Gouverneur Rescue is a non-profit advanced life support ambulance agency that serves multiple close-knit communities in Upstate NY in St. Lawrence County. Our volunteers and staff members treat our neighbors, families, and friends in a service area that is a designated rural and super rural area through the Center of Medicare Services, as well as hrsa.gov. We serve a population of 17,788 through total of 744.3 square miles in southern St. Lawrence County. Our population density is 23.89 per square mile, with towns that include a population density as low as 5.9 per square mile. There are 21,701 residents under 18 years of age according to census.gov. 

Our population of focus with this project is prospective EMS providers and currently certified EMS responders, including EMTs,  AEMTS, Critical Care Techs, and Paramedics in Upstate NY.

New York State is hemorrhaging Emergency Medical Service Providers. 70,000 EMS providers are listed in the state while only approximately 30,000 appeared in patient care reports as active in 2021. Our county, like many other rural areas, relies heavily on volunteers. Our county, the largest in NY state includes 21 EMS agencies, with only 7 having any sort of paid provider, 3 having 24/7 paid coverage, only 1 of these agencies is 100% paid. 

Initial EMS education is a struggle in St. Lawrence County. In 2019 we lost our county course sponsor. Our local college assumed the course sponsorship in 2022, but the courses are primarily located on their campus and require financing upfront. The $700 cost for the EMT class, in addition to the cost of the books, is unattainable for prospective volunteers, and many agencies do not have the funding. The cost of the 1-hour drive to campus 2-3 nights a week is also a barrier to access to education. 

Our rural area has a lack of EMS education from not only the entry-level, but continuing education to maintain certifications. Very few stations in our county hold any form of formal continuing medical education (CME) programs. The cost of CME training programs, lack of certified instructors, the difficulty of attendance due to long drives and time involved, as well as work and family commitments have made agencies shy away from continuing education. While the recommendation for pediatric emergency training should amount to 10% of EMS education, less than 2% focuses on pediatrics in the NYS re-certification manual

Despite pediatrics being 20% of our population, EMS providers only receive minimal education. 

St. Lawrence County NY currently only provides EMS provider wellness or mental health education in the initial EMT class, despite having three local EMS provider suicides, and 1 line of duty first responder heart attack in the tri-county area past few years. EMS providers have 1 hour of material in their initial entry course and are required to obtain 1 hour in a 3 year re-certification period. The material given in 1 hour does little more than identify the need for EMS provider wellness and mental health without giving any guidance or practical advice. EMS providers have a 5.2% risk of suicide vs. 2.2% of the general population, and a higher risk of alcoholism and substance use disorders.