Rural EMS bends under the strain
You know those problems about which people say, “It’ll take a disaster before anything gets done?”
And if North Dakota and Minnesota could avoid the disaster — which likely will involve sick or injured North Dakotans and Minnesotans dying because ambulances can’t get to them in time — by being proactive, that would be great.
“Emergency medical service in rural Minnesota is approaching a dangerous dearth of volunteers as baby boomers age out of the demanding work and into needing more care themselves,” a news story in the Star Tribune newspaper of Minneapolis concluded last month.
“Already the shortage of recruits has shuttered some small emergency squads, lengthening response times as ambulances race to help from farther away.”
The Strib is not alone in its finding. “There is a workforce shortage in many states,” and “this is most pronounced in rural areas,” the National EMS Assessment by the Federal Interagency Committee on Emergency Medical Services concluded in 2011.
The assessment by the North Dakota Rural EMS Improvement Project was both starker and more bleak: “Rural EMS in North Dakota faces a growing and potentially dangerous crisis,” the project concluded in 2011.
In fact, the effects of that crisis already are showing up, according to the North Dakota report. Rural ambulance services already “have trouble mustering crews at certain times of the day or week. Some services are experiencing delayed response, and some are even missing calls.
“Such a situation is dangerous for patients, the public and overworked EMS workers.”
One issue that surfaces again and again in these reports is the fact that no single agency is responsible for emergency service. As the North Dakota report describes, “No mandate exists for the provision of EMS in North Dakota, and it is not clear who is ultimately responsible for the provision and funding of rural EMS.”
Lawmakers should change that status as a way to start solving the problem. For example, the North Dakota Century Code requires that all counties have an elected state’s attorney and an elected sheriff (among other officers), and charges the Department of Health to “establish standards, rules, and regulations which are found necessary for the maintenance of public health, including sanitation and disease control.”
Emergency medical care — no less than “sanitation and disease control” — deserves the same formal recognition and assignment of responsibility.
Like safe food, clean water and clean air, prompt ambulance service has evolved over the past 40 years into a fundamental expectation of modern life. It’s time for state law to start treating it that way.