EMS Shortages amid the COVID-19 Pandemic

Bruce Hildebrant started his career in emergency medical services (EMS) in 1979 and has been a paramedic since 1982. He is currently in his 21st year at Allina Health as the Ambulance Operations Manager for EMS as well as the President of the Minnesota Ambulance Association.


Bruce joined us on our Cities Speak podcast last month to talk about the Minnesota Ambulance Association and the issue of EMS worker shortages in the rural communities of Minnesota.


What is the Minnesota Ambulance Association?


Founders created the Minnesota Ambulance Association in 1960. The organization acts as a representative for all the EMS providers in the state by monitoring legislation and other governmental action that may affect EMS workers in Minnesota. They also focus on recruiting potential EMS providers, navigating financial issues and promoting education and leadership. They also work with other public safety professionals such as law enforcement and fire service.


“Our vision is a member-driven advocacy organization promoting and strengthening EMS within the state of Minnesota,” said Hildebrandt. There are currently 385 members. 80 of these members are actually not EMS workers, but just individuals who want to be involved in EMS worker advocacy. 


In Minnesota, there are 60,000 registered first responders, the majority of which are volunteers. They get up early in the morning and respond to emergency calls, not because of the pay, but because of the goodness of their hearts, according to Hildebrandt. “It goes largely unrecognized,” said Hildebrandt.


EMS shortages


Last year, NBC reported that a third of rural Americans face EMS shortages. One of the biggest impacts of this according to Hildebrandt are delayed responses. This is happening because now more than ever, it’s extremely difficult to recruit people. “There’s a fear with the COVID, there’s a fear with infectious diseases that are out there. And we’ve got overworked volunteers that are currently doing it,” said Hildebrandt.


For many rural hospitals, they do not have the capability to treat all of the patients EMS providers bring in. Because of this, EMS workers end up transferring patients to hospitals long distances away from their homes and families. 


Hildebrandt hopes to connect with the community to share what it’s like to be an EMS provider and recruit those who are interested, specifically in schools. “We need to impress upon those kids that this is important. This is a way to give back to your community. It’s not all about me, it’s what I can do for somebody else,” said Hildebrandt. 


COVID-19 impact


The COVID-19 pandemic has clearly affected the EMS field, but Hildebrandt said they have adapted rather smoothly. Although there have been quite a few PPE shortages around the nation, EMS providers in Minnesota have kept a sufficient supply for day-to-day duties. “We’ve got a lot more defined guidelines on how to handle COVID patients, whether they are already tested positive or potentially positive. We know ahead of time the steps that we need to take to protect not only ourselves, but the patient,” said Hildebrandt. 


When the COVID-19 wave hit back in March, many EMS providers across the state were hit hard by the reductions in ambulance transport volumes by the government. “The state is looking at nearly a $5 billion deficit, and at times they turned to Medicaid cuts as a way to fill those gaps,” said Hildebrandt. Legislatively, Hildebrandt and other EMS providers want to see reductions in reimbursement from Medicaid services they provided in these times.


Making a difference


Hildebrandt believes that the work he and his fellow emergency medical service providers do is not only impactful, but rewarding. “It’s an opportunity for an individual to make a difference in someone’s lives when, at that point in their life, it’s life-changing to them, whether it’s a minor injury or a significant injury, we can make that difference for them,” said Hildebrandt.