Wyo. hospital, county struggle to sustain rural EMS
Since 2017, 7 EMS agencies across the state have closed while others face staffing and funding problems along with increased calls
By Aedan Hannon
Casper Star Tribune
CONVERSE COUNTY, Wyo. — Amid speculation Glenrock could be losing its ambulance service, Memorial Hospital of Converse County says it has never considered suspending the town's emergency medical services.
However, the Douglas-based hospital, which operates ambulance care for Glenrock and Rolling Hills, is working with public officials to address the long-term sustainability of Glenrock EMS, according to an announcement last week.
"One of the big issues, and one that Memorial Hospital is currently facing, is being able to operate sustainable Emergency Medical Services with viable funding within rural communities while also dealing with rising health care costs and reduced reimbursements," Shawna Litzinger, a spokesperson for the hospital, said in a statement.
News circulated last month that Memorial Hospital could cut ambulance services to Glenrock and Rolling Hills beginning in July due to the costs. While the hospital has no plans to change its EMS operations, it has begun discussions with the two towns and Converse County officials to find a more sustainable path forward.
Converse County has subsidized ambulance services for Glenrock and Rolling Hills and it will continue to do so in the interim while the local governments and hospital work together, said Jim Willox, chairman of the Converse County Commissioners. But like so many other Wyoming communities, the challenge is that EMS receives relatively few calls in the Glenrock area. Willox said first responders answer only a couple of calls each day on average.
"The discussion started around the financial cost of 24-hour service for limited calls, but that's not the only factor," he said. "The conversation is much broader and deeper."
At play is the fundamental question of how Glenrock and other rural communities and hospitals manage ambulance services. A basic ambulance costs roughly $530,000 between equipment and staffing to operate annually, requiring a minimum of about 650 paid trips each year, according to a Wyoming Department of Health. The costs are even higher for more advanced ambulances.
As with many other health care professions, Glenrock also faces difficulties finding the trained first responders to staff ambulances, said Mayor Bruce Roumell, who has long worked in EMS in Glenrock and with Banner Wyoming Medical Center in Casper.
"We used to have close to 25 people or better that were qualified to work on an ambulance at this end of the county at one time and we're down to two full-time that actually live here," Roumell said. "That tells you what type of predicament we're in."
Glenrock and Rolling Hills are not alone. The Joint Labor, Health and Social Services Committee spent hours discussing the future of EMS in Wyoming during its last interim meeting, the product of years of concern. Since 2018, seven EMS agencies have closed across Wyoming, according to an October report from the Wyoming Department of Health, double the number that closed between 2005 and 2016. At the same time that many of Wyoming's rural ambulance providers stand on shaky ground, they have also had to respond to increasing calls over the last six years, data shows.
EMS leaders identify staffing and funding as the most significant hurdles to sustainability, according to the task force's report. Funding is a particular problem because many ambulance agencies aren't fully reimbursed for the care that they provide. Each year, 911 calls account for more than 70% of ambulance responses in Wyoming, but EMS agencies aren't paid for about a third of those trips, according to the Department of Health.
Lawmakers have taken some steps to address the challenges, using federal pandemic funds to shore up EMS and passing a bill during the last legislative session that allows county boards to form EMS districts.
Willox said the group is listening to all suggestions as it aims to ensure a stable future for EMS in Glenrock and Rolling Hills. Creating an EMS district is one consideration, but the measure would have its own obstacles. County commissioners can pass a resolution, but funding the district would require voters to approve an increase in property taxes.
There is no singular solution to steady Glenrock's EMS ambulance service, but the solutions that do exist will take time. Roumell said it will likely take at least a year to make progress. "It's not something that's going to happen overnight," he said.
For now, Converse County, Glenrock and Rolling Hills will continue to partner with Memorial Hospital to outline the next steps, but both Willox and Roumell were confident that the group could find a fix.
"We're gonna continue to work with them and see that we can still provide the level of care that everybody in Converse County deserves," Roumell said.