By Jackson Kimball
Missoulian
RAVALLI COUNTY, Mont. — Ravalli County officials including the Commissioners and Chief Financial Officer Jana Exner, members of Ravalli County’s Opioid governance group, recently approved multiple applications for Montana’s Opioid Abatement Trust, including a $68,000 assistance for EMTs who need paramedic training at Bitterroot Health.
“Paramedic school is expensive,” Bitterroot Health EMS Manager Sarah Monroe told commissioners at their at their Aug. 14 meeting. “We have more vacancies than we’ve ever had. People cannot afford to live here.”
| MORE: Opioid settlement funds: A critical resource for addressing the crisis
The governance group, which started reviewing Montana Opioid Abatement Trust (MOAT) applications in September of 2024, dictates how Ravalli County spends its portion of the national opioid settlement disbursements. Ravalli County’s portion is listed as $332,161.37 for 2024-2025, $221,440.92 for 2025-2026 and $221,440.92 for 2026-2027, according to the MOAT, these expectations are about 3.7% of all MOAT funds.
The group either approves or denies applicants, if approved the application is sent to the national governance group who provides final approval.
Numerous opioid governance structures have been formed across Montana following the landmark national opioid settlement in which over a dozen opioid manufacturers, distributors and consultants were sued for more than 50 billion dollars by U.S. state and local governments. Ravalli County was deemed a “metro region” based on its population size and therefore has received direct funding from the national settlement, as well as a portion of an abatement trust.
The Bitterroot Health’s opioid abatement application stated that the Bitterroot Valley’s unaffordable housing market was negatively impacting their recruitment rates and that funding assistance would allow EMTs to afford paramedic training.
“With increasing housing costs we are struggling with recruitment of Paramedics for our service,” the application states. “Many of our staff are EMTs who have their roots in the community and who obtained their EMT licensure through local volunteer fire departments. Many of them would like to attend paramedic school but are unable to do so due to the cost at the nearest paramedic program in Missoula, which averages about $15,000 per student. We would like to apply to the Abatement Trust to receive grant funding to provide tuition assistance to our EMTs wanting to attend paramedic school.”
Monroe told commissioners that Bitterroot Health offers competitive pay with the rest of Montana, but that because of the Bitterroot Valley’s unaffordable housing market, applicants are still deterred from signing on.
“When we’re interviewing paramedics from out of state, people are interested and they want to come here to the Bitterroot,” Monroe said. “They can’t move here, they can’t afford housing … I look at this as an opportunity to create our own paramedics. It’s a big part of our job.”
Monroe explained that paramedic training is directly linked to opioid abatement in Ravalli County because paramedics are first responders for opioid overdose.
“Our paramedics are really the ones that are gonna go out there and provide that community education and really help these people when they truly are in a crisis,” Monore said. “It’s part of this community, we see the deaths.”
Commissioners raised concerns about EMTs possibly benefitting from free training and then getting jobs elsewhere and leaving Ravalli County . Commissioner Greg Chilcott told Monroe that it has happened before.
“There’s one concern; we have a number of opportunities to fund education and training,” Chilcott said. “As soon as we get them trained and certified they disappear, and we just dumped all this money into getting their training.”
Commissioners asked Monroe if Bitterroot Health had organized measures to decrease the amount of applicants that train in the valley and then migrate elsewhere. Monroe said they did not have concrete methods of encouraging staff permanency, but said they had ideas of how Bitterroot Health could incentivize staying in Ravalli County longer.
Monroe thanked group members for their approval and emphasized the impact that increased paramedic presence will have on Bitterroot Health’s operations.
“I’m tired of having vacancies, our people are working 70 and 80 hours a week to cover the holes in the schedule,” Monroe said. “If it all goes through, you guys have no idea what you’ve done for some people. It’s huge. Huge.”
“I voted for Bitterroot Health because that’s a direct benefit for increasing training for EMTs and paramedics,” Commissioner Jeff Burrows said. “So I support that project.”
The governance group also approved a $35,000 application from the Montana Meth Project, which will be used for Fentanyl prevention, education and outreach.
The group tabled an application for $600,000 from the LifeGuard group, a nonprofit utilizing a “faith-driven approach” to combat human trafficking, according to their MOAT application.
Ravalli County’s governance group will not meet again to review MOAT applications until 2026.
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