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Rural Texas — already starved for health care — faces a dearth of volunteer first responders

Instructor Doug Anderson works with students in the back of an ambulance while Sabrina Rodriguez, playing the part of a patient, lays on the gurney during an EMT certification class at the Olton Volunteer Ambulance Association.
Justin Rex for The Texas Tribune
Instructor Doug Anderson works with students in the back of an ambulance while Sabrina Rodriguez, playing the part of a patient, lays on the gurney during an EMT certification class at the Olton Volunteer Ambulance Association.

After a tornado barreled through the small town of Matador last month, volunteers mobilized to pick up the pieces — so many that the town was closed by law enforcement the following day.

The scene of neighbors helping neighbors sift through debris offered a fresh reminder that in lonely stretches of rural Texas, help after a natural disaster, a house fire or a heart attack is likely to come in the form of volunteers.

An abundance of volunteers, however, is not commonplace. In fact, in nearby Olton, the volunteers who answer the pleas of their fellow residents are worn out and ready to hang up their boots. There is uncertainty about who will refill the ranks.

“We’re getting older and some of us would like to slow down, we’ve got a couple that’s going to retire this year, so that’s on our minds all the time,” said Jimmy Brooks, director of the Olton Volunteer Ambulance Association. “We just do the best we can with what we’ve got, and we’ll continue to do that as long as we can.”

Rural fire trucks and ambulances have long been staffed by neighbors and friendly, familiar faces in the community. The will to volunteer can be seen in the face of disasters, but finding consistent volunteers to staff those critical resources is a challenge in rural communities and nationwide.

In 2020, 65% of U.S. firefighters were estimated to be volunteers — nearly a quarter less than in 1984.

The problem is bound to get worse as the current batch of volunteers is getting older and close to retiring, and there are fewer people living there to refill the ranks, Brooks and other local officials fear.

“Our situation here mirrors pretty well what’s going on in rural Texas as far as EMS and fire departments are concerned, and that’s the lack of volunteers,” said Lamb County Judge James DeLoach. “We don’t have as many people here as we used to in rural areas, and not as many people willing to volunteer.”

New census data shows several of the rural counties surrounding Lamb County — which includes Olton and is about 55 miles northwest of Lubbock — have had population decline over the last year. Lamb itself has lost 2.4% since 2020.

More volunteers are also needed in the Panhandle, where wildfires can burn for days and stretch for miles. So far this year, there have been at least 23 wildfiresrecorded in the Panhandle by Texas A&M Forest Service.

“The emergencies don’t always happen where there’s a population center,” said Steven Denny, public information officer for Potter County Fire Rescue. “So it’s important to have these volunteer departments, especially in West Texas rural areas.”

The station is close to Perryton, where another tornado hit last month, but they didn’t respond to the disaster because, like Matador, the town was full. Potter County Fire Rescue relieved the usual crews there and responded to emergencies unrelated to the tornado, something Denny said stations in the region do to help after deaths in the department.

“It’s pretty critical that we have volunteer responders, but it can be a rewarding activity to do,” Denny said. “You get to help somebody on their absolute worst day.”

For the people who live and travel through the vast Texas plains, where medical care is already limited, the lack of volunteers could eventually make it harder to get any kind of aid in a life-or-death situation.

“Once in a while when we get caught short, it’s because we’ve got one truck out on a call and have another coming in,” said Brooks, who is also director of the EMS in nearby Earth. “Most of the time we can cover that, but sometimes we’re short. It depends on how many people we’ve got in town at that particular time.”

According to DeLoach, there are 12 EMS trucks to serve the population of nearly 13,200 in Lamb County, and some of the crews worry about what could happen if multiple calls come in, and there aren’t enough people to respond.

The crew at Olton VAA is mostly full, with 12 certified personnel and six drivers that cover two trucks. The trucks are typically staffed with a driver and two EMTs — more certified people on board means better care for the person injured or dying during the nearly hourlong trek to the nearest major hospital.

But, Brooks said, finding certified personnel — let alone on a volunteer basis — has been tough to come by. This is why training new health care workers has become a priority of his, even if the students will possibly leave Olton and practice elsewhere as soon as the course is done. The current class has a dozen people in it, but only three are likely to practice in the small town of 1,860 people.

 The Olton Volunteer Ambulance Association is across the street from the public school.
Justin Rex for The Texas Tribune
The Olton Volunteer Ambulance Association is across the street from the public school.
First: Jimmy Brooks, director of the Olton Volunteer Ambulance Association, in front of the station's ambulances on July 10, 2023. Last: A town map hangs in the association's office.
Justin Rex for The Texas Tribune
First: Jimmy Brooks, director of the Olton Volunteer Ambulance Association, in front of the station's ambulances on July 10, 2023. Last: A town map hangs in the association's office.
Jose Martinez practices CPR during an EMT certification class in the Olton Volunteer Ambulance Association.
Justin Rex for The Texas Tribune
Jose Martinez practices CPR during an EMT certification class in the Olton Volunteer Ambulance Association.

While that can be a bittersweet part of the training process, it is inevitable in rural communities. DeLoach has been a licensed paramedic since 1990 and says he has seen less and less people willing or able to volunteer over several decades now.

“When I started, it wasn’t hard to get a class anytime we wanted and we used to never start an EMT class without 10 people,” DeLoach recalled. “Now, we’re lucky if we get a class every year and then, we might get two people out of that class.”

This has happened for a number of reasons, such as the rising cost of living limiting people’s ability to work for free, ongoing workforce shortages or how few certification courses are offered in rural areas.

“I’m amazed our rural ambulance services still have enough volunteers to run calls,” said DeLoach, who started as a volunteer. “I encourage my judges and commissioners courts that I’m familiar with to meet EMS and fire departments at the table and work on a solution.”

One of those solutions is more certification courses, which DeLoach helps with by running basic and advanced EMT classes in Littlefield and Muleshoe. He used to only have students from the towns he was teaching in, but now they travel from across the region.

“You very rarely had someone from out of your county in your class when I first started,” DeLoach said. “Now, it’s not out of the ordinary for somebody to drive 40 or 50 miles to come to a class.”

Since October, more than $9 million has been awarded by the Texas Department of State Health Services to fund EMS scholarships, particularly for students in rural or underserved areas, as a way to build up the workforce.

A truck drives through Olton on July 10, 2023. Olton is about 50 miles northwest of Lubbock.
Justin Rex for The Texas Tribune
A truck drives through Olton on July 10, 2023. Olton is about 50 miles northwest of Lubbock.


From The Texas Tribune