Report: Montana volunteer EMS model unsustainable

Department of Health describes reimbursement, recruitment and retention problems facing volunteer EMS agencies

HELENA, Mont. — A new report from the Montana Department of Health and Human Services highlighted the critical situation in which the state EMS volunteer model is in today.

Three-fourths of Montana is covered by volunteer EMS, but more and more of these agencies face education and funding challenges, the Helena Independent Record reported.

"Especially the last five to six years, I’m becoming more and more troubled about our EMS system," Jim DeTienne, EMS and trauma systems section supervisor for DPHHS, said. "It is very fractured. It is very troubled. It is not going to sustain in the same way we’ve built it in the last 30 years for much longer."

Unlike police and fire, EMS services are not legally mandated in Montana and their budget can be subjected to cuts. Moreover, the services are only reimbursed for transporting patients to hospitals, which is often not enough to cover the actual expenses, according to the report.

"Nobody pays for it, but everybody thinks you call 911 and they’ll be there," DeTienne said. "It’s becoming more common that a service calls me and says, 'I don’t know that we have people to respond this weekend. Are we going to get in trouble with the state if someone calls 911 and no one responds?'"

The report said it is increasingly difficult to recruit and retain volunteers due to the low pay and high education requirements.

DeTienne suggested a solution to decrease expenses could be implementing community paramedicine programs. Also, better incentives for volunteer EMS providers need to be in place to solve recruitment and retention issues.

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