Idaho task force focuses on sustainability in rural EMS
Proposed legislation and discussions take on funding, recruitment and making EMS an essential service
By Kathy Hedberg
BOISE, Idaho — When the 2024 Idaho Legislative session kicks off in January, it will begin with a proposal from the Emergency Services Sustainability Task Force to try to remedy the critical shortage of workers, especially in rural areas.
The draft legislation aims to recognize EMS units as an “essential service,” akin to law enforcement agencies, which currently are the only state-recognized essential services in Idaho.
“How do we re-do EMS in Idaho?” asked Clearwater County Sheriff Chris Goetz, who is the past president of the Idaho Association of Counties.
“What kind of incentives can we provide? Is there a way to incentivize people in the next year or two? I’m hoping it’s not too little, too late.”
The draft legislation also proposes to establish an EMS fund to help offset personnel and operating costs associated with assuring the availability of emergency medical services.
Bill Spencer, of Grangeville, a member of the task force, said there are some details to be worked out — such as whether an EMS unit would be district- or county-based.
“They plan to get the counties to be more involved in creating some kind of system,” Spencer said. “Right now there are about as many systems as there are counties.”
Spencer said once that is in place, the task force would shift its focus to other vital ways to attract and keep EMS workers. That includes providing a certain level of health insurance for compensated and volunteer workers and could include an option to buy insurance coverage for spouses and other dependents at a reasonable cost.
Spencer believes that offer would encourage a lot more self-employed people to step up as EMS volunteers.
A second recommendation, he said, would be to establish a length-of-service retirement plan for people who had worked on EMS units for five or more years.
The total number of licensed EMS personnel has remained relatively stable over the past 15 years but has not kept pace with the population growth in Idaho. Much of the increase in the numbers of licensed EMS personnel has been in the urban population centers while the number in rural communities continues to shrink. If the current trend continues, many rural communities will be at risk of longer EMS response times because of a the lack of EMS personnel. Communities that currently have a local ambulance service may have to rely on the ambulance service from a distant neighboring community.
Goetz said the shortage of volunteers for all first-responder units, including ambulance, search and rescue, and fire departments has become epidemic.
“What’s happening,” Goetz said, “is volunteers are getting old. They’re in their 60s and 70s and they’re getting tired. We’ve got several fire districts (in Clearwater County) and they’re all in the same boat.”
Goetz characterized the situation as “a generational thing. That generation (of older people) did a lot more volunteerism. It’s harder for younger people to volunteer” because they’re involved with careers and family.
Continuing with the same level of service in many places, Goetz said, “is getting difficult because we’re seeing more multiple-ambulance calls at one time. So far we’re able to call on people and people are still willing to go. But, to me, it’s getting to a critical point. Right now we’re meeting the demand, but just barely.”
Christopher Fisher is one of three emergency medical technicians in Elk City, one of Idaho County’s most remote towns. Although one of the other EMTs is going through cancer treatment and the other is a snowbird, Fisher said the Elk City unit is in better shape now than it has been in the past.
“We’ve had a number of years when we had only one EMT in town who was able to run (on calls) and he also happened to be the postmaster,” Fisher said. “So that provided a conflict. When the bell went off (for an emergency) you had to shut down the post office.”
People’s ability to support the EMS service in Elk City, he said, is limited.
“The people who are able to do the job well are usually working-age adults who are already working at something else.”
Being a volunteer, he added, pays only a small stipend. And if a unit needs to transport somebody from Elk City to Grangeville, that usually takes about four hours. If the call comes from Dixie, travel time is more like six hours.
Although a little more money would be nice, Fisher said, he doubts that the suggestions of the EMS task force would influence many people in his area.
“We’re happy for the perks but as far as making a difference in our actual staffing, it doesn’t affect the key components,” Fisher said.
“What we really need is more younger adults in town. Our median age is over 50 ... and older people in their 70s, they just have limited ability. And these are the people who are fishing people out of the Clearwater River.
“I’m really not sure what the government can do to improve the situation a whole lot. It’s kind of up to individuals and whatever a community can do to increase the economic appeal for younger people,” Fisher said.
The conflict between paid work and volunteer service is also a problem for the Troy Volunteer Ambulance and EMT service.
“We are volunteers, so we have a decent amount of people on the crew,” said Britney Woolverton, president of the Troy ambulance.
“But since COVID ... everything costs so much. It’s hard to live on volunteer wages so more people are doing more jobs or working more hours, so that is hurting us.
“We love our town; we want to help our town as much as we can. But we’re not being paid anything. That’s why it’s so hard sometimes to go for a call because everybody is working so much more.”
Woolverton said there are currently 11 people on the ambulance crew and it includes a mix of ages and experience. The unit responds to about 100 to 120 calls a year and is supported through donations and patient billing.
“A long time ago we were running on donations but now it’s more expensive and we charge the insurances and whatever donations we get from the community,” she said.
Fundraisers include a show and shine car show during Troy Days and a spaghetti feed in November.
“We have a really loving town that really shows us how much they love us and how much they appreciate us,” she said. The Troy Fire Department also helps out with fundraisers and mutual exchange activities.
“Speaking for myself,” Woolverton said, “I’m very much, ‘I see a need; I want to fill it.’ It’s just one of those things. You really want to help. I personally love doing it.”