ABSAROKEE — It was early in his paramedic career, but Aaron McDowell still remembers the four-hour ambulance ride, rushing through the fog, to hospitalize a newborn girl with a life-threatening heart condition.
“We got her there. She had heart surgery. She lived,” McDowell said. “Last time I knew, she was 10 years old. What has she gone on to do? How many lives did she improve?”
That ripple effect is what motivated McDowell to begin a career in the EMS field, one that’s brought him to Absarokee to become the first-ever full-time emergency medical technician for a fire district that spans more than 250 square miles in rural Stillwater County. And he hopes that embrace of public service can translate to more local recruits for an ambulance service that has been chronically understaffed in recent years.
Since joining the town’s rural ambulance service 20 years ago, LeAnn Vorhes has watched the roster of emergency medical volunteers shrink steadily to the point that many calls can’t be answered locally.
The Absarokee Ambulance Service, for which Vorhes is the assistant director and a volunteer EMT, used to have more than 20 regular emergency medical services volunteers, she said, who typically remain on-call for 12-hour shifts at a time. That number has since fallen into the single digits.
“They’re working their own jobs and giving their own time, but the paperwork was getting to be so much, with state regulations and everything, that we were losing volunteers,” Vorhes said. “We just got the idea that if we could hire at least one paramedic with education in management, we would be able to get our ambulance up and running again.”
The problem is not unique to Absarokee. Across the country, declines in volunteer participation have been well documented. In Montana, rural fire departments and emergency medical services have struggled to hold onto volunteers.
In a 2016 report to the state legislature, the Department of Health and Human Services identified “persistent” workforce shortage problems in rural EMS outfits, warning that the “key challenges include difficulty in recruiting and retaining both volunteer and career EMS providers.”
McDowell sees the problem in part as a generational one, but said it also boils down to time — both the reticence of working people to part with their spare time and the hours spent navigating EMS volunteers’ ever-expanding paperwork and training.
“People just don’t have time to volunteer anymore. It costs more money to live, (and) some people are holding down two jobs,” McDowell said. “People around here appear to have really good jobs at the mine, but their schedules are erratic.”
McDowell describes his role at Absarokee Ambulance Service as roughly 10 percent emergency medical response, and 90 percent administrative; preparing coursework and instructing classes for volunteers, completing paperwork for insurance providers and hospitals, and managing the day-to-day operations from the fire hall.
As he works to more than double the ambulance service’s current number of volunteers, McDowell also said he needs to spend time getting to know as many people in the rural community as possible.
“That takes attention,” he said. “It takes somebody focusing on it, to be out in the community, to go to the basketball games, to show up at the Main Street Commons, to find out where the old men have coffee in the morning and have coffee with them, and have one of them say, ‘Hey, my daughter might be interested in this,’ and going and recruiting them. Or recruiting one of the old men themselves.”
McDowell previously served as the deputy fire chief for nearly 13 years in Red Lodge, during which time he helped to grow the town’s ambulance service. After a brief stint in South Dakota, he returned to south-central Montana to become Absarokee’s first full-time paramedic since the volunteer fire department was formed in 1955.
Having always preferred working for small-town, “frontier” ambulance services, where the operation’s survival is almost entirely dependent on volunteer hours, McDowell is familiar with the declines in volunteerism and expects it will take time to get the EMS roster healthy again.
But Vorhes believes having a dedicated staffer to complete paperwork and fulfill other managerial duties “will free up our volunteers to be volunteers,” and make the work more attractive to prospective recruits.
“As a volunteer, that’s big, it’s not taking all my time from my family,” she added. “I’m hoping this will make a difference, and I’m hoping this will make a difference for other rural communities.”