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Ohio’s rural EMS providers face a staffing emergency

First responders prepare an IV in a Coshocton County ambulance.
Erin Gottsacker
The Ohio Newsroom
Todd Shroyer, director of the Coshocton County Emergency Medical Service, works with a first responder to prepare an IV. They responded to a call of breathing difficulty in a remote corner of the county.

Chiefs across the state need paramedics and EMTs to fill open positions. But in many cases, none can be found.

Todd Shroyer was already in his emergency vehicle when the 911 call came in.

An elderly man in a remote corner of Coshocton County, sixty miles east of Columbus, was having trouble breathing.

“EMS one to central,” Shroyer, an EMT and the director of Coshocton County Emergency Medical Services, radioed to the station’s headquarters, “I’ll be responding.”

He flipped on sirens and raced down a two-lane rural highway, past rolling hills, corn fields and an Amish school building.

Todd Shroyer, the director of Coshocton County EMS, poses for a portrait in his office.
Erin Gottsacker
The Ohio Newsroom
Todd Shroyer, the director of Coshocton County EMS, says his department is struggling to recruit new emergency responders.

Another EMT and paramedic were already at the scene by the time he arrived. Together they lifted the man onto a stretcher and carried him to an ambulance.

According to Shroyer, calls like this are common in Coshocton County.

“We have a lot of breathing difficulty,” he said. “It's gotten better. But when I first started, we had a lot of factories. We still had the coal mines.”

Shroyer’s crew responded to this call in less than 20 minutes.

That’s pretty typical for the county, Shroyer said. But he worries that won’t be the case for long.

A statewide EMS shortage

Coshocton County has lost 40 percent of its staff in the last two years, and Shroyer is struggling to find new workers to take their places.

He’s not alone.

More than 60 percent of Ohio EMS administrators had an open position for six months or more last year, according to a report by the Paramedic Foundation.

EMS providers in rural parts of the state are hit especially hard. They cover wider areas, and many can only afford to pay a fraction of the wages offered in bigger cities.

Additionally, the pandemic has exacerbated a nursing shortage, so some hospitals have started hiring paramedics to work in emergency rooms, leaving even fewer people on call to respond to 911 crises.

“Here we run four crews,” Shroyer said. “There are times of the day when all four crews are busy. So if you're the fifth caller to 911, you have to wait. Depending on where you are, that wait can be 10 minutes, 15 minutes, a half an hour.”

It could be worse. Shroyer knows of a county that had to drop one of its crews because they couldn’t staff it. Another only has enough people to respond to 1 in 5 calls.

Dixie Harmon, a paramedic who has worked with Coshocton County EMS for 40 years, sits in a red chair for a portrait.
Erin Gottsacker
The Ohio Newsroom
Dixie Harmon, a paramedic, has worked with Coshocton County EMS for 40 years.

So far, his team has been able to stave off a staffing shortage that severe. But it might not be far off.

Looming retirements

Of the 17 people on Shroyer’s staff, 11 have worked at the station for more than 30 years.

I started my training in March of 1983, so here we are 40 years later,” said Dixie Harmon, a paramedic.

She, and many of her peers, are thinking about retirement.

But when they leave, Shroyer doesn’t know who will fill their shoes. If he can’t find younger recruits, he’s concerned people won’t get the immediate help they need in an emergency.

You don't want people to be fearful that when they call 911 no one's coming,” he said. “But if we don't do something at some point, that's where we're headed.”

Harmon and Shroyer have both been working to attract young people to the field, but their efforts have met limited success.

“Part of the people they see, maybe, shows on TV and think, ‘Wow, that's something I really want to do,’” Harmon said. “But then when they get in and do it, they realize it's not for them.”

Harmon and Shroyer both go to high school career fairs and Shroyer has even tried partnering with a local community college to offer free training.

“We couldn't get enough students interested to hold the class,” he said. “There's just not the interest that there was 30 years ago.”

You don't want people to be fearful that when they call 911 no one's coming. But if we don't do something at some point, that's where we're headed.”
Todd Shroyer, Director of Coshocton County's Emergency Medical Services

What’s next?

For now, people like Dixie Harmon keep showing up to work.

“If you're part of your community, you stay there,” she said. “I guess it's just a matter of your community pride and helping your local people.”

That local pride hasn’t been enough to attract new EMTs though, so Shroyer is left considering alternatives.

He doesn’t have the resources to boost pay, but the county is building a brand new EMS station using one-time CARES Act funds.

“Especially for some of the younger generations, that's a big draw,” he said. “We're hoping the fitness area, nice quarters, individual bunk rooms, that those non-monetary incentives will help retention.”

Harmon hopes that will work too. But if it doesn’t, there’s a good chance she’ll still be around.

No matter how alluring retirement is, she said, she can’t fathom leaving her neighbors stranded when they’re in crisis.

Erin Gottsacker is a reporter for The Ohio Newsroom. She most recently reported for WXPR Public Radio in the Northwoods of Wisconsin.