Small rescue units starved for volunteers

AREA — Strict certification standards, expensive training and a struggling economy have affected small, rural rescue companies making it difficult to attract and retain volunteer EMTs.

Previously, all-volunteer squads have turned to hiring staff to cover daytime calls, but finding volunteers for night and weekend shifts can be a struggle. 

A regional web of mutual aid ensures ambulance coverage, but it also could mean delayed response time as neighboring services head to a far-off call.

In general, the future for all-volunteer services doesn't seem bright, say members of the EMS community.

Services

Joanne LeBrun, Tri-County EMS coordinator covering Franklin, Oxford and Androscoggin counties says she's seen all-volunteer departments disappear in the past 20 years.

Strict certification requirements, expensive training and a tough economy have challenged volunteer services across the country, LeBrun says.

Regardless of a service's size or budget, regulations demand that volunteers provide the same level of patient care as paid professionals, she says.

That means volunteers have to maintain their certification and keep up with training – finding the time can be tough for someone already working at least one other job.

Buckfield Rescue Chief Lisa Buck says her department has paid staff that covers the station on weekdays, but finding volunteers to cover nights and weekends is nerve-wracking – only nine of the 16 volunteer EMTs sign up for shifts. 

"It's very stressful as a chief when I look at the schedule ... and I'm praying that I have people available to cover the call even if their name isn't on the schedule," Buck says.

Losing even one of those EMTs scares her, but in a tough economy, many department members are busy making ends meet, leaving little time to pick up a 12-hour shift.

"Who picks up the time?" Buck asks. "Every one of us is already maxed out on what we can give ... I don't know of anyone on my department besides one or two that don't work a second job."

Buckfield volunteers are paid an hourly stipend if they respond to a call, but a volunteer can spend 12 hours waiting at the base without receiving any reimbursement.

The department covers Buckfield and part of Hartford. It responds to between 200 and 250 calls a year.

At a selectboard meeting in February, Buck suggested the town offer a small, $2 to $5 hourly stipend, to encourage volunteering. It's a tactic other rescue squads have used with some success, she reported.

The Buckfield Rescue Association raises money for training and uniforms, but volunteers still need to provide fuel to and from the base and associated expenses, Buck says.

"Volunteering costs," she says.

Patty Hesse, captain of Oxford Rescue, says the department has given on-call stipends for at least 15 years and has succeeded in retaining its volunteers.

The department, merged with Oxford Fire Department, handles around 458 calls a year, Hesse says. Fire-rescue has four daytime paid staff on weekdays and two during the weekend. 

There's usually a night or two per month the department needs page department members to pick up shifts, Hesse says – Saturday night shifts can be tough to fill - but in general the department's 30 volunteers are able to maintain coverage.

Stoneham Rescue relies on volunteers who offer their time without any compensation, says Chief Fred Coffin. 

The non-profit squad responds to less than 200 calls annually, but covers a wide swathe of rural Oxford County, including Albany, Stoneham, Lovell and Waterford.

When he became chief three years ago, Coffin brought on paid weekday staff and recently hired an EMT to cover weekends, overcoming a shortfall in volunteer shifts.

Stoneham's 13 volunteers manage to cover nights – sometimes driving to calls in their own vehicles as first responders – but recruiting new members has been a struggle, Coffin says.

Stoneham Rescue funds education and training for new EMTs, but there is no certainty they'll last. Only two out of the last six people he's sent to EMT training are still serving with Stoneham, says Coffin. 

"They can be the most gung-ho person in the world but you don't really know until ... they have their first extremely bad call whether they're going to be an EMT or whether it's not for them," he says.

Training

The cost of even becoming an EMT can be prohibitive – LeBrun says a beginning training course is $630 alone.

Rescue services help fund volunteer training, but as they've needed to take on more paid employees, there has been less funding for training in their budgets, LeBrun says.

Budget concerns are compounded by the cold truth that the rescue squads have a hard time receiving payment, LeBrun says. It's not uncommon for them never to be paid for their services.

Dan Greaney, assistant chief for Tri Town Ambulance and Rescue says it's even hard to retain and recruit paid staff – the pay is lousy and certification requirements are stringent.

Tri Town, which covers West Paris, Greenwood and Sumner, has been able to maintain a staff of per-diem employees and volunteer drivers. About 90 percent of Tri Town staff work at other EMS services.

Especially for services that handle less than 500 calls a year, getting enough experience to maintain certification can be difficult for part-timers, Greaney says. Spending thousands of dollars on advanced training and then not being able to use it can be frustrating.

"I think it's really not worth it for some people," Greaney says.

Coverage

Volunteer shortfalls, particularly on nights and weekends, have strained services, LeBrun acknowledges.

A network mutual-aid arrangements covers the region, but if volunteer EMTs aren't available nearby, a neighboring rescue service might be called in, lengthening response time, she says.

Although Stoneham Rescue is depleted, it still manages to pick up between 97 and 98 percent of its calls, Coffin says – even big companies don't always reach 100 percent coverage.

Before hiring night and weekend staff, Stoneham was hitting around 95 percent of its calls, Coffin said.

Buckfield Rescue also manages to cover most of its calls, Buck says, but it's getting harder – she sometimes finds herself scrambling to find someone to take the call.

"When ... that tone goes out and I know I don't have anybody around and I'm begging people to take the call it's very nerve-wracking," Buck says.

Future

For the past decade, chiefs say, volunteer numbers have been dwindling, but the trend has been particularly noticeable in the past five years – it's getting tougher and tougher to fill shifts and recruit new EMTs.

The all-volunteer model is probably not going to be viable in the future, LeBrun says, although services across Maine and the country have been working on ways to boost interest in the community.

Rescue squads are reaching out to different groups, LeBrun says – Buckfield is strengthening its relationship with Buckfield Junior-Senior High School to encourage a new generation of EMTs and other services are reaching out to former, retired members who may have more time on their hands.

In other states, some towns have even offered property tax breaks for volunteers, LeBrun says.

For many small rescue units, just maintaining is a victory.

Coffin says Stoneham Rescue should be OK for the next decade, but can't predict the future after that – he doubts it will ever be as strong as it once was.

Just finding a new volunteer to replace one who has left is a success, Coffin says.

"Just when it seems like it's about to die off, you always get one or two people who step up ... usually only one makes it but it's just enough, it seems, to keep the organization going."