Grants Dashboard

Project Violet aims to address the pressing issue of substance use disorders (SUD) in our community through a collaborative, multifaceted approach. Recognizing the complexities of SUD and the need for comprehensive care, our project focuses on several key initiatives. Firstly, we prioritize the recruitment and training of medics, ensuring they possess the necessary skills and knowledge to respond effectively to SUD-related emergencies. Additionally, we provide ongoing SUD training for current medics to enhance their capacity for patient care. Secondly, we establish protocols for medics to facilitate warm handoffs with Hopeful Grounds Recovery Community Organization (RCO) for overdose victims and their families. This seamless transition ensures individuals receive immediate support and access to recovery services. Thirdly, we launch a Community Paramedicine Program to provide targeted support to individuals struggling with SUD. By delivering personalized care and connecting patients to resources, we aim to reduce repeat drug poisonings and improve outcomes. To support the Community Paramedicine Program, we acquire an SUV funded by local county resources and add one Community Paramedic per shift. This investment enables Community Paramedics to reach patients more efficiently and expand our intervention efforts. Lastly, we procure buprenorphine and provide training for its use to assist patients with withdrawal symptoms. This medication-assisted treatment approach bridges individuals into ongoing support and facilitates warm handoffs to peer support specialists. Through these initiatives, the Project Violet seeks to enhance community support for SUD recovery, reduce overdose incidents, and improve the overall health and well-being of individuals affected by SUD.

The Amboy Fire Protection District (AFPD) will recruit and train five Emergency Medical Technicians (EMTs) and five Emergency Medical Responders (EMRs) to Illinois and national certification levels. The certified personnel will close AFPD's service gap of too few EMT and EMR personnel responding to ambulance alarms. This gap is due to the recent expansion in AFPD’s primary service area and its total population served. AFPD’s Recruitment and Training program is meeting the emergency medical services needs of the people in rural Lee County Illinois by expanding it service where other rural EMS organizations are failing. The AFPD now provides emergency medical services (EMS) for 250 square miles of the 729 square miles that make-up Lee County, Illinois. The population served is 6,995 with an increase of 50,000 during the summer when urban visitors enjoy its outdoor recreation areas, averaging about 550 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 2022 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 Recruitment and Training grant project, AFPD plans to recruit and train five personnel to EMT certification level and five personnel to EMR certification level and equip these personnel members with personnel protective equipment and supplies. AFPD will set-up in-house training in the fire station it came into ownership of with its recent service area expansion. This station is needed to house personnel and vehicles to serve its increased geographic area. Furthermore, AFPD will train its entire EMS department of fifty-one (51) 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 provide Motivational Interviewing and Recruitment in its training curriculum, and work with a film contractor to create rural community-specific training videos for recruitment, onboarding recruits, and training in substance abuse and other mental health illness care. AFPD will acquire and Automatic Chest Compression Device and other AED and Cardiac Monitor supplies for training in cardiac emergencies, including those caused by drug overdoses. AFPD will implement pediatric, child, and adult training simulation manikins for patient assessment and basic and advanced life support skills development, including airway management, CPR, and for continuing education credits for CPR and Narcotic Overdoses. This grant project maintains AFPD’s capacity for all its personnel to complete continuing education requirements in in-service group trainings 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 and situated to continue an in house training curriculum for all its personnel to meet their continuing education requirements and maintain their EMS certifications.

The proposed project will be led by the Jamestown Fire Department (JFD), one of two paid Fire Departments in Chautauqua County in partnership with Jamestown Community College. This project will have three target geographical areas for outreach and engagement activities: the City of Jamestown, Chautauqua County, and Cattaraugus County. Jamestown, a designated Justice40 community is located in southern Chautauqua County in Western New York. With a population of only 29,393, Jamestown is the largest population center in Chautauqua and Cattaraugus Counties, which speaks to this region's rurality. With access to trauma-informed and recovery-based care training and education and access to life-sustaining medical equipment, this project will increase the capacity of all EMS personnel serving the rural areas of Chautauqua and Cattaraugus County to provide emergency care appropriately and effectively to individuals with substance abuse disorders and co-occurring disorders. With SAMHSA funding the project will provide current Emergency Medical Technician (EMS) Instructors at JCC and JFD Battalion Chief, municipal training officers, and EMS Supervisor at JFD with 20 hours of SAMHSA-approved training on SUD, COD, Trauma Informed, and/or Recovery Based Care best practices, interventions and resources annually. Increase the number of students who attend and successfully complete the NYS emergency medical technicians (EMT) at JCC by 10% for each year of funding. Increase the capacity of current EMS professionals in the region to effectively respond to SUD and COD, and provide trauma-informed, recovery-based care for people with such disorders in emergencies by providing access to 12 hours (recertification) of training (virtual and/or in person) annually. Finally, increase outcomes for non–fatal overdose and quality of care for SUD/COD patients by providing access to appropriate lifesaving equipment used by EMS personnel in their daily operations serving rural counties.

Virginia Commonwealth University Healthcare and Hospital Systems (VCUHealth) and two of its programs: Center for Trauma and Critical Care Education (CTCCE) and Injury and Violence Prevention Program (IVPP) – Project Empower (Empower) are collaborating with rural Emergency Medical Services (EMS) and local sexual and domestic violence agencies (SDVAs) across Virginia to launch the Virginia Rural EMS Training Collaborative. This initiative brings these entities together to train volunteer pre-hospital providers on an advanced EMT course with a specialized focus on mental health, substance (ab)use, domestic/intimate partner violence, sexual assault injuries, and healthcare challenges. All applicants that complete the course will become certified A-EMT providers. This will provide critical EMS training in rural areas that rely on volunteer pre-hospital providers and do not have the funding for advanced training. This Collaborative will continue to expand our rural partnerships across Virginia. All rural designated counties with a HRSA established a need for medical personnel and expertise. The goal is to expand to other rural counties that fall with the catchment area of VCU Health System hospitals and emergency centers. Rural areas lack the funding to offer their mostly volunteer staff access to advance training or specialized training. We will recruit and train personnel from rural communities as well as establish partnerships with local specialized service agencies (SDVAs and community service boards). This will ensure patients with substance use disorder or victims of domestic or sexual violence obtain the appropriate follow-up services. By the end of the grant, we will have: •Developed a hybrid-EMT curriculum to be used by rural sites across Virginia. •Train 30 pre-hospital providers in select rural areas. This training will meet state and federal standards for licensing and certification. •Establish partnerships between rural EMS agencies and local SDVAs and community service boards •All trained pre-hospital providers will be trained and have access to Naloxone. •All trained pre-hospital providers will successfully be able to identify, screen, and respond to victims of violence

Spark of Hope is a pilot program designed to extend critical training and referral initiatives in response to emergencies involving opioids, other substances, and co-occurring mental health conditions throughout rural Clark County, Nevada, the nation's 11th largest county. Located on the outskirts of Las Vegas, Spark of Hope offers wrap-around programming made possible by the united efforts of firefighters, police, healthcare, judiciary, education, and recreation personnel. Given that over 65% of Nevada's overdose cases occur in Clark County (NV Department of Health) and that NSDUH National Maps of Prevalence record Nevada as one of 8 states with the highest rates of illicit drug use (20-26%) of the annual average percentages between 2021 and 2022), the number of people this program will serve, by training at least 100 new EMS responders, is unforeseeable but extreme. To reduce disparities in behavioral health access, services. substance use, and outcomes nationwide, Spark of Hope offers resources essential for effective EMS response, intervention, and recovery-oriented programming. Through this SAMHSA Grant, this multifaceted coalition will develop the cadre and capacity of EMS staff to deliver medical care under emergency conditions and to provide immediate SUD-related support to the rural and tribal population of Moapa Valley, NV. To benefit its vastly underserved, rural community, Spark of Hope will promote mental health, resilience and wellbeing by increasing the cadre of trained EMS responders, training at least 100 EMS responders to: 1) efficiently and compassionately respond to people who suffer from substance-use disorder and co-occurring mental health issues 2) administer opioid antagonist medication, and 3) offer recovery resources. The recognition that EMS personnel may be the only professionals who interact with PWUD in an emergency escalates the need for this project and for interagency cooperation. As recommended by SAMHSA Connecting Community, Spark of Hope will use evidence-based methodology to further develop EMS responders' understanding of: 1) substance use and misuse (emphasizing that accurate reporting helps vs. hinders recovery) 2) trauma-informed approaches (providing a sense of safety, support, and sensitivity) 3) effective triage methods (including when and how to administer naloxone) 4) facilitating connections to substance use disorder treatment and other resources. Overarching objectives are to: 1) Outreach to recruit trainees and to expand coalition resources 2) Use evidence-based curriculum and hands-on modules to train EMS staff to address substance-use disorders & co-occurring mental health conditions in emergency situations 3) Adopt and implement reporting/data collection procedures and interagency collaboration

The City of Hastings Fire Department’s Hastings TEAM Care Program is being established to provide EMS learning opportunities for our staff and regional partners within Adams County, Nebraska utilizing in-person, online, and hands-on simulation learning resources to deliver primary and continuing education along with advanced EMS certification in rural areas. The population of focus for this study is the rural residents of the City of Hastings and Adams County, Nebraska. The statement of need pertains to the lack of EMS providers and comprehensive substance abuse treatment in the surrounding communities, leading to disparities in health outcomes. Lack of sufficient funding and resources is a major barrier to addressing these disparities. Goal 1: Hastings TEAM Care Program will address the shortage of responders by recruiting and training both new and current EMS providers. Grant funds will be used to provide EMR, EMT, and Paramedic Certification programs for our current employees and county residents who are interested in volunteering with one of our regional partners in Adams County. Objectives: 1. 50 EMS personnel will be trained and certified as EMR’s. 2. 25 EMS personnel will be trained and certified as EMT’s. 3. 5 EMS personnel will be enrolled in a Paramedic Certification Program. 4. By the end of year two, an additional 25 EMS personnel will be trained and certified as Goal 2: Hastings TEAM Care program will address the lack of available Substance Use Disorders (SUDs) and Co-Occurring Mental Health Conditions (CODs) by providing continuing education to all EMS providers within our region. Objectives: 1. 43 HFD EMS providers will participate in Mental Health First Aid Course 2. 43 HFD EMS providers will participate in 24 hours of training on SUDs and trauma-informed, recovery-based care for people with the disorders in emergency situations. 3. 43 HFD EMS providers will participate in a First Responder Peer Support Training. Goal 3: Hastings Team Care Program address the lack of available basic and add-on trainings by providing training courses required for EMS personnel to maintain licenses and other relevant certifications. Objectives: 1. CPR certification classes will be provided to 80 EMS providers within Adams County. 2. ACLS Course will be provided to 43 HFD EMS providers. 3. PHTLS Course will be provided to 43 HFD EMS providers 4. PALS Course will be provided to 43 HFD EMS providers. 5. AMLS Course will be provided to 43 HFD EMS providers Goal 4: Hastings TEAM Care Program will improve interagency, multi-disciplinary cooperation by providing hands-on, high-fidelity, scenario-based EMS quarterly trainings that will be available to all HFD staff and our regional partners within Adams County. Objectives: 1. Eight Quarterly Simulation Trainings will have been offered. 2. Purchase and Implement SimX VR EMS Curriculum and integrate its use in training. 3. HFD EMS providers will participate in a Responder Safety and De-escalation Course (8 hr). This training will also be available for all EMS providers within Adams County. Total non-duplicated EMS staff trained: 155 EMS providers

This Rural Emergency Services Training grant will focus on the increasing capabilities of pre-hospital care provided by St Johns County Fire Rescue (SJCFR) to the residents and workers in the rural communities of Flagler Estates, the Town of Hastings and the Town of Elkton. The problem is the agency has a deficiency of paramedics to provide the desired level of care to this rural community. The essential objective is to reduce the consequences of substance abuse and co-occurring mental health conditions by providing rapid and highly skilled EMS intervention. The task shall be achieved by increasing the level of EMS service by providing the essential funding for SJCFR to facilitate the Florida State Paramedic curriculum to 15 existing SJCFR employees. The paramedic curriculum will include advanced medical interventions to include a focus on substance use disorders, co-occurring disorders and mental health disorders. Each student shall be required to meet the demands of the course and achieve certification through the Department of Health as a Florida State Paramedic. This level of certification shall provide the first responders the skills and abilities to provide life sustaining, counteractive drug and mental health interventions to prevent unnecessary injury and death in this rural area of St Johns County. This rural area, identified as the Tri-County Agricultural Area, consists of approximately 80 square miles and is primarily utilized for farming purpose. The population is 13,283 with a seasonal 8% increase due to the arrival of essential workers during the harvest season. Consequently, the nearest medical facility to this area is a travel distance of 18 miles with an average drive time of greater than 30 minutes. During 2023, SJCFR responded to 1,244 incidents in this area to provide emergency medical care. The median household income is 64,868.00 with a poverty rate of 17% The resident population by race is 52% white, 41% Black or African American, 6% Hispanic and 1% other. This program shall address four objectives to achieve the desired program results: 1) Increase the level and quality of EMS care provided by SJCFR to the rural areas by training and certifying 8 SJCFR employees as paramedics in the first year of the program and certifying 7 SJCFR employees as paramedics in the second year of the program. 2) Increase the efficiency of delivering Naloxone and related Advance Life Support interventions to prevent the loss of life on substance abuse or accidental overdose incidents in the rural community by 9/25. 3) Deliver comprehensive mental health crisis intervention education to the first responders to assist in the reduction of negative outcomes during mental health incident mitigation by 3/25. 4) Provide outreach and establish community relations to the at-risk community to provide information, education and resources to prevent at risk behavior by 1/25. The obtainment of this objectives will reduce or eliminate the incidents of harm or death due to substance abuse and mental health crisis in the area of focus. The program data will be quarried utilizing existing agency databases and a comparative analysis completed on 14-day increments. SJCFR is committed to providing a high level of EMS response to this community to include a focus on mental health and substance abuse interventions. SJCFR has the experience and expertise to sustain this program which will provide essential medical care with positive outcomes for the residents and workforce of this agricultural community.

K'ima:w Medical Center (KMC), an entity of the Hoopa Valley Tribe is requesting $400,000.00 for training and to purchase much needed equipment for the ambulance. KMC operates the only tribally owned ambulance in California, who service all of Eastern Humboldt County, including the Highway 299 corridor. Recruiting EMS staff in this area is very difficult. It is a 1.5 hour drive from the Coast for people to commute and housing in Hoopa is very scarce, all contributing to issues with staff recruitment and retention. Training local tribal and community people is beneficial because they are vested in the community, know the community and will be here long term. Additionally having trainings for Public Advanced First Aid Responders is essential. With only two ambulances, many times there are calls where First Responders, Tribal Police or trained community members are the only ones in the Valley to respond, until an ambulance is available. The base camp for the ambulance is Mad River Hospital. There is a level 4 hospital in Eureka and both of those require transport times anywhere from 1 to 2.5 hours away, depending on which part of Eastern Humboldt someone is being transported from. There has been a surge of opioid overdoses in this small rural area over the past three years. The Hoopa Tribal Council has even declared a "State of Emergency" due to the opioid epidemic here and the large number of fatal overdoses that the community has seen in the past three years. A CDC Epi Aid team came to Hoopa in October of 2023 and studied January 1, 2019 to October 23, 2023. They identified 177 overdoses in this time period with 27 or 15% being a fatal overdose. This does not include unreported overdoses where family or peers used Narcan to reverse an overdose. Lifesaving equipment is also needed in this area. With no nearby hospitals, lives can be saved by having AEDs strategically placed as well as other equipment for rescue and medical emergencies.

During this project, we plan to reach as many people as possible within our rural community by educating the public with resources about the ongoing epidemic of narcotic use and misuse and mental health crises. As rural emergency care providers, we see the need for more help caring for and educating the people within our parish, as we have limited resources. We plan to bridge that gap by having classes to train people for emergency situations through EMR and EMT classes to improve the number of providers available within our parish. We will offer and teach classes to further educate the local fire departments, law enforcement, and the public on resources and products that are available that may be used during a narcotic overdose or crisis, such as peer support and community outreach. Throughout our project we will be collecting data to further help us in overdose prevention. During our classes we will be distributing overdose prevention kits, training when and how to use Naloxone, and distributing Naloxone products to be used

Mercy Health - St. Vincent Medical Center, the lead agency for the Northwest Ohio EMS Consortium, will implement Emergency Medical Services (EMS) training in the following rural counties and census tracts located in northwest Ohio in Year 1: Fulton County, OH (rural census tract 040900), Henry County, OH (rural census tract 000600), and Seneca County, OH (rural census tract 963500). The proposed activities will strengthen the quality and consistency of training of EMS personnel in these counties by delivering basic and advanced continuing education in the areas of acute care, critical care, and trauma care, while also establishing new competencies in behavioral health, including the ability to recognize and identify underlying behavioral health issues and serious mental illness (SMI) in the population and to interact with these individuals in a therapeutic manner. The provided training will be responsive to the needs of the communities in which the EMS personnel serve. With funding from the Substance Abuse and Mental Health Services Administration (SAMSHA), Mercy Health will be able to provide educational services to at least 120 unique rural EMS personnel in Year 1, and an additional 120 unique rural EMS personnel in Year 2 (for a total of at least 240 unique individuals over the funded two-year period).

The Rural EMS Mental Health and Substance Use Capacity Initiative is a Maine-based initiative aimed at providing a statewide and comprehensive approach to increasing Maine's EMS workforce; building the capacity of EMS professionals to meet the needs of patients with mental health and/or substance use orders; and improving EMS agencies’ capacity as vicarious trauma-informed organizations. The overarching and primary goal of the Initiative is to support Maine’s EMS workforce in meeting the changing needs of Maine residents, while also protecting the mental health and wellbeing of EMS personnel. The Initiative is being led by United Ambulance Training Center, in partnership with other EMS agencies across Maine’s six EMS regions to reach as many EMS personnel as possible, even within the state’s most rural areas. Maine has the highest rurality rate in the U.S., with 60.9% of residents living in areas designated as rural. Historically, Maine has been characterized by its majority of older adults (22.6% of the population is 65 years old or older). However, its demographic landscape has been shifting to a younger, more transient population, with 76.9% of the population being below the age of 65. Mental health and substance use issues within the state are on the rise, with nearly a quarter of Maine adults experiencing lifetime depression and/or anxiety and an overdose death rate of 37.3 per 100,000 population. These changes are altering the nature of care needed from EMS professionals. However, over the past few decades, the EMS system in Maine has faced staffing and funding challenges that have made it difficult to respond to the state’s changing needs. The Initiative aims to address these needs through three primary goals. First, the Initiative will recruit and train EMS students to increase their awareness of EMS as a career path and support them in obtaining relevant state licensures. It is anticipated that the Initiative will train around 150 students per year, for a total of 295 EMS students trained as EMS professionals throughout the Initiative. As a result of the training, it is expected that each year around 80 students will complete the national exams for licensure, for a total of 162 newly licensed EMS professionals over the course of the Initiative, with at least 75 expected to enter the Maine EMS workforce. Second, the Initiative will improve the mental health literacy competencies of Maine’s EMS personnel, through assessments and seminars, to care for patients with mental health and/or substance use disorders. The entirety of Maine’s EMS workforce will be invited to participate in an initial assessment of their mental health literacy skills, the results of which will inform the development and implementation of a training module and series of seminars. In addition, a system will be developed to support the referral of patients with mental health and/or behavioral health issues to a community paramedic to facilitate the connection to appropriate behavioral health care services. Third, the Initiative plans to develop and facilitate a Learning Collaborative for EMS agencies to build their capacity as vicarious trauma-informed EMS organizations. Over the two-year Initiative, it is hoped that at least 4 EMS agencies will participate in a self-assessment of their capacity as vicarious trauma-informed organizations and at least 2 agencies will document their experience of implementing organizational changes to increase their capacity.

Abstract: FY 2024 SAMHSA Rural EMS Training Grant The Vermont Rural EMS Training Program (VREMS), an initiative of the University of Vermont Larner College of Medicine's Department of Emergency Medicine, is launching a collaborative effort with the Vermont Department of Health to transform emergency medical services (EMS) in rural areas of Vermont. Aimed at tackling the opioid crisis, addressing EMS workforce attrition, and enhancing emergency response capabilities, VREMS combines three integral components: the Vermont Initiative for Treatment and Linkage (VITAL), the Prehospital Vermont EMS Buprenorphine Treatment program (PREVENT), and a comprehensive array of EMS initial and continuing education courses. VITAL targets the enhancement of care continuity for individuals with opioid use disorders by ensuring those who decline transport to emergency departments are connected with essential recovery resources and would be initiated throughout Vermont under this proposal. A cornerstone of VREMS, the PREVENT program, equips EMS personnel with the ability to administer buprenorphine after an overdose reversal, facilitating effective opioid withdrawal management and smooth transition to long-term treatment. This innovative approach signifies a major advancement in prehospital care and addiction management and would be initially started in three rural Vermont communities. Emphasizing workforce development, VREMS provides specialized training and education to EMS personnel, including opportunities for high school students to pursue free EMT education with the possibility of obtaining college credits. This strategy would bolster the capabilities of the current Vermont EMS workforce by 50 First Responders and 80 EMTs, while attracting future EMS professionals, addressing the need for a sustainable EMS workforce in rural Vermont. VREMS operates under a comprehensive approach that combines expert-led training, utilization of state EMS infrastructure, and educational partnerships, aiming to improve the accessibility and quality of emergency care in rural communities. By integrating immediate improvements in emergency response with long-term workforce development, this initiative stands as a significant effort to advance rural EMS services in Vermont. Particularly, the introduction of buprenorphine administration in prehospital settings through the PREVENT program highlights VREMS's dedication to innovative solutions for combating the opioid epidemic, ultimately enhancing patient care and community health.

The “Increasing the capacity for Trauma Informed EMS in Alaska’s rural Copper River Region” project seeks to 1. Significantly increase the training of local EMS personnel focused on Trauma Informed Care and recovery based treatment of mental health and substance use disorders in emergency situations; 2. Increase by 40 percent the number of active local paramedics serving the region; 3. Increase by 50 percent the number of active local AK Certified EMS Instructors serving the region; 4. Recruit five additional EMS personnel into local service actively responding to medical emergencies throughout the region; 5. Create and proactively distribute a comprehensive resource manual for the region’s EMS personnel with procedures, guidelines, information and a training curriculum focused on warm hand-offs, referrals to recovery based care, local peer support resources, opioid overdose reversal, connecting appropriate individuals to SUD treatment, data reporting of emergency responses to individuals experiencing an opioid overdose, trauma informed care, and motivational interviewing. The project will focus on training active EMS personnel in Motivational Interviewing, Trauma Informed Care, Nonviolent Crisis Intervention Trauma Training, and Mental Health First Aid in addition to traditional EMS certification and recertification courses. By the end of the project period, the unduplicated number of people trained will be no less than 55 with an estimated 35 to be trained in year one and 20 additional unduplicated people in year two of the project period. The project’s scope will include all local EMS personnel to include the region’s FT Paid Ambulance crew, volunteer first responders, and EMS Certified personnel serving in various capacities such as Mobile Integrated Healthcare, Community Health Aids, and Village Public Safety Officers. In the rural Copper River region, EMS personnel serve an area greater than the state of West Virginia with a total population of around 2,600 residents. However, the region’s infrastructure, including EMS resources, are strained annually by a dramatic influx of nearly 100,000 visitors to the region during the short but intense three months of summer largely due to tourism and fishing. The project will serve all of the region’s residents and visitors. The racial demographics of the region’s 2,600+ residents are primarily composed of Alaska Native (25 percent) and Caucasian (60 percent) with no other single ethnic group consisting of more than 3 percent of the total resident population. There are also a significant number of Veterans living in the Copper River region at 15.4 percent of residents, and more than one-third of residents are greater than 55 years old. Major health problems include cardiovascular disease, diabetes, obesity, hypertension, various cancers, poor nutrition, edentulism, substance abuse (e.g., alcoholism, methamphetamine, and a growing OUD challenge, including prescription drug abuse, heroin, and fentanyl), STIs, and orthopedics. Barriers to health care access include poverty, high rates of uninsured residents, the region’s very rural frontier Alaska location, extreme weather conditions and lack of public transportation. The region has no hospital, Emergency Room, specialty care, or after-hours medical care within a 140-220 mile radius. On average, local EMS personnel respond to 380 emergency dispatches annually. The entire region is served by only one centrally located Full-Time ambulance crew and small groups of volunteer first responders. More than 50 percent of the region’s population lives greater than 30 miles from the region’s only ambulance.

Golden Valley Memorial Hospital (GVMH) requests $348,890 for the Enhancing EMS Care in Rural West-Central Missouri Project. This project seeks to a) enhance the capabilities of the system's EMS personnel and other first responders in the community to respond to mental health crises and substance use disorder emergencies, b) develop the skills of existing personnel and increase the number of trained Paramedics employed by GVMH, and c) significantly expand GVMH’s capacity to train EMS personnel to maintain required licenses and certifications. Golden Valley Memorial Healthcare (GVMH) is based in Clinton, Missouri, and operates a 56-bed hospital and 24/7 emergency department, as well as four multispecialty physician clinics, an outpatient clinic and a cancer center. GVMH provides accessible and affordable care to rural communities across Henry County, MO and Benton County, MO. Henry and Benton Counties will serve as the geographic catchment area of this project, with the population of focus including: a) individuals aged 65 or older and b) maternal and pediatric populations. As part of their efforts to enhance EMS capabilities in their service area, GVMH will a) administer training on responding to mental health crises and substance use disorder emergencies through 24 instructional Community Training and Naloxone Distribution Sessions, b) support four (4) current EMTs in completing an EMT-to-Paramedic Bridge Program, c) enrolling four (4) GVMH Paramedics in training to become Prehospital Trauma Life Support (PHTLS) instructors, d) enrolling four (4) GVMH Paramedics in training to become Mental Health Resilience Officer (MHRO) instructors, e) enrolling four (4) GVMH Paramedics in training to become Emergency Pediatric Care instructors, f) enrolling four (4) GVMH Paramedics in training to become EMS Vehicle Operator Safety instructors, and g) enrolling six (6) Paramedics in Critical Care Paramedic Training. Additionally, GVMH will use this expanded capacity to increase internal training opportunities for the system’s EMS personnel, with Instructor-trained GVMH Paramedics providing MHRO and Emergency Pediatric Care training to 10 GVMH EMS personnel. Overall, the proposed project would include the administration of EMS training to 271 unique individuals. In addition to the training components outlined above, the proposed project would include the procurement of an EMS defibrillator and heart rate monitor, five (5) point of care lactic testing systems, three (3) emergency patient transport cots, and five (5) CO2 detectors, as well as an EMS vehicle for use by a Community Paramedic.

The goal of this project is to increase capacity of the Crisp EMS and regional EMS agencies to provide critical care transports leading to improved health outcomes for those in the region requiring EMS services. To address and overcome the many challenges facing Crisp and the regional EMS agencies described above, Crisp will implement a comprehensive recruitment plan to enroll 22 new EMS personnel in training for certification and will improve existing EMS trainings and services through new equipment. As a result of this project, 8 participants will become licensed/certified EMTs, 8 participants will be licensed/certified as AEMTs, and 6 participants will be upskilled to become Paramedics. Further, the project will enable Crisp to provide for the continuing education requirements of 10 current EMS personnel. Lastly, Crisp will also engage in a comprehensive recruitment/outreach campaign both digitally and throughout the rural central GA communities that Crisp serves (through community events, collaboration with local schools, etc.).

Wayne County Hospital (WCH) (Corydon, IA) requests funding for their Advancing Rural Iowa's Services in Emergencies (ARISE) project. The goal of WCH's Rural EMS Training project is to increase capacity of WCH and the communities' EMS agencies to provide emergency and critical care transports, through more accessible training opportunities and a larger quantity of trained and certified EMS personnel, which will in turn lead to improved health outcomes for those in the region requiring EMS services. This goal will be reached by expanding the capacity of current WCH personnel and recruiting & training additional individuals in Emergency Medical Response (EMR). WCH will partner with Indian Hills Community College (IHCC) to provide EMR and EMT training and Des Moines Area Community College (DMACC) to provide Paramedic and Critical Care Paramedic (CCP) training.The population of focus for this project encompasses Wayne County and surrounding areas. The communities being served face significant economic, geographic, educational, and healthcare challenges that hinder their quality of life and are meaningful barriers to overall well-being. Wayne County residents have higher rates of uninsured, more residents living in poverty compared to the state, and lower level of education and median household income. Wayne County meets the criteria for rural designation due to being in nonmetropolitan statistical areas. Additionally, all of Wayne County is designated by HRSA as a Health Professional Shortage Area (HPSA) for mental, dental, and primary care. The principal goal of the project is to increase the capacity and competencies of Wayne County Hospital's EMS personnel, particularly in responding to mental health crises and substance use disorder emergencies - in turn leading to improved health outcomes for those in the region who require EMS services. WCH has developed the following objectives to measure the success of this training project in achieving the overarching goal: In year 1, WCH, in collaboration with partners, will have trained at least forty-four (44) unduplicated individuals total - 30 WCH health professionals and 14 community members - with the grant funds during the initial 12-month budget period. In year 2, WCH, in collaboration with partners, will have trained at least forty-five (45) unduplicated individuals total – 30 WCH health professionals and 15 community members – with the grant funds during the second 12-month project period.

In the heart of Jonesboro, Louisiana, the Jackson Parish Ambulance Service District (JPASD) stands as an emblem of emergency medical care excellence, serving the diverse needs of Jackson Parish and beyond. Leveraging the SAMHSA Rural EMS Training Grant, JPASD aims to continue to enhance emergency medical services through comprehensive training initiatives focused on narcotic overdose response and mental health awareness. Situated in northern Louisiana, Jackson Parish encompasses an area of 580 square miles. The village of Jonesboro serves as the vibrant hub of Jackson Parish, with a population that reflects the parish's cultural diversity. Statistics show that Jonesboro is home to approximately 3,983 residents, with a racial composition mirroring that of Jackson Parish as a whole. Whites constitute the majority at 69.1%, followed by Black/African Americans at 28.1%, Hispanic/Latino individuals at 1.9%, and smaller percentages of American Indian/Alaska Native and Asian individuals. In addition to its demographic diversity, Jonesboro also boasts a robust economy, with a median household income of $26,378 and a poverty rate of approximately 20.4%. Despite these economic realities, Jonesboro residents enjoy access to a variety of recreational opportunities, including the nearby Caney Lake Reservoir and Jimmie Davis State Park, which draw over 116,000 visitors annually for activities such as boating, fishing, and hunting. Recognizing the importance of providing equitable access to high-quality emergency medical services, JPASD is committed to expanding training opportunities for its personnel and partnering with local stakeholders to address the unique healthcare needs of Jonesboro and surrounding rural areas. Through collaborative efforts and a commitment to continuous improvement, JPASD endeavors to be a beacon of excellence in rural emergency medical services, ensuring that every individual receives the compassionate, high-quality care they deserve.

Abstract: Substance-use and mental health disorders are a significant burden to Sandoval County and the limited healthcare system resources available in the mostly rural county. EMS encounters provide a vital opportunity in the continuum of care to identify the need for and facilitate referral to substance use or mental health disorder services and ancillary supports, especially since at least 20% of opioid overdoses refuse transport to the hospital. However, most EMS clinicians lack the training and education to capitalize on these opportunities and there is a lack of standardized systems to connect patients to services. To develop the foundational skills and capacity of EMS clinicians to respond to substance use or co-occurring disorders this project will employ a community-wide approach to training and education, developing community resources, developing protocols for EMS treatment and referrals, developing evidence-based quality measure to define a standard of what good care is in the prehospital setting and implement a quality improvement model for sustainability and continuous improvement in pre-hospital behavioral health care. Sandoval County, New Mexico is a predominantly rural/frontier county in north-central New Mexico encompassing 3700 square miles. The community of approximately 44,000 people outside of the Rio Rancho metro is predominantly AIAN and Hispanic and the prevalence of negative social determinants of behavioral health such as poverty and lack of health insurance are common. The burden of substance abuse and undertreated behavioral health conditions (or the combination thereof) are often evident as either primary or secondary pathology on emergency medical services (EMS) calls throughout the County. Sandoval County Fire Rescue (SCFR) is a combination paid-volunteer fire department providing EMS care throughout the most rural areas of the county. The funding support to combat the often-catastrophic consequences of substance use and co-occurring disorders will be used to increase the capacity of EMS clinicians to provide culturally relevant, trauma-informed, recovery-based care. SCFR will achieve this through the following objectives: train 100% of the 50 career and 75% of the 200 volunteer EMS personnel on a core curriculum of trauma-informed, culturally-relevant, recovery-focused care for patients experiencing behavioral health emergencies through training resources provided by SAMHSA and local behavioral health collaborators, identify and train 7 EMS clinicians to serve as substance use and behavioral health patient care champions, increase harm reduction efforts and access to emergency opioid reversal agents and long-term medication-supported opioid abstinence through community outreach and benchmarking similar programs, partnering with the County hospital’s behavioral health division to develop a behavioral health field response team, develop the capacity to refer EMS patients directly to community support resources, and develop and implement EMS quality improvement measures related to substance use disorder and behavioral health emergencies that will be implemented within our EMS system and will be disseminated nationally through a partnership with the National EMS Quality Alliance (NEMSQA).

EMS Training & Opioid Response - PROJECT ABSTRACT SUMMARY The EMS Training & Opioid Response Program through Bennington Rescue is a series of targeted initiatives to improve the capacity and capabilities of EMS response to substance use disorder and mental health emergencies. This program targets rural Bennington County in the southwest corner of the state of Vermont with an estimated population of 37,235. This program uses a combination of education, equipment, and partnership to improve outcomes and increase the number of EMS clinicians for the region. Specific interventions in this program include providing initial EMS education; continuing education to maintain EMS certifications or licenses; targeted education for improving care of patients experiencing substance use disorder and mental health emergencies; equipment purchases to support education and the field care of patients; harm reduction via distribution of naloxone leave behind kits and recovery resource information; field buprenorphine by paramedics to facilitate care after acute opioid withdrawal; and partnerships with peer recovery coaches and medication assisted treatment providers in the community. Bennington Rescue established commitment from partners within the community toward this program including the regional EMS District Medical Advisor (medical director), peer recovery and coaching organization Turning Point Center of Bennington, and mental health and medication assisted treatment providers United Counseling Service and SaVida Health.

The Confederated Tribes of the Colville Reservation (CTCR), located in rural northeast Washington State, is aiming to improve mental health. CTCRs tribal enrollment is over 9,000, many living in Okanogan and Ferry Counties, spanning 1.4 million acres. CTCR has answered the call for the FY 24 Rural Emergency Medical Services Training Grant. The CTCR Emergency Medical Services (EMS), and Fire and Rescue Department are already well trained; however local trends in substance use and mental health struggles have prompted the CTCR Business Council to take action. Plans include training all EMS personnel on Substance Use Disorder (SUD) and Co-occurring Disorders (COD); establish a progressive EMS Certification Program, and expand on mental health and wellness training. CTCR Emergency Medical Services (EMS), Fire and Rescue (hereafter Department) equip two stations with twenty-one full time staff, and two three-team Firefighter/Emergency Medical Technicians (EMT) on staff twenty-four hours a day, year around. Station 1 is located in Nespelem, WA, and Station 2 is located in Inchelium, WA, both responsible for EMS, Fire and Rescue services. The Department averages 900 calls a year, often Coulee Medical Center (CMC) located in one of adjacent communities (Grant) receives the bulk of calls from Station 1. Results from a CMC Community Health Needs Assessment showed Substance Abuse and Mental health in the top 5 problems our community is struggling with. Suicide is the 10th leading cause of death in the United States, accounting for the deaths of approximately 48,000 Americans in 2018. The suicide rates in Okanogan County and Douglas County (another adjacent county) are higher than the average in the state. This further highlights the need for increased behavioral healthcare access in the community. With the requested funding, the Department will recruit and certify 10 new EMT personnel from across the counties and facilitate training for 10 EMTs to advance to AEMT. To specifically address our community's behavioral health needs, the Department will provide additional training to 60 EMS personnel including responders from our Department and mutual aid agencies. Personnel will receive training in addressing mental and substance use disorders through specialized courses within one year of funding. In order to meet the recruitment and training needs of our EMS personnel, the Department also requested funds to update audio and visual learning technology and purchase two smart simulator manikins. Simulator manikins would allow training staff to accurately simulate critical adult and pediatric patients to focus on life saving assessment and interventions. Simulation manikins will be a critical component to improving and maintaining EMS training.

Emergency Medical Service (EMS) providers across the US continue to face multiple challenges as they strive to 'answer the call' in 911 medical emergencies. The overall purpose of the SAMHSA FY 2024 Rural EMS Training program as proposed is to recruit, train and maintain EMS personnel across the rural and frontier project area that will competently and compassionately serve rural populations. These providers will be cognizant and proactive in their ability to address patients with substance abuse disorders, particularly as they co-occur with behavioral health and/or mental health conditions and prior trauma and will be knowledgeable of relevant recovery care options. As a recipient of consecutive SAMHSA Rural Emergency Medical Services Training Grants, Sanford Health’s EMS Education (SHEMSE) training center has been working diligently to address these challenges across the existing project’s eleven rural and/or frontier partners in the northern Midwest. We will use this experience to add a remote, rural area in Idaho to enhance their EMS responses, availability to technology, and mental health/substance abuse training. In addition, a proposed partnership with the White Earth Reservation and its Ambulance Service is proposed. This collaboration will enable training which will include Suboxone treatment in EMS/CP interactions, Post-Traumatic Growth, and harm reduction service delivery for the services that respond to the residents of the Reservation and its neighboring communities. Over the 2-year project timeframe, Sanford Health EMS Education (SHEMSE) and its partners will meet these challenges in part through the training and certification of 40 unduplicated EMTs, 4 Paramedics, and up to 4 Community Paramedics (CP). This will incorporate targeted training on substance use disorders, co-existing SUD and behavioral challenges, and include an awareness of trauma-informed, recovery-based care for people with such disorders in emergency situations. Ongoing training will also target existing EMS providers, to enable them to maintain licenses and certifications relevant to serve in their respective EMS agencies. This ongoing certification training will be augmented with focused coverage of mental and substance use disorders, together with options for trauma-informed recovery-based treatment options. The FY 2024-2026 EMS Training project will implement a structured, iterative monitoring and data collection process to drive ongoing project management and to strengthen short- and long- term outcomes. The project director and Project Guidance Team will oversee an adaptive management approach that utilizes required data collection and reporting.

The Jersey Community Hospital (JCH) EMS Training Program will provide high quality Emergency Medical Services training to personnel in the JCH training center as well as the rural communities of Jersey, Greene, and Calhoun Counties. The proposed activities will strengthen the quality of the Emergency Medical Service providers' ability to handle all emergency situations as well as elevate our rural hospital to showcase the growing program we have in place and expand services to the community. The provided training will be responsive to the needs of the communities in which the EMS personnel serve with a particular focus on mental health and substance use disorders, and how to care for individuals dealing with these issues. The project goals are as follows: Goal 1- JCH will offer CEU classes at least quarterly. JCH will teach PALS accreditation to 25 individuals in Year 1 and again in Year 2. Goal 2- JCH will conduct an EMT class in January of 2025 and January of 2026. The goal is to have 10 participants graduate from the program with EMT certification each year. JCH will also reimburse 4 students for tuition costs associated with obtaining a Paramedic license through Lewis and Clark Community College during year 1 and then 2 more in year 2. Goal 3- JCH will send two staff members to a continuing education conference in year 1 and 2 as well as have one instructor complete courses to become a Level 1 instructor and one instructor complete courses to become a Level 2 instructor. 2 staff members will continue to be certified to teach additional NAEMT certified courses throughout year 1 and 2. Goal 4- JCH will provide a minimum of 2 trauma informed training sessions each year, that will train all EMS personnel on mental health and substance use disorders as well as how to refer to peer counselors, harm reduction services including Naloxone, and local treatment clinics. Goal 5- JCH EMS will purchase necessary supplies to conduct trainings for EMS personnel. Goal 6- All EMS personnel will attend one Mental Health First Aid training provided by Chestnut Health Systems and one motivational interviewing training session provided by the Illinois Critical Access Hospital Network (ICAHN). They will also receive an annual refresher course on how to administer Naloxone. Goal 7- Continue to work with the tri-county area officials to update overdose reporting and enhance awareness of hot spots so that we can provide services to those areas most affected. In total the grant will allow Jersey Community Hospital to train at least 300 individuals in our community on life savings techniques.

North Arkansas Regional Medical Center (NARMC) is seeking funding from the SAMHSA Rural EMS Training program. The goal of the NARMC EMS Training program is to increase the number of paid and volunteer EMS staff in Boone and Newton Counties and the surrounding area by providing all levels of EMS training as appropriate to maintain licenses and certifications relevant to serve in an EMS agency. The objectives are to increase Emergency Medical Responder (EMR) and Emergency Medical Technician (EMT) instruction within the next two years. Generally, NARMC trains approximately 25 EMS personnel and three paramedics per year. EMR classes would train 40 people in 2024-25 with 20 projected for 2025-26. EMT classes would train 15 in 2025-26 for a total of 75 people. In addition, four paramedics will be trained in 2025-26. For the purposes of this proposal, the population of focus will be Boone and Newton Counties where NARMC's emergency medical services are concentrated. A major distinguishing feature of the Medical Center's community is the age breakdown of this population. According to U.S. Census Quick Facts, about 24% of the community’s population is over age 65, which is much higher than in Arkansas (17%) or the United States (16%) as a whole. This age group uses more health services than any other and is the focus or target population of this proposal. Most of the population is white, making it much more racially homogenous than either the State of Arkansas or the U.S. Most of the remaining population is Hispanic or Latino, and about a third of this group has limited English proficiency. The average household income in the Medical Center’s community is $56,915, compared to $66,557 for the State of Arkansas and $88,607 for the U.S. Lower-than-average household income suggests that many members of the community may have difficulty obtaining healthcare, especially preventative care. Additionally, in some of the counties in the community, the levels of poverty are significantly higher than the rates in the State of Arkansas and the U.S. Increasing the number of EMS workers in the catchment area will reduce the number of volunteer hours necessary for each EMS worker to provide 24/7 service. With the high rates of unemployment and low median income in the rural service area, the program will provide educational opportunities for individuals who might not otherwise be able to afford the classes, as well as paid career prospects. Looking toward the future, this program will enhance NARMC’s Community Paramedicine (CP) program, where paramedics and emergency medical technicians operate in expanded roles and resources are deployed in a more efficient and effective manner. This program can continue to grow in the region with the goal of ensuring continued access to emergency medical services in rural communities, particularly with the increased number of EMS workers in Newton and Boone Counties through the EMS Training program.

The Missouri Rural Emergency Services Collaborative for Underserved Education EMS Training Program (MO-RESCUE) aims to provide EMS education for rural EMS providers looking to begin or advance their training and develop a continuing education program for rural Missouri EMS agencies both of which include comprehensive training in mental health and substance use care. The number of people to be served by this program is estimated at 100 annually. The objectives of the MO-RESCUE Training Program are: 1. Create a comprehensive, sustainable continuing education curriculum which provides training specific to mental health and substance use. 2. Develop rural EMS agency toolkits containing local resources and public health linkages which will be adapted according to each agency’s local resources. 3. Acquire emergency medical services equipment to prepare for a response to substance use and mental health emergencies. 4. Train EMS personnel to maintain licenses and certifications relevant to serve in an EMS agency. 5. Conduct EMS training to rural EMS students to qualify them for national registry and Missouri State Licensure

Ridgeview Medical Center requests funding from the Substance Abuse and Mental Health Services Administration to help recruit and train EMS personnel to provide services to rural communities in our network. Ridgeview's network of hospitals and clinics covers over 950 square miles and includes the counties of Carver, Sibley, southern Wright, western Hennepin, eastern McLeod, Le Sueur, and Scott counties. Our goal is to use funding from this grant request to equip our EMS staff with the tools, information, and resources needed to support residents in our rural communities that struggle with mental illness or substance abuse. Funds from this grant will help continue to bolster Ridgeview's response to the mental health and addiction crisis facing our communities by providing our EMS team with training and equipment needed to care for patients in need of our help.