On November 17, the Virginia State EMS Advisory Board met in Richmond and among regular business, discussed several updates regarding reported financial irregularities and budget shortfalls in the Office of Emergency Medical Services (OEMS). Updates provided by Acting Director of OEMS Cam Crittenden, State Health Commissioner Dr. Karen Shelton, and others indicated that OEMS programs are facing a multimillion-dollar deficit and that several years’ worth of past OEMS budgets were created not in-line with available funding. This has the potential to significantly impact OEMS aid to localities and first responders.
The Virginia Department of Health (VDH), which is the parent agency for OEMS, is working to understand the state of financial affairs at OEMS. This past Spring, VDH initiated budget reviews and learned in May of financial irregularities at OEMS, including significant portions of the Four-for-Life pass throughs not being available. An internal audit is currently ongoing. Also, as was reported in several media outlets, an ongoing investigation into potential financial irregularities by the Office of the State Inspector General, Virginia State Police, and the U.S. Attorney for the Eastern District of Virginia is also underway.
OEMS is funded almost solely by special revenues, primarily tied to vehicle registration through the DMV. OEMS oversees programs such as Four-for Life Fund, the Return to Locality Fund, and the Rescue Squad Assistance Fund (RSAF), which support vital programs and activities in the field of Emergency Medical Services. This also includes support to the EMS Regional Councils, which are charged with the development and implementation of an efficient and effective regional emergency medical services delivery system. Regional EMS Councils collaborate with the office of EMS, local government officials, physicians, hospitals, and EMS agencies to plan and coordinate EMS activities at the regional level to promote quality of care. A slide from Friday’s meeting showing the various funding streams and their uses can be viewed here.
VDH and OEMS staffs indicated that the current FY 2024 OEMS budget does not align with projected revenues, thus triggering a need for a restructuring of OEMS funding. Kevin Dillard, Chair of the State EMS Advisory Board, will create a workgroup to make recommendations to the Board on restructuring of funding streams due to the deficits. VACo communicated to the Chair and to OEMS the need for local government representation on any such workgroup. Current Return to Locality payments are pending and RSAF grants have already been awarded, but OEMS is unable to make new grant awards at this time. According to OEMS, previous commitments will be honored, and OEMS is working to resume delayed payments, but could not give a specific date when this will occur.
A Board Member remarked that in his nearly 50 years of service, that this was an unprecedented event and that the full extent of what has happened still remains unknown. A representative of the Regional EMS Council Executive Directors warned that the EMS Councils are in crisis due to the freezing of funds and are depleting cash reserves while payments from OEMS remain frozen. This threatens financial collapse for the councils. The State EMS Advisory Board unanimously passed a motion that VDH should prioritize the release of payments to regional councils that have been contractually made.
This issue first came to VACo’s attention in August. After inquiries to OEMS about alleged budget shortfalls, available information was communicated by VACo staff to the VACo Board of Directors and to County Administrators concerning a deficit of funding. Since then, Gary Brown, former Director of OEMS, retired. As mentioned, several media pieces about the situation also indicated an ongoing investigation by various state and federal authorities. VACo will continue to monitor and report on this situation.
VACo Contact: Jeremy R. Bennett