Rural ambulance service under threat, especially in the West

This topic has been covered by two major media outlets in recent months.  First the New York Times' Ali Watkins reported a few months ago out of Wakashie County, Wyoming, population 8,533.

Then NPR's Aaron Bolton reported yesterday out of Dutton, Montana, population 316.  Bottom line:  

[S]agging [Medicare and Medicaid] reimbursement and volunteerism mean rural parts of the U.S. can no longer rely solely on volunteers but must find ways to convert to a paid staff.

The lack of anonymity and community aspects of this story caught my attention, though the following excerpt focuses on other practical and fiscal issues, too.  

Communities need to find ways to stabilize or convert their volunteer programs, or private services like his will need financial support to keep responding in other communities...

But lawmakers' appetite for finding ways to fund EMS is limited. During Montana's legislative session earlier this year, DeTienne [until recently Montana health department's EMS and Trauma Systems chief] pushed for a bill that would have studied the benefit of declaring EMS an essential service, among other possible improvements. The bill quickly died.

Back in Dutton, the EMS crew chief [Colleen Campbell] is thinking about her future after 17 years as a volunteer. Campbell says she wants to spend more time with her grandchildren, who live out of town. If she retires, there's no guarantee somebody will replace her. She's torn about what to do.

"My license is good until March of 2022, and we'll just see," Campbell says.

I can't help thinking about the parallel between EMS volunteers and volunteer fire departments, which have been the subject of many posts over the years.    

Postscript:  On July 8, NPR ran this story on the expanding urban-wildland interface in relation to fire danger, and it includes the topic of volunteer fire departments and their struggle to respond adequately to wildfires.