NFPA Journal - January/February 2020 - 56

First Responder by John Montes

DISPATCHES
FROM THE
EMERGENCY
RESPONDER
COMMUNITY

Going, Going, Gone
RURAL COMMUNITIES ACROSS THE COUNTRY ARE FACING A CRISIS IN VOLUNTEER-RUN
EMERGENCY MEDICAL SERVICES. CAN ANYTHING BE DONE?

magine someone you

a system that relies solely on the altruism
love is having a medical
of its citizens to function. But with citiemergency. You frantizens increasingly unavailable, the system
cally dial 911, but it just
is breaking down. Federal grants for EMS
rings. Nobody answers.
and fire programs have recently experiIt seems inconceivable, but that's
enced cuts, compounding the problem,
what's happening in rural areas of the
along with the fact that insurers often
United States, according to a recent
don't pay for the full cost of EMS care.
report by NBC News. As many 60 million
Clearly, something has to give.
Americans now live in areas where they
A vital first step to fixing the problem
are at risk of being stranded in a mediwould be for more states to declare EMS
cal emergency, largely because no one is
an essential service. This would force
available to help. Or, in some cases, to
local governments to ensure that EMS
even answer the phone.
is provided to all citizens. Communities
The heart of the
This is a stunning development. Not
would have to come up with creative
problem lies in the
long ago, volunteer-run emergency
ways to pay for it or face penalties.
fact that the pool
medical services (EMS) were incredibly
Agencies must also get creative with
of EMS and fire
efficient and successful at serving their
how they recruit volunteers. When I
volunteers has
communities. In many towns, those
worked at Santa Clara County EMS in
rapidly
diminished
volunteer positions were coveted spots
California, we offered free continuing
across much of
that you had to earn through training
education credits for all levels of medirural America.
and participation. What happened? More
cal licensure and dedicated a part-time
importantly, can we fix it?
employee to volunteer recruitment and
A number of issues have contributed
management. We were able to triple our
to the problem, but at its heart is the fact
all-volunteer medical reserve corps in
that the pool of EMS and fire volunteers
just two years. Not every volunteer orgahas rapidly diminished across rural America, leaving agencies nization has the resources to dedicate to these efforts, but the
struggling to staff shifts. Younger people who would have tradi- point is that sometimes just a little extra incentive can go a long
tionally filled those roles have moved to urban areas in search way. Money-saving efforts such as combining EMS systems,
of higher paying jobs, and those who remain must often work combining EMS with the fire service, and sharing resources
multiple jobs to make ends meet-it's tough to ask someone with neighboring communities should also be explored.
already working 10 to 15 hours a day to donate their time to
The bottom line is that we're long overdue when it comes
staff an ambulance or fire engine. On top of that, volunteers to acknowledging the critical services provided by our fire,
must also take classes to maintain proficiency, pay out of their EMS, dispatch, and law-enforcement volunteers nationwide.
own pockets for training and license renewal, and often must We can no longer assume that things will magically take care
organize department fundraisers for supplies and equipment. of themselves, and we can't make our volunteers bear the
Many of these issues stem from how EMS is funded-or not- entire responsibility of devising solutions to fix these problems.
in many parts of the country. Currently, only 11 states consider Governments-local, state, and federal-must actively take on
EMS an essential service, meaning there is no legal obliga- this challenge, and they must find creative ways to ensure the
tion for communities to provide EMS the way they provide continuation of these essential services.
fire and police services. Faced with tight budgets, towns often
choose to cut funding for these "nonessential" services, leaving John Montes is specialist, emergency services public fire protection, at NFPA.

56 | NFPA JOURNAL * J A N U A R Y / F E B R U A R Y 2 0 2 0

MICHAEL HOEWELER

NFPA Journal - January/February 2020

Table of Contents for the Digital Edition of NFPA Journal - January/February 2020