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Is an Emergency Medical Services Cooperative a viable solution to the challenges facing rural counties, hospitals and EMS departments in Glacier, Toole, Pondera and Liberty Counties? 

County Commissioners, hospital and clinic administrators, EMS personnel and concerned community members met via conference call on Thursday, April 18, to discuss the feasibility of the cooperative model, which is currently used by school districts in providing specialized services. 

Following the two-hour call, representatives from the four counties decided to form a smaller working group of interested individuals to pursue ”possible solutions and collaborative efforts” in addressing the challenges of providing emergency medical services.

The meeting was coordinated and facilitated by Northern Rockies Medical Center Chief Executive Officer Cherie Taylor. Sandy Watkins, the accountant for Northcentral Learning Resources Cooperative, provided a detailed explanation how the cooperative operates, who is involved and the funding challenges faced by the cooperative.

In order to learn more about each EMS department and how it operates, representatives from each county and Blackfeet EMS shared information on the following:

•Equipment inventory

•Personnel numbers and certifications 

•Average number of calls and transports

•Payor mix (Medicaid, Medicare, self-pay, IHS, etc.)

•County funding

During the discussion, it became evident Glacier County has the most extensive equipment resources with seven ambulances, Advanced Life Support (ALS) equipment and new facility. Five of those ambulances, however, have in excess of 300,000 miles on them. As for personnel, Glacier County EMS currently has just five full-time employees after losing two employees last week.

Blackfeet EMS has 13 full-time employees and has assisted area hospitals in providing ALS transports, but because it does not have a “dedicated facility” it cannot offer round-the-clock staffing. 

Pondera County has a staff of two full-time paramedics, four part-time paramedics and 15 volunteer EMTs along with three ambulances. Over 70 percent of their transports are ALS transports. 

Both Pondera and Glacier County providing approximately $50,000 in funding for the EMS services in their county.

Toole County has four ambulances but none are equipped for ALS transports. Their crew is made up of 15 volunteers, eight of whom are advanced EMTs. According to County Commissioner Mary Ann Harwood, Toole County provides approximately $80,000 in funding to their EMS.

In Liberty County, their EMS service receives no county funding. They have 17 volunteer EMTs on staff, but only six to eight of those are active at this time.

Shari Graham, EMS System Manager of the Department of Public Health and Human Services (DPHHS), was also on the conference call and pointed out there is currently no dedicated funding source in Montana for EMS since it is not considered an essential service. Legislation that would have established it as such once again did not pass during the 2019 session.

DPHHS has applied for a Rural Flex Grant to study the feasibility of regionalism of EMS. The current model using volunteers is failing, she pointed out.

Leo Rattler of Blackfeet EMS pointed out EMS is not “being reimbursed for the services they provide.” He said is not just a local, regional or state problem, it is a national problem. “EMS needs to be an essential service in Montana,” he added.

The group briefly discussed House Bill 38, which establishes the Community Paramedic Program, allowing EMS personnel to respond in non-emergent situations and to be reimbursed for their services by Medicaid and Medicare.

Matt Waller, Administrator of Liberty Medical Center in Chester, is chairman of the recently formed EMS Task Force in Montana. Waller said this week’s meeting was the kick-off for those in the four-county area to look into “opportunities to collaborate” with equipment, personnel, assets and training to provide EMS services. 

“We have a lot of learning to do together,” he stated, adding, he was “excited about what we can do.”

Taylor concluded, “We have to find solutions we can do ourselves…how do we do this together with what we have.”

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