Montana State helps create tailored resources for emergency medical services

BOZEMAN - According to federal government analysis, Montana and many other U.S. states have faced funding and staffing challenges for emergency medical services for decades. In rural areas, EMS services are often run entirely by volunteers, who spend their free time driving countless miles responding to calls. However, scores of dedicated volunteers are nearing retirement age as the population increases in the areas they serve, meaning that demand for EMS is only growing.

The firestorm of challenges facing EMS workers is not easy to solve. But in partnership with the state Department of Public Health and Human Services, Montana State University has rolled out resources to help bolster the state's EMS landscape.

Housed in MSU's Mark and Robyn Jones College of Nursing, the Montana Office of Rural Health and Area Health Education Center (MORH/AHEC) has been a leader in creating and disseminating online trainings for Montana's rural EMS leaders. Now, a recent project, called the "Montana Frontier EMS Leadership Academy," is creating rural-specific courses for interested EMS workers focused on topics such as recruitment, retention and mentorship.

A federal award from the Health Resources and Services Administration in 2024 is funding the project for five years, with $250,000 allocated per year. Project leaders hope that after this initial funding, they can secure additional dollars to further distribute the resources.

EMS leaders from six towns are participating: Lewistown, Ennis, Fort Benton, Hamilton, Glendive and Thompson Falls. The leaders receive a small stipend for participating.

"Our work seeks to address a critical staffing shortage of emergency medical services, which is a challenge across the U.S. but is felt acutely in rural and frontier areas," said Kailyn Mock, director of MORH/AHEC at MSU. Frontier areas are the most remote and sparsely populated type of rural area. "Unfortunately, many EMS services are just one or two EMT retirements away from being unable to respond to 911 calls. It is imperative to help our current EMS leaders recruit the next generation of people who are going to pick up the phone and come help in an emergency event."

The training topics are borne of requests from the participating sites. The modules are online and structured so that emergency care providers can easily take them at their own pace. Nearly 20 people have completed the training so far, Mock said.

DPHHS also coordinates a monthly discussion call for the participating sites. Those have been fruitful opportunities for EMS leaders to discuss everything from their preferred billing software to how they use social media to recruit new volunteers, she said.

"Emergency medical services in Montana face many challenges, from a dwindling workforce for both volunteer and career agencies, increasing emergency call volume, and increasing public expectations, to name a few," said Shari Graham, EMS system manager for Montana DPHHS. "The Montana Frontier EMS Leadership academy addresses these and many other challenges and serves as a critical resource for the development of current and future EMS leaders."

Mary Jo Gehnert, director of the Glendive Ambulance Service, has engaged in several of the leadership trainings. At 64 years old, she has been an emergency medical technician for nearly 28 years.

The Glendive Ambulance Service is run by a group of about 20 volunteers. Last year, the team responded to 830 calls in Dawson County.

One of the main challenges Gehnert faces is motivating volunteers and preventing burnout, she said. When a call comes in, she contacts her network of volunteers to respond. But sometimes volunteers will turn down a call, and there's not much she can do.

One training session helped Gehnert identify her leadership style and taught her to communicate more effectively with volunteers when her approach isn't effective. She learned it's critical to motivate people by reminding them they are part of a larger team, but the approach to those conversations may change from person to person.

Gehnert also appreciated the training on using digital tools and social media. After completing it, she created a social media page for the Glendive Ambulance Service that another volunteer is helping to run. They post spotlights on each volunteer, which has been both a fun way to recognize people and also connect with the community they serve.

Overall, the trainings have been a great resource, Gehnert said, because the modules are interesting, specific to EMS in Montana, and they don't take too much time.

Another training participant is James McBirnie, the 50-year-old director of Madison Valley Emergency Medical Services. The Madison-area EMS differs from Glendive, because the ambulance service began partnering with the Madison Valley Medical Center in Ennis in 2021. Prior to that, the service was run by volunteers, but it became difficult to maintain an acceptable response time due to the county's growing population, which led to increased call volume and sometimes traffic.

Now that the ambulance service is part of the hospital, the EMS staff is paid. But there are only three responders per shift, plus one person on call, and they still share the other challenges facing volunteer-run EMS entities. One example is the sheer size of the service area: McBirnie noted that because Madison County is so geographically large, responders sometimes have to drive 45 minutes to reach a caller.

In addition to the state's expansive geography, another challenge, especially in southwest Montana, is finding affordable housing for employees. Several of McBirnie's employees live hours from Ennis and commute for their shifts.

Sometimes, people understandably leave for higher-paying jobs, McBirnie said. One thing he has taken away from the trainings so far is the importance of mentorship and helping his employees grow professionally, cultivating a place where they want to stay. For him, that includes conducting one-on-one evaluations and working with employees to establish specific goals to build up their skills.

McBirnie said he hopes the state allocates more funding for both the EMS Leadership Academy and county EMS offices in the future.

"It can feel like an uphill battle," McBirnie said of EMS work. "The need for emergency services in Montana is only growing, and investing in the development of our future EMS leaders is how we will meet that demand."

More information about the trainings is available at healthinfo.montana.edu/ems/leadership.html.