, chief of operations for Lewis County Search and Rescue, told the General Services committee that New York State saw a 17.5% decline in active certified providers over recent years and that many volunteer and hybrid agencies report delayed or missed responses because of shortages. "If search and rescue hit tomorrow were to close its doors, who's gonna pick up the pieces? It's going to be horrible," Bevec said during the presentation.

Why it matters: Lewis County relies on a mix of volunteer and paid providers spread across a rural geography. Bevec said limited call volume in some areas, low Medicaid/Medicare reimbursement and a national decline in volunteers mean the current patchwork risks local coverage gaps and longer response times.

Proposal and costs: Bevec presented a schematic 4-crew countywide EMS system intended to provide coverage from strategically placed bases and enable mobilization of crews across zones. He estimated the fully-staffed four-crew model would cost about $5,400,000 annually, of which roughly $4,600,000 would be employee compensation and benefits. He said anticipated insurance billing and non-contract revenue would cover about $1,890,000 of that total, leaving an estimated $3,500,000 to be covered by town contracts or other taxpayer support.

Bevec described proposed hourly wage targets in his model: Basic EMT $25/hour, Advanced EMT $35/hour and Paramedic $50/hour (with benefits and employer burdens to be added). He said the county's local EMT base pay range in his organization currently runs roughly $17 to $19 per hour and paramedic pay ranged from $25 to $27 per hour there.

Discussion and governance: Committee members pressed for financial detail, board oversight and external validation. Bevec said the organization has a seven-member volunteer board and recently opened two seats for outside expertise. Some legislators urged a careful approach and recommended an independent countywide study to examine feasible models and taxpayer impacts.

Action taken: In committee the remark was made to "make a motion to go out to RFP" for a study; participants agreed. Committee minutes record a motion to proceed with an RFP process to solicit a countywide EMS study. Bevec said he would provide the pro forma budgets and supporting financials to legislators upon request.

Ending: Legislators directed staff to pursue a request for proposals for an EMS system study and said they want thorough financial analysis and community education before pursuing a countywide funding plan.