Volunteer emergency medical services becoming less prevalent as they run short of volunteers

Volunteer EMTs in Maddock, N.D.

Volunteer emergency medical service squads appear to be dying out as rural populations change and EMS evolves. Volunteer squads have long been the sole emergency responders in many rural areas, reports Candi Helseth of the health-oriented Rural Assistance Center, but according to a 2010 study, "Rural Volunteer EMS: Reports from the Field," 69 percent of 49 local EMS directors in 23 states reported problems recruiting and retaining volunteers.

The North Carolina Rural Health Research and Policy Analysis Center study reported three main reasons for loss of EMS volunteers: high numbers of retirees or elderly in rural areas are unlikely to have physical strength required for EMS, many working-age individuals leave rural areas to find jobs elsewhere, and volunteers have too many obligations to cover weekends. Voluinteer fire departments have reported similar problems.

Almost three-quarters of the all-volunteer EMS agencies hosted fundraising events to get necessary funding, requiring further time commitments. At least one-half of these agencies have started some type of paid compensation, but it's still less than maintaining a full-time staff. Twenty percent of EMS leaders reported being "uncertain of their ability to maintain future service," and 8 percent were "frankly pessimistic" about the future. (Read more)

GAO suggests more clarity, oversight in use of funds sent to counties with federal lands

In rural counties with federal lands, a share of the revenues from the sale or use of the natural resources on that land came back to the counties. So when Western counties dependent on federal timber revenue steeply declined in the 1990s, Congress passed a law to provide for roads and schools in rural counties. In 2008 it allowed those counties to use the funds to protect themselves from the threat of catastrophic wildfire and provide emergency services on federal lands.

Now the Government Accountability Office, the auditing arm of Congress, has found that the Bureau of Land Management and the Forest Service have provided little oversight of that program, and the counties, given vague guidelines on how to use the money, have used it on projects that appear inconsistent with federal law and failed to properly disclose their spending to the public. The GAO contacted 44 counties in 22 states across the nation.

The Secure Rural Schools Act, which was recently reauthorized for one year as part of the transportation bill passed in late June, is now under review to be renewed for another five years. In a letter to New Mexico Sen. Jeff Bingaman, the GAO reported that since 2008 the law has provided more than $2 billion in federal assistance, with more than 350 counties receiving $108 million for fiscal 2008 through fiscal 2011, with individual counties receiving anywhere from $3,600 to more than $2 million a year.

The GAO's recommendations to Bingaman and to the Senate Committee on Energy and Natural Resources included regulations and clearer guidance so counties can make better funding decisions. In addition, Congress should consider revising the law to clarify whst types of projects are allowable under the act. (Read the GAO report)