When Ahu Terzi of Hound Books in Roscoe suddenly collapsed while serving a customer two summers ago, the customer called 911, expecting help to quickly arrive. After all, the local EMS garage was around the corner.

Instead, it took 25 minutes for a crew to get there.

The first responders consisted of a a few senior men in their 60s and an older woman, who administered oxygen.

They placed Terzi on a stretcher and transported her to the nearest emergency facility about 30 minutes away. Fortunately, she made a full recovery. But the rescue highlighted an ongoing two-fold problem facing rural emergency medical services in the area.

Older volunteers, and fewer

Volunteer responders often must be summoned from home before they can assemble and head out to the emergency. There is a lack of new recruits to take the reins. An older generation of first responders makes up the core of many volunteer ambulance crews in Sullivan County and they are not adequately being relieved by a new younger class.

Manor Ink coincidentally interviewed Sullivan County EMS Coordinator Alex Rau shortly before Terzi’s incident at the bookshop. His concern then was the direction EMS services were taking and finding volunteers to succeed some of the veterans.

“What keeps me up at night is imaging a landscape where there not enough EMS providers, and hopefully we never get to that point,” Rau said at the time. He is more optimistic now about the system’s ability to cope with the staffing shortage, and also the continuance of a task force organized to recommend improvements.

“They’re starting to pay people, so we have guaranteed coverage – in some areas,” Rau said. He also pointed to a state-mandated plan to revamp EMS in rural counties that is nearing completion.

The New York State Rural Ambulance Services Task Force was formed in 2021 to identify coverage gaps, and requires each county to submit an annual comprehensive assessment of their needs by Dec. 19.

Susan Sherwood is the president of the EMS Council of Sullivan County and noted that their plan is still being drafted as the deadline nears. “I wouldn’t say we’re really recommending changes – we are suggesting them. I would estimate only 15 percent of EMS personnel in our area are being paid,” said Sherwood.

Another problem is that the state does not see EMS as an essential service and does not provide funding. However, one of the proposals put forth by the task force draft recommends a competitive wage be paid to EMS responders.

Payment for EMS workers

The move to pay EMS workers seems to be growing. “Rock Hill went into paid service and nonprofit agencies are starting to get a bit stronger as they have risen to the challenge, because commercial service is struggling,” Rau said.

Roscoe still has one paid attendee who works Monday through Friday, but the hamlet relies on a senior crew to cover the rest of the week.

“They are very much dependent on donations,” Rau said. “Livingston Manor is 100 percent volunteer, and they rely on two or three senior members that are in their seventies.”

Rau estimates Rockland is running more than 1,000 calls a year, with 30 percent in the town and the rest helping neighbors in surrounding townships.

“I think you’re going to see a shift from the volunteer EMS world. It’s already happening,” Rau said. “I am sleeping a little better lately, I really am,” he said.

There is reason for hope, but the problem has not disappeared. Recruitment remains difficult, veteran volunteers cannot serve forever and the distance between an emergency and the nearest available crew can mean the difference between a timely response and a critical delay.