EMT Shortage Story Archives - West Virginia Public Broadcasting

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.

Issues With Weedkiller Round Up And W.Va.’s EMT Shortage Is Improving, This West Virginia Morning

On this West Virginia Morning, the dire shortage of EMT’s and paramedics across West Virginia is now trending in a positive direction. 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.

On this West Virginia Morning, the dire shortage of EMT’s 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.

Also, in this show, we listen to the latest story from The Allegheny Front – a public radio program based in Pittsburgh that reports on environmental issues in the region. Their latest story looks at Monsanto and problems with the weedkiller Round Up.

West Virginia Morning is a production of West Virginia Public Broadcasting which is solely responsible for its content.

Support for our news bureaus comes from Shepherd University.

Eric Douglas produced this episode.

Listen to West Virginia Morning weekdays at 7:43 a.m. on WVPB Radio or subscribe to the podcast and never miss an episode. #WVMorning

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.”

Monongalia County Tech Center EMT Students Win State Championship, Head To Nationals

In West Virginia’s first SkillsUSA Emergency Medical Technician competition, Gabriella Chico and Olivia Tennant from Monongalia County’s Technical Education Center (MTEC) bested all competitors and were named state champions.

SkillsUSA is a national organization with a stated mission of empowering its members to become world-class workers, leaders and responsible American citizens. The vocational enhancement group states it works to improve the quality of the nation’s future skilled workforce through the development of framework skills that include personal, workplace and technical skills grounded in academics.

Moving through local, regional and state competition, Chico and Tennant participated in a written exam and psychomotor skills testing, similar to what they will perform next year for their National Registry for Emergency Medical Technician Certification. They demonstrated first responder skills such as bleeding control, CPR, airway management in a full patient scenario.

State EMS Director Jody Ratliff is still challenged with low EMT and paramedic workforce numbers. He recently met with the student winners and said he was impressed by Chico and Tennant’s skill and enthusiasm.

“We went through a bunch of skills with them when they showed us what they did,” Ratliff said. “It was exciting to see two young ladies in high school, excited about EMS and wanting to get other high school students involved in EMS. If we can get them when they’re in high school and bring them out and put them through classes, that makes me excited.”

This was the first year for the EMT program at MTEC. It’s a two-year program for Monongalia County high school juniors and seniors where they can complete the required coursework, perform clinical requirements, and go through the testing process to obtain their National Registry Emergency Medical Technician Certification.

The center said the funding for this program was made possible from the governor’s initiative “Answer the Call,” meant to encourage EMT and paramedic recruitment and retention.

Ratliff said 2022-23 was the first time in at least 11 years that EMS gained personnel in West Virginia.

“We gained 391 EMT’s, 22 AMT’s and 109 paramedics,” Ratliff said. “We did lose 190 people, you’re gonna have people retire. But we gained more than what we lost.”

Chico and Tennant will go on to represent the Monongalia County Technical Education Center and West Virginia in the SkillsUSA EMT National competition held in Atlanta next month.

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.”

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.