- Associated Press - Friday, October 2, 2015

LINCOLN, Neb. (AP) - Nebraska lawmakers are looking for ways to bolster the state’s rural emergency medical services, which providers said Friday rely heavily on volunteers despite difficult and time-consuming training requirements.

Medical personnel also told a legislative committee that the state relies on a patchwork of local ambulance services, with nothing to prevent a rural service from closing its doors. At the same time, they noted, the state has increased its training and record-keeping requirements while the number of emergency calls has increased.

“The state of Nebraska continues to require more and more of a smaller and smaller pool of volunteer EMS providers,” said Micheal Dwyer, an emergency medical services technician from Arlington. “… This shortage has already caused significant concerns for patient care, particularly for small communities.”

Dwyer said the state has failed to pass any “meaningful incentives” that would help retain volunteers, who often have to sacrifice work, family and vacation time. Lawmakers considered a $500 tax credit for volunteer firefighters in 2013, but the proposal died in committee.

The hearing was scheduled as part of a legislative study by Sen. Dan Watermeier of Syracuse, who is looking for ways to recruit and retain more EMS volunteers. Becoming an EMS provider in Nebraska generally requires 160 hours of classroom training, plus independent study time, after which candidates must pass a national exam that has a high failure rate.

Watermeier said he doesn’t yet know whether he’ll introduce legislation when lawmakers reconvene in January, but the problem may require changes from the Legislature, state agencies and local governments.

“I think the answers are going to be very multi-faceted,” Watermeier said after the hearing.

Some of the solutions proposed include regionalization of services, financial incentives for volunteers and providing more rural representation on the state’s emergency medical services board. Using a combination of paid and volunteer emergency personnel was also an option, as some local governments have done.

Some senators questioned whether increased training requirements and costs are a barrier, but doctors urged them not to lower the current standards. Emergency personnel need even more training nowadays because of advances in medical diagnostics and equipment, said Dr. John Bonta, an emergency room physician in Lincoln.

“Your quality of care shouldn’t be compromised because of your distance from a hospital,” Bonta said.

Justin Scamehorn, an EMT from Waco, said rural providers need a greater voice on the state regulatory board, which is required to have at least five members from each of the state’s three congressional districts.

Gov. Pete Ricketts said in a letter to the committee that he continues to hear concerns from residents about Nebraska’s emergency medical services, and is eager to work with lawmakers on the issue. Ricketts said he has directed Courtney Phillips, the CEO of the Department of Health and Human Services, to review all of the state’s EMS program requirements.

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The study is LR298

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