Dear Commissioner,
Recently, during a quiet family dinner, my elderly father began choking on his food. Realizing what was happening, I immediately called 911. After three rings, a dispatcher answered: 鈥淒ispatch, do you need fire, police or EMS?鈥�
I explained that my father was choking, and we needed an ambulance. The dispatcher replied that there was no longer an ambulance service in our area and that she would transfer me to her partner. The second dispatcher calmly said she would try to contact neighboring counties to see if they were willing to send an ambulance.
In the midst of panic, I couldn鈥檛 fully grasp what that meant 鈥� that there was no help on the way.
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The dispatcher stayed on the line and gave me instructions on how to begin care for my father while we waited. A few moments later, she informed me there were no ambulances available to respond. Instead, she advised me to drive my now-unresponsive father to the hospital if I could safely do so.
I asked, 鈥淲ho鈥檚 coming for us?鈥�
No one was.
My father was pronounced dead approximately 15 minutes after arriving at the hospital. He was 76 years old, had no major medical conditions, and still walked 3-5 miles every day. We are left with a painful, unanswerable question: If an ambulance had arrived, would he still be with us today? We believe he would.
Our family is now asking how this happened 鈥� how an entire community lost its access to emergency medical services.
We鈥檝e seen speculation online that the local EMS provider, which had served this area for over 75 years, faced insurmountable staffing challenges during COVID and never recovered. At a recent town hall, the fire chief confirmed this and explained that the provider was unable to meet the community鈥檚 growing needs, and that efforts to bring in a new service were underway. But as of today, there is still no ambulance service in place.
While we understand the challenges in staffing and funding that EMS systems across the country are facing, the complete absence of an ambulance service in our community is not just a concern 鈥� it is a crisis. It鈥檚 a matter of life and death.
We are not alone in our grief. Other families in our community also deserve to know that help will come when they call 911. We are asking for your leadership in solving this crisis. No one should feel as helpless as we did that night. And no family should have to live with the question: 鈥淲hat if?鈥�
Thank you for your attention to this urgent matter. We look forward to your response 鈥� and more importantly, to tangible steps to restore emergency medical services to our community.
Sincerely,
A concerned resident
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When 911 doesn鈥檛 answer: A wake-up call for EMS reform
To most people, the idea that a 911 call might go unanswered by an ambulance seems unimaginable. We grow up believing that if something terrible happens, help will arrive 鈥� fire, police or EMS will come rushing in. But for a growing number of communities across the country, that belief no longer reflects reality.
The story that opened this article may be fictional, but it reflects a harsh and heartbreaking truth. In some areas, the complete collapse of local EMS services has become a lived experience. Families call for help and are told no ambulance crew is coming. That in itself is a tragedy 鈥� and a sign that our emergency care infrastructure is in crisis.
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Much of this crisis stems from the invisible struggles that private ambulance providers face. Unlike fire departments or law enforcement agencies, private EMS companies often operate without public funding. They rely almost entirely on reimbursements from insurance companies, Medicare, and Medicaid 鈥� many of which fall well below the cost of care. At the same time, providers are burdened with skyrocketing costs: fuel, medical equipment, vehicles and labor are more expensive than ever, while regulatory requirements and workforce shortages pile on additional pressure.
In some communities, EMS agencies have closed their doors or significantly reduced services. In others, response times have increased dramatically due to limited availability of ambulances or extended offload delays at overcrowded hospitals. And unfortunately, when an ambulance doesn鈥檛 arrive in time, the result can be fatal.
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Too often, when a local EMS agency begins to falter, the conversation immediately turns to replacing them with a fire-based system. While fire departments are vital to public safety, this solution isn鈥檛 always feasible or effective. Fire agencies face the same staffing shortages and funding issues; and building an EMS operation from the ground up within a fire department can be expensive, time-consuming and logistically complex.
Instead, community leaders and local governments should look first at how they can support and stabilize the providers they already have. These are the agencies that know the streets, know the people, and have been responding to emergencies for years. With the right support 鈥� whether it鈥檚 through bridge funding, better reimbursement rates or access to training programs 鈥� many of these providers can continue serving their communities effectively.
This is where education and advocacy become critical. The public needs to understand that EMS isn鈥檛 automatically covered by tax dollars in most places, and that private providers often operate behind the scenes without the recognition or support given to fire and police. Local and state policymakers need to understand the challenges EMS agencies face, and what tools 鈥� legislative or financial 鈥� might help stabilize the system before it collapses entirely.
What鈥檚 at stake here isn鈥檛 just business viability; it鈥檚 human lives. No one should have to ask, 鈥淲ho鈥檚 coming for us?鈥� when they call 911. And no family should have to wonder whether their loved one might still be alive if an ambulance had arrived sooner.
We need stronger partnerships between EMS providers and their local stakeholders. We need open dialogue, responsive leadership and a commitment to protecting a critical component of public safety. Most of all, we need to ensure that when someone calls for help, someone will be there to answer.
