EMS Services Are Desperately Needed In Rural Colorado

EMS Services

Denver Post reported that residents in remote areas of Colorado can’t always be sure that EMS services will arrive when they call. People in rural Moffat County often find their way into a hospital in an emergency, relying on emergency medical service (EMS) workers to pick up extra shifts. Because of the low reimbursement rates for Medicare and Medicaid patients, funding for EMS is very low. There’s also not enough staff to cover the costs.

If voters do not step in, the EMS service in northwest Colorado could disappear completely. EMS leaders warn that rural Colorado departments — and elsewhere in the U.S. — may follow. Some of them have already closed.

Contrary to fire and police, EMS is not considered a vital service by the state. This is contrary to the norm in this country. Even though the state has a growing economy and billions of dollars in federal stimulus money, EMS funding is not a priority for the legislature. In many cases, this lifesaving service is kept afloat through bake sales, potlucks, and endless hours of unpaid labor.

“We are an essential service. The community expects it. Tim Dienst, CEO of Ute Pass Regional Health Services District, stated that we are available 24/7. However, it costs a lot to provide it, and no one really wants to spend the money.

Sam Weaver, Boulder’s mayor, was a 15-year veteran of a volunteer mountain fire station that provides EMS west. He said that there would be more people calling for an ambulance without better funding and no one showing up. People will die. “It’s an emergency in some areas. He said that this was not excessively dramatic.

Let’s hope you don’t have a heart attack.

Moffat County is nearly as big as Connecticut but only has one ambulance crew working. The group text chain is used to request backup, but this may take twice as long as is ideal, or more.

According to the EMS world, time is brain or time is tissue. Every minute counts if someone is suffering from a stroke, cardiac arrest, or any other type of emergency.

There are no ambulances near Dinosaur, Utah. However, Brooks Bingman, a paramedic, recalled a patient who had a heart attack and was near the area. She would like to respond to this type of call within 10 minutes or less, or even 20 minutes.

She said that she was sweating after 45 minutes. It took 75 minutes.

Bingman said that an EMT in Craig could earn more at Wendy’s. He also has a second job. Trevenen has three jobs.

Shana Silver, director of Baca Grande Emergency Services in Crestone, said that “this is a field you can run in your blood.” It is a passion for those who love it.

She said that EMT work in her region pays less than $12 per hour and that hers is one rural Colorado department that covers a large area with limited resources. She said that it was absurd to come out of Colorado. … From where are they attracting them? Why would they quit their jobs?

Silver and her peers agree that it’s not acceptable and should be stopped. But it can get worse.

According to Scott Sholes (EMS chief at Durango Fire Protection District, President of the Emergency Medical Services Association of Colorado), there are approximately 200 EMS agencies in Colorado.

Sholes stated that approximately half of the fire department staff are employed by paid staff or volunteers. The remaining half is split between city- and county-provided services as well as health systems or private companies that operate in urban and suburban areas.

The more remote and poor an area is, the more difficult it becomes for economics to work. Although it is expensive to maintain an EMS department with low call volume and low reimbursement rates, there is no guarantee of profit.

Sholes stated that the fire department would respond to a fire, spend as long as necessary, and investigate the situation. This can cost a lot of money per call. People understand that they must pay for police, fire, and school security. There is confusion over who pays for the ambulance.

Memorial Regional Health, home to Moffat County’s EMS service, suffered a loss of $600,000. Unfortunately, this has been the case for many years, and it is expected that losses will continue to increase in 2022.

According to the hospital, it cannot sustain this. So, in November, the voters of the county will decide on a property taxes hike, which is about $35 per year for the average homeowner. This will create a new countywide program that provides consistent service in Maybell (which is volunteer-only) and Dinosaur.

Sam Radke, Chief Financial Officer, thinks it’s reasonable to ask. But he is worried. “I have people telling me that it won’t pass. Moffat County experts, people in authority

This conservative region is not a fan of tax hikes.

Vicki Crawford, EMT, stated that the death of a family member is not an option. “I would pay $100 more per year — I would pay a thousand, or a million per year — if it were my family member.”

Often nobody pays. Memorial Regional Health states that it cannot continue to support EMS with more lucrative lines of service.

Radke stated that he has thought about whether it would be better to clarify any confusion regarding EMS funding by making absolutely, painfully clear with the voters what could happen if they reject the tax increase.

“Could take up to 12 hours per day. Radke, working with 17 rural hospitals since arriving in Craig two years ago, said that the other 12 hours could be life-threatening.

He suggested that the hospital might have to eliminate EMS completely. He said that the only place he worked in that didn’t have a consistent EMS service was Liberia, one of the world’s poorest countries.

A Typical Day At Work

As it stands now, Rural EMS is mainly fueled in part by the passion of volunteers and workers who keep their phones close and make financial and family sacrifices to ensure that every call gets answered.

“It gives you a lot of gratification, helping people. Even if it’s just holding their hand,” Crawford spoke Tuesday morning at the Moffat County EMS Headquarters.

She got into this work after crashing her car into a ravine and being rescued by an ambulance crew. She stated that she felt inspired to give back. Many EMS personnel have such personal stories.

This crew’s office is located in the corner at the hospital on Craig’s hill. It has an ambulance garage, two sleeping rooms, and a few desks—a speaker blasts out new calls. Around 11:15 am, a call comes in from a 44-year old woman suffering from panic attacks. She is just down the street in Craig.

Bingman and Trevenen arrive in police custody at 11:23. The patient lies on a bed in a cramped home, sobbing and shaking.

A few feet away, a seven-year-old girl with dyed-pink-colored hair cries.  Through deep, heavy breaths, the patient informs her daughter that “Mommy is gonna be fine.”  Seven minutes later, she’s in the ambulance.

The crew takes care of her and is aware of her multiple ailments, including anxiety, obesity, and hypertension. Bingman talks to the woman as she examines a monitor and uses various tubes. Bingman is friendly and congratulates the patient for quitting smoking. She also asks lots of questions like “Are you warm enough?” Are you too warm? Have you had any recent falls?

The ride home is much easier for the woman, and she thanks Bingman for being such a “godsend.”

She said, “I thought that I was keeping it all together.” Bingman replied, “Sometimes, we just don’t, and that’s okay.”

Five calls a day are average for the crew, but most of them are not critical. Trevenen said that they could be problematic in other ways. He tries to forget previous calls for his own sanity.

He said, “Some stick, some don’t,” as the crew returned to the hospital around noon. “The little girl on call right there. It’s going to upset me.”

He and his crew later said it was a cliché, but it is true: You don’t get into this job for the money.

“Did We Miss Out?”

Recent evidence shows that Moffat’s threat of losing service should be taken seriously. Many agencies have reduced their staffing, and Penrose shut down its EMS agency this month in rural Fremont County this month.

The department stated on Facebook that “The community cannot assume an ambulance will be readily available for a call.” Kim Schallenberger said, an EMS chief from that region of the state: “The volunteer aren’t there.” They don’t exist anymore, and the public still expects a response to 911.

EMS advocates are aware of the concern, but they have not yet made a case for more funding to state policymakers.

The EMS association approached Gov. Jared Polis asked for $40 million in emergency funds. They did not receive it. They tried to get a few hundred thousand in the springtime budget-writing process for 2021-22 but were again unsuccessful.

Polis said that $3.8 billion from the federal American Rescue Plan Act, a once-in-a-generation infusion, has not been reserved for EMS.  All this despite the fact Senate President Leroy Garcia is a veteran paramedic and still occasionally takes out an ambulance in Pueblo.

He stated that the legislature is largely unable to fund EMS funding due to its complexity and differences depending on geography and population.

“Ambulances and other services are not regulated by the state,” he said. He said that it is county-driven. “So, when I first visited the legislature, my thinking process was that we should combine these things—the dynamic changes to battling county commissioners. I have never even written a bill.

EMS leaders believe they need a new message.

David Patterson, the regional CEO at Falck, a private company that provides EMS services to Aurora, stated, “We need to do a more thorough job.” “The greatest fear I have is the man, with us, not having all our stuff, did we miss anything?”

Patterson suggested that Patterson’s sector would benefit from lawmakers encouraging them to think radically and funding a reimagining of EMS. Eagle County and others on the Front Range are trying to divert people away from emergency rooms by having paramedics do more preventive care and then transport them to urgent care and specialist offices.

He said, “In terms of bread and butter — someone calls us for an emergency, and they take them to the ER. The basic format has remained the same since the 1970s.” “It would be great if we could get someone who has a particular need to a more targeted resource.

Garcia stated that only a few legislators are interested. However, Garcia promised that next year — his last at the Capitol, due to term limits — he’ll make it a priority.

Moffat County voters will have decided on funding EMS funding by January’s legislature. Although the ambulance crew is anxious, they have trouble picturing themselves leaving the field. But, there is always a way.

There were four calls at once — one for a patient who needed a helicopter transport, one for a patient with a traumatic injury to his leg, one for a patient with cardiac issues, and one for a victim of domestic violence with injuries.

Bingman stated, “It all worked out.” However, it was, as you can see, stressful.

Trevenen stated that the love for the job and a sense of purpose wouldn’t allow the ambulances to run at some point. How can he and his fellows meet the demand if nobody in Moffat County is willing to pay?  He said, “You don’t.”

The residents would like more options or choices for EMS services in their county, and hope funds will become available to have companies that are currently in Denver will open offices inside their county.

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