Rural EMS at Risk
This article is brought to you by your local ambulance service. It is one of a series of articles that will discuss the challenges rural EMS services face in the coming years.
Rural EMS is changing and the challenges it faces ahead threaten the ability of rural EMS services to survive.
It’s happening in towns across the country and whether or not you are aware; it’s most likely occurring in your town too. Many rural ambulance services are shutting down or consolidating with neighboring towns. Nationwide, it is estimated that up to three rural agencies are closing each month.
What’s going on? It’s been called the “perfect storm.” For years, rural towns have depended on local community volunteers to staff their ambulance and firstresponder services. But that has begun to change.
Changing socioeconomic conditions are placing more demands on people’s time and an aging volunteer base is resulting in a shrinking volunteer pool.
Lack of funding is also a major problem. Contrary to popular belief, most ambulance services receive no funding from federal, state or local governments. Many services rely almost entirely on private donations and local fundraisers.
But those dollars are no longer enough to pay for the increasing costs associated with running an ambulance service. Just as medicine as become more advanced, so too have the expectations placed on EMS services. Every town wants an ambulance equipped with the latest lifesaving medical technology in addition to well-trained EMTs. Volunteers often don’t have the time or the money to invest in that type of education and on-going training. Keeping up with the latest medical technology is often prohibitive to rural EMS services and the cost of operating an ambulance service often outpaces the money they bring in.
So why can’t the federal or state government step in and fix the situation? EMS services are not federally mandated nor is there long-term federal funding. The same is true for most states.
How critical is the situation? How badly would rural towns suffer without reliable
emergency services? In many cases, it could mean the difference between life and death, according to a report entitled “Emergency Medical Services in Rural America” produced by the National Conference of State Legislatures in April 2007. The conference brought together experts from around the country to inform policymakers about the challenges facing emergency medical service providers in rural America and reported these statistics: • The relative risk of a rural victim dying in a motor vehicle crash is 15 times higher than in urban areas, after adjusting for crash characteristics, age and gender. • Injury-related deaths are 40% higher in rural communities than in urban areas. • 87% percent of rural pediatric trauma deaths did not survive to reach the hospital.
Rural ambulances in rural America are disbanding nationwide due to a lack of funding and volunteerism. This is creating major issues concerning the ability to provide timely emergency care. The first hour is crucial. Trauma patients who can be transported to a trauma center quickly have fewer complications and are more likely to survive. Nearly 85% of US residents can reach a level one or level two trauma center within an hour, but only 24% of residents in rural areas have access within that time frame. Timely emergency care will only get worse with the gradual dismantling of rural emergency care. Wait times will be longer if towns have to depend on service from neighboring towns.
Noted one expert in the report, “Like good water and great schools and healthy environments, emergency medical services and trauma systems are a quality of life issue.”
Please get to know more about your local ambulance service and the challenges it is facing today. Watch for an upcoming article about problems rural towns face concerning emergency services and volunteerism.
(Ed. While Catron County EMS receives state funding, like other rural services EMS in our county faces funding and volunteer issues. A First Responder course is being taught this June & July—see Events on Page 2 for more information—and Catron County EMS maintains some of the best training available. Do ask what you can do to help your local EMS— volunteers are always needed and it indeed a case of many hands making the work much lighter. Check with your local EMS to ask how you can help. This includes Reserve, Glenwood, Luna, Quemado, Datil, Pie Town, Apache Creek Rescue, and Horse Mountain Rescue.)