The Membership Organization of State Offices of Rural Health
Last month, the State Offices of Rural Health and NOSORH were represented by Matt Strycker, NOSORH Program Manager, at the National Association of State EMS Officials (NASEMSO) Regional Meeting in Denver, Colorado. Strycker spoke on a panel with Ron Seedorf, Emergency Preparedness Manager at the Colorado Rural Health Center, about the work of SORHs and NOSORH, and how State Offices are leading the charge through the EMS Flex Supplemental funds they received.
With EMS officials and those on the ground taking the lead on the opioid crisis, representation at this meeting was quite timely. The session “A Rural EMS Story”, presented by Chris Beltz of Campbell County EMS in Wyoming, detailed how a failing EMS provider partnered with the Wyoming State Office of Rural Health and the Wyoming Office of Emergency Medical Services to do an assessment of Campbell County EMS. They set out key areas for improvement; personnel issues, overtime problems, building a partnership with their hospital, etc. They were able to go from losing money to making their hospital and Campbell County EMS almost one million dollars. This real-life success story highlighted the importance of building partnerships between EMS providers and the State Offices of Rural Health.
Input on an EMS Addendum to the Rural Hospital Closure Toolkit was collected at the meeting. This addendum will include information and resources on what EMS providers can do if their hospital has closed or if there is a threat of a hospital closure. If you have any information that you may be able to provide on the addendum, please contact Matt Strycker at stryckerm@nosorh.org or at 1-888-391-7258 ext. 102.
Matt Zavadsky, MedStar Mobile Healthcare, speaks on National Community Paramedicine/Mobile Integrated Health Programs
NOSORH, the Joint Committee on Rural Emergency Care, and the National Association of State EMS Officials would like to thank all who helped make the 2018 National Rural EMS & Care Conference a resounding success in Tucson, Arizona! Together with the Arizona Office of Rural Health, over 100 participants attended the conference for two full days of engaging sessions. Attendees were presented with topics ranging from new EMS payments models, to different approaches to tribal and frontier paramedicine projects, to a panel of state EMS directors, and more.
NOSORH will be compiling and sharing the information gleaned from the working lunch discussion focused on what EMS can do when a rural hospital is facing closure into a toolkit later this year.
A panel of State EMS Directors discuss national rural EMS issues
All conference resources, including presentations from the meeting, will be available here on the NOSORH website by May 7th.
If you’re interested in connecting with someone who attended from your state, check the participant list here.
By: Beth Blevins
Rural EMS organizations in Wisconsin are learning to work together and rally for their needs, as evidenced by the recent EMS Day at the Capitol.
The event grew out of an effort begun in 2015 by the Wisconsin Office of Rural Health (WI-ORH) to assess rural ambulance services in the state. That initial work also has generated targeted technical assistance, system-wide collaboration, and other types of advocacy.
Over 100 EMS providers from across Wisconsin gathered in Madison to visit with their legislators for EMS Day at the Capitol.
EMS Day at the Capitol, held on November 1, 2017, had 105 attendees, including representatives from 50 EMS agencies. “Several people said if we get 30 people we’ll be doing well because it’s a long drive and they would have to take the day off—but the registrations just kept rolling in,” said John Eich, WI-ORH Director. “For a first-time event, that was exciting.”
The group met with 97% of their senators and 70% of their representatives. “First and foremost, the purpose was to introduce themselves and start building a relationship, with the promise that ‘you’re going to hear from us more often’,” Eich said. The attendees were from four associations representing EMS providers: the (WSFCA), the (PAAW), the (PFFW), and the (WEMSA), as well as the State EMS Advisory Board.
“Fire and EMS don’t have any conflict in doing the work,” Eich continued. “But they sometimes have conflicting goals legislatively. And that can lead to bruised toes and a wariness to collaborate.”
In addition, Wisconsin has two separate EMS associations. “They had had a very acrimonious split many years ago, so part of our goal was to get them working together again,” Eich said. “The bait was the legislation coming up, which was something people were willing to set aside their differences for and show a united front. And they blew us away with how well they did that.”
The group had “three asks” before the legislature, Eich said. “First, the community paramedic bill before the Senate; second, a bill giving tax credits to volunteers; and third, a public safety exemption to state-mandated community levy limits.”
The EMS Day activity received television and other media coverage in the state. Perhaps more importantly, according to Eich, “The people who met with legislators came back with huge smiles on their faces—they were really enthused.”
Although the event was planned in only two months, its seeds were planted two years earlier, when WORH convened a national group of EMS leaders to help design an assessment of what makes a successful rural ambulance service. That work became a springboard for other EMS activities.
“That assessment put us on the map for all the state associations because, in order to do it, we had to email every EMS provider in the state—all 19,000 of them—from paramedics to first responders,” Eich said. “It made them aware of who we are, what we were doing, and helped establish trust in our intent.”
Then in the summer of 2016, Eich was asked to be part of a state legislative study group on rural EMS and firefighters. “That helped to rally EMS folks the following spring, because from that committee came some proposed legislation,” Eich said. “We reached out to those four associations and the EMS Board, and got together every quarter in our conference room. We started with developing a legislative plan, and out of that came the advocacy day for EMS.”
“For all of this, we served as the convener and host.” Eich said. “As with many of our counterparts in other states, we can’t advocate directly, but our university (where WI-ORH is housed) is comfortable with us facilitating a process for others to advocate on their own behalf.”
Funding for most of WI-ORH’s EMS work comes through Flex funding since that federal program was started as a merger of rural hospital and rural EMS federal grants. Their work on EMS Advocacy Day was funded through non-grant sources, such as their fee-for-service work.
The group is already planning to hold the next EMS Day at the Capitol, finding a time that fits the legislature’s biennial calendar.
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Wisconsin Office of Rural Health’s assessment tool, , is available online for free for any ambulance service or organization working with ambulance services in any state.
Does your SORH have a “Promising Practice”? We’re interested in the innovative, effective and valuable work that SORHs are doing. Contact Beth Blevins at to set up a short email or phone interview in which you can tell your story.
NOSORH, National Association of State EMS Officials, The Joint Committee on Rural Emergency Care, and the Arizona Center for Rural Health invite you to join them on April 24-25 in Tucson, Arizona, for the 4th Annual National Rural EMS & Care Conference. Invited attendees include rural EMS directors, medical directors and officers, rural health care providers, state EMS officials, state rural health officials, hospital administrators, elected officials, federal agency officials, and other EMS partners.
The conference will be held at the Westward Look Wyndham Grand Resort, 245 E. Ina Road, Tucson, AZ. To book a room, please call 800-722-2500 and reference the “National Rural EMS & Care Conference 2018” to get the $91 + tax room rate. You may also book online by clicking here. Conference registration will be made available soon.
The EMS Grant Writing 101 Institute starts next month! This 3-part webinar series introduces EMS agencies to the basics of grant writing, how to connect with funders and partners, and where to find funding. Please share this information with EMS agencies and partners in your state and encourage them to participate. The Institute begins on July 11 and will be held on three consecutive Tuesdays at 3:00 pm ET. All sessions will be recorded.
EMS Grant Writing 101 Institute Flyer
To register, go to https://www.regonline.com/EMSGWI17. The deadline to register is June 30.
For more information, please contact Kassie Clarke at kassiec@nosorh.org.
NOSORH is launching another EMS Grant Writing 101 Institute this July. This 3-part webinar series introduces EMS agencies to the basics of grant writing, how to connect with funders and partners, and where to find funding. NOSORH will also provide templates to help agencies get started with the writing process. The series begins on July 11 and will be held on three consecutive Tuesdays at 3:00 pm ET. All sessions will be recorded. Please share this information with EMS agencies and partners in your state.
EMS Grant Writing Institute Flyer
To register, go to https://www.regonline.com/EMSGWI17. Registration ends June 30.
For more information, contact Kassie Clarke at kassiec@nosorh.org
by Beth Blevins
A study commissioned by the Georgia State Office of Rural Health is looking at the feasibility of regionalizing 911 emergency services in rural counties in the state.
Between 2010 and 2016, six rural hospitals closed in Georgia, and others reduced their service lines in an effort to save money. As a result, emergency services were left to fill the gap. This led to an increase in 911 calls and in the distance ambulances traveled to transport patients to an appropriate facility, sometimes leaving no coverage in the county. As rural county tax revenues decreased, the idea of “regionalization” seemed promising.
“Since 24/7 response-ready EMS is expensive, and each small rural county seemed to be duplicating the efforts of the surrounding counties, it seemed logical that having three to four counties join together in a regionalized effort would be an efficient and effective way to provide quality patient care while reducing operating costs,” said Nita Ham, director of SORH Programs at the Georgia Office of Rural Health (GA SORH).
When approached to find funding for a regionalization pilot project, Ham said she was worried that an unsuccessful first attempt would prevent anyone from trying again. “We decided to commission a solid, comprehensive study first, to evaluate if the climate was right for Georgia to attempt something that had never been fully attempted before,” she said.
The grant for the study was awarded to the Association County Commissioners of Georgia (ACCG), which, Ham said, “has a strong working relationship with all counties in Georgia and has been directly involved in EMS issues.” She also noted that the relationship between SORH and ACCG is invaluable. “Since the ACCG has such an intimate working knowledge of county needs, finances, and local government, we have recognized that including them in our discussions and projects is extremely helpful,” she said. “They can give us insight to how well a project may be received, or potentially rejected, based on the local budgets, community relationships, needs, and political climate.”
According to Ham, the intent of the study was to present the information as research findings and to allow state, regional, or local leaders to decide if, how, or when they will use the information. Since the report was issued last June, the findings have been widely distributed at ACCG meetings, as well as state and local EMS meetings.
“The primary takeaway from these meetings, so far, is that there probably will be an effort to consolidate some aspects of daily EMS operations such as purchasing, medical direction, training, and CQI programs,” Ham said. “Some stakeholders also noted a potential benefit in forming a multi-county consortium to fund one ambulance for 12 hours per day to cover gaps within those counties when the primary unit leaves the county for a long-distance transport.”
Ham said it could take one to two years before they can expect to see changes in practice as a result of these efforts. “Accepting ‘change’ as well as budgeting for that change will take time,” she said. She added, “The Georgia State Office does intend to use these findings to guide other future projects, and will also monitor any programs that may be created within the state as a direct or indirect result of the Study.”
The Georgia State Office is making the publicly available. “Through this, we are hoping to perhaps engage with other states and counties that are considering regionalizing their services,” said Patsy Whaley, the Executive Director of the GA SORH.
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Following the NOSORH Annual Meeting, the Joint Committee on Rural Emergency Care (JCREC) invites you to join a learning session on Friday, September 9, from 8:00 am– 12:00pm. Breakfast will be provided. Topics include an introduction to “FirstNet”, an update from the National Highway and Transportation Safety Administration, information on State and National Policy Impact on Rural EMS, and much more. “The JCREC learning session is a great opportunity for SORHs and state EMS leaders to share information about EMS issues. SORHs are encouraged to invite leaders from their state to attend,” said Teryl Eisinger, NOSORH Executive Director.
Click here for the agenda. To register for the JCREC learning session, please click here. If you have already registered for the Annual Meeting and would like to register for the learning session, simply edit your registration. The deadline to register is August 8. There is no charge to attend.