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Rural ambulance services struggling in Oklahoma

Updated:

OKLAHOMA CITY (AP) _ Low pay for ambulance workers and ever increasing training requirements are making it harder for ambulance services to break even in rural Oklahoma.

Officials say ambulance workers are underpaid compared with other health care workers, rural services are understaffed and emergency technicians and paramedics get little recognition compared with their counterparts in fire and police departments.

Training for paramedics is nearly the equivalent of a registered nurse, but the pay doesn't come close. And ambulance service standards require sophisticated trucks that can cost up to $150,000. Equipping them with monitors and life-saving gear easily can add another $12,000 to $40,000.

Ambulance services must also cope with gaps in coverage. New Medicare fee schedules will take effect in April, but many rural operators say they already struggle to maintain adequate staff at the wages they're able to offer.

``When they pick up my grandma, I want them to be Dr. Kildare on wheels,'' said R. Shawn Rogers, a paramedic and director of the state Health Department's emergency medical services division.

Tim Sinor is president and owner of Sinor EMS, which serves 22 communities in a 100-mile area in southwestern Oklahoma. Sinor said he recalls as late as 1973 listening to a scanner in his station wagon.

``It was a load-and-go scenario,'' Sinor said. ``I'd go out and bandage them up, put a splint on them, get them on a cot, hop in the driver's seat and go to the hospital.''

Now, emergency workers are trained at several levels, from a first responder providing basic life-saving skills to basic and intermediate emergency medical technicians trained to manage shock, vital signs, deliver babies, put tubes in lungs and start intravenous injections. Then there are paramedics, whose training includes that plus everything from obstetrics and geriatrics to psychiatry and dialysis.

Sinor said that for every dollar he bills, he collects about 53 cents. And the low pay for paramedics hurts the retention rate.

Sinor said his paramedics start out at $23,400 plus benefits _ and his rate is higher than many. A basic first responder barely earns more than minimum wage in rural areas and must take refresher courses, often at his or her own expense.

Ed Kirtley, chief of the Guymon Fire Department, which also operates the city's ambulance service, said area paramedic students drive two hours one way to Woodward two nights a week for one required class. Many of their technicians train in Amarillo, Texas.

``They made the requirements so stiff, people just can't do it,'' Kirtley said. ``We're not training them to be physicians here. Certainly I'm all for adequate training and quality assurance programs, but I think there's a middle road.''

Rogers said the extra training is necessary. The push, he said, is collaborating to make classes more accessible. Other suggestions include satellite-based and Internet classes. But some training must be done in clinics, not in classrooms.
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