In Norton County, as in many parts of rural Kansas, the ambulance service is stretched thin.
Norton, with a population around 5,400 in the northwest corner of the state, has six full-time ambulance workers and nine volunteers to respond to all the 911 calls as well as transport patients from one hospital to another.
“Sometimes patients needing to be transferred are left waiting,” said Craig Sowards, Norton County EMS director.
Statewide, a shortage of trained personnel has put county ambulance services in a difficult position: having to delay hospital transfers, which can take several hours, to ensure they have enough staff on hand for emergencies.
One proposed solution making its way through the state Legislature could help alleviate the shortage by allowing drivers without medical training to transport stable patients in rural areas. Ambulances would still need to have another person with medical training riding in the back, such as an EMT or a nurse.
But some state and local EMS officials say it could be risky if a patient deteriorates en route with only one medically trained worker aboard. And they worry about lowering standards of care in rural areas.
“Occasionally patients decline and it’s often helpful to have an extra set of hands to stabilize [patients] before they move on,” said David Johnston, president of the Kansas Emergency Medical Services Association.
Joe House is executive director of the Kansas Board of Emergency Medical Services, which writes EMS and ambulance regulations for the state. Those regulations currently require ambulances be staffed with two medically trained workers, including the driver.
“We write our regulations to protect the public's well-being and safety,” House said. “It’s either safe to do or not safe to do.”
House said the starting wage for emergency medical service personnel is around $21,000 a year. Ambulance services are competing with clinics, hospitals and schools where workers with similar training can earn higher wages.
So many rural ambulance services rely on certified volunteers.
Phillips County is fortunate in that regard. The county in northwest Kansas with a population just under 5,400 draws from a pool of 84 volunteers. That number drops significantly in surrounding counties.
The EMS director for Phillips County, Pete Rogers, said the county is able to maintain such a robust volunteer pool because it hosts the necessary continuing education and the community holds its first responders in high esteem.
Rogers said though he can understand why rural counties with fewer volunteers would want to, he can’t imagine operating ambulances without two medically trained personnel on board.
“If you have somebody that's simply a driver and you still have two technicians in the back of the truck with the patient then, then I, I see absolutely no problems with it,” he said. ”But I would be concerned if it was a non-certified person driving and only one technician in the back.”
In Norton County, Sowards doesn’t think having two trained EMS workers for stabilized transfers is necessary.
“I’ve been in EMS for 20 years running transfers — maybe once in 20 years I’ve had to have a driver come help,” he said, adding allowing non-certified ambulance drivers would help his agency. “On the transfer side that could help a lot.”
Corinne Boyer is a reporter based in Garden City for High Plains Public Radio and the Kansas News Service, a collaboration of KCUR, Kansas Public Radio, KMUW and HPPR covering health, education and politics. Follow her on Twitter @Corinne_Boyer .
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