Posted 6/21/16 (Tue)
By Kevin Killough
Professionals and volunteers within the state’s emergency medical services (EMS) arena gathered in Ray on Tuesday to discuss the challenges and nuances of providing EMS in rural areas.
Jim Restemayer, president of the North Dakota EMS Association, said the purpose of the meeting was to take input from stakeholders to help EMS providers improve the state’s system and be better prepared for the future.
“We’re just starting the discussion on these issues and getting people thinking about it,” he said.
Unlike other public safety services, there is no state mandate to provide EMS in communities.
By law, the state is required to provide fire and police services, but much of the responsibility for creating an EMS service falls on the community. While the state does provide some funding for it, much of the planning and management of EMS are grown organically from community interest.
That means rural areas are dependent on their volunteers, and the future of that supply could be in jeopardy.
Randall Pederson, a certified EMT in Tioga, has been involved with volunteer EMS services for much of his career at Tioga Medical Center, often in a leadership capacity.
He said the “spirit of small-town volunteerism” is fading, which may result in fewer volunteers in the future. When key people driving the EMS retire, it could suffer diminished service.
This was a recurring theme in the presentations at the meeting.
Kelli Sears, State EMS Training Coordinator, said studies are showing that people really aren’t volunteering less. But they aren’t “jumping up and down” about it.
To be an EMS requires $850 plus 160 hours of training, all to get up at 3 a.m. to answer a call and go to your regular job at 8 a.m.
“That’s not the best volunteer job in the world,” she said.
She said that the EMT volunteer rosters are full, but people are less active. And training new recruits is time consuming, making it difficult to replace outgoing volunteers.
“This is a national trend,” she said.
If volunteer ranks and activity do dwindle, Sears warns we could see diminishing or disappearing service coverage. They are seeing calls receiving no response in other parts of the state.
Two ambulance units in the state have been reduced to quick response units, which provide support to patients waiting for ambulances, and one ambulance unit has closed.
Sears said 17 other EMT outfits have expressed uncertainty with their future, which didn’t include any in the region.
In a region with a low volume of calls spread out over a wide area, this can greatly affect emergency response.
Sears said the state is actually quite supportive of local EMS services compared to what some places face, but resources are still limited.
Ken Reed, director of EMS for the Rugby EMS/Golden Heart Services department, said the lack of a state mandate for EMS leaves the funding for the service uncertain.
As such, they often have to define themselves in different terms to chase whatever monies are available to support their objectives.
They’re a non-profit when they need to be, a public safety entity when they need to be, or a medical provider if they need to be, depending on the interests of the grant maker.
District 2 Sen. David Rust (R-Tioga) discussed the challenges ahead in the next legislative session with falling oil and sales tax revenues shaking up budgets across the board.
The lack of revenues will impact energy impact monies, which are doled out based on a system of “buckets,” Rust said.
The formulas are extremely complicated but no funding is released until priorities above it are satisfied.
Money for local EMS services comes at the bottom of the buckets, and Rust said he doesn’t expect to see any of that money released this coming year.
The state also allocated $8.4 million for rural EMS services through the Department of Health budget, which was an increase of $1.1 million over previous years.
But this money, Rust said, may be cut when the DOH meets the governor’s mandates for 4.05 percent in budget cuts.
“If you want an ambulance service you need to pay for it at the local level,” Reed said.