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		<title>Ambulance driver charged with homicide for crash that killed 66-year-old patient</title>
		<link>https://cincylink.com/2021/11/17/ambulance-driver-charged-with-homicide-for-crash-that-killed-66-year-old-patient/</link>
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		<pubDate>Wed, 17 Nov 2021 05:18:55 +0000</pubDate>
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					<description><![CDATA[Police: Ambulance driver charged with homicide for crash that killed 66-year-old patient Updated: 12:33 PM EST Nov 16, 2021 A Georgia ambulance driver has been arrested and charged with driving under the influence and second-degree homicide-by-vehicle after he crashed the ambulance he was driving, killing the dialysis patient he was transporting, according to authorities.Kevin T. &#8230;]]></description>
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<p>Police: Ambulance driver charged with homicide for crash that killed 66-year-old patient</p>
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					Updated: 12:33 PM EST Nov 16, 2021
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					A Georgia ambulance driver has been arrested and charged with driving under the influence and second-degree homicide-by-vehicle after he crashed the ambulance he was driving, killing the dialysis patient he was transporting, according to authorities.Kevin T. McCorvey, 34, was driving a private ambulance on West Campbellton Street in Fairburn just before 7:30 p.m. Friday when police say he veered off the shoulder of the road causing the ambulance to roll over into a ditch. A patient, Wilton Thomason Jr., 66, was in the back of the ambulance and was not restrained in any way, according to preliminary investigative findings of the Georgia State Patrol. He suffered fatal injuries, GSP said.A Fairburn Police officer wrote in an incident report that the officer stopped McCorvey and the other person who worked in the ambulance from getting an Uber to leave the scene and the officer reported smelling alcohol on McCorvey's breath. The officer called GSP to take over the investigation.When GSP arrived, troopers gave McCorvey a field sobriety test, and he was arrested, according to the incident report. The Fairburn officer wrote in the report that McCorvey admitted to smoking marijuana, taking Adderall and drinking a beer while driving the ambulance.McCorvey was arrested, taken to Fulton County Jail and charged with DUI combination less safe, homicide by vehicle 2nd degree, failure to maintain lane and possession of an open container, according to GSP.The other ambulance employee in the vehicle during the crash has not been charged, according to police.On Monday, McCorvey made an initial appearance in Fulton County Superior Court, was assigned an attorney and was denied bond, according to court records.CNN has reached out to McCorvey's attorney for comment.
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					<strong class="dateline">FAIRBURN, Ga. (Video from WGCL via CNN) —</strong> 											</p>
<p>A Georgia ambulance driver has been arrested and charged with driving under the influence and second-degree homicide-by-vehicle after he crashed the ambulance he was driving, killing the dialysis patient he was transporting, according to authorities.</p>
<p>Kevin T. McCorvey, 34, was driving a private ambulance on West Campbellton Street in Fairburn just before 7:30 p.m. Friday when police say he veered off the shoulder of the road causing the ambulance to roll over into a ditch. A patient, Wilton Thomason Jr., 66, was in the back of the ambulance and was not restrained in any way, according to preliminary investigative findings of the Georgia State Patrol. He suffered fatal injuries, GSP said.</p>
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<p>A Fairburn Police officer wrote in an incident report that the officer stopped McCorvey and the other person who worked in the ambulance from getting an Uber to leave the scene and the officer reported smelling alcohol on McCorvey's breath. The officer called GSP to take over the investigation.</p>
<p>When GSP arrived, troopers gave McCorvey a field sobriety test, and he was arrested, according to the incident report. The Fairburn officer wrote in the report that McCorvey admitted to smoking marijuana, taking Adderall and drinking a beer while driving the ambulance.</p>
<p>McCorvey was arrested, taken to Fulton County Jail and charged with DUI combination less safe, homicide by vehicle 2nd degree, failure to maintain lane and possession of an open container, according to GSP.</p>
<p>The other ambulance employee in the vehicle during the crash has not been charged, according to police.</p>
<p>On Monday, McCorvey made an initial appearance in Fulton County Superior Court, was assigned an attorney and was denied bond, according to court records.</p>
<p>CNN has reached out to McCorvey's attorney for comment.</p>
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		<title>In ambulances, an unseen, unwelcome passenger: COVID-19</title>
		<link>https://cincylink.com/2021/09/03/in-ambulances-an-unseen-unwelcome-passenger-covid-19/</link>
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		<pubDate>Fri, 03 Sep 2021 05:19:45 +0000</pubDate>
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					<description><![CDATA[It's crowded in the back of the ambulance.Two emergency medical technicians, the patient, the gurney — and an unseen and unwelcome passenger lurking in the air.For EMTs Thomas Hoang and Joshua Hammond, the coronavirus is constantly close. COVID-19 has become their biggest fear during 24-hour shifts in California's Orange County, riding with them from 911 &#8230;]]></description>
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					It's crowded in the back of the ambulance.Two emergency medical technicians, the patient, the gurney — and an unseen and unwelcome passenger lurking in the air.For EMTs Thomas Hoang and Joshua Hammond, the coronavirus is constantly close. COVID-19 has become their biggest fear during 24-hour shifts in California's Orange County, riding with them from 911 call to 911 call, from patient to patient.They and other EMTs, paramedics and 911 dispatchers in Southern California have been thrust into the front lines of the national epicenter of the pandemic. They are scrambling to help those in need as hospitals burst with a surge of patients after the holidays, ambulances are stuck waiting outside hospitals for hours until beds become available, oxygen tanks are in alarmingly short supply and the vaccine rollout has been slow.EMTs and paramedics have always dealt with life and death — they make split-second decisions about patient care, which hospital to race to, the best and fastest way to save someone — and now they're just a breath away from becoming the patient themselves.They gown up, mask up and glove up, “but you can only be so safe,” Hammond said. “We don’t have the luxury of being 6 feet apart from the patient.” Statistics on COVID-19 cases and deaths among EMTs and paramedics — especially ones employed by private companies — are hard to find. They are considered essential health care workers but rarely receive the pay and protections given to doctors and nurses.Hammond and Hoang work for Emergency Ambulance Service Inc., a private ambulance company in Southern California. They, like so many others, have long fostered goals of becoming first responders to serve their communities.Hoang is attending nursing school. Hammond is one test away from becoming a paramedic. Both were called to a life in the medical field after traumatic experiences: Hammond had to call 911 after his mother had an allergic reaction, and Hoang witnessed a young bicyclist get hit by a car.Yet as COVID-19 infections surge and the risks increase, they wonder: Is it worth risking your life — and the lives of your loved ones at home — for a small paycheck and a dream?“It's really hard to justify it beyond ‘I really want to help people,’” said Hammond, 25. “Is that worth the risk?”For now, yes.“I do want to do my part in helping people get better, in a sense,” said Hoang, 29.And so their day starts at 7 a.m.Wearing masks, Hoang and Hammond clean their ambulance and equipment, wiping down every surface even if the previous crew scrubbed it already. They take no chances during their daylong shift covering the Orange County city of Placentia.The 911 calls come in with limited information: a broken bone, chest pain, difficulty breathing, stomachache, fever. Every patient is a potential carrier of the coronavirus, whether they know it or not.Related video: California EMS crews struggle with ambulance wait timesSometimes, people know they're infected and tell 911 dispatchers before the EMTs arrive. Other times, the symptoms themselves — fever, shortness of breath — signal a possible case. But Hammond remembers one woman, suffering from hip pain, who didn't tell him or his partner about her coronavirus diagnosis.He only found out afterward, saying it reinforced the importance of treating every patient as if they have tested positive.“That was definitely a call where we learned a lot,” Hammond said.Unlike doctors and nurses, first responders must go inside homes. They walk into hot zones where everyone in a household is sick, where the virus is in the air. They lift immobile patients onto gurneys, their masked faces just inches apart.They race to hospitals already overwhelmed with sick people, sometimes only to wait hours outside before their patient can be admitted. And then they do it all again when the next 911 call comes in.“We don’t know the end result,” Hoang said. “We only know the beginning to the hospital.”Then there are those who direct the EMTs where to go. In Los Angeles County, 20 miles northwest from Hoang and Hammond, three young women stood before six screens apiece recently, talking into headsets with clear, clipped voices, marshaling other ambulance crews around a territory stretching from the mountains to the sea.Ashley Cortez, Adreanna Moreno and Jaime Hopper work 12-hour shifts as dispatchers for Care Ambulance Service Inc. If the EMTs are the front lines, these women are the scouts.They play chess with ambulances all day. When one gets stuck at a hospital for eight, 10 or 12 hours, the dispatchers must reposition the others to cover its area. When an EMT reports a positive COVID-19 test, the dispatchers must find a way to cover the ambulance's calls if the whole crew must quarantine. When one household has multiple coronavirus patients requiring two ambulances, the dispatchers have to plug the hole.Their greatest fear is what's called a “level zero” — when there are no ambulances left to send to an emergency. In Los Angeles County, one of the nation's hardest-hit counties during the pandemic, the fear becomes a regular reality.For Moreno, 28, the anxiety begins the night before her shift.“I lay there and know I'm going to come in, and I know I'm going to have no units to run these calls,” she said.On Christmas weekend, Cortez watched as call after call piled up on her screen — with no ambulances available. Typically, it takes 30 seconds to send one out. That weekend, it took up to 15 minutes. And this was even before ambulances started languishing outside hospitals for hours.“I was just in disbelief,” said Cortez, 26.There's not much more the dispatchers can do. They watch those screens. They listen to radio chatter. They rearrange the crews to cover the most territory possible. And they wonder what fresh horror awaits in a virus-ravaged world where the dangers are too many and the ambulances are too few.“What if something happens to my daughter,” Cortez said, “and there was nobody to send for her?”
				</p>
<div>
<p>It's crowded in the back of the ambulance.</p>
<p>Two emergency medical technicians, the patient, the gurney — and an unseen and unwelcome passenger lurking in the air.</p>
<p>For EMTs Thomas Hoang and Joshua Hammond, the coronavirus is constantly close. COVID-19 has become their biggest fear during 24-hour shifts in California's Orange County, riding with them from 911 call to 911 call, from patient to patient.</p>
<p>They and other EMTs, paramedics and 911 dispatchers in Southern California have been thrust into the front lines of the national epicenter of the pandemic. They are scrambling to help those in need as hospitals burst with a surge of patients after the holidays, ambulances are stuck waiting outside hospitals for hours until beds become available, oxygen tanks are in alarmingly short supply and the vaccine rollout has been slow.</p>
<p>EMTs and paramedics have always dealt with life and death — they make split-second decisions about patient care, which hospital to race to, the best and fastest way to save someone — and now they're just a breath away from becoming the patient themselves.</p>
<p>They gown up, mask up and glove up, “but you can only be so safe,” Hammond said. “We don’t have the luxury of being 6 feet apart from the patient.”</p>
<p>Statistics on COVID-19 cases and deaths among EMTs and paramedics — especially ones employed by private companies — are hard to find. They are considered essential health care workers but rarely receive the pay and protections given to doctors and nurses.</p>
<p>Hammond and Hoang work for Emergency Ambulance Service Inc., a private ambulance company in Southern California. They, like so many others, have long fostered goals of becoming first responders to serve their communities.</p>
<p>Hoang is attending nursing school. Hammond is one test away from becoming a paramedic. Both were called to a life in the medical field after traumatic experiences: Hammond had to call 911 after his mother had an allergic reaction, and Hoang witnessed a young bicyclist get hit by a car.</p>
<p>Yet as COVID-19 infections surge and the risks increase, they wonder: Is it worth risking your life — and the lives of your loved ones at home — for a small paycheck and a dream?</p>
<p>“It's really hard to justify it beyond ‘I really want to help people,’” said Hammond, 25. “Is that worth the risk?”</p>
<p>For now, yes.</p>
<p>“I do want to do my part in helping people get better, in a sense,” said Hoang, 29.</p>
<p>And so their day starts at 7 a.m.</p>
<p>Wearing masks, Hoang and Hammond clean their ambulance and equipment, wiping down every surface even if the previous crew scrubbed it already. They take no chances during their daylong shift covering the Orange County city of Placentia.</p>
<p>The 911 calls come in with limited information: a broken bone, chest pain, difficulty breathing, stomachache, fever. Every patient is a potential carrier of the coronavirus, whether they know it or not.</p>
<p><em><strong>Related video: </strong></em><em><strong/></em><em><strong>California EMS crews struggle with ambulance wait times</strong></em></p>
<p>Sometimes, people know they're infected and tell 911 dispatchers before the EMTs arrive. Other times, the symptoms themselves — fever, shortness of breath — signal a possible case. But Hammond remembers one woman, suffering from hip pain, who didn't tell him or his partner about her coronavirus diagnosis.</p>
<p>He only found out afterward, saying it reinforced the importance of treating every patient as if they have tested positive.</p>
<p>“That was definitely a call where we learned a lot,” Hammond said.</p>
<p>Unlike doctors and nurses, first responders must go inside homes. They walk into hot zones where everyone in a household is sick, where the virus is in the air. They lift immobile patients onto gurneys, their masked faces just inches apart.</p>
<p>They race to hospitals already overwhelmed with sick people, sometimes only to wait hours outside before their patient can be admitted. And then they do it all again when the next 911 call comes in.</p>
<p>“We don’t know the end result,” Hoang said. “We only know the beginning to the hospital.”</p>
<p>Then there are those who direct the EMTs where to go. In Los Angeles County, 20 miles northwest from Hoang and Hammond, three young women stood before six screens apiece recently, talking into headsets with clear, clipped voices, marshaling other ambulance crews around a territory stretching from the mountains to the sea.</p>
<p>Ashley Cortez, Adreanna Moreno and Jaime Hopper work 12-hour shifts as dispatchers for Care Ambulance Service Inc. If the EMTs are the front lines, these women are the scouts.</p>
<p>They play chess with ambulances all day. When one gets stuck at a hospital for eight, 10 or 12 hours, the dispatchers must reposition the others to cover its area. When an EMT reports a positive COVID-19 test, the dispatchers must find a way to cover the ambulance's calls if the whole crew must quarantine. When one household has multiple coronavirus patients requiring two ambulances, the dispatchers have to plug the hole.</p>
<p>Their greatest fear is what's called a “level zero” — when there are no ambulances left to send to an emergency. In Los Angeles County, one of the nation's hardest-hit counties during the pandemic, the fear becomes a regular reality.</p>
<p>For Moreno, 28, the anxiety begins the night before her shift.</p>
<p>“I lay there and know I'm going to come in, and I know I'm going to have no units to run these calls,” she said.</p>
<p>On Christmas weekend, Cortez watched as call after call piled up on her screen — with no ambulances available. Typically, it takes 30 seconds to send one out. That weekend, it took up to 15 minutes. And this was even before ambulances started languishing outside hospitals for hours.</p>
<p>“I was just in disbelief,” said Cortez, 26.</p>
<p>There's not much more the dispatchers can do. They watch those screens. They listen to radio chatter. They rearrange the crews to cover the most territory possible. And they wonder what fresh horror awaits in a virus-ravaged world where the dangers are too many and the ambulances are too few.</p>
<p>“What if something happens to my daughter,” Cortez said, “and there was nobody to send for her?”</p>
</p></div>
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		<title>Rural ambulance crews are running out of money and volunteers. The fallout could be unanswered 911 calls</title>
		<link>https://cincylink.com/2021/05/23/rural-ambulance-crews-are-running-out-of-money-and-volunteers-the-fallout-could-be-unanswered-911-calls/</link>
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		<pubDate>Sun, 23 May 2021 04:19:26 +0000</pubDate>
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					<description><![CDATA[America's rural ambulance services, often sustained by volunteers, are fighting for their survival — a crisis hastened by the impact of the pandemic.More than one-third of all rural EMS are in danger of closing, according to Alan Morgan, CEO of the National Rural Health Association. "The pandemic has further stretched the resources of our nation's &#8230;]]></description>
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<p>
					America's rural ambulance services, often sustained by volunteers, are fighting for their survival — a crisis hastened by the impact of the pandemic.More than one-third of all rural EMS are in danger of closing, according to Alan Morgan, CEO of the National Rural Health Association. "The pandemic has further stretched the resources of our nation's rural EMS."In Wyoming, the problem is especially dire. It may have the smallest population in America, but when it comes to land, Wyoming is the ninth-largest.In Washakie County, which lies in Wyoming's southern Bighorn Basin, it means a tradeoff for the nearly 8,000 residents living here: While there is vast open space, the nearest major trauma hospital is more than 2.5 hours away.  On a recent drive from Cody — the closest town with an airport — the land stretched endlessly while cattle and wildlife outnumbered people. The sole reminders of civilization were the occasional oil rigs pumping silently in the distance.But for the residents, speedy access to emergency medical services — paramedics and an ambulance — can be a matter of survival.It's a fact Luke Sypherd knows all too well. For the past three years, he has overseen Washakie County's volunteer ambulance service. But on May 1, the organization was forced to dissolve."We just saw that we didn't have the personnel to continue," Sypherd said. "It was an ongoing problem made worse by COVID with fewer people interested in volunteering with EMS during a pandemic and patients afraid of getting taken to a hospital."A nearby hospital system, Cody Regional Health, has agreed to provide ambulance service for Washakie County, averting a crisis. But it's a problem playing out across rural America: Ambulance crews are running out of money and volunteers.Phillip Franklin, the EMS Director for Cody Regional Health, said the crisis is a result of several problems."The majority of the ambulance service staff are not paid so if you don't have your volunteers, they can't run calls," Franklin said. "Another problem is that there's simply just not enough volume to keep ambulance service afloat and in the state of Wyoming, EMS is not essential, which means there's nobody responsible to fund these entities."Sypherd said the funding model for EMS is fundamentally flawed, with most service providers reimbursed only if they take patients to a hospital or clinic. In rural areas like Washakie County, smaller populations mean fewer calls, and consequently, less money."You're reimbursed based on the number of patients that you transport to a hospital, so you could get called 1,000 times a year and only transport 750 patients — those other 250 calls you made no money on," Sypherd said.Plea for federal assistanceThe American Ambulance Association sent a letter earlier this month to the U.S. Department of Health and Human Services asking the agency to earmark $1.425 billion in federal aid for its members, warning that emergency medical systems across the U.S. are "on the brink of collapse.""It is critical that we not let the financial hardship caused by the pandemic to permanently deteriorate our EMS systems, especially in rural areas where an ambulance service may be the only emergency medical service provider, and ensure that all Americans continue to have access to vital emergency 9-1-1 and medically necessary non-emergency ground ambulance services," the letter said.According to the National Association of State EMS Officials, just eight states consider local emergency medical services "essential" by law, as they do for fire and police. "That mandate means that somebody has to consciously think and plan and ensure that EMS is available," Sypherd said. "If you're in one of the states that doesn't mandate EMS as an essential service and your local ambulance provider shuts down because they lost funding or there weren't enough volunteers — that means if you call 911, it might be that nobody shows up.""When you look at what's happening here (in Washakie County, it) is just the tip of the iceberg," said Franklin. "There's other services throughout the state that are just one bad year away from closure."'A matter of life and death'One of those is Fremont County — home to the Wind River Indian Reservation. Fremont is roughly the size of the state of Vermont. An economic downturn and budget cuts prompted the county to privatize its ambulance service in 2016. But the private company, American Medical Response, says it can't afford to keep going after losing $1.5 million in revenue last year. AMR announced it won't renew its contract when it runs out on June 30. No others have bid."We just couldn't renew that current contract because it was set up for a financial failure," said Matt Strauss, Regional Director for AMR parent company, Global Medical Response.One of the problems, according to Fremont County Commissioner Larry Allen, is the so-called payer mix. Many of the county's residents rely on Medicare, Medicaid and Indian Health Services, which reimburse ambulance providers at a lower rate. And without state or federal designation of EMS as an essential service, Allen said "there's no source of revenue to operate an ambulance.""Because of the distance and the ruralness of this county, we just don't have people standing in line wanting to provide ambulance service," Allen said.The Wind River Indian Reservation stretches across more than 2 million acres and is shared by two Native American tribes, the Eastern Shoshone and the Northern Arapaho. It has three tiny clinics but no ambulance services and relies on Fremont County for EMS."Right now the response time is pretty slow and it's going to be nonexistent," said Northern Arapaho tribal member Juan Willow. His grandfather struggled with health problems and Willow said there were many times when the family couldn't wait for an ambulance and had to find other ways of getting to the hospital. "Not everyone here has a car," he said.It's a concern shared by Jordan Dresser, the chairman of the Northern Arapaho Tribe."I think if we didn't have access to ambulances, death rates would be higher," said Dresser, adding that many tribal members don't have working vehicles and therefore can't take themselves to the hospital or clinics. "It's a matter of life and death for us."
				</p>
<div>
<p class="body-text">America's rural ambulance services, often sustained by volunteers, are fighting for their survival — a crisis hastened by the impact of the pandemic.</p>
<p>More than one-third of all rural EMS are in danger of closing, according to Alan Morgan, CEO of the National Rural Health Association. "The pandemic has further stretched the resources of our nation's rural EMS."</p>
<p>In Wyoming, the problem is especially dire. It may have the smallest population in America, but when it comes to land, Wyoming is the ninth-largest.</p>
<p>In Washakie County, which lies in Wyoming's southern Bighorn Basin, it means a tradeoff for the nearly 8,000 residents living here: While there is vast open space, the nearest major trauma hospital is more than 2.5 hours away.  </p>
<p>On a recent drive from Cody — the closest town with an airport — the land stretched endlessly while cattle and wildlife outnumbered people. The sole reminders of civilization were the occasional oil rigs pumping silently in the distance.</p>
<p>But for the residents, speedy access to emergency medical services — paramedics and an ambulance — can be a matter of survival.</p>
<p>It's a fact Luke Sypherd knows all too well. For the past three years, he has overseen Washakie County's volunteer ambulance service. But on May 1, the organization was forced to dissolve.</p>
<p>"We just saw that we didn't have the personnel to continue," Sypherd said. "It was an ongoing problem made worse by COVID with fewer people interested in volunteering with EMS during a pandemic and patients afraid of getting taken to a hospital."</p>
<p>A nearby hospital system, Cody Regional Health, has agreed to provide ambulance service for Washakie County, averting a crisis. But it's a problem playing out across rural America: Ambulance crews are running out of money and volunteers.</p>
<p>Phillip Franklin, the EMS Director for Cody Regional Health, said the crisis is a result of several problems.</p>
<p>"The majority of the ambulance service staff are not paid so if you don't have your volunteers, they can't run calls," Franklin said. "Another problem is that there's simply just not enough volume to keep ambulance service afloat and in the state of Wyoming, EMS is not essential, which means there's nobody responsible to fund these entities."</p>
<p>Sypherd said the funding model for EMS is fundamentally flawed, with most service providers reimbursed only if they take patients to a hospital or clinic. In rural areas like Washakie County, smaller populations mean fewer calls, and consequently, less money.</p>
<p>"You're reimbursed based on the number of patients that you transport to a hospital, so you could get called 1,000 times a year and only transport 750 patients — those other 250 calls you made no money on," Sypherd said.</p>
<h3 class="body-h3">Plea for federal assistance</h3>
<p>The American Ambulance Association <a href="https://ambulance.org/2021/05/07/aaa-letter-to-hhs-secretary-on-the-provider-relief-fund/" target="_blank" rel="nofollow noopener">sent a letter</a> earlier this month to the U.S. Department of Health and Human Services asking the agency to earmark $1.425 billion in federal aid for its members, warning that emergency medical systems across the U.S. are "on the brink of collapse."</p>
<p>"It is critical that we not let the financial hardship caused by the pandemic to permanently deteriorate our EMS systems, especially in rural areas where an ambulance service may be the only emergency medical service provider, and ensure that all Americans continue to have access to vital emergency 9-1-1 and medically necessary non-emergency ground ambulance services," the letter said.</p>
<p>According to the National Association of State EMS Officials, just eight states consider local emergency medical services "essential" by law, as they do for fire and police. </p>
<p>"That mandate means that somebody has to consciously think and plan and ensure that EMS is available," Sypherd said. "If you're in one of the states that doesn't mandate EMS as an essential service and your local ambulance provider shuts down because they lost funding or there weren't enough volunteers — that means if you call 911, it might be that nobody shows up."</p>
<p>"When you look at what's happening here (in Washakie County, it) is just the tip of the iceberg," said Franklin. "There's other services throughout the state that are just one bad year away from closure."</p>
<h3 class="body-h3">'A matter of life and death'</h3>
<p>One of those is Fremont County — home to the Wind River Indian Reservation. Fremont is roughly the size of the state of Vermont. An economic downturn and budget cuts prompted the county to privatize its ambulance service in 2016. But the private company, American Medical Response, says it can't afford to keep going after losing $1.5 million in revenue last year. AMR announced it won't renew its contract when it runs out on June 30. No others have bid.</p>
<p>"We just couldn't renew that current contract because it was set up for a financial failure," said Matt Strauss, Regional Director for AMR parent company, Global Medical Response.</p>
<p>One of the problems, according to Fremont County Commissioner Larry Allen, is the so-called payer mix. Many of the county's residents rely on Medicare, Medicaid and Indian Health Services, which reimburse ambulance providers at a lower rate. And without state or federal designation of EMS as an essential service, Allen said "there's no source of revenue to operate an ambulance."</p>
<p>"Because of the distance and the ruralness of this county, we just don't have people standing in line wanting to provide ambulance service," Allen said.</p>
<p>The Wind River Indian Reservation stretches across more than 2 million acres and is shared by two Native American tribes, the Eastern Shoshone and the Northern Arapaho. It has three tiny clinics but no ambulance services and relies on Fremont County for EMS.</p>
<p>"Right now the response time is pretty slow and it's going to be nonexistent," said Northern Arapaho tribal member Juan Willow. His grandfather struggled with health problems and Willow said there were many times when the family couldn't wait for an ambulance and had to find other ways of getting to the hospital. "Not everyone here has a car," he said.</p>
<p>It's a concern shared by Jordan Dresser, the chairman of the Northern Arapaho Tribe.</p>
<p>"I think if we didn't have access to ambulances, death rates would be higher," said Dresser, adding that many tribal members don't have working vehicles and therefore can't take themselves to the hospital or clinics. "It's a matter of life and death for us." </p>
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