Lacking Volunteers, Small Towns Considering Closing, Merging EMS

Feb 14, 2019

A lot of Vermont’s emergency medical services are on life support thanks to declining volunteers and increasing costs. For some, time has run out.

After 52 years of serving its community, Cabot Emergency Ambulance Service will shut down this summer. Most Cabot residents work far outside of town. That’s a problem for the volunteer ambulance service.

"I think it’s a combination of attracting people [and] retaining people, because people have full-time jobs and there’s not enough people in town to respond to medical emergencies," said Cabot selectboard chair Michael Hogan.

"I joined to help the community, back years ago, and a few others did," said Andy Luce, a 30 year veteran of the squad. "And the older ones that were there have passed on."

Luce said they’ve been struggling to fill shifts for a couple years now. Another part of the problem is that young people are leaving town.

"We got a bunch of people we trained," he said. "They went to other services or moved out or went to college and didn’t come back or went to the service and didn’t come back."

The squad doesn’t have the money or the manpower to continue the ambulance service. Come June 30 it plans to downgrade to a fast squad, which responds to incidents but can't take people to the hospital.

"We’ll go to the scene," Luce explained. "We’ll take care of the patient at the scene. We will wait for a transport ambulance to come in."

This newsletter, detailing Cabot Emergency Ambulance Service's first year, is on display at the fire department. Between Feb. 1967 and Feb. 1968, the service transported 22 people during 19 trips. The emergencies included 'heart attack, stroke, auto accident, childbirth, concussion and fracture of limbs.'
Credit Amy Kolb Noyes / VPR

On Town Meeting Day, voters will be asked to approve $45,000 for a one-year interim contract with an outside ambulance service. The town has set up a study group to explore long-term alternatives.

Cabot isn’t the only community in the state that’s facing tough choices about its ambulance service. During the last legislative session lawmakers asked an advisory committee to look at Vermont’s emergency response system. Chair Drew Hazelton says the story’s pretty much the same across the state.

"So kind of the bottom line, what we’ve decided, and what we’ve kind of submitted to our legislators is that the EMS system is in trouble," he said.

Eight out of ten of the EMS directors who responded to the committee said they were having difficulty recruiting new members. In a lot of ways Hazelton, who is director of the Brattleboro-based ambulance company Rescue Inc., said the small, rural EMS services face a lot of the same issues as small schools.

Some communities are starting to discuss Act 46-like mergers of emergency services.

Hazelton’s not asking for forced merger plan, yet. But as more ambulance services close, he said small towns will be forced to consider the idea.

"So after many years of sitting on a school board and going through many variations of forced discussions, I’m very hesitant to ask for additional forced merger in any form," he said. "We do have services in Vermont that have closed which have kind of forced more regional thought processes. So, I think as that kind of works itself out, the committee will probably take up that discussion."

Gwynn Zakov, who’s with the Vermont League of Cities and Towns, said towns may no longer be able to delay talks on regionalizing EMS services.

"We’re at a critical stage right now where if we don’t do something we will have pockets of the state where potentially you could pick up the phone and call for an ambulance and not get service at all," Zakov said.

The advisory committee report found that as more volunteers and staff members leave EMS companies, there’s a greater strain on neighboring services that are called during emergencies. The report also found that response times across the state inched up slightly in 2018.