CRANBERRY TWP — On Tuesday evening at Cranberry Township Municipal Center, township officials and a panel of experts discussed ongoing challenges faced by EMS at the second Cranberry Conversation workshop.

The session started with a presentation by J.R. Henry, an EMS consultant. Henry is one of the leaders of the township’s efforts to study and analyze ongoing EMS struggles.

The presentation was followed by a discussion between a panel of experts, which included Henry, as well as Matt Nickl, executive director of EMS at Cranberry, and Allan Klapper, president of AHN Wexford Hospital.

The discussion was moderated by Dan Santoro, township manager. Santoro said the goal of the workshop was to share a high-level overview of the hurdles EMS services have been up against across Pennsylvania and the rest of the U.S.

Members of the township’s EMS team were available at the session for individual questions from attendees.

In his presentation, Henry said EMS’ major challenges at the moment are growth in technology, a significant loss of volunteers and insurance reimbursements not covering EMS costs. All three have contributed to increased expenditure, he said.

Better technology, while improving EMS quality, means increased costs for equipment, Henry said. Likewise, the “dramatic decline” in volunteers has led EMS to rely mainly on paid workers, which has also increased costs.

Also contributing to staffing shortages is that starting and five-year wages for EMS employees do not match up to what other public service employees, such as police, make, Henry said. Due to low wages, many of the EMTs and paramedics have to work two to three jobs to provide for their families, said Henry.

Intense scheduling and fatigue from the nature of the job also discourages many from continuing down the EMS road professionally, Henry said. The average EMS employee lasts about five years now in the profession, he added.

“This is one of the most stressful occupations you can have,” Henry said. “We deal with life and death on a daily basis.”

According to Henry, a recent survey found there were 46,000 certified EMS providers in Pennsylvania in 2025, which is down from about 200,000 in the late 1980s. Of the 46,000, only 7,000 are actively working in the field.

Henry said a common misconception among Pennsylvania residents is additional funding for EMS is not necessary since the services can just bill insurance companies.

But he said that notion does not factor in missed reimbursements or write offs for patients who can’t afford to pay.

Nickl said the biggest challenge for Cranberry EMS has been insufficient reimbursements. Additionally, he said insurers have not adjusted payments for current Medicare and Medicaid rates. Costs of ambulances have gone up as well.

Henry also pointed out cases where EMS is called but there are no injuries or illness, which generate no revenue.

Santoro noted the township is legally responsible for EMS. He said, while the ongoing funding concerns are not an immediate worry for the township, planning ahead to avert any crisis is a goal for the township.

Bruce Hezlep, Cranberry Township Board of Supervisors Chairman, noted of the three agencies brought up at the panel discussion — police, EMS and fire — residents are mostly likely to interact with EMS.

“These people make a difference in your life every day,” said Hezlep.

Klapper said great emergency care is critical for hospital workers to do their job well.

“So much of the outcomes for critical situations is dependent upon training: the expertise, the equipment and the ability to get patients to a hospital quickly so that the doctors and the staff can intervene and provide that great care — it could be life saving,” he said.

“As a community, we have to make sure that essential service will be there for years to come and make sure it's there to respond,” Nickl added.

Santoro said the conversation sessions are the first step in the township’s plan to address EMS funding concerns, starting with public discussion and feedback.

The township is in the early stages of considering forming a municipal authority that would generate a mandatory fee for households and businesses, Santoro said. He added, while the township has some early estimates, it is too early to tell what that fee will be.

Henry said the township has looked at other municipalities which have implemented a similar fee to help fund the EMS shortfall.

“We believe, as consultants, in looking at all options,” said Henry. “That's probably the best option.”