Communities across Michigan are struggling to recruit and retain emergency medical service EMTs and paramedics.
A combination of factors has made the situation especially dire in rural Michigan, especially in the U.P., where services have been faced with staffing issues, consolidation, and closures due to poor reimbursement and funding.
The shortage of emergency medical services personnel begs the question, how will EMS responses in rural communities be affected and what will happen to the workload of EMS agencies facing personnel shortages?
“One of the biggest issues in emergency medical services is emotional and physical burnout among workers. If you regularly have to carry someone down three flights of stairs, it takes a toll on your body. You’re always lifting and bending,” says Pat Boberg, CEO of Mercy EMS in Calumet on the Keweenaw Peninsula. Mercy EMS has struggled to fill positions in recent years as well because of a variety of issues. “Really, there is just a shortage of EMTs and paramedics. It’s a nationwide situation.”
Help is on the way in Michigan. The Michigan Center for Rural Health has tapped $350,000 in grant money to provide funding to train emergency medical services paramedics across the state. Scholarship recipients are expected to be enrolled in training programs by September 30.
“It’s a national problem,” says Andrea Abbas, who is the EMS program manager for the Michigan Center for Rural Health, one of only three non-profit State Offices of Rural Health in the country. EMS agencies across the nation are struggling to attract and retain talent.
The Michigan Association of Ambulance Services, a statewide trade association representing and advocating for ambulance services, reported two years ago that there were more than 1,000 openings for full-time paramedics and emergency medical technicians across the state. The exact number of openings, however, is not known; the state does not mandate staffing reports from those agencies. There are more than 800 EMS agencies across the state.
Helping train more paramedics is one step toward addressing the statewide shortage, officials say.
The EMS workforce scholarship program offers two tracks for eligible applicants. One track provides up to $20,000 in student tuition and fees for applicants to attend an approved initial education program of choice. The other offers reimbursement for time spent in EMS training, at a rate of $15 an hour and up to a maximum of $16,000 per student.
“This scholarship fund will cover the cost of initial paramedic education for our rural Michigan EMS students. These grant funds will help alleviate the workforce shortage in our rural Michigan communities,” Abbas says.
The focus of the program is to establish, implement and operate workforce development programs. These resources will train people in emergency medical services and address the critical shortage of paramedics by increasing accessibility to EMS educational programming, specifically paramedic programs, in rural Michigan.
Preference has been given to EMS professionals serving rural Michigan, single parents with a desire to serve as paramedics, women with a desire to serve as a paramedic, and racial and ethnic minorities and veterans who are interested in jobs in the field.
“It is a struggle across the state,” says Sarah Helveston, Trauma Program manager at Munson Medical Center in Traverse City. Munson is a level 2 trauma center, verified by the American College of Surgeons and the state of Michigan.
“We are very fortunate to have a local trauma center that can care for almost anything,” Helveston says, “so we do not have to rely heavily on transferring out of Traverse City. In the cases we do transfer, such as a badly injured pediatric patient, if ground EMS is unavailable immediately then we look to our air medical partners to transport. North Flight Aeromed is our local helo and fixed-wing air option.”
Typically it is not the emergent cases that have long waits for transport, she says, it is the less acute or behavioral health cases that really suffer from the lower numbers of EMS professionals.
In Allegan County, Otsego residents have seen demand for ambulance medical emergency calls soar in recent years, outstripping the ability of the volunteer fire department to continue to respond with an on-call firefighter staffing model, says City Manager Aaron Mitchell.
“The sheer number of medical calls the Otsego Fire Department responds to is astronomically higher than in years past,” Mitchell said in a letter to residents before a spring election in which voters approved a millage proposal to fund around-the-clock staffing for emergency services. With voter approval of the millage, Otsego has had 24/7 staffed Medical First Responder (MFR) coverage since July 1.
"Overall, it has been a great success,” Mitchell says.
In 2022, the fire department responded to a record 1,238 calls — a steep increase from even a few years ago (960 calls in 2020).
The paid-on-call firefighter model the city’s department has followed until now is intended to have a capacity of around 500 calls, Mitchell says. “We are at 240 percent higher than that.”
With those numbers, Mitchell says, the city could no longer rely only upon first responders who are “working (other) full-time jobs and living their lives while their pagers are going off needing for someone to respond.”
“I think the scariest part is that it is only going to get worse,” he predicts. “The (EMS training) schools are having fewer and fewer students enroll. You put that on top of the increase in calls for all departments and you are left to wonder how this problem is going to get any better.”
The Keweenaw Peninsula’s Boberg believes the Michigan Center for Rural Health’s grant program will help ease the shortage. Mercy EMS, which serves Houghton and Keweenaw counties – the northern-most counties in Michigan – has one grant recipient beginning training in the fall.
“I think it will have an impact,” says Boberg, who became CEO in 2020 and despite his title still pulls shifts on the rigs. “The EMS community as a whole has made a good plea that things need to change and EMS services need support from local governments in order to be sustainable.”
Mercy EMS has managed to bolster its staff in recent years because of local initiatives, including a local training program at UP Health Marquette, a community outreach coordinator and hikes in hourly wages. Mercy has six full-time paramedics and seven part-time paramedics, serving a 1,200-square-mile area with about 4,000 emergency calls a year.
“We’re sitting pretty good right now,” he says, “but we can always use more medics.”
This story appeared in the August 31, 2023, edition of the Rural Innovation Exchange (RIX), a digital publication focused on innovation, talent, entrepreneurship, social innovation, and community development taking place in rural Michigan and features the work of rural talent and content creators.
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