Minn. approves stipend to recruit EMS volunteers

Lawmakers passed a three-year pilot program that includes giving a $500 annual stipend to volunteer recruits in 14 counties

By Heather J. Carlson

MABEL, Minn. — Neil Folstad knows all too well just how critical each and every minute is during an emergency.

The Mabel Ambulance director has spent 30 years rushing to care for patients suffering from heart attacks, crash injuries, strokes and a whole range of other life-threatening conditions.

"They call it the golden hour. In a lot of cases, it's the golden 10 minutes — especially with heart attacks and strokes," he said.

But Folstad is worried that Mabel will soon lose the ambulance service the small town has come to rely on. He is one of only six volunteers serving on the ambulance crew. To be at full strength, they should have 18 to 20 people. If the ambulance service stops running, the city with a population of 780 near the Iowa border will have to rely on emergency responders from neighboring communities, meaning response times will possibly climb to 15 minutes.

"We have just got to get some of our people to really think about it and what would happen if the ambulance went away," he said. "What if it's one of their kids or one of their parents and something happened?"

Mabel isn't the only community faced with a shortage of emergency medical services volunteers. Small towns across Minnesota are struggling to recruit volunteer firefighters, emergency medical technicians and first responders. The crisis prompted Minnesota lawmakers this year to pass a three-year pilot program aimed at recruiting and retaining volunteers for these critical services. The legislation provides a $500 yearly stipend for them in 14 counties, including Fillmore, Freeborn and Houston.

The bill's chief author, Rep. Shannon Savick, DFL-Wells, said she wanted to do something to try to help small towns bring in new volunteers.

"To me, it's a public safety issue. Plus it's an economic issue, because if you don't have adequate fire and safety protection, business is not going to come into your area," Savick said.

Initially, Savick had proposed a tax credit for all EMS volunteers in greater Minnesota but due to limited funding available this year, she had to scale back the measure. It will cost the state roughly $1.6 million per year. To be eligible, volunteers in the selected counties would need to serve an entire year. They would receive $500 per year for service provided in 2014, 2015 and 2016.

Rep. Greg Davids, R-Preston, co-authored the bill. He said he is hopeful that if data collected as part of the pilot program shows the stipend has been helpful, lawmakers will be willing to expand the program statewide.

"I think it's a great idea," Davids said. "It just seemed to make sense, and Mabel is not the only one whose numbers are down. You go across the state and this is a big problem."

One of the major reasons small towns are having such a tough time finding volunteers has to do with the state's aging population, said Tim Held, deputy director of the state's Office of Rural Health and Primary Care.

"Really one of the primary issues facing rural EMS is just an aging workforce," Held said. "People have been doing this for 30 years and 40 years, and they are getting up there in age and they are not being replaced, so it is a very serious concern for the sustainability of rural EMS providers."

Other challenges include finding employers willing to let employees serve on these emergency crews, Held said. Then, there's the issue of low reimbursement rates for providing emergency care to Medicare and Medicaid patients, which can financially strain small-town ambulance services.

Mabel Ambulance crew member Tim Mengis said ever growing education requirements are also adding to recruitment challenges. Mabel Ambulance is required to have at least one EMT on every run. But in order to be certified as an EMT, volunteers need to take more than 200 hours of training.

"That is another thing that has hurt our small towns. It makes it harder for us to get the recruits," Mengis said.

Folstad chalks up the lack of interest in volunteering to societal changes as well.

"People don't want to commit anymore. I think that's a lot of it," he said.

Mabel Ambulance, on average, responds to about 130 calls per year. Volunteers are paid a small amount for being on call that, generally, amounts to 50 cents per hour. Half of the ambulance team is related to each other. Folstad's two daughters — Liz Folstad and Ashley Rein — also serve on the crew. Liz Folstad is recovering from a back injury and won't be able to volunteer again in September. While the accountant said in some ways it would be easier to walk away from the ambulance service, she is determined not to leave her fellow crew members in the lurch. She has been undergoing physical therapy so she can start helping out again.

"Just tonight I heard, 'Oh I don't know if I could handle seeing somebody with a broken leg,' or 'I'd like to do it but I can't handle blood.' 'I'd like to do it but I know everybody in town,'" she said. "Adrenaline is an amazing drug. You don't focus on what you're looking at. You focus on how to fix it."

There may be hope for Mabel Ambulance. In the wake of some recent media coverage, eight people have signed up to do the 40 hours required to become first responders. And while that is a big help, Folstad said he remains hopeful that some people will step up to do the EMT training to lessen the burden on others. The City of Mabel is also offering $500 to new recruits who serve at least a year.

Fillmore County Emergency Management Director Kevin Beck said he knows of several communities fighting to keep their ambulance services going. Making it even more difficult is that the county is large geographically but has a smaller population. Beck said he was not aware of the volunteer EMS stipend passed by lawmakers. While he said residents generally don't step up to volunteer for the money, the stipend certainly can't hurt recruitment efforts.

Beck added, "I am glad lawmakers are trying to do something,"

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