EMS Story Archives - Page 2 of 5 - West Virginia Public Broadcasting

State, Federal Funds Support Fire Services, Water Infrastructure

Millions of dollars in state money will help the state fund fire services, as well as infrastructure improvements.

During his weekly media briefing Thursday, Governor Jim Justice announced the first distribution of $3 million dollars in funding for fire services in West Virginia.

“Our volunteer fire departments, gosh. What would we do without all these people?” Justice said. “People that are stepping up and volunteering and trying to help communities over and over and over. And they do, not only they save all kinds of lives, but to help us in every way imaginable.”

The funding comes after the passage and signing of Senate Bill’s 1022 and 1023, supplementing appropriations to the Division of Emergency Management, Growth County Fire Protection Fund, and County Fire Protection Fund.

The first round of funding contained in SB 1022 has been released through the County Fire Protection Fund, delivering resources to all 55 counties in West Virginia.

The funds can be used for Fire Departments and Emergency Medical Services (EMS) to purchase equipment, education and training expenses or to offset costs associated with compliance with Insurance Service Office (ISO) recommendations, utility bills and insurance payments.

The governor also announced more than $10 million in federal funds for infrastructure advancements in three West Virginia communities.

“I’m thrilled to be able to share some news regarding critical infrastructure projects in West Virginia,” Justice said.

The funding from the U. S. Environmental Protection Agency was secured through $2.8 million in matching funds from the state.

The projects in Randolph, Wyoming and Tucker counties will improve water infrastructure, including water treatment and extending water service to communities lacking a reliable drinking water source.

State EMS Director Tackling Recruitment, First Responder Mental Health Challenges

The dire shortage of EMTs and paramedics across West Virginia is now trending in a positive direction, but there is still much to be done to remedy what many call a first responder mental health crisis.

Randy Yohe spoke with Jody Ratliff, director of the state Office of Emergency Medical Services, on meeting the challenges facing those who come to our aid when we need help the most.

This interview has been lightly edited for clarity.

Yohe: Director Ratliff, where do things stand? What are the telling numbers right now regarding EMS vacancies, statewide?

Ratliff: Statewide, we’re still down. We look at it this way, over the past 11 years, we’ve lost. Over the past year, we have gained around 600 providers. That’s a huge plus that we’ve turned everything around in the right direction. But the question is, people aren’t really seeing those numbers. When you lose for 11 years, one positive year doesn’t equate to 11. So we’re still low, for sure, but we are heading in the right direction.

Yohe: You were, not too long ago, down a third of your staff. It’s not that anymore, is it?

Ratliff: Not a third, but we’re not far from a third either. We’re still pretty far down. We still need to add more EMTs and paramedics, for sure.

Yohe: What else are you doing for recruitment and retention?

Ratliff: Senate Bill 737 came out. That was for EMS enhancement funding and we’re still working with that right now. We just sent a letter out to the county commissioners on how they can spend that money. It’s basically that monies be able to be spent for an enhancement on payroll. For a provider, they’re going to see, I’ll use the term bonus, above and beyond what they would normally get paid.

Yohe: What are the key challenges your department faces, and what is underway or planned to meet these challenges?

Ratliff: We have a lot of challenges. The state medical director is working on rewriting protocols, updating protocols, or reformatting protocols. Somewhere around June 2024, if not before, we’re going to have a whole new EMS system with all new protocols. They’re going to have more medications, we’re doing away with some of the older medications. We’re gonna allow paramedics to be paramedics and EMTs to be EMTs in the state.

Yohe: What are the benefits to the protocol changes?

Ratliff: The benefits are implementing more modern medicine. We’re getting away from the old stuff that we’ve been doing for years and years and years. It’s outdated. We know it just doesn’t work the way it should. So that’s a benefit to the patients.

Yohe: You had some first responder mental health care initiatives on the drawing board. Some of them may have kicked off to help handle what many responders, and now some legislators, are calling a mental health crisis. Where do the state support and response team projects stand?

Ratliff: That’s a great question. So right now, with Senate Bill 737, 90 percent of it went to enhancement of the funding and 10 percent of it goes to mental health. Each county got $18,800 some odd dollars, and they were able to develop a response team.

If, in that EMS region, an agency has a bad call, and they need that debriefing for their mental health, we’re going to have a response team to come out and be able to do that.

Yohe: Does that also include proactive or preventive care before mental health issues come up for first responders?

Ratliff: That’s the other thing we’re looking at. We’re trying to gather some data. Hopefully we start that in 2024, to be able to get some data so we can do preventative care for first responders. We want to be able to get that data handed over to the EMS coalition so they can start to decipher it and then start figuring out what we need to do to be preventive, not just long-term. Then we get preventative, we get in the moment, and we get long-term. That way we start covering mental health across the board.

Yohe: In the moment care, with that dividing up of $18,000 plus to each county, is there actually a response team available if there’s a real critical trauma incident and some of the first responders need some counseling right then and there?

Ratliff: Right now we do have some folks around the state. I wouldn’t say it’s a critical response team. We’ve just got some areas around the state, some agencies, if you will, handle situations like that. We want to be able to develop those response teams. So EMS, fire and law enforcement are helping EMS, fire law enforcement. There’s no better health and people who do it themselves.

Yohe: Is there a particular mental health training for EMTs? Is talking about mental health and trying to understand things as an incoming EMT involved in the training?

Ratliff: I’m glad you asked that because it will be. We’ve already got plans that if when you come in to EMS with an EMT class, paramedic class, or a critical care class, every time that you go into one of those classes, we’re going to have it set up hopefully, in 2024, that you’ll get about 10 slides about mental health. Not just your own mental health, but also who you can call, how to get a hold of people, things like that. We want from the start of your career, all the way to the top of your career, we want you to see that every single time that you take a class.

First Responders Form Grassroots Mental Health Support Service

Faced with mounting suicides and PTSD rates, some West Virginia first responders struggling with job-related mental health issues are taking matters into their own hands.

Randy Yohe spoke with Dylan Oliveto, the founder of SCARS Support Services. SCARS stands for “shared compassion and resource services,” an organization to help first responders in times of personal crisis.

This interview has been lightly edited for clarity.

Yohe: Dylan, tell me what the philosophy and impetus is behind SCARS.

Oliveto: As many folks have talked about mental health among first responders and frontline workers, it has come to the forefront in the last couple of years, especially since the COVID-19 pandemic. We started identifying more and more folks that were suffering from PTSD, and having some mental health problems that went undiagnosed for years. Basically, this was really an idea on a napkin not too awful long ago. We wanted to find a way to help our fellow first responders and until you’ve experienced that, you really don’t realize you need it, and my own personal struggles is where this idea was born.

Yohe: Talk to me a little bit about your personal struggles and how this related to you helping get this organization started.

Oliveto: I’ve been in the business for about 25 years. We don’t realize the stressors that we put on ourselves. I was unfortunate enough to see my first fatal accident at 16 years old. That was clear back in 1996, when I first started. So over the years, you have trauma that continues to build. You go from this traumatic scene, and then the next traumatic scene erases that memory. And so we just have this constant barrage of these memories that keep building up. For me personally, I’ve worked in the fire service, both paid and professional EMS, as an EMT, paramedic, I went on to be a flight paramedic, and a director level manager and operations of EMS organizations. I’ve had the fortune of working for very great organizations, taking care of some really sick patients and some really ugly trauma patients. In 2021, while I was an operations director, I had a paramedic get stabbed on a call, he took five stab wounds, patient became violent, and got out of his seatbelt. And that started to trigger problems. Shortly after that call, I ended up taking care of a lot of our own employees that were really suffering mentally, of seeing that scene and to know that we had a colleague and a friend that, luckily, had non-life threatening injuries. But that result could have been much different with just a few inches of a knife blade. From that call, the rest of the year was just bad call after bad call. My tipping point was a traumatized infant. Through that, it forced me to take a step back and care about my own mental health, but also start researching how to prevent this build up that our first responders see day in and day out.

Yohe: Do first responders around West Virginia get to take a breath between calls, especially between traumatic calls or is it right off to the next one?

Oliveto: It’s hit or miss. I think most first responders would agree that when you have one bad call, you have a string of bad calls. And then you’ll go to times where nothing’s ever routine and you don’t have traumatic experiences. I think almost any first responder you talk to would say, “Oh, yeah, I had a month’s worth of really nasty calls.” I can remember at a very young age, in the Morgantown area, we had several fatal accidents over the span of maybe 30 days, So we just get a buildup. When many of us started, there was no support, other than talking about it, maybe with your partner, but if it bothered you, it was portrayed as a weakness. We had this very much “suck it up” and deal with it, move on to the next call attitude. And that broke a lot of our first responders over the years,

Yohe: We’ve heard that term quite a bit, “suck it up.” Some say that’s an expired term when it comes to first responders, others say no, that there’s still a pervasive “suck it up” attitude throughout the business, which is it?

Oliveto: The unfortunate part is many of our current administrators come from the “suck it up” era. A lot of these folks that come from that timeframe, are in a position where they’re not on the truck as much anymore, they’re not out in the field as much anymore, they’re not working directly in the emergency room anymore, so on and so forth. They don’t have a full grasp of how bad it has gotten out in the field. Not only are we dealing with trauma, but now we’re dealing with a post-pandemic of just call after call after call, we’re dealing with overdose after overdose. The service that is provided by fire and EMS, law enforcement, the volume itself is so taxing that that’s a whole new stressor that a lot of people are not ready to handle.

Yohe: State EMS Director Jody Ratliff said that he is working as hard as he can to put that “suck it up” attitude in the past.

Oliveto: He is. And he’s got a really good backing from the State Medical Director. Our state is very fortunate to now have a director and a medical director who understands the current situation of EMS and the current situations of care providers. And I do believe that he’s working very hard with not only the agencies but at the state and federal level to make sure that there’s funding and resources in place to get our responders to help that they need.

Yohe: I see on your website where SCARS offers a “judgment free zone” and a place “where it’s okay to not be okay.”

Oliveto: That’s kind of become the catchphrase of a lot of our responders throughout the state and actually throughout the country. I’ve been fortunate enough to visit a lot of places where they are very serious about mental health. That kind of slogan is making the newer responders and even the older responders understand that it is okay to not be okay. And it is okay that this trauma does affect you on a daily basis. What we wanted to make sure to try to provide was a space that was safe, where we could allow people to interact with each other, share their stories, share their problems, and not have any fear of being mocked or made to feel like less of a responder or less of a person for allowing these calls to bother them. Because, a normal human being does not have to see what we see.

Yohe: You’ve got your organization SCARS in Harrison County. I know over in Huntington, they’ve got COMPASS, which is similar. How vital is it right now that the state’s plans for getting a statewide program to help first responders with their mental health be implemented?

Oliveto: Next to funding, it should be next on their list. We’re losing first responders by the hundreds. Without any funding, we’re not going to keep our squads alive. Without any funding, we can’t address the mental health issue. Funding’s got to be number one on the agenda. Then number two is our mental health. I think a big initiative for the state to do is figure out how to have an EMS worker recertify every two years or every four years, part of that needs to be some kind of a mental health check. It should be no different than getting your yearly checkup at your doctor’s office, to make sure you’re okay and at an organizational level, to make sure that there are resources in place to help mitigate mental health struggles within the community of the first responders.

Report On First Responders Mental Health Issues Sparks Crisis Reaction

Firefighters are more likely to take their own life than to die in the line of duty. First responder PTSD rates are triple the general population.

Firefighters are more likely to take their own life than to die in the line of duty.

First responder PTSD rates are triple the general population.

Those are just two of the many devastating statistics House Education Committee Chief Counsel Melissa White laid out in a Tuesday interim meeting of the Joint Committee on Volunteer Fire Departments and Emergency Medical Services.

“A journal of Emergency Medical Services reported that 37 percent of EMS first responders contemplated suicide and 6.6 percent attempted suicide, making them 10 times more likely than the CDC average,” White said.

White told lawmakers that combining EMS and firefighter duties made the individual six times more likely to report a suicide attempt than just firefighting duties alone.

“Here in West Virginia, in the month of September 2022 alone, four suicidal first responders were referred to inpatient treatment through the assistance of local non-profit organizations,” she said.

White spelled out research that showed “after experiencing a traumatic incident, just one of those, the CDC reports that first responders may experience the following system symptoms…chest pain and difficulty breathing, signs of shock, nausea, vomiting and dizziness, heightened or lowered alertness, poor concentration and memory, nightmares, anxiety and depression, guilt, grief, blaming others or self intense anger and outbursts, excessive alcohol drug consumption and inability to rest or pacing.”

White told the committee more than two thirds of EMS professionals never have enough time to recover between traumatic events.

“As a result of this repeated, often unprocessed trauma and working conditions inherent in the job,” she said. “Studies consistently report the first responder’s mental health suffers, resulting in increased risk of PTSD, substance use disorders, depression and other mental health conditions, all of which are associated with suicidality is the cumulative effect of the day to day hard to process moments shooting and stabbings, highway wrecks, children harmed, quiet deaths in quiet homes.”

She said in rural West Virginia, a first responder’s exposure to trauma is greater than in urban areas.

“In rural areas, substance use suicide and older adult populations needing EMS assistance is significantly higher,” White said. “Rural EMS take on higher call volumes, often with less resources and that call volume has increased over the last 20 years. Moreover, living in and responding to emergencies in small towns means that first responders may respond to a call of someone that they know or love, and that takes a huge toll on the first responder.”

White said there is a critical lack of training, support and education regarding first responders coping with overwhelming stress and trauma.

“The literature is clear that a majority of fire EMS departments do not provide education regarding mental health risks and symptoms,” White said. “They do not have behavioral health systems in place to help first responders cope.”

She said the long-standing mentality of what many have termed “suck it up” is still pervasive throughout the state and country.

“Even when first responders do realize they need help and do have support accessible,” White said. “They are discouraged from using it or even told what to say.”

She referred to Huntington’s Compass program that directly addresses first responder mental health issues.

“Therefore, a template to begin to support first responders as this exists locally. In addition, other cities have established similar programs and national organizations exist to provide assistance,” she said.

Committee Chair, Sen. Vince Deeds, R-Greenbrier, said White’s presentation demonstrates a crisis in first responder mental health.

“I challenge our Senators or Delegates and those that are hearing these words to do something,” Deeds said. “Because now is the time to do something.”

State EMS Director Jody Ratliff said in a May 2023 WVPB interview, that he is tackling mental health issues head-on.

Ratliff said EMT’s are now using the 988 suicide Crisis Lifeline. He said the “suck it up” mentality “is not what it was.”

“When I was brought up, it was that ‘suck it up’ mentality, we’ve got to move on to the next call,” Ratliff said in the interview. “Unfortunately, that’s still EMS, we still have another call that’s coming, we don’t know when it’s going to stop for the shift.”

Ratliff said, on Tuesday, that a network of first responder critical debriefing teams to deal with the trauma will soon be deployed throughout the state. His hope is “that the older medics out there have to be the leaders in mental health.”

Post Special Session, Bills Passed And Failed

Earlier this week, 35 of 44 bills proposed in the recent special legislative session passed. But what about the bills that failed?

The special session included about $30 million to address the ongoing crisis in the state correctional system, $12 million for volunteer fire departments and EMS, and $45 million to help Marshall University establish a Cybersecurity Program. Several other passed bills will make a mark on the state.

Gov. Jim Justice, who called the legislature into special session to address the 44 bills, said corrections and roads were his top priorities. Senate Bill 1026 appropriated $150 million to the Department of Highways. Justice said in a media briefing that road maintenance funding makes more money for the state.

“We have made incredible progress there,” Justice said. “It’s an economic driver beyond belief.”

Other passed bills include allocating $4 million to help make the West Virginia Culture Center compliant with the Americans with Disabilities Act and $1 million dollars that will replace worn patient beds in state veterans’ hospitals.

In 2019, the legislature eliminated the state severance tax on timber. But that left the state forestry department without a source of income for fire suppression. That’s according to Senate Finance Chairman Eric Tarr, R-Putnam.

“So we went back in and put in about $4 million for fire suppression equipment for forestry,” Tarr said.

Find a complete list of passed special session bills here.

The nine bills that did not pass included funding denied for the Attorney General’s technology litigation staff, some state park repairs, mine reclamation emergencies and rejected appropriations to the Department of Revenue.

Tarr said there was nothing inherently wrong with the bills that did not pass. He said when the House of Delegates rejected a procedural funding bill that incorporated a rainy day fund “smoothing” mechanism, it greatly reduced the surplus money available to allocate.

“Fixing that problem would have reduced the rainy day transfer from $231 million to about $87 million,” Tarr said. “So you have to go through and prioritize some of these spends. It really comes down to ‘Do you take the the miser ideology, or do you take an entrepreneurial approach, and invest in the state?’”

Tarr said “I can’t say that what we did aren’t the end all solutions, but they are really big steps toward comprehensive solutions that we do with these issues.”

The nine failed bills include:

HB 101 – Relating to combining the totals of the Revenue Shortfall Reserve Fund and Revenue Shortfall Reserve Fund

HB102 – Supplementing and amending the appropriations to the Department of Revenue

HB 108 – Relating to pretrial release

HB 111 – Authorizing agreements for reimbursement for certain training costs and to authorize the division to cooperate with the Supreme Court of Appeals on developing a comprehensive transportation plan

HB 113 – Relating to making West Virginia an agreement state with the United States Nuclear Regulatory Commission

HB 118 – Supplementing and amending the appropriations to state board of education

HB 135 – Supplementing and amending the appropriations to the Department of Environmental Protection

HB 136 – Supplementing and amending the appropriations to the Department of Commerce, Division of Natural Resources

HB 140 – Supplementing and amending the appropriations of public moneys out of the Treasury from the balance of moneys remaining as an unappropriated surplus balance in the State Fund, General Revenue, to the Attorney General

Firefighters Receive One-Time Legislative Funding, EMS Gets Zero

Many counties cannot raise enough money to properly fund their Emergency Medical Services, even though the state has a $1.8 billion dollar budget surplus. Most ambulance agencies are either non-profit or private entities that receive little, or no funding from state, county and local governments.

West Virginia Code establishes that counties have a duty to fund EMS — if and to what extent they can afford to. In areas where tax revenues are diminishing due to the decline in the coal industry, local governments struggle to provide adequate funding to EMS.

The West Virginia EMS Coalition notes that at least 15 EMS organizations have ceased operations since 2022 and anticipates more closures without additional funding for EMS. Trish Watson, director of Services at Lincoln EMS, said some counties go 24 hours without an ambulance available and those wait times can lead to significantly reduced patient outcomes.

“Every county is short at this point,” Watson said. “That can very easily mean death. If you have an auto accident and you’re thrown out of your car, and the closest ambulance is an hour away obviously we know how that’s gonna turn out.”

Watson says there is a golden hour, that vital time period that a patient needs to receive care to survive a medical trauma.

“If you’re having a heart attack you can’t wait an hour for an ambulance to get there from another county — or maybe there’s not even one in the next county. Maybe those guys are all out too because we are all short staff,” she said.

In some areas of West Virginia ambulance wait times can be long due to staffing shortages, equipment shortages, longer routes, and winding mountainous roads. *Credit: West Virginia EMS Coalition*

Many rural areas in the state already had higher wait times. ow, many of those same areas are facing labor shortages due to lack of funding. Longer routes through rural areas of the state result in higher operating cost for EMS organizations. A statement put out by the West Virginia EMS Coalition said that ambulance agencies are only reimbursed by insurance when transporting a patient. They are not reimbursed for transportation to the patient’s residence, or from the hospital.

Last year, Gov. Jim Justice approved a one-time 10-million-dollar EMS Salary Enhancement Fund. However, the West Virginia EMS Coalition said that they are not able to give raises with that money because it’s not enough money to sustain a raise in wages. They said once the money is used, they could be forced to decrease wages again.

In the Special Legislative Session that began Sunday, Justice’s call proposed 44 bills. One of those bills, House Bill 122, would allot $12 million of the surplus for one-time payment to support fire response. The bill offered no funding for EMS.

“I will bring all parties to the table very soon, including the counties and the Legislature, so that we can all work together to find a responsible funding stream for our First Responders without raising taxes,” Justice said in a press release. “We all know that our first responders are our heroes, so I’m very proud to propose this funding.”

Watson said that while funding shortages affect patients’ health outcomes from emergency situations, they also affect the well-being of first responders.

“It is not just about the readiness, it’s about the staffing. You know, our crews are tired. They are short-staffed, we are short-staffed, so they are overworked, and underpaid. They are working excess hours because there is no one,” she said.