The Rotterdam EMS in Schenectady County has had their hands full these days, even as new coronavirus cases subside in New York. 

The problem? Executive Director Dean Romano said it's becoming harder than ever to hire new staff to provide vital health care, often in rural expanses of upstate New York.   

"We have about 50 employees," he said on Thursday in an interview outside of his squad's offices. "It varies from time to time. But right now we're at just about 50. We have maybe 12 full-timers." 

At issue is reimbursement rates and funding set by the state, which Romano said have not been updated in years or kept pace with a rising minimum wage. That's put ambulance services in competition for workers with other industries. 

"It absolutely is a statewide problem," Romano said. "The state really needs to study what it is that funds the ambulance services and how they compete with other industries." 

The problem has not led to lower response times for the Rotterdam EMS. But other emergency medical providers have struggled and Romano's EMS has helped with coverage. 

"We've been able to staff using overtime. We've never dropped an ambulance or anything like that," he said. "I know there are agencies around us that have staffed less ambulances because they don't have the staff. We're doing mutual aid in this territories all the time."

Recruitment of new EMS workers, meanwhile, has been hampered by the pandemic delaying education of new EMS workers. 

"The number of graduates that came out of last year's education slowed down and everyone needs EMS providers," Romano said. "The call volume has not slowed down at all."

The issue is an especially concerning one for people who live in rural areas and rely on ambulance services for their health care, Assemblyman Angelo Santabarbara said, as they continue to provide vital services. 

"We look at EMS services as the avenue to be able deliver these vaccines to the people who can't get to a vaccination site, people who are homebound seniors," he said. "People who are in are areas where many times this is the only health care that can reach them."

State lawmakers this year approved a bill to study the needs of ambulance services in rural areas of New York and the challenges they face. It's heading to Gov. Andrew Cuomo's desk.