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Instability in Emergency Services

As the Flathead Valley grows and fire department call volumes increase, officials remain short staffed with limited budgets

By Maggie Dresser
A fire crew loads up into an engine at Kalispell Fire Station No. 62 on Jan. 20, 2021. Hunter D’Antuono | Flathead Beacon

When Kalispell Fire Station 62 closed for a few days last July due to a staffing shortage, first responders worried about delays in emergency response times for Kalispell residents experiencing medical and trauma-related emergencies.

Emergency officials put a sign on the fire station entrance announcing, “Sorry, this fire station is closed today due to a staffing shortage,” but it would not be the last time. Kalispell Fire Chief Dave Dedman says the fire station closed a handful of times after that for the same problem, which has been an ongoing issue both locally and nationwide.

Right now, the fire station is filling three firefighter/paramedic vacancies. With long certification processes and decreased interest in the frontline healthcare world, Dedman is seeing fewer applicants.

In 2019, the nationwide median pay for Emergency Medical Technicians (EMTs) and paramedics was $34,400 per year while the annual mean wage for Montana ranged from $22,030 to $33,310 in 2018, according to the U.S. Bureau of Labor Statistics.

Kalispell officials said the city’s current labor agreement, however, provides an annual base salary for firefighter positions of more than $52,000, well above the state average, although it can still be difficult to find qualified applicants.

“(It’s hard) to find good, qualified people to apply,” Dedman said. “There’s an extensive background check, and as firefighters and paramedics we go into people’s homes. We are hardworking, honest people who are skilled and qualified who will provide great customer service.”

Over the last 18 months, the city has conducted two independent hiring operations for five openings. City officials said the first hiring process started in response to two retirements and was completed following pandemic-caused delays. Those two employees are currently in service.

The second hiring started in September for the three current vacancies, which occurred due to one retirement and two additional positions added through budget approval in August. That hiring process has been completed, and the three new hires are expected to begin within the next month, according to city officials.

Once the new employees start, the department will have 30 people on staff with nine EMTs and 21 paramedics.

“We appreciate the work of Chief Dedman and the rest of our dedicated firefighters/emergency personnel who are serving this community and appreciate their efforts over this past year when we had openings during the hiring process,” city officials said in a statement.

But as Kalispell continues to grow and aging baby boomers suffer from increasing medical problems, call volumes are increasing about 3% each year. The fire department receives nearly 4,000 calls per year, which is up about 1,000 calls since 2010.

“It’s pretty substantial growth,” Dedman said. “I look back 10 years ago and it’s not comparable.”

Kalispell is not alone in its struggles to find staff. Dedman says fire departments locally and nationwide are experiencing shortages, but lack of applicants is not the only problem. Funding, increasing call volumes and diminishing volunteers are also contributing factors, and Dedman has noticed a drastic change in the last 25 years.

Dedman started working for the Kalispell Fire Department in 1996 as an EMT and after becoming a paramedic through one of Flathead Valley Community College’s (FVCC) first paramedicine programs, he rose through the ranks and became the fire chief in 2011. He says the budget is the most significant difference he’s noticed since he started his career.

“When I started, the ambulance fund was flush,” Dedman said. “It paid for itself.”

Since state and federal funding dried up in the last few decades and EMS providers cannot refuse care based on an individual’s inability to pay, that means they often provide services without reimbursement, creating a slew of budget constraints. Dedman said when he started in the 1990s, people paid their bills more consistently.

In addition to the city’s general fund, the department compensates for the lack of federal and state funding by utilizing supplemental payment funds from the state care plan, which helps with Medicaid transports. The department also has funds from an EMS county levy, which the department uses to maintain credentials and training. A proposed city levy failed in 2014 by fewer than 200 votes.

Budget constraints are also impacting the Whitefish Fire Department’s ability to upgrade equipment, but Fire Chief Joe Page says the city’s changing demographics and building structures are major factors in the department’s needs.

As buildings in the valley continue to grow taller, the department is still lacking the necessary equipment required to safely respond. While it’s generally able to replace ambulances in a timely manner, it still doesn’t have a ladder truck, which is needed for many new buildings.

Page, too, has noticed a significant increase in calls, and with almost 2,000 calls a year, he would like to see seven people on a shift, but there’s typically only four on duty.

But in contrast to the Kalispell Fire Department, Page doesn’t struggle to fill positions. He doesn’t have openings.

“I don’t have the budget to hire more,” Page said.

The department works with FVCC’s paramedicine program, which gives students an opportunity to do ambulance ride-alongs as part of their education, and Page says many of them also become volunteers with the department.

Once they graduate, many look locally for a paramedic position, and FVCC EMS Lab Coordinator James LaPierre says more than 90% of paramedic graduates in his past two classes presently work in the field. “The community college is doing a good job graduating paramedics,” Page said.

But fresh paramedic graduates are looking for career positions on fire departments, and the Whitefish Fire Department only has 15 paid staff and relies heavily on volunteers. In Page’s 36-year career, however, he has seen volunteers slowly diminish.

With higher qualifications needed nowadays, including a two-year degree for paramedicine school, many volunteers are unwilling to make those commitments.

While the Kalispell Fire Department can’t have volunteers, Dedman says the surrounding fire departments like Whitefish and Smith Valley struggle to recruit. In addition to lengthy certification processes that deter volunteers, he also sees a generational gap.

“Volunteering used to be a big deal,” Dedman said. “As a society, you would do it. With the newer generations, it’s a little different.”

To address staffing shortages, Page would like to implement a resident volunteer program, which has been successful in other parts of the country and would offer free housing and paramedic tuition assistance in exchange for shifts.

Page calls staffing his “biggest concern.” A short staff means longer response times and higher risks for providers, and simultaneous calls can leave the fire station empty.

“We do the most good for the most people with the resources we’ve got,” Dedman said.