Changes May Hurt Ambulance Units Nationwide

Eric Van Dusen of Mobridge Regional Ambulance became a paramedic partly because he wanted to give back to the community. Now he's worried other EMTs like himself won't be able to do the same.

If proposed national standards are adopted, the training hours for EMTs will more than double. This leaves Van Dusen fearing that Mobridge Regional and other rural volunteer ambulance services across the state will have trouble meeting the requirements and attracting members willing to make such a training commitment.

"The (proposed) standards came out of helping urban fire and rescue squads, not groups like us," Van Dusen said. "My fear is that by increasing the number of training hours, you might lose some smaller services who are limited already."

The revamped curriculum is being developed for federal regulators by a group of EMTs, doctors and emergency medical directors. To become reality, the increased training standards must be approved by the National Association of State Emergency Medical Directors, whose members are already debating the issue.

Bob Graff, the director of the South Dakota Emergency Medical Services, said the proposed ideas were introduced last year. A final draft is due later this year. Changes wouldn't take place until at least 2006.

But Graff said rural ambulance teams shouldn't worry just yet.

"The first proposal is to increase the EMT basic course from 110 hours to about 240 hours, but that's not a done deal," Graff said. "There will be a new curriculum, but I think they'll be a lot of changes from the first draft."

For Diane Wientjes, Mobridge Regional Ambulance's service director, the proposed standards hit close to home. Wientjes said she already has trouble recruiting employees for her 12-person staff made up of two full-time paramedics - including Van Dusen - and 10 volunteers.

"Anytime there's advancement I'm for it, but with some of the changes they're proposing, someone needs to sit back and look at the rural areas," Wientjes said. "Most of these people are volunteers. If the changes do go through, they're going to have to be paid."

South Dakota officials estimate that almost 90 percent of the state's 131 ground ambulance services are made up of volunteers.

"When I first heard about the proposals, there was an apprehension of possibly losing some valued employees and co-workers," Van Dusen said. "But what it all boils down to is your patient care. The reason we get into this business is to help people and to give back to the community. If the changes did go through, I'm confident we'd find some way to make it work."

Graff doesn't think that will be necessary. He doesn't see the first draft being approved.

"It was presented to the National Association of State EMS Directors at their October conference and the north-central states came out unanimously opposed to the new proposal," he said. "It would be nice to have something like a new course, but realistically, if you take volunteers in rural America, I think we'll find we won't get them to take the class. Even as it is, it's difficult to keep our rural ambulances staffed."

Wientjes agreed.

"EMTs are a strange breed," she said. "'We'll give you no money, we'll give you the worst equipment, we won't pay you a cent but we'll expect you to do a good job. These people are already doing this on a volunteer basis. If those requirements go through - although I don't think they will - they'll have to pay these people. Pre-hospital medicine is a serious business."