Even with paid EMS, North Gilliam Medic faces shortage

Part 2 of a series that explores the challenges and potential solutions for ambulatory services in Wheeler, Gilliam, and Sherman counties

Last week we covered the crisis unfolding in Fossil with its volunteer ambulance crew.

In Fossil, the two remaining Emergency Medical Technicians (EMTs) resigned in July. The Fossil City Council oversees the volunteer ambulance and has been searching for answers. Similarly, in Spray, fewer people have stepped up to volunteer with Emergency Medical Services (EMS), leaving the remaining volunteers stretched and worried about the future.

With only a small budget to work with in Fossil and Spray, some wish that more funds were available to help ambulatory services and adequately pay volunteers.

In stark contrast, the North Gilliam Medic in Arlington has benefited from a steady cash stream.

Under the umbrella of the North Gilliam Health District, money from wind and solar projects has buoyed public coffers. North Gilliam Medic has funding that other communities in the region can only dream of.

The ambulance hall is fully stocked with medicines and tools. A new ambulance is on the way.

And in the spring of 2023, the health district agreed that volunteer EMTs were unsustainable. The board moved to convert EMS volunteers into part-time personnel. Not only would ambulance drivers, Emergency Medical Responders (EMRs), and EMTs get paid, but they would also be eligible for employee protections under Oregon labor laws, as well as paid sick time.

But now, just over a year later, the North Gilliam Medic is still in a tight spot.

Despite offering $22 an hour for EMTs with stepped increases after six months, the North Gilliam Medic has just two staff members with EMT status or above, which is required to transport patients by ambulance.

Last month, EMT Richard Hernandez was tragically killed in a car accident. Hernandez had joined the North Gilliam Medic last winter. Another EMT recently moved out of the area, and suddenly, the crew went from being short-staffed to anemic.

Like their colleagues in Wheeler County, this creates intense pressure on the two remaining staff members: paramedic and North Medic EMS Chief David Anderson and Advanced EMT Laurel Williams.

Should two emergencies occur, both Anderson and Williams would be toned out and would need to respond. This makes running simple errands out of town or having a beer with a friend on a day off nearly impossible.

The North Gilliam Health District has been advertising aggressively for months. They have done local, statewide, and national ads on job boards, and targeted recruitment on industry websites. They have also spoken to everyone they can think of in the Arlington area and along the I-84 corridor. But so far, they have come up empty.

North Gilliam Medic Chief David Anderson is a seasoned veteran of emergency care. He has over 30 years of experience and has worked as a paramedic at Oregon Health Sciences University (OHSU) Hospital in Portland and with private and public ambulance services.

Anderson believes that state and federal leadership and action are required to address the shortage of EMS personnel in Oregon and throughout the United States.

When looking at funding for emergency services, Anderson says that police and firefighters get a regular annual amount at the federal and state levels. However, emergency medical services have been unable to garner lawmakers' attention, and a crisis is unfolding across the country as a result.

For more than a decade, the United States has faced a growing shortage of EMS providers, including paramedics, ambulance drivers, and EMTs, according to the National Institute of Health. However, the COVID pandemic was especially catastrophic for EMS personnel.

In 2021, about one-third of EMTs quit their jobs, and in 2022, approximately 3,000 more EMS staff left the field than entered it.

"It is frustrating that volunteers do about three-quarters of the EMS and fire (fighting services) in the United States," says David Anderson. "There are EMS agencies that have to do bake sales to put gas in their trucks."

But even with resources, Anderson says that the pay for EMS responders is drastically low. "People can get a job at McDonald's for nearly the same hourly rate," Anderson says.

It takes at least six months to finish an EMT course and get licensed, which costs about $5,000. But the distance to access such programs is not worth it for many people in rural areas, who are looking at weekly commutes of several hours.

To take an EMT class, students must travel to either the Columbia Gorge Community College in The Dalles, or to Blue Mountain Community College in Hermiston.

Although many classes in community college have gone online, Anderson says in-person, hands-on learning is essential for EMS training and licensure.

Anderson also believes that, in some cases, the state should allow local agencies to provide instruction to eliminate barriers and make programs more accessible.

"The state can authorize an agency to do a state-sponsored class, which means you don't have to do it with the community college," Anderson says.

The Arlington Ambulance Hall is well equipped to offer such classes, and in fact, they have done EMT and EMR classes at the ambulance hall and with students at the Arlington High School. In addition to his 30 years of experience in the field, Anderson is also regarded as a talented teacher.

But ultimately, without competitive compensation and a recognition that EMTs, Intermediate and Advanced EMTs, and paramedics are valid career paths – shortages in the EMS field will likely continue.

"When you look at nurses, they fought hard for years to unionize and to not be treated as someone who empties bedpans," says David Anderson. As their pay increased, so did the recognition that it was a good career path. In Oregon, registered nurses make on average about $99,000 a year.

By contrast, paramedics, who are required to get an associate's degree and complete a significant amount of medical training, are paid a fraction of this amount – about $56,000 a year.

"The state and federal government need to realize that they have to put money out for EMS," Anderson says. "People can't just keep volunteering for a t-shirt."

He also says that programs like rural nursing that knock off money from student loans would be a good incentive.

"A dietician will get money knocked off their student loans, but paramedics and EMTs won't," Anderson says with a sigh.

"Ultimately, we need recognition – to truly be recognized as a profession by our government," Anderson says. "That would be a good start."