Retirements are shrinking the ranks of volunteer medical responders at a time when calls for service are up and area populations are getting older.
For 23 years, Joe Mercil stayed within earshot of an emergency radio as he lived and worked in tiny Brooks, Minn., ready to rush to the medical aid of anyone in his community who needed it. As a volunteer first responder, he tended to more than his share of bloody car crashes, heart attacks and other problems as he stabilized patients until the ambulance got there. It was stressful, physically demanding work.
So when Mercil turned 64 last year, he decided it was time for him and his wife to retire. Now the town of 140 has only one first responder left.
“We were the only ones in town that were on it, so that’s why we kind of held on,” Mercil said. “I decided it was time for me to quit and let the younger people take over, but you can’t get anybody in these towns to take over. … The first question they ask is ‘How much money do you make?’ They don’t realize you’re [a] volunteer.”
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, emergency service leaders say. The shortage is hitting patient-stabilizing first responder groups as well as volunteer ambulance workers who rush to transport patients.
An estimated 60 percent of emergency medical technicians (EMTs) and paramedics are volunteers in the state’s approximately 200 rural ambulance services, industry analysts say. First responders are almost completely volunteer.
Already the shortage of recruits has shuttered some small emergency squads, lengthening response times as ambulances race to help from farther away. Emergency service leaders say the problem will only get worse and they will have to get creative with solutions, likely by mixing in some paid staff and figuring out a way to pay for them.
“I think we stand at a critical point,” said Mark Schoenbaum, who directs the state health department’s Office of Rural Health and Primary Care. “Given [baby boomers’] predominance in the rural EMS volunteer workforce, in 10 years few of them will still be on the scene.”
‘A scary situation’
Rural regions of the state have a disproportionately aging population, with 17 to 18.5 percent of residents in northwest, southwest and west central Minnesota now age 65 or older, compared to 11.5 percent in the Twin Cities. Those percentages will continue to grow. By 2020, at least 21 percent of residents in those rural regions will be older than 65, according to state estimates; by 2030, that figure should swell to more than 26 percent.
Ambulances charge for calls, but rural areas see so few calls that many struggle to maintain expensive equipment and training, let alone pay workers. In rural Minnesota, more than 70 percent of payments come from Medicare and Medicaid, which sets its own price, according to the Minnesota Ambulance Association.
“That pays us below cost and it’s a huge part of our population,” said Buck McAlpin, the group’s lead lobbyist.
Retirees also are spending more time at cabins in the lakes regions, stretching volunteer services to their limits there, service leaders say.
From Floodwood in northern Minnesota, Lori Schumacker directs an ambulance service that covers roughly 400 square miles in an area where more cabins have been built. The service has 10 volunteers handling two or three calls a week, down from 20 volunteers several years ago when they had slightly fewer calls, Schumacker said.
“It’s the older population that we’re getting the calls for,” she said. “Heart issues, trouble breathing, they just don’t feel right, falls within a home.”
It would take 45 to 50 minutes to bring an ambulance in from elsewhere, so Schumacker, a 40-year-old financial analyst and mother of two teenagers, finds herself on call about 60 hours a week. She’s missed family birthdays and Christmas and sometimes is gone in the middle of the night.
“You’re giving back to people that need you,” she said.
The state Emergency Medical Services Regulatory Board didn’t have statewide statistics on the age of patients calling for help, though numbers are available for some specific areas.
The Le Sueur Ambulance Association, which answers about 400 calls a year, has seen its percentage of calls from patients 65 or older rise to 46 percent last year from 39 percent in 2011, President Pam Williams said.