Vern Smith, of Butler, retired as 911 director of emergency services for Clarion County six years ago, but he's not letting his 50 years of emergency medical services experience, including as a teacher and an administrator, go to waste.

He's joined with other veterans of the EMS/paramedic field to form Citizens Concerned for EMS, a group pressing to educate the public about EMS, aiding the growth of new EMS leaders and assisting elected officials to ensure the availability of pre-hospital emergency care in their respective communities.

Smith was honored as a Hometown Hero on Sept. 5 by the Butler AM Rotary Club.

Smith, who has been involved with the field since he qualified as an emergency medical technician in 1974, said current conditions are forcing the closure of ambulance services and driving EMTs and paramedics from the field.

He said the rising cost of certification and equipment and the lagging reimbursement offered by Medicare, Medicaid and private insurance companies for services is creating a crisis.

“The biggest problem is compensation. The government has not kept up with that,” said Smith. “It costs $550 just to roll out the door. There's equipment, supplies and personnel expenses.”

“Ambulance services can't charge for mileage unless its 20 miles or beyond. With hospitals popping up, there's usually one (hospital) within a 5- or 10-mile radius,” said Smith.

And what costs ambulance services can recoup from Medicare, Medicaid and private insurance are inadequate to cover the costs of an ambulance run.

According to Smith, on average 80% to 85% of the time, reimbursement is less than the actual cost to respond to an emergency call.

At the same time, the costs of training and certification to become an EMT/paramedic have increased.

“In the beginning when I started, it was $275 for a book and malpractice insurance,” said Smith.

Now because of mandates requiring accreditation and certification, it can cost $11,000 to become an EMT/paramedic.

That’s money an EMT/paramedic can't regain with his or her pay. “A paramedic can make $20 an hour. You can make that at a convenience store,” said Smith.

And at the same time an ambulance costing $200,000 has to be outfitted with millions of dollars in medical equipment.

The money squeeze is already being felt.

“It's a shame,” said Smith. “At some point, it's going to mean less EMS services.” He noted in recent years that ambulance services in Unionville, Prospect, Marion Township, Penn Township and the Buffalo EMS service have all shut down.

This means the surviving ambulance services are being spread thin over a larger area. “You may be waiting 20 to 45 minutes to get an ambulance on-site,” Smith said.

It was different in 1982 when Smith — after he became certified as a paramedic l — was asked by doctors at Butler Memorial Hospital to start a paramedic response unit that later became known as Medic One.

“These were the first paramedics in the county,” said Smith, who was the director of the program and oversaw 12 paramedics.

Smith later oversaw the EMS/police programs at Butler County Community College for 12 years, co-authored a trauma textbook, and worked in international disaster management and for U.S. Department of Homeland Security.

Because of his long involvement in the paramedic/EMT field, Vern Smith was nominated for the Butler AM Rotary Club's Hometown Hero Award by his son, Jason Smith.

“He has been a first responder since before I was born,” said Jason Smith. “Both my brother, Shawn, and I went through paramedic and EMT programs. We got involved in it because my father was an example.”

Despite the field's current problems, Vern Smith said, “There still are plenty of exciting opportunities opening up for those with EMS training, such as careers in nursing or Homeland Security. EMS is a good steppingstone.”

“I'm proud to say I participated in doing it,” said Smith.