Here in New York State (where the company in that article is located), State Department of Health just transitioned to the National EMT Standards. To do that, for a Basic EMT, required about 13 hours of additional classroom time plus FEMA IS100, IS700, and IS5a certifications. Advanced and Paramedics have even more added on. The instructors now estimate classroom time for EMT-B to be north of 175 hours and that's if they hustle through some topics. They're already short on skills labs as is. Very few first time EMT students make it through the skills testing on the first try.
I got my first EMT card in 1973. It was a bridge course from Red Cross Advanced First Aid. (Those of you old enough to remember will know that AFA, propery taught, was an excellent program for its time. I wish today's EMTs could have the skills that AFA folks had.) I don't think that class was more than 30 hours or so. And I watched the Basic and Refresher classes eat up more and more hours over the years since.
The problem is most severe in rural areas where volunteers are few and far between to begin with. I've watched several squads implode right in this area since I moved up here 4 years ago.
But it's not limited to the outlying communities. My original squad was in a suburb of Rochester with a decent call volume, enough members, and close to plenty of high grade training opportunities. 15 minutes by ground to a Level 1 Trauma Hospital, and the same to a Level 2. IMHO, it was one of the best situations for a volunteer squad to be in. But they lost their contract with their community because they could not cover 70% of their calls. They're gone. 73 years of great service to the community blown out the window. Primary cause was lack of volunteers to cover their calls; both day and night.
A larger squad on the other side of Rochester just merged with a neighboring service. They were both originally volunteer, but one has moved to the third party billing with paid crews model. Again, running low on volunteers was the primary problem.
I can't blame the State's expanded training requirements completely. It's high time that EMS providers, paid or volunteer, were held to a proper standard. I don't want slugs next to me on calls. The fire service is in the same boat. Much better training and OSHA standards are the way to go.
Something else that is going to really hurt EMS, especially here in NYS is the Health Commissioner's Order on Ebola. Those requirements are going to drive volunteers out the door. I'm in the middle of presenting transition training to all of our squad members on that, and I expect to see several resignations right away, and probably several more in the months ahead.
We're seeing a industry wide drift towards paid personnel. It's been coming for a long time and the pace is increasing. The concern is local coverage and rapid response time. How that's going to play out in rural areas is unknown in many cases, including my own town. Ultimately, I suspect that we'll see many volunteer ambulance services become first response agencies with ALS and transport coming from commerical operations. In NYS, it only requires one EMT for 1st response, no driver needed. A lot of squads could do that even if they no longer have the manpower to run an ambulance service.
When I was younger, I always thought the older guys and gals were out of place in EMS. Now that I'm on the other side of that coin (67) and retired, I'm one of the very few that can respond on lots of calls, teach others, work around the squad building, go to lots of classes and meetings, etc. I score better on EMT tests than ever before and everybody in the squad comes to me to solve their computer problems. I'm lucky to have retained my health and keep my wits about me. My EMS Chief is 10 years older than me. We've got a driver who is 70 and best I've seen. He also drives school bus full time. Between the three of us, we cover fully half of our squad's call volume. I'd love to have three or four more retirees like us.
But it is only a temporary solution at best. I keep asking the younger members what they are going to do when any one of us (let alone two or all three) is gone. I want to know what their plan is. I want to help them make sure that the plan works and coverage continues beyond the three of us. But all I get is the "deer in the headlights" look on their faces. They don't know what to do, don't know how to sit down and plan what to do, let alone how to implement.
I don't have all the answers, but I have plenty of questions.
