EMT and paramedic students are taught a variety of skills to prepare them for any situation they might run into, but the incidents always begin with the same step — work together to identify the problem before beginning to solve it.

The principle applies to everyday emergencies, but chronic problems require teamwork and complex solutions that aren’t one-size-fits-all, which is why there’s an Emergency Medical Services Council of Butler County.

The council meets the second Wednesday of each month at Butler County Community College to share ideas, launch initiatives and find solutions to national problems plaguing EMS at a local level. It’s open to every EMS agency that primarily operates in Butler County. It also includes units from Allegheny Health Network, University of Pittsburgh Medical Center and representatives from Butler County Emergency Services and BC3.

“All the services took an opportunity to say we’re in this together,” said Matt Nickl, chief of Cranberry Township EMS and a member of the council’s executive board.

The council has committees for staffing and education, response and mass-casualty-incident planning, EMS funding and outreach and public information to solve problems EMS faces.

If you ask retired emergency services coordinator Vern Smith, he’ll say EMS is the black sheep of emergency services.

For instance, the Office of the State Fire Commissioner has a direct line to the Pennsylvania Emergency Management Association. EMS has a director, who leads a division of the Department of Health, instead of its own office. The department also hears from the Emergency Health Services Council, an independent advisory board.

Further, firefighters are also on every fire truck in the state, but not every ambulance gets a paramedic.

“Most people think every time they see an ambulance, there’s a paramedic in the back. That’s not true,” Smith said.

The problem was recognized in a 1966 white paper published by the National Highway Traffic Safety Administration titled “Accidental Death and Disability: The Neglected Disease of Modern Society.”

The paper found “accidents” were the leading cause of death in people ages 1 to 37 and advocated for local authorities and citizens to make initial care and transportation their responsibility.

According to Smith, the county’s EMS Council began in 1980 to solve their shared problems and act as a liaison between the ambulance services in the county and the state Department of Health.

The state caught up with local councils in 1985 with the Pennsylvania Emergency Medical Services Act, which established a statewide EMS system.

Smith said he then began the EMS Institute in 1988, which is known today as EMS West.

EMS West is one of several regional councils in the state that coordinates conferences and training across counties.

The 1985 act established the Emergency Medical Services Operating Fund (EMSOF), which can cover operating costs. The funds were allocated based on population, the number of emergency services in a county and types of responses.

It was funded through a $25 surcharge placed on all moving violations in the state, Smith said. He said the county would usually be allocated between $5,000 and $6,000 it had to match.

“As nice as the concept was for the EMSOF dollars, it didn’t pan out,” Smith said.

He said lawmakers at the time included other mechanisms that allowed the funds to be used for other purposes and eventually, it went to state expenses.

Smith was also instrumental, as emergency services coordinator, in starting the county’s first paramedic education program with Butler Memorial Hospital. He said paramedics back then could get certified for about $275.

Today, Smith said paramedics are lucky to get certified for less than $10,000.

In the mid-1990s, Smith said his position at the hospital changed along with the state funding drying up, so the county EMS council stopped meeting for a couple years until 1997 or 1998.

The EMS council came back to life in 2020 with meetings at BC3, according to Tom Buttyan, coordinator of EMS and police training at BC3.

Buttyan has been the coordinator for about three years, but he has been with the college since 2007. He began his emergency services career working for Butler Ambulance Service making $4.25 an hour, he said.

BC3 provides the location and up to basic life support credentials, while Impulse Academy uses their space to teach advanced life support.

The minimum wage for an EMT is no longer $4.25, but EMS leaders say it’s still not enough to sustain interest.

“People don’t see public safety as a career. It’s a stepping stone,” Buttyan said.

He said two to five years is the average career span in EMS today, and service of 25 to 30 years is rare. Students can go to school for another year to be a nurse and make more money, he added.

That hasn’t slowed the county EMS council, though. Nickl said Smith is spearheading a roundtable discussion with municipal leaders about the challenges EMS providers continue to face, similar to the presentations many services have given at municipal government meetings.

The council’s executive board holds elections every two years and consists of Nickl, Cranberry Township EMS Deputy Chief Rich Jones and Saxonburg EMS Chief Chuck Lewis.