Emergency Medical Services Story Archives - West Virginia Public Broadcasting

State EMS, Fire Department Leaders Address Job Vacancy, Mental Health Crisis

State fire and EMS leaders face challenges with job recruiting and retention, keeping stations open and maintaining mental health in the wake of experiencing overwhelming tragedy. They are asking for help from the West Virginia Legislature.

Emotions ran high on Tuesday afternoon, as the Joint Committee on Volunteer Fire Departments and Emergency Medical Services heard stories of first responders’ continuing mental anguish in the aftermath of so many trauma response calls.

Jody Ratliff, the state Emergency Medical Services director, said a key to keeping people on the squads is addressing mental health issues. He said 988 Crisis Lifeline counselors are now working with traumatized EMTs and sending staff to ride along on serious ambulance calls.

Ratliff is also establishing regional critical debriefing teams throughout the state, responding when trauma and grief counseling are most needed.

“When there’s a major incident, we can deploy that team out to those areas, and they can actually do critical debriefing for it,” Ratliff said. “All these services, we’ve been able to pull off for free. So it’s not costing taxpayers a penny.”

Ratliff plans to eventually include firefighters in his trauma relief plans.

Randy James, the president of the West Virginia State Fire Chiefs Association, relates the dire funding woes of volunteer fire departments (VFDs) to mental health. James said new legislation gives VFDs the option to purchase a separate insurance policy to cover mental health issues for their members, but he added that it’s not working since it’s not affordable.

“As far as I know, I have not heard of a single fire department purchasing the extra insurance to cover PTSD for its members, they can’t afford it,” James said.

Joint committee members began the meeting by working to revitalize failed House Bill 3153, which would have markedly increased funding for volunteer fire departments and emergency medical services providers.

James told lawmakers if an EMS squad runs short of funds, they shut down. He said in 2022, 15 squads closed their doors. However, he said when VFDs lack funds, they lose volunteers.

“The departments will just keep doing what they do,” James said. “They cut back on services, maybe they don’t purchase as much equipment or they buy used equipment or even cut back on training. But one major thing that happens to a volunteer fire department when you don’t have adequate funding, is they lose members.”

James said it is aggravating to come away from legislative sessions with basically no increase in funding since 2005 while hearing the news about surplus funds and record tax collections. He asked the committee what else first responders can do to turn around 1,900 EMS vacancies with a workforce short by nearly a third.

Del. Joe Statler, R-Monongalia, echoed his fellow member’s sentiments when he said “don’t give up.”

“We know all the departments across the state are frustrated,” Statler said. “We hear when we’re back home, we hear from our local volunteer fire companies and EMS services. We are continuing to work on this problem that we have before us.”

Committee members said they would continue to make the failed funding bill better suited to passage. They plan to draft a letter to Gov. Jim Justice that the bill be included in any upcoming special session.

Fire and EMS Committee Chair Sen. Vince Deeds, R-Greenbrier, ended the interim meeting with a promise.

“As you can tell, everyone on this committee really is involved and engaged on all these issues,” Deeds said. “I give you my word, we’ll do everything we possibly can to get it right.”

Senate Passes Bills On Alcohol, SSAC And EMS

The Senate passed 20 bills Monday on a variety of issues ranging from alcohol consumption to high school sports.

Senate Judiciary Chair Sen. Charles Trump, R-Morgan, said on the floor that Senate Bill 534 was intended as technical cleanup for a bill the Senate passed last year relating to beer, cider, wine, and liquor license requirements.

After changes in committee, and the addition of three floor amendments, the bill would expand how and where alcoholic beverages can be sold and enjoyed responsibly.

“It authorizes municipalities to establish private outdoor designated areas that are zoned for alcohol consumption in that area for alcohol drinks sold for by qualified permit holders, who are class A licensees,” Trump said. “The bill allows a product I’ve not heard of before, but I’m eager to learn about beer slushies. Maybe members of this body are familiar with the product? I don’t know. But the bill will permit that. It would be currently unpermitted under our present law.”

Trump stated that the changes would serve to promote tourism in the state. The bill had its detractors, but ultimately passed on a vote of 25 to 8.

Senate Bill 667 would require periodic performance audits by the legislative auditor of the West Virginia Secondary Schools Activities Commission, the main governing body of high school sports, cheerleading, and marching bands in the state.

There was a brief debate over the legality of such a bill.

Sen. Mike Woelfel, D-Cabell, stood to oppose the bill and raised concerns that the proposed oversight would not stand up to legal scrutiny.

“The Supreme Court of Appeals held that the WVSSAC is not a state agency. In fact, they went on to say it’s not even what’s called in the law public body,” Woelfel said. “So respectfully, I believe it’s an unconstitutional attempt by us to have an audit of an autonomous group. And that’s what the Supreme Court of West Virginia described the SSAC as.”

Sen. Ryan Weld, R-Brooke, one of the bill’s co-sponsors, spoke in favor.

“What I think we’re trying to get here, with this piece of legislation, Mr. President, is a look under the hood of the agency that is responsible for all the activities in the state that our kids who attend high school partake in, any sports, whether they’re in the band,” he said. “An organization that has millions in assets.”

Senate Bill 737 was the second bill introduced Monday to deal with compensation for Emergency Medical Service workers.

Senate Finance Chair Sen. Eric Tarr, R-Putnam, said the bill would create a special revenue account, the Emergency Medical Services Salary Enhancement Fund, to supplement the salaries of EMS workers across the state.

“The rules are to provide a mechanism for distribution of the funds to the county with the parameters of distribution to counties demonstrating the most need, counties who have a special levy, counties who have reached the maximum rate on a regular Levy and counties that suffer from competition from border states,” he said.

According to a state coalition of Emergency Medical Service workers that presented earlier in the legislative session, the state has lost 1900 EMTs over the past three years.

All three bills, along with 13 others, now go to the House of Delegates for its consideration.

Nearing Completion

The Senate also took up four bills originating in the House.

House Bill 2062 completed legislative action. If signed by Gov. Jim Justice, the bill would modify e-bike regulations to more closely conform to federal law and allow certain e-bikes to be operated on public lands. The bill also states that users of e-bikes would have the same rights and privileges as regular bicycles.

House Bill 3340, which modifies the state’s Tax Increment Financing system, also completed legislative action and is awaiting the governor’s signature.

The other two bills were amended on the Senate floor and will complete legislative action if the House concurs on the Senate’s amendments.
House Bill 3307 would establish the West Virginia-Ireland Trade Commission, and House Bill 3428 transitions the West Virginia Business Ready Sites Program from a pilot to a permanent status.

EMS Coalition Brings Concerns To W.Va. Legislature

A state coalition of Emergency Medical Service workers brought their causes and concerns to the West Virginia Legislature on Thursday. Recruitment and maintaining mental health loom as two challenges that need to be met.

Emergency medical technicians and related personnel came in from around the state, at least as many who could break free from their jobs.

West Virginia has lost more than 1,900 EMTs over the past three years. The workforce is short by a third. Clinton Burley, CEO of HealthNet medical transport and services said Gov. Jim Justice’s “Answer the Call” EMT recruitment program, along with streamlining changes in certification and training need to be continued, if not increased.

“Out of the governor’s initiative, we have another 293 New EMTs that are working throughout the state right now and more in training,” Burley said. “We’ve got to continue that process. We’ve got to work on making continuing education available in rural communities to retain those providers who are out there now. We’ve got to work at the high school level to make EMS education a core part of what they’re doing to get people involved in their community.”

Burley said he’s encouraged by state infinitives under consideration to offer more mental health services to stressed, overworked EMTs who see life or death trauma on a regular basis.

“Mental health crises among EMS providers is at unprecedented levels. This is very difficult work and our providers see people at some of the most challenging moments of their lives and these things stick with them,” Burley said. “Being able to tie mental health into the lifeblood of EMS will help with retention. The governor has visibility with that and the legislature has visibility with that and the hope is that through these combined efforts we’re going to have a very structured middle health care program for West Virginia’s clinicians. It’ll make a difference.”

West Virginia’s Emergency Medical Services coalition was recognized by the House and Senate on Thursday as heroes. Almost to a man and woman, ‘boots on the ground,’ EMTs say, they’re just doing their job.

Stemming The EMT Mental Health Crisis With Communication

With statewide Emergency Medical Service worker numbers still down a third, there’s plenty of overtime for those often making life and death ambulance runs. With all that OT, there’s overwhelming stress — and a dire need for more mental health support.

With statewide Emergency Medical Service worker numbers still down a third, there’s plenty of overtime for those often making life and death ambulance runs.

With all that OT, there’s overwhelming stress — and a dire need for more mental health support.

Bridgeport Director of Emergency Management Tim Curry recently wrote an article in the National Journal of Emergency Medical Services entitled, Suck it up Culture is Killing First Responders. He wrote that he had answered a call like a hundred others, but one was about an interstate wreck that killed a young girl.

“I was looking through her phone and seeing the text from her mom, saying, ‘Hey, why aren’t you home yet? Where are you at? I’m worried,’” Curry said. “That hit me really hard. I had seen things that were way worse than that up to that point, but that was the point I got to where it was too much. I had to step away.”

The incident of post-traumatic stress overwhelmed the veteran EMT. Curry said he turned to alcohol, forsaking the longstanding “suck it up” first responder mantra, before realizing he needed help.

“Realizing that this is not normal and that I needed to talk to somebody was a hard journey for somebody that’s always been, ‘I’m okay, I’m tough, I can handle it, I don’t need any help,’” Curry said. “I looked in the mirror and said, ‘I need to deal with this.’ It was a long journey to get here.”

Nationally, more than 100 first responders committed suicide in 2021, more than died in the line of duty. West Virginia has lost more than 1,900 EMTs over the past three years to retirement and simply leaving the job. While recruitment and retainment efforts are ongoing, Curry said his overworked colleagues need more mental health support and outlets to deal with the trauma.

“They need to know that it’s okay to need to take a break, and it’s okay to not be okay and to talk about it with somebody. They need to have healthy coping mechanisms, good diet, exercise, hobbies, things that are outlets for your stress from the workplace,” Curry said. “Go and do something, whatever it is, play golf, go skiing, go hiking, whatever it is to blow off that steam in a healthy way.”

West Virginia Emergency Medical Director Jody Ratliff takes personal calls from traumatized first responders needing to talk to someone who knows the feeling. He said more mental health support is paramount to leaving the “suck it up” mentality behind — while moving forward.

“If we talk about retention and keeping folks in EMS and first responders across the board, if we’re going to talk about retention, mental health is a huge issue that we’ve just never spoken about,” Ratliff said. “It affects you over time, it affects your physical ability, your mental ability, and then people want to leave the business because they just can’t handle it anymore.”

Ratliff said he is looking at West Virginia adopting an EMS mental health support program and an app now seeing success in Florida.

“First responders across the state can go into this app, and they plug in some things on how they’re feeling that day, or something that might have just happened,” Ratliff said. “It might say to reach out to someone in the next few days, or it might put you in contact with a mental health professional right then and there.”

Curry calls setting up a mental health support app is an excellent first step.

“The fact that people are waking up to this and doing something about it now speaks volumes to where we’re at versus where we’ve been. We’re seeing the effects of long-term burnout and long-term issues dealing with everything that first responders see, and we’re facing a massive paramedic shortage now, because we neglected this problem for a long time,” Curry said. “There needs to be better access to get good mental health care covered by your insurance. These agencies need to do a better job of saying we’re going to cover this, we’re going to even employ somebody and help in-house, which is what the city of Huntington is doing.”

Ratliff said he’s working with EMS directors across the state to get the “suck it up” monkey off of everybody’s back.

“It’s okay to talk about the stigma, it’s time for the stigma to go away. We all deal with this, whether we want to admit it or not. It’s something that we’ve all dealt with in our careers,” Ratliff said. “I speak very publicly about me dealing with my own trauma during my career, and getting help and what it meant to me and my career and my life.”

Curry said a quarter of West Virginia EMS workers report mental health issues and those are only the ones who admit it. He said it is past time to go from “suck it up,” to stand up — and deal with the issues.

State EMS Director Addresses Hiring Challenges, Explains Future Goals

Randy Yohe spoke with state Emergency Medical Director Jody Ratliff on all that’s being done now – and planned for the future – to keep local EMT departments fully staffed.

Major challenges remain across West Virginia in recruiting and retaining enough emergency medical service workers to keep ambulances running.

Randy Yohe spoke with state Emergency Medical Director Jody Ratliff on all that’s being done now – and planned for the future – to keep local EMT departments fully staffed.

Yohe: In June, I saw that West Virginia had lost more than 1900 EMTs over the past three years. At that time the workforce was short by nearly a third. Is that still the general case?

Ratliff: It is still the general case. It’s stressful for the EMS directors in the state right now and they’re trying to recruit as best as they can. Everybody’s looking for different ways to recruit people and get them into the EMS workforce.

Yohe: You told a recent legislative interim committee that the future of EMS across West Virginia is trending positively. So, what are the biggest challenges to EMT recruitment and retention? And, what are the key developments helping meet those challenges?

Ratliff: It takes a special kind of person to go into EMS. The directors out there have to target that person. Typically, we like to target them when they’re first coming out of high school and is that kid who’s who’s looking for something more in life, maybe he doesn’t want to go to college, maybe he does want to go to college, maybe she wants to do something different, whatever the case might be. It’s a very specific person who can do the job and stay in the job. So the challenges are first, finding that person and in today’s society, getting the right pay for that person, and then – the right benefits for that person.

Yohe:Talk about the streamlining regarding the online EMT certification website.

Ratliff: When the state went to (Healthcare & Emergency Response software company) ImageTrend, it developed into basically a self service. It allows the EMS folks out there to do what they want to do without having to call us all the time, without having to email us all the time and then wait for us to get around to it. It streamlines the whole process. They can go in and do it all. Within just a few hours they can have someone certified. It was a barrier at one time. It took anywhere from one to four weeks to get someone certified.

Yohe: You now have a command center and have updated education policies, talk about the benefits there.

Ratliff: Education drives everything for EMS. We’ve been stuck in the mud over the last probably 10 or 15 years with the same education. We know if we’re going to push EMS into the future and have it continue to be part of the healthcare system, then we have to educate our folks better. And, we’re going to do that. We can’t really do much with the initial education, that’s set by national standards. What we can do is update state education. We hope to help the EMS providers out there really become part of that system.

Yohe: I believe there’s a partnership with one if not more, universities, or colleges when it comes to leadership training.

Ratliff: It is, leadership training through the University of Charleston. They do a great job. I just went to their graduation and it warms my heart to see all those folks out there and how many people took the opportunity to go to that class. We also have partnerships with a lot of community colleges who teach the paramedic program.

Yohe: It seems that the state’s mid-level management leadership training happening across several state agencies has really started to pay off.

Ratliff: It has, and people love that. I’ve spoken to a few of our people that went out west and when they spoke to the EMS people there, they didn’t know that other state governor’s did that for them. It was great to hear that our governor stepped up and did that.

Yohe: Explain what the normalization of treat-in-place policies means and how it takes pressure off the state’s emergency rooms.

Ratliff: The treatment in place right now will affect three people, the diabetic, the seizure patient, or someone with COPD. It’s common that EMS will go out and run a diabetic patient and when they do this, the patient won’t be responding correctly. They’ll have low blood sugar, they’ll pass out, they’ll start an IV. When the patient comes back around, what we tend to find out is, maybe the patient took their insulin, missed their breakfast, something along those lines. As soon as we treat them, they come back around and don’t want to go to the hospital. We’re very specific on the patients that we’re targeting for that treatment-in-place. It allows us to treat-in-place and it keeps that patient out of the ER. The ER staff knows that all they (the patient) had to do was eat once they got EMT treatment. It clears us up, clears the ER staff up and clears the beds up in the ER and allows us to get back in service sooner.

Yohe: Some of the $10 million that was allocated by the governor to address these challenges went into the “Answer the Call” recruitment and retention campaign. How has that worked?

Ratliff: It takes time to go through the EMT process or paramedic process and get all the education. So we’re not going to see the true effects and true success until 2023. That’s when we’re really going to start to see how many people were able to get in. Some of the people that we lost during that process that maybe didn’t complete class, we’re not done with them. We still want to go back out and target those people and say, Hey, we want you to come back in, let’s try it again. We’re finding different ways to educate people. One of the things that I can say that is great about the directors right now across the state of West Virginia – is they’re working outside their box. They’re looking at everything they can possibly look at to say, how do we educate these people? Educating a 16-year-old kid and educating a 36-year-old person calls for two completely different ways to educate someone. We’re targeting both audiences and changing the way we educate, and it’s working.

Yohe: Is there anything else that you want to tell me about where EMS stands and where it’s going that I didn’t ask?

Ratliff: There’s still a lot of sleepless nights, people working to make sure they get their shifts covered. People trying to find more employees out there to come into EMS. We encourage anybody who’s ever thought about a career in EMS to come out and join us. We’re more than happy to train you, get you educated and create a future for you.

Legislators Receive Update On EMS Recruitment Initiative

Legislators received an update on the state’s emergency medical services recruitment initiative during Monday’s interim meetings.

Earlier this summer, Gov. Jim Justice announced $10 million for the Answer the Call initiative, designed to recruit, train, and strengthen West Virginia’s EMS workforce.

Dr. Cynthia Persily presented the Joint Committee on Volunteer Fire Departments and Emergency Medical Services with various updates from the initiative, including initial results from a survey of the state’s EMS workforce.

“What we asked is how many years they thought they would be working as an EMS worker before they retired,” she said. “One thousand fifty answered this particular question. Three hundred fifty or close to a third of those people said they’d be retiring within the next zero to five years. So as we think ahead in terms of replacement of this workforce and the need for continued training, this is important information for us to have.”

Persily said the Answer the Call initiative is helping to keep the state’s EMS services going in the face of the high retirement numbers, with more than 500 people having been trained or currently in training through the initiative.

She pointed out that as CARES Act money, the Answer the Call funding must be spent by September 30.

“We are also continuing to work with adult ed on making sure that all of our EMT and paramedic grads are ready for testing,” Persily said. “As we talked about at the last meeting, we don’t have a great percentage of pass rate on our testing.”

She said the initiative has purchased 300 subscriptions to the Platinum EMS Testing Program to address that issue.

Persily also gave an update on the state’s initiative to provide every EMS worker with a medic pack, stocked with all of the equipment that they may need in order to be a first responder.

“We have a distribution plan, it will depend on when they begin arriving in the state,” she said. “Right now we’re on target for the first about 2,000 to come into the state at the end of the month.”

Dr. Beth Wolfe presented on the University of Charleston’s EMS Leadership Training.

“We’re very proud of what the students are already saying that they’re taking out of these classes, and giving back to their teammates, as well as their communities,” she said. “We see this leadership certificate as a way to recruit, retain and prepare EMS professionals to lead.”