Expose spotlights the shortage of rural EMS services

The report shares an in-depth look at the strain on rural communities as emergency service agencies close in record numbers around the country


NAEMT President Matt Zavadsky discusses how this NBC News coverage highlights the plight of rural communities, and exposes a dilemma for communities in both rural and urban areas, and shares NAEMT positions on lobbying Congress to enact the SIREN Act, and for states to recognize EMS as an essential service. Read more here.

By EMS1 Staff 

HEBRON, N.D. — An expose by NBC News highlights the dangers of living in a rural town, as EMS agencies struggle to maintain shift coverage through volunteers, and the distance between hospitals grows.  

Growing distance between hospitals 

The report shares the story of Jerrid Soupir, whose life was saved because the event happened in the right place at the right time – in the presence of four EMS volunteers and a nurse – as the closest hospital was 60 miles away.  

Soupir went into cardiac arrest during a softball game, and four members of the Hebron ambulance service were in the vicinity and able to respond, with a nurse even starting an IV on the field. Those life-saving services kept Soupir alive during the 60-mile drive to the hospital. 

“If there had been no ambulance, and people wouldn’t have acted the way they did,” Soupir said in an interview with NBC News,” I wouldn’t be alive.” 

Covering shifts is a challenge for providers 

Two hours south of Hebron in Marmarth, North Dakota, the local ambulance service struggles daily to adequately staff the agency.  

“We are literally one person away from closing,” volunteer Paramedic Erick Hartse said, one of 12 EMS volunteers for the town’s entire population of 143. “We’ve been relying on volunteers to be the backbone in EMS for a long time, and unfortunately that needs to change. Could you imagine being a volunteer doctor? It’s unfathomable.” 

While those dedicated paramedics volunteer out of a sense of duty and loyalty to their community, with rising healthcare costs and a lack of resources, it’s becoming increasingly difficult to maintain service, putting citizens at risk.  

Populations are decreasing in rural towns, which makes it difficult to staff departments to adequate levels, as younger people leave and head for urban areas, leaving a small pool of qualified individuals to take care of the elderly left behind.  

“The reason that they’re managing to hang on is that some of the volunteers just look around and say, ‘Well, good grief, if I don’t continue to do this, who will?’” said Andy Gienapp, head of the Office of Emergency Medical Services for the Wyoming Department of Health.  

According to a report from the University of North Carolina Cecil G. Sheps Center for Health Services Research, 118 rural hospitals have closed across the country in 2010, which compounds the problem for emergency services in those rural areas.  

Addressing the volunteer problem through pension legislation 

The majority of providers in rural areas are volunteers, which means they often hold full-time jobs in addition to the EMS shifts they cover, which don’t come with benefits, pensions or even compensation for the most part.  

A bi-partisan bill sponsored by Sen. Susan Collins (R-Maine) and Ben Cardin (D-Maryland) would allow increased contributions to pension plans, as well as making the program tax-deferred and eligible for rollover to a different plan.  

“If you’re serving your community through volunteer service as either an emergency medical person or firefighter, you want to make sure that your family is protected later in life because you’re giving up some of your ability to put resources away with a traditional employer,” Cardin said. “We gotta make it easier for volunteers to serve.” 

What drives many responders in small communities, however, is the fear of what will happen if emergency services goes completely under, Hartse said.  

“What happens if my family’s the one that needs the ambulance, and there’s nobody here?” 

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