CEO Update: Raising Awareness of Rural EMS
Celebrating EMS is one of the greatest weeks we have the honor of supporting at CRHC.
You may not know, but my husband has been a firefighter for over 30 years, so EMS is very near and dear to my heart. One of the greatest skills that EMS providers possess is that they are masters of teamwork and change, since each day they face is different. I’d encourage you to learn more by reading the history of EMS.
In rural American EMS is vital. While only 20 percent of the nation’s population lives in rural, nearly 60 percent of all trauma deaths occur in rural. Some of the challenges we face are:
- Sparse populations covering large geographic areas make the per-person cost of providing emergency care expensive. EMS has fixed costs in operations and capital costs, i.e., ambulance vehicle license, insurance, and maintenance; facility or building rent and maintenance; liability insurance; training for volunteers, staff, and physician adviser; utilities; and supplies, including expensive medications with short shelf lives. Most of these fixed costs are constant regardless whether an EMS provider responds to 10 or 100 calls monthly. The current reimbursement system, such as Medicare, is based on per trip (or per mile) and does not consider the cost of constant readiness.
- Recruiting and retaining staff and volunteers who are available, trained and committed is one of the major challenges currently being reported by Colorado rural EMS providers. Rural and frontier EMS agencies are often dependent on volunteers, and volunteerism is declining as people focus on their paid jobs and as rural areas experience a decreasing and aging population. Retaining EMS providers in rural areas is challenging because of demanding expectations to conduct administrative work and fundraising, health risks, and the costs and time to meet training requirements. Dedicated EMS providers often find themselves saddled with administrative duties that they have little or no training to perform the tasks, which can lead to resignations.
- In rural Colorado we have a higher proportion of seniors. This factor may also result in an increase in the number of calls from those suffering age-related injuries and illnesses. Additionally, there is a higher reliance on Medicare for reimbursement.
- Rural EMS systems usually have longer travel time over greater distances to medical facilities, which is made more difficult and dangerous in adverse weather. The further a patient is from an emergency medical facility, the more a patient will benefit from an advanced level of local EMS; however, rural and remote areas are less likely to provide advanced levels of EMS. The advanced levels of care are difficult to establish and maintain in areas that experience insufficient volume. Paramedics will often relocate to areas that can compensate them for their skills and experience, making retention a problem for rural EMS providers.
Despite the challenges we face in rural with EMS, we are lucky to have amazing individuals that dedicate their lives to making the lives of other better. Here’s a quote by an EMT, “most do not understand, but I stand ready all the time, to help my fellow man.” We at CRHC appreciate everything that our EMS providers do and below are some of these dedicated individuals.