Grants Dashboard

The Creighton Ambulance Service is seeking a grant to augment their training to improve skills and maintain quality patient care. Objectives include improved patient and caregiver safety and additional training for substance abuse and mental health issues. Funding in the amount of $92,300 is requested for IV and enhanced cardiac training equipment, Personal Protective Equipment (PPE), a chest compression device, radios, and minor renovations to upgrade existing ambulances. The Creighton Ambulance Service is a volunteer ambulance squad that services the community of Creighton, NE and the Creighton Rural Fire District in Knox County, NE. Geographically, Creighton is located in Northeast Nebraska and is the largest community in Knox County with 1200 permanent residents inside the city limits. Creighton is located 10 miles from Highway 20 and 6 miles from Highway 14. In addition, Highways 13 and 59 run through the city. A railroad is located within the Mutual aid service area and frequently hauls hazardous materials. The Creighton Ambulance Service district has a total population of 1873 people and covers over 240 square miles. According to Rural Health Grants Eligibility Analyzer and Goldsmith Modification, the service area is considered "rural". Creighton Ambulance Service is operated by a volunteer squad but is owned and partially funded by the City of Creighton. Currently, there are 29 members, EMT's and drivers. The Creighton Ambulance Service is responsible for responding to all transportation accidents, fires, and medical calls located within the service area. The population served is diverse and aging.

EmergyCare will impact the PA EMS Crisis by increasing the number of functioning providers and limiting the loss of providers by providing high quality, blended virtual training opportunities for EMT, AEMT, and continuing education within the catchment area of the grant. Additionally, EmergyCare will increase the competency of career and volunteer EMS providers to deal with mental health and substance abuse disorders and the care of such disorders through continuing education programs.

The Powder River First Responders (PRFR) Emergency Medical Services Training Project will increase the capacity of the emergency medical system in the greater Powder River region through increased EMT and paramedic training and enhanced life-saving equipment. PRFR serves residents, visitors, and people traveling through an area of almost 4,000 square miles in the rural southeastern portion of the Montana. PRFR is a community-based, non-governmental organization, which serves the greater Powder River County region with emergency medical services (EMS). The resident population is approximately 1,700 for roughly six months of the year but swells to 50,000 during the six months of summer and fall with hundreds of thousands of motorists traveling through annually (400,000 motorcyclists during the Sturgis Rally on top of an average of 3,000 vehicles through the area each day). Thirty-seven percent of PRFR’s call volume is for visitors to the area. All of these individuals, both resident and tourists, are included in the population of focus and will benefit from proposed emergency response training and purchase of life-saving equipment. PRFR’s service area is removed by over 85 miles from the nearest medical facility. On calls to the extreme edge of PRFR’s service area, it can take responders over 1.5 hours to arrive on the scene and over 3 hours to transport to the nearest emergency department. Powder River County residents experience increased incidence of multiple health factors (rate per 100,000) compared to Montana as a whole, including ischemic heart disease, diabetes, urogenital, blood, and endocrine disease mortality, and transport injuries. Specifically, the grant will: • Recruit 20 students in two Basic EMT training classes, with the goal of graduating 16 trainees as Basic EMTs. • Conduct two upkeep classes to support licensure maintenance and expansion for all existing and new registered PRFR EMTs. • Complete two upgrade classes for Advanced EMT (AEMT) endorsement for three students each class. • Support two AEMTs to obtain paramedic certification. • Purchase a cardiac monitor/defibrillator and two Automatic Chest Compression devices, and train all current and newly trained EMS staff to use equipment. • Continue to purchase and train EMS personnel on the use of the opioid overdose antidote, naloxone. • Increase the ability of EMS personnel to respond effectively to behavioral health needs in emergency situations.

The Rural Emergency Medical Services Training Collaborative (REMSTC) has formed to expand our local EMS training and align Mental Health and Substance Abuse education for a rural and isolated part of California. Our training goals are targeted at incentivizing community members into entry level EMS roles, keeping local EMS First Responders’ licensure and certification current while also creating opportunities for career development and advancement. Coast Life Support District (CLSD) is a 911-dispatched bi-county ground ambulance public provider partnering with four separate Fire Districts to form the REMSTC. Currently, there are nine Paramedics, 51 EMTs, 17 First Responders, and 42 Fire Fighters serving the region. Ninety percent of their personnel are volunteer and (67%) of their dispatches are for emergency medical services. The District is located in a remote and mountainous region along the Pacific Ocean with two+ hour transports to regional hospitals. The District is federally designated as “Frontier Area” due to being rural and isolated. Per the 2010 Census Data, the population is estimated to be 5,300 full time residents surging to ~11K many times during the year as it is a popular tourist destination. Fifty nine percent of the population served by CLSD in FY19 were between the ages of 60-99 with the overall median age ~60 years. With a large elderly population, there is an increasing prevalence of chronic disease such as cardiac, respiratory, hypertension, diabetes and dementia. There is a large and growing number of families who speak Spanish at home. There are also two Kashia Bands of Pomo Indians on reservations. A local partner engaged and committed to improving EMS resilience along with Mental Health and Substance Abuse services is Mendonoma Health Alliance (MHA). MHA offers a diversity of prevention-based and harm reduction services to address Opioid and Substance Use Disorders. Additionally, Redwood Coast Medical Services (Federally Qualified Health Center) offers Primary Care, Urgent Care (UC), Dental, and Behavioral Health services. RCMS UC sees over 5,000 patients a year and is a strong EMS partner. REMSTC’s strategy is to: 1) Expand, engage and convene all District EMS agencies in collaborative EMS Training rather than working in silos; 2) Solidify the newly certified EMR/EMT coursework program in the District; and 3) Expand evolving Distant Learning technologies to enable students optimal time management to attend didactic EMS coursework.

Margaretville Hospital will partner with Delaware County, NY Department of Emergency Services. Our goal is to provide all levels of EMS training as appropriate to maintain licenses and certifications relevant to serve in an EMS agency; conduct courses that qualify graduates to serve in an EMS agency; and fund specific training to meet New York State licensing/certification requirements. Margaretville Hospital is a rural Critical Access Hospital, located in Delaware County, whose mission is to provide immediate access to high quality medical care and services to medically underserved areas in the Catskill Mountains. The Margaretville Hospital EMS Training Program will serve the geographic catchment area of Delaware County, NY, which is a HRSA-designated rural county, and parts of Greene, Sullivan and Ulster counties that are also HRSA-designated rural areas that border Delaware County and are serviced by Margaretville Hospital. The fourth largest county in the state with a population of 47,980, Delaware County’s unemployment rate exceeds New York State averages, and according to 2017 NYS Community Action report, 26.4% of youth under 18 are living in poverty in Delaware County. Delaware County is home to 16 transporting agencies dispatched by Delaware 911 and six basic life support first response agencies. Of the 16 transporting agencies, only four have paid staff, while the remaining 12 are operated by volunteers. The volunteer agencies have an average of six people certified to provide emergency medical treatment by the state. To provide 24/7 coverage, each volunteer would need to commit 28 hours a week, the equivalent of an unpaid part-time job. Our objectives are to offer Certified First Responder (CFR), Advanced Emergency Medical Technician (AEMT), and Emergency Medical Technician (EMT) instruction each year for the four years of the grant. CFR classes would train ten people each year, AEMT and EMT 15 students each for a total of 160 people. In addition, we will train six paramedics, two each year beginning in the second year of the grant. If we are able to increase the number of EMS workers in our catchment area, this will reduce the number of volunteer hours necessary for each EMS worker to perform to provide 24/7 service. With the high rates of unemployment and low levels of income in this rural area, the program will provide educational opportunities that individuals might not otherwise be able to afford and will provide some paid career prospects.

Winnebago Comprehensive Healthcare System (WCHS) and its Winnebago Public Health Department (WPHD)’s Emergency Medical Services (EMS) division serves all 2,983 Native and non-Native people living on the Winnebago Indian Reservation. This "WPHD EMS Training Project" will adopt strategies to adequately staff the EMS Team to ensure that Reservation residents receive robust, efficient, and skilled EMS support at all times (24/7). This will be accomplished by recruiting more EMS personnel and making training available to upgrade staff certification levels. Training opportunities will also be offered to other regional EMS departments, with a particular emphasis on collaborating with the nearby Omaha Tribal Ambulance Service. A Learning Lab will be available to both Tribal EMS staffs. We will leverage professional association and other ad hoc opportunities to adopt best practices. The need is growing; transports to the WCHS Twelve Clans Unity Hospital were up 9.9% from 2018 to 2019; including trips to other urgent care facilities, pre-Covid-19 demand was estimated at 850 – 1,000 transports (note: it is anticipated demand will increase; regional packing plants will remain C-19 hotspots throughout the Project length). According to the internal EMS database, the focus population is statistically dispersed by age with a slight preponderance of 60-69 year olds. Clinical characteristics are also dispersed: suicidal ideations (11.31%); abdominal pain (9.05%); altered mental status (6.79%); dyspnea, aka difficulty breathing (5.88%) are the highest prevalence issues in 2020 Year to Date. Other conditions include unclassified pain; lower extremity leg pain; and altered mental status, along with 59 other distinct categories, all with 2.5% or less occurrence statistics. Increasing staff members, upgrading their credentials, and developing regional cooperation through ongoing Regional EMS convenings will be coordinated by an Outreach & Training Coordinator (O/TC) funded through this grant. WCHS will attempt to make the O/TC position sustainable (and will allow WCHS Marketing Director to collaborate to ensure community awareness and buy-in); in the meantime, the O/TC will focus in this first year on deliverables that tangibly benefit EMS for the future. These include: upgrading staff so that 4 Paramedics and 4 additional National Registered EMTS are in place; sustainable recruiting efforts developed at regional high schools and community colleges; quarterly regional EMS convenings which explore economies of scale/regional cooperation; strategies to enhance cooperation between dispatchers and EMS personnel; robust participation in national professional associations to support best practices and recruitment efforts; the Learning Lab’s ability to support traditional coursework as well as simulations; and culturally congruent training, primarily through a staff retreat that will help Native and Non-native team members understand historic and current community trauma and will arm Winnebago and Omaha EMS staff with self-care techniques.

The FY2020 EBCI EMS Training project will be utilized to train persons in rural NC to be able to take and successfully pass the required EMS certification examinations. Other credentialed EMS personnel will be able to increase their knowledge and skill level through training not regularly offered in rural locations. The primary populations to be served by the project are persons residing in rural western North Carolina and its surrounding areas, with an emphasis on the native American population residing on the Qualla Boundary of the Eastern Band of Cherokee Indians. At various location throughout the area recruitment activities will be held with a goal of recruiting at least 100 interested parties. Recruitment will be through educational offerings and hands-on activities. The goal will be to train at least 20 people in initial EMT education and 20 people in Advance EMT training. The outcome of the training will be to successfully complete the North Carolina certification examination or the National Registry of EMT’s certification examination. In addition to initial training the goal will be to enhance the knowledge and skill of 100 non-duplicated EMS credentialed personnel. Some of the methods used will be through real-world simulation exercises, guest speakers, critical-care certification review courses, psychological trauma in emergency patients certification courses, and substance/mental health disorders.

FM Ambulance is affiliated with Sanford Health, a rural, not-for-profit health system, with regional headquarters in Sioux Falls, (SD), Bismarck (ND), Bemidji (MN), and Fargo (ND) that are integrated with a wide network of rural, super-rural and frontier hospital, clinical, and ambulance locations. This project’s population focus is comprised of eight rural target areas that are geographically distributed across Sanford’s northern Midwest service region in North Dakota, South Dakota and Minnesota. EMS recruitment, training, recertification and retention initiatives will be integrated into ongoing comprehensive action planning in these locations. Didactic training will be provided electronically/online and at rural EMS service areas located throughout the catchment area. Rural emergency medical services (EMS) agencies are facing multiple challenges across the upper Midwest in North Dakota, South Dakota and Minnesota. Recruiting, training, recertifying and retaining qualified rural EMTs and paramedics, on both a paid and volunteer basis, are continual challenges. Many rural EMS services are also financially challenged, commensurate with low patient volumes, associated low reimbursement rates, and clientele who may struggle to pay. Although 911 call demand across these regions is relatively low, call severity tends to be higher, consistent with aging and more isolated populations in rural and/or frontier areas of the 3 states. The goal of this proposed EMS Training project is to help achieve a fully staffed and well-trained cadre of Emergency Medical Services personnel that proactively support Sanford’s rural health services and clientele across the northern Midwest catchment area. This goal will be achieved through a sequence of measurable objectives, including: assessment of current recruitment strategies, the launch of new recruitment which will result in a total of 50 EMT candidates, training through distance learning strategies, MHFA and substance abuse training, and recertification sessions. These objectives will guide project implementation, together with ongoing monitoring, reassessment and evaluation. The proposed recruitment, training, recertification and retention initiatives will result in an increase in emergency medical services personnel at 8 rural ambulance services, across our footprint in Minnesota, North Dakota, and South Dakota.

The proposed project focuses on recruiting and training of three EMTs to become paramedics for Kimaw Medical Center. Recruiting and retaining paramedics is especially difficult in this rural area due to remoteness and time and distance of transports. Additional training will be offered to KMC EMS staff in order to increase skill level and enable better response to calls requiring specialized knowledge (i.e. swiftwater and over the bank rescues).

Ute Pass Regional Health Service District (UPRHSD) is offering Emergency Medical Service (EMS) learning opportunities for residents of the District and expanding learning opportunities to the rural population with Technology-Enhanced Education (TEE). Through the Leaders in Education Around Rural Need (LEARN) program, rural students will be able to engage in primary and continuing education /advanced EMS certification. This program will allow students to access course material without driving an hour or more to get to a city offering collegiate level classes. In these rural areas, emergency calls take longer to respond to, and the transport time to definitive intervention for critical patients is extended, necessitating a higher provider level working the calls. The level of new provider training is limited to those residents who can drive over an hour each way for classes, multiple days a week, or who are already trained and can be recruited from outside the District. Some EMS courses are already offered in the District, and a collaborative effort with Pikes Peak Community College (PPCC) was put in place last semester for students to do Advanced Emergency Medical Technician labs at the UPRHSD classroom. This collaboration allowed students from the Teller County, CO area to do some classwork closer to home. The LEARN program will equip the UPRHSD classroom to record and edit training materials and to live-stream classes to 360 students annually, regardless of their proximity to the building, and will provide supplies, equipment, and training on specific medications that will benefit populations at risk for Alcohol or Substance Use Disorder. Principles from social distancing have given the LEARN program ideas on how to effectively connect and teach residents interested in learning and furthering EMS skills.

As its EMS workforce numbers continue to decline, Lancaster County EMS finds itself battling an opioid epidemic, rapid population increase, and an aging population. Private EMS companies in neighboring counties and retirement have depleted Lancaster County EMS of valuable talent. However, with grant funding, Lancaster has plans for a unique recruiting and training strategy to bolster its workforce to combat the growing turmoil within its borders.

Bladen County, North Carolina is applying for the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration’s FY 2020 Rural Emergency Medical Services Training Grant, FG-20-005. Many individuals in Bladen County lack access to primary care and use 9-1-1 and emergency medical services to receive healthcare in non-emergency situations. Alcohol and opioid abuse have only compounded the issue. This creates a tremendous burden for EMS, both for personnel and the system as a whole. Lack of enough qualified paramedics has been a long-standing burden for the county. The current budget does not have the funding needed to pay for the salaries of the staff to obtain continuing or advanced education. This has a negative impact on the department’s ability to support the growth and retention of the staff they do have. Bladen County is committed to finding alternative ways of providing quality and timely services to those we serve. The goals of this grant are: • To provide continuing and advanced EMS training to meet the needs of the community. • Initiate a community paramedic program and through that program, • Decrease non-emergency calls by 25% • Decrease behavioral health emergency calls by 25% Utilizing the community paramedic position, the expectation will be to improve access to appropriate care, reduce repeated transports and readmissions, thus decreasing the daily non-emergent load from EMS. These reductions will ease staffing stresses on the department, decrease response times for other calls while filling a gap and providing coordination of care. EMS responded to almost 9,000 calls in 2019 and over 1,000 were classified as non-emergent. The Community Paramedic will also collaborate with law enforcement, mobile crisis and the hospital ED to provide follow-up visit/calls to individuals encountered with a mental health crisis and/or substance issue who refused treatment or received naloxone. The Community Paramedic will work to connect all individuals to the appropriate treatment, services and resources Bladen County is the fourth largest land area in square miles in North Carolina. Spanning 874.33 miles, the county is located in southeastern North Carolina in what is known as the Coastal Plain. The 2020 census is projected as 34,497, according to the North Carolina Office of State Budget and Management. The largest town is Elizabethtown with a population of 3,473; Bladenboro is the next largest with 1,657. Bladen County is one of 56 counties in North Carolina classified as rural with an average population density less than 250 by the U.S. Office of Management and Budget. In 2018, Bladen County had a higher percentage of poverty at 29.1% than the North Carolina benchmark of 14.1%. The poverty rate for those under the age of 18 was 44.2%, with N.C. at 20.2%. An analysis of the population shows that 61.5% of the Bladen County population identify as white, 33.4% African-American and 9.6% as Hispanic.

Focused training would be offered in the following areas: state certified paramedic course, existing personnel to receive instruction certification, training equipment, and diversity training for staff. The requested grant funding would specifically support the following: (1) Paramedic level training course and certification for five staff members. This ensures the highest level of 911 services available in the county for all employees. (2) Purchase training equipment and supplies required by the State of Indiana to become a state certified training institution; and (3) Purchase virtual training software and hardware to enable the facility to host hybrid training courses Parke County has a population of 17,334 and receives nearly two million visitors annually due to its two State Parks, outdoor recreation venues, and festival events. Our county is also home to a growing population of over 1,500 Amish citizens. Our county does not have a hospital, emergency care facility, or assisted living facility. Paramedic level trained staff is crucial for our residents and visitors. Over 56% of the county population is age 44 and older with 39% of that being 55 and older (Purdue University Center for Regional Development). All the aforementioned would benefit from enhanced skill training, increase the pool of state certified personnel, and provide opportunity for our volunteer first responders and firefighters. As a county owned 911 service, our budget doesn’t allow for training new personnel, maintenance of existing certifications, or upskilling our current staff. Today, the responsibility of this expense is falling on the individuals serving the residents and visitors of our community. We experience difficulties recruiting new employees due to pay level and limited training opportunities. We do our best to be creative by partnering with other ground services, air services, and hospitals to provide some training for our employees. Our ambulance service has a training space available but we’ve been unable to fully utilize due to lack of funding for training and equipment. In 2019 our agency responded to 20 overdose related calls, 4 suicide attempts, and 31 mental health disorders. The patients from those calls would have benefited from having responders with narcan training, de-escalation training, and mental health first aid training. These courses are all offered as a portion of the classes that we will to offer all responders who attend. The narcan training could have potentially saved the life of a young overdose patient in our county in early 2019. Due to the response time of the ambulance, an overdose victim did not get their first dose of narcan for 14 minutes after they were found unresponsive by family. First responders were on scene within 5 minutes but lacked the proper training to carry or utilize the needed medication that could have saved a patient’s life.

The Pine Ridge Reservation, governed by the Oglala Sioux Tribe (OST), is located in southwestern South Dakota in Oglala Lakota and Bennett counties, and portions of Jackson and Sheridan counties. It is more that 2,469 square miles (larger than Delaware and Rhode Island combined) and is home for more than 32,152 American Indians (American Indian and Population and Labor Force Report, 2013). The Oglala Sioux Tribe Ambulance Service covers the entire Pine Ridge Reservation, so resources are already stretched thin across this area. The OST Ambulance Service has struggled to recruit and train EMT's to join their team and is currently understaffed and underfunded. The program is supposed to include 45 EMTs and paramedics, but the current staff is 28 employees, 24 of whom live off the reservation in Rapid City, South Dakota. The purpose of this project is to recruit and train local people to join the OST Ambulance Service and increase the representation of American Indian EMT's on the Service. Recruiting local people will help make the Ambulance Service shifts more sustainable by shortening them and provide the dual benefit of increasing the cultural and linguistic diversity of the staff. Training 20 new EMTs will allow the Ambulance Service to increase staffing to their full capacity and dramatically increase the success rate of previous training sessions. The training will occur in two courses that happen simultaneously on the East and West side of the Pine Ridge Reservation. Current staff will be supported to maintain their certifications to ensure the continued efficacy of the OST Ambulance Service. In addition to recruiting and training new staff, this project will also increase the capacity of the OST Ambulance Service to offer training through the SAMHSA TTC by purchasing computers. The OST Ambulance Service currently has one computer that is nearly 10 years old and defunct, so they are not able to do online training for their staff. This capability will greatly expand the service's ability to offer professional development to staff and will serve as an enduring investment in the technological capacity of the program. In short, this project will bring critical resources to a department that is stretched thin, especially following COVID-19 and will improve rural emergency services in the poorest county in the United States.

The Fayetteville Volunteer Fire and Ambulance Department’s Training Institute’s (FVFDTI) project entitled “Bringing EMT Training into the 21st Century” (BET21C) is intended to reverse the 5-year downward trend of Emergency Medical Technician (EMT) class enrollments. The project involves of the listed percentages of the following counties within the 13th Congressional District in Pennsylvania (100% of Franklin, 45% of Adams, and 20% of Cumberland Counties). This encompasses a total geographic area of 1471.4 square miles and a total population of 195,330. The demographics of the area that we provide training for are as follows: Average median income is $47,420.74 and the per capita income is $20,754,86. There are 5.5% of families and 8.9% of the population living below the poverty line. According to the 2010 US Census the ethnic breakdown of races are as follows: 95.8% = White; 2.1% African American; .4% = Asian; 1.9% = Hispanic; and .8% = Multi-race: Project Goals of the project were determined via polling of past and prospective students: 1. Increase the enrollment in EMT classes in this region. 2. Reduced the number of individuals failing the state EMT certification test. 3. Make practical training scenarios as realistic as possible. 4. Increase the knowledge and skills of emergency responders to recognize the signs of mental disorders and substance abuse through educational seminars. 5. Provide opportunities for EMTs to maintain their certification. Objectives: 1. Provide three 220 hour EMT classes, through virtual and classroom training, to train approximately 80 people as EMTS by the end of the project year. 2. Provide quarterly Mental Health & Substance Abuse educational seminars to over 400 individuals by the end of the project period. 3. Purchase 2 sets of new CPR Mannequins, 4 new AED Trainers, and a state of the art Rescue Mannequin for use in each class. 4. Offer Continuing Education classes monthly, to allow individuals to attend and meet the training requirements of the Department of Health. 5. Purchase an Audience Participant Response System to provide immediate feedback to both the students and the instructors on the comprehension of the material being covered. When we started the development of this project it was our original intention was to extend the goals beyond 4 years, which was the original performance period. Now that the performance period has been reduced to one year, we are confident this project’s cost benefit ratio will extend for several years.

The Amboy Fire Protection District EMS Training Improvement Project will train eight Emergency Medical Technicians and four Paramedics to Illinois and national certification levels. The certified personnel will close the Amboy Fire Protection District's service gap of too few EMT personnel responding to ambulance alarms and too few Paramedic personnel responding to maintain advanced life support licensing for Illinois ambulance runs. The Amboy Fire Protection District provides emergency medical services for 200 square miles of the 729 square miles that make-up Lee County, Illinois. The population served is 8,000 with an increase of 50,000 during the summer when urban visitors enjoy the outdoor recreation areas, averaging about 400 EMS alarms per year. Lee County's population's average age is older than the state or national average population age. More than 50% of respondents to the 2019 Community Health Needs Assessment said they or someone in their household had a mental illness. The top health needs of county residents are behavioral health, obesity and physical inactivity, access to care and transportation, food insecurity, and tobacco and e-cigarette use, all of which can result in the need for emergency medical services. In this EMS Training grant project, AFPD plans to train personnel to EMT (eight) and Paramedic (four) certification levels and equip these personnel members with pre-employment physical examinations, immunizations, and personnel protective equipment. Furthermore, AFPD will train its entire EMS department of forty-one (41) personnel members with SAMHSA virtual Technology Transfer Center's in mental and substance use disorders and care for such people in emergencies and with the use of Naloxone opioid overdose antidote and the care of overdose patients. AFPD will place 30 Chromebook laptops into service with Google Classroom and Targeted Solutions software and curriculum. Implementation of the Chromebooks project will allow all personnel to complete continuing education requirements in in-service group training and self-study to maintain their EMS certifications and HR requirements, including but not limited to Standard Medical Orders (SMOs), annual clinical recertification; OSHA bloodborne pathogens, patient lifting, hearing loss, sexual harassment, and HIPPA requirements. At the end of this grant project's year, AFPD will be fully staffed, ALS licensed on all its ambulance alarms and situated to continue an in-house training curriculum for all its personnel to meet their continuing education requirements and maintain their EMS certifications. A fully staffed EMS agency will be at the capacity to provide high-quality ALS emergency medical services to the community serves.

The Mercy Health Rural EMS Training Initiative will provide high quality Emergency Medical Services (EMS) training in rural Sandusky and Henry Counties, located in Northwest Ohio. The proposed activities will strengthen the quality and consistency of training of EMS personnel in both counties by delivering continuing education that focuses on the use of hands-on skills using high fidelity manikins with scenarios that mirror common cases and low frequency/high risk procedures. The provided training will be responsive to the needs of the communities in which the EMS personnel serve. In Sandusky County, Mercy Health will partner with Sandusky County EMS, which has five EMS locations. Mercy Health will also partner with the Napoleon Fire and Rescue department, located in Fulton County, in Napoleon, Ohio. The goal to increase the capacity of rural EMS personnel to provide high quality and consistent emergency medical services in their communities will be achieved by training at least 125 EMS personnel in Henry and Sandusky counties. At least 65 EMS personnel will be trained on care of patients with mental and substance use disorders. At least 65 personnel will also be trained on best practices in the administration of opioid overdose antidotes. Training will include special care of COVID-19 patients, including simulation scenarios using personal protective equipment and advanced airway management. The project will result in an infusion of advanced equipment for EMS personnel training, naloxone doses and bag valve masks for overdose treatment, and personal protective equipment such as N-95 masks, goggles, and face shields.

NorthStar Emergency Medical Services (NorthStar), a nonprofit rural emergency medical service, part of MaineHealth d/b/a Franklin Memorial Hospital (FMH) will implement Franklin County, Maine’s Rural Emergency Medical Services Training Project to recruit and train emergency medical services (EMS) personnel in the federally designated rural catchment area of Franklin County, Maine. NorthStar, the sole EMS provider in this county, is part of the local Franklin Memorial Hospital and also MaineHealth, an integrated not-for-profit healthcare system. Healthy Community Coalition, also a division within the same company, will collaborate with NorthStar to accomplish project goals. The population served is approximately 40,000 and includes EMS personnel, individuals who could be recruited and trained to serve as EMS personnel, and the region’s residents. The population like many other rural communities is older, sicker, and poorer. More than 50% of the aging population have more than 3 coexisting chronic illnesses. Franklin County is one of the poorest counties in Maine with 13.7% of individuals living below the poverty level. The median household income is $48,053 versus the state at $60,293. The majority of the population face additional socioeconomic vulnerabilities such as poor health, isolation, limited educational attainment, and under or lack of insurance. Program Goals and Objectives include: Goal 1: Increase recruitment, training and retention of EMS personnel in Franklin County, ME by implementing recruitment and training programs. Objectives 1.1: By the July 30, 2021, Program staff will recruit and train 20 EMS personnel. Objective 1.2: By May 31, 2021, program staff will provide EMS career information to 1,500 individuals at 10 career fairs at state-wide middle/high-schools and career centers. Objective 1.3: By March 31, 2021, NorthStar will provide job-shadowing to 20 University of Maine Farmington Community Health students. Objective 1.4: By June 30, 2021, NorthStar will offer Emergency Medical Response training to 20 local fire department and law enforcement officers. Objective 1.5: By July 31, 2021, strengthen retention strategies to engage 80% of EMS personnel in career expansion programs. Goal 2: Provide EMS personnel with training to understand, and provide safe, stigma free treatment for mental health and substance use disorders, including Opioid Use Disorder. Objective 2.1: By June 30, 2021, Offer mental and substance use disorder training via SAMHSA’s Technology Transfer Centers to 75% of EMS personnel. Objective 2.2: By January 31, 2021, HCC will provide Opioid Use Disorder and Naloxone training to 75% of EMS personnel. Objective 2.3: By November 30, 2020, provide 4 Stigma trainings to reach 75% of EMS personnel. Objective 2.4: By June 30, 2021, Offer Mental Health First Aid/Trauma Debriefing and Suicide Prevention education for 50% of EMS personnel. Goal 3: Ensure EMS personnel have the equipment and training tools needed to provide high quality care. Objective 3.1: By July 31, 2021, NorthStar staff will utilize appropriate training equipment in training classes.

Indiana University Health – South Central Region provides Emergency Medical Services in Monroe, Lawrence, and Orange Counties. Through the proposed EMS Training Project, we will provide innovative EMS training opportunities to address the paramedic shortage, particularly in rural areas of our catchment area, including Paoli. SAMHSA funds will support the establishment of three local state-of-the-art training sites, the purchase of EMS training equipment, and training on mental and substance use disorders and the use of naloxone in opioid overdose emergency situations. Project Name: Indiana University Health – South Central Region EMS Training Program Population to be served: The estimated combined population for Monroe, Lawrence, and Orange Counties is 212,074. These counties have experienced a spike in need for EMS services as a result of an ageing population, the opioid crisis, and the fact that Indiana ranks 41st out of the 50 states in health. These issues are especially prevalent in rural service areas. Strategies/interventions: Through the proposed project, we will address the paramedic shortage using Zoom Room, a cutting-edge software-based training room system. We will recruit and train 10 to 15 new paramedics during the grant period, implementing all SAMHSA required grant activities. Project Goals and Measurable Objectives: Through the proposed 12-month project, we will expand EMS training, resulting in increased EMS staff serving in our highest need locations. Measurable objectives related to this goal include establishing two new EMS training sites using Zoom Room technology and EMS training equipment, we will train 10 – 15 new paramedics and improve outcomes for residents experiencing opioid overdose. 10-15 class participants will be trained on the selected curriculum addressing mental health and substance use disorders, including Naloxone administration. Furthermore, SCR will purchase 20 Naloxone Kits to be distributed to all EMS providers in the South Central Region. Finally, we will improve EMS service response time for residents of rural Paoli by making necessary renovations to the ambulance garage at the IU Health EMS in Paoli.

The purpose of Washington County Ambulance District’s Fundamentals of Critical Care Transport Program is to recruit and train emergency medical services (EMS) personnel in rural Missouri. The goal, in partnership with the Missouri Emergency Medical Services Association, Mineral Area College and Washington County Memorial Hospital is to increase capacity of Missouri EMS agencies to provide critical care transports through certification and continuing education. Over the four-year project, this will be achieved by certifying 200 paramedics in southeast Missouri through the FCCT Program; expanding FCCT to every region in the state; increasing continuing education by 1,000 EMS personnel in critical care and increasing the number of registered nurses receiving FCCT certification. The number of individuals certified will increase from 20 in year 1, to 40 in year 2, 60 in year 3 and 80 in year 4, for a total of 200 individuals certified. Annually, the number of individuals receiving continuing education will also increase by 100 individuals annually from 100 in year 1 to 400 in year 4, for a total of 1,000 individuals trained. Training is focused on “big picture” assessment and management of disease processes with emphasis on complexly ill patients. Measurable educational objectives are used to determine students’ learning needs. The outcomes of this program are 1) that students are prepared to take the Certified Critical Care Paramedic (CCP-C) exam as administered by the Board for Critical Care Transport Paramedic Certification (BCCTPC) in order to receive a national level Critical Care certification and 2) to function as a “review course” for currently certified CCP-C or Certified Flight Paramedic (FP-C) clinicians needing re-certification and continuing education. The WCAD FCCT program is a 19-week educational program with an advanced curriculum designed to meet and exceed the national BCCTPC/ International Board of Specialty Certification (IBSC) guidelines. Locations are identified at the start of each 19-week session and outreach conducted to maximize participation. While FCCT program participation is targeted toward individuals with at least three years of experience as a paramedic, with current licensure as a paramedic in Missouri, the course is offered to others, including registered nurses to increase the pool of Emergency Medical Services (EMS) workforce, as nurses are often hired by ambulance districts. Nurses in CAHs throughout Missouri have participated in the program and report an increased comfort level with caring for critical patients prior to discharge or care transition.

This grant endeavor is in response to the SAMHSA initiative to recruit and train EMS personnel in rural areas. The development of the HCHC EMS Training and Recruitment Program will capture the strengths of participants, encourage professional growth and address challenges that limit progress to date. This work will benefit both EMS providers, community volunteers and patients, and strengthen our rural region’s health care environment. Activities and processes developed will be targeted towards EMS professionals and volunteers, and patients receiving care in Henry County, Iowa and adjacent townships; approx. 66 EMS responders and 26,500 area residents. Located in southeast corner of Iowa, Henry County is comprised of 473 square miles with a population density of 46 people per square mile. A regional program will allow the development of tailored solutions responsive to local needs, share resources, further servicing area Medical First Responders (MRF), and aid in personnel retention. To accomplish the charge, HCHC EMS will: • Establish a regional partnership with area Community Colleges (CC) to identify and address issues with current education/training processes that inhibit student enrollment; • Increase area CC’s capacity to transition EMT students to Paramedic certification by partnering with HCHC EMS in developing a robust preceptor program; • Expand regional partnership between HCHC EMS and county-wide MRF Agencies by providing training and managerial support that reduces the administrative burden on MFR directors and improves compliance with state licensing; • Increase the availability of educational offerings and further develop critical care and cultural sensitivity skills of career EMS staff and volunteer MFRs through the purchase and implementation of technology-enhanced educational equipment and educational/ monitoring software. • Improve EMS personnel safety through the purchase, implementation and training on PPE including turnout gear and N95 fit-testing equipment. Our expected outcomes for the Program by the end of 12 months are: • Improved organizational and community collaboration for EMS recruitment and retention; • Improved access to and coordination of EMS training programs; • Strengthened network of responders and partners better capable of addressing psycho-social and medical needs of our local communities.

The BT has an enrolled Tribal membership of 17,321 members (Source: Blackfeet Enrollment 2020) with ancestral ties reaching as far as Canada and throughout the United States and has been in existence for more than 10,000 years. Over half of all tribal members still reside on the Blackfeet Indian Reservation (BFIR), which has a land base of 1.463 million acres and which is considered our homelands. The largest town on the reservation is Browning (population 1,026) which has served as the headquarters of the Blackfeet Tribal government since 1894. Browning is considered the gateway to Glacier National Park and is also the principal center of commerce on the reservation. As per the US Census Bureau, our geographic area is considered a rural community because our population is less than 50,000 residents. In 2017, the BTHD conducted a Community Health Assessment (CHA) which is a needs assessment that identified the health needs of the Tribe via systematic data collection and analytic techniques. The CHA contains information and data about healthcare within the Blackfeet Nation. Featured community health priorities include mental health, substance abuse, access to primary health care, EMS services, violence and public safety, and maternal/infant health. One of the findings in the report indicated that the BT lacked a sufficient number of trained and licensed Tribal members in all healthcare professions, including EMT and Paramedic positions. In 2015, the EMS department had 1,851 calls for service and in 2019 we had 2,546 calls for service. Thus, between 2015 and 2019 we had a 38% increase in calls for service (Source: 2020 Blackfeet EMS Department statistics). Further, on many occasions, our response team is required to transport a patient to hospitals in either Great Falls (252 miles R/T) or Kalispell (200 miles R/T) for more advanced medical care that our local clinics are not qualified to handle. The Primary Goal of our project is: “To increase the number of enrolled Tribal members who will become State and Nationally Certified and Licensed Paramedics.” Our Major Objective is: “During the 12-month project period, the BTHD, in partnership with FVCC and BCC, will recruit and provide tuition, fees, and travel expenses to six (unduplicated number) Tribal members (current EMTs) who will eventually receive an AAS Degree in Paramedicine as measured by records of course completion, travel records, National Register of Emergency Medical Technicians (NREMT) certification, and State of Montana Medical Examiners Certification.”

The Missouri Rural Emergency Services Collaborative for Underserved Education EMS Training Program (MO-RESCUE) will design and implement a training curriculum targeting people in rural Missouri communities who are interested in pursuing a career in Emergency Medicine Service (EMS). The program will utilize an online training curriculum paired with on-site skills education in student’s local areas leveraging existing partnerships with University of Missouri Extension and rural EMS agencies. The objectives of the MO-RESCUE Training Program are: 1. Conduct continuing education required to maintain license of current EMS professionals 2. Conduct EMS training to rural EMS students in the Central Missouri EMS Region 3. Recruit high level EMS educators to prepare rural learners in National Registry Certification requirements 4. Adapt substance abuse and mental health training from SAMHSA’s Technology Transfer Centers 5. Provide adequate training equipment and materials to rural EMS students 6. Provide adequate training for opioid overdose treatment including the opioid antidote 7. Collect robust data on student opinions and success of courses.

The MiSIREN project will provide training for rural first responders in the Northern Region of the lower peninsula of Michigan, including the region commonly referred to as the Thumb. Eastern Huron Ambulance Service has chosen to partner with the Michigan Rural EMS Network and the Northern Michigan Fire Chiefs Association on this project. The project is an outgrowth of a 2019 Needs Assessment funded by the Staffing for Adequate Fire and Emergency Response (SAFER) program of the Federal Emergency Management Agency. SAMHSA funding will leverage recruitment and retention efforts that are currently underway through a SAFER recruitment and retention implementation grant awarded in December 2019. A SAMHSA training grant will help fill the training demands created through the SAFER recruitment and retention project and increase the competencies related to mental health and substance use disorders for current and new EMS providers. Additionally, we will work with other EMS agencies and fire departments in the catchment area and regional Medical Control Authorities. We will collaborate with the EMS Division of the Michigan Department of Health and Human Services to launch their new SUD curriculum and implement continuing education programs. The MiSIREN project will provide initial EMT training to 40 individuals and 168 hours of continuing education with 130 unduplicated participants. The focus of continuing education programs will be mental health and substance use disorders. The project has three main goals: Goal A: Leverage efforts of the FEMA funded recruitment and retention project to ensure adequate initial certification courses are available to meet increased demand for training. Objective A-1: By September 30, 2020 establish processes to monitor recruitment efforts and meet the demands for certification training. Objective A-2: By August 30, 2021 enroll 50 recruits in EMT courses Goal B: Increase the capacity of the prehospital medical system. Objective B-1: By December 31, 2020 increase the availability of resources for training of first responders and implementation of system changes Objective B-2: By July 31, 2021, increase the use of technology-enhanced test preparation and remediation for students in EMT training programs. Objective B-3: By August 29, 2021, increase programs to maintain the practical skills of EMS personnel in rural areas Goal C: Increase the competencies of new and existing first responders regarding mental health and substance use disorders. Objective C-1: By August 29, 2021, reduce stigma and barriers to training related to critical stress, mental health, and substance use disorders.

Humboldt Bay Fire serves the City of Eureka, California and the greater, unincorporated area of Humboldt County. We serve a diverse and underserved population, totaling about 55,000 people. HBF faces challenges related to training, recruitment, and medical care stemming from our rural reality. The medical facility within our jurisdiction cannot provide the level of care necessary to serve the community due to spacing and medical care capacity, forcing long wait times and helicopter flights out of the area for care. Our mental and psychological aid resources are even more strained, creating a huge need for EMS personnel competent and confident in providing emergency mental health first aid. Our department wants to take steps to increase our level of EMS care to increase offerings to the community and reduce the strain and surge on local medical facilities. We are seeking $189,819.20 of federal funds to provide a plethora of EMS training to EMS personnel, increase Advanced Life Support capacity by 5 paramedics, acquire supplies and equipment necessary to serve our community's growing medical needs, and determine the feasibility of instituting a Community Paramedicine Model within our jurisdiction.