Examining the Relationship Between 911 Public Safety Answering Point (PSAP) Closures and Rural-Urban Disparities in Ambulance Response Times

For over two decades, state and federal legislators have prioritized improving the effectiveness and financial stability of Public Safety Answering Points (PSAPs), the 911 call centers that are the backbone of the nation's emergency response system. Federal laws such as the Ensuring Needed Help Arrives Near Callers Employing 911 Act of 2004 and the Next Generation 9-1-1 Advancement Act of 2012 were enacted to address challenges facing PSAPs, including funding shortages, outdated equipment, staffing issues, and the need to modernize emergency communication infrastructure. Similar ongoing efforts at the state level underscore the importance of accessible and high-quality emergency services for communities nationwide.

Despite these initiatives, many PSAPs continue to grapple with persistent funding and staffing shortages. In response, closure and consolidation of PSAPs has emerged as the primary strategy to address these crises, but there is little data available on how these actions impact public health and ambulance response times. This research project aims to fill this critical gap by compiling the first comprehensive set of data that examines ambulance response times after PSAP closures and explores whether these impacts differ between rural and urban areas. Understanding these differential effects is crucial to ensuring equitable emergency care access for all Americans, especially those in rural regions.

Efficient PSAP operations are vital to the timely dispatch of emergency medical services (EMS), and delays can have serious consequences. More than four million Americans live in so-called “ambulance deserts,” where waiting times for ambulance arrival can exceed 25 minutes. The importance of improving emergency service access for rural communities has prompted further legislative action, such as the recently introduced Advanced, Local Emergency Response Telecommunications (ALERT) Parity Act, which seeks to guarantee connectivity for rural and remote populations.

The findings of this project will provide invaluable evidence to help policymakers and emergency service providers understand the effects of PSAP closures and consolidations. Ultimately, the research aims to inform and guide future rural health policies and 911 system improvement initiatives, ensuring that even the most isolated communities can access timely, effective emergency care.