Most of the region’s medical response agencies consist of on-call teams — some paid per call, some volunteer — who work day jobs they often have to leave to make it to emergencies. Sometimes, especially in rural areas, responses already take longer than ideal, officials said.

After two calls by central dispatch, if nobody is in the area of the emergency, 911 dispatchers send out another call to neighboring departments for assistance, which could increase the response time.

For serious health issues, every second counts, and a quick dispatch and response is critical to having a positive outcome, local emergency management coordinators say.

Mike Karll, emergency management coordinator for Montmorency County, said that, often, paid-on-call first responders need to gather needed gear before heading to an emergency, which slows down the process.

News Photo by Mike Gonzalez Zachary Wilburn, an emergency medical technician with Tri-Township Emergency Medical Services, checks the spine boards on the side of an ambulance while it’s stationed at the Tri-Township headquarters in Atlanta on July 24.

“The fire departments are all volunteer, so the largest amount of time is spent waiting for someone to respond to the page, run to the station and grab a truck, and then go to the scene,” he said. “We don’t have full-time departments because we aren’t the richest area in the state, for sure.”

Alpena County Emergency Service Coordinator Kim Elkie said the system is designed to ensure first responders will come to an emergency, even if that response comes from outside the area from which the call originated.

She said, in some instances, it may take longer than ideal, but, for the most part, response is swift.

She said a shortage of first responders is the real issue, because, the fewer paid-on-call responders there are, the higher the odds people won’t be able to respond to the page.

Elkie said most departments suffer from a lack of medical first responders or volunteer firefighters.

“Everyone is in the same boat — there just aren’t enough bodies,” she said. “We also have an aging force, so we are trying to find a way to recruit for everybody right now. Getting the next generation in now is a challenge right now. We need them to not only replace the older responders, but also to learn from them.”

Most municipalities don’t have a dedicated ambulance service because of the cost of operating and maintaining one and because low call volumes don’t justify that expense.

Alpena, Alcona, Presque Isle, and Montmorency counties each have ambulance services separate from first responders for taking people from a scene to the hospital.

In Montmorency County, three entities provide emergency medical services and ambulance transfers to the townships and cities: Albert Township Fire and Emergency Medical Services, Tri-Township Ambulance Service, and Hillman Area Fire and Ambulance Service.

Alcona County utilizes a 1.5-mill property tax — costing the owner of a $100,000 house about $75 a year — for emergency medical services. That money pays Alcona County EMS to handle ambulance responses countywide from two different stations.

Presque Isle County residents depend on Cheboygan Life Support Ambulance Service and Onaway Area Ambulance for transfers to hospitals in Alpena and Petoskey. East Grand Lake Fire Department has its own ambulance service.

The Alpena Fire Department handles medical calls for the entirety of Alpena County via a contract with the county paid for with funds from a 1.5-mill property tax.

In general, when a 911 call comes into central dispatch, the dispatcher prompts a call to the nearest department to the scene. Because some of the departments depend solely on paid-on-call employees, there are times many responders head to the scene and other times there are a few — if any, Elkie said. If nobody reports they are enroute after a second page, the dispatchers put out another page seeking help from another nearby municipality, which is also likely made up of paid-on-call employees.

So a positive outcome for a local emergency is often dictated by the number of paid-on-call firefighters and medical first responders who go to the scene and how long it takes them to get there, Alpena Fire Chief Rob Edmonds said.

Medical first responders who show up to a call for help are key, Edmonds said. He said that, when a call comes in, township medical first responders — who are often paid-on-call firefighters, as well — are directed to the scene at the same time the ambulance from Alpena is called out.

Edmonds said ambulance response takes longer in the far reaches of the county, but most runs are shorter in distance. He said about two-thirds of the medical calls come from Alpena, and, on average, it only takes about eight minutes for help to arrive.

Tax money from the ambulance millage in Alpena County is used to recruit and train medical first responders and firefighters, Edmonds said.

He added that a lot of people don’t step up to help because there are more educational requirements, detailed training, and time away from family than ever before.

To help, Edmonds said, the Alpena Fire Department holds classes for medical first responders and emergency medical technicians, which saves the townships or the trainees from paying the fees to do so. He said the higher credentials from the classes should improve the care provided to those who need help while an ambulance is enroute.

“We put on a (medical first responder) to (emergency medical technician) matriculation, which is like a short path to becoming an (emergency medical technician), so people who are already licensed as an MFR don’t have to repeat training they already had,” Edmonds said. “We also had a straight EMT class when we partnered with MyMichigan (Health), which both had a 100% pass rate, so we put another 17 EMT into the system. We are also doing a paramedic program over 18 months. This benefits all of the outlying townships.”

Presque Isle County Emergency Services Coordinator Sarah Melching said that, when an ambulance is dispatched, which hospital a person is transferred to is usually based on the location of the scene. She said medical emergencies that require transport in some sections of the county are typically taken to McLaren Northern Michigan in Petoskey, while ambulance calls in the Rogers City area or other surrounding areas usually have patients transferred to MyMichigan Medical Center Alpena.

Melching said local fire departments and medical first responders continually work together to improve the system and find new partners to help during emergencies. She said one of the newest initiatives is becoming a member of the Mutual Aid Box Alarm System, which is a statewide program designed for its members to share manpower and equipment.

She compared it to local mutual aid agreements, in which one department sends personnel and equipment to other departments in need, but on a much larger scale that makes more specialized personnel and equipment available.

“It is something that is another tool for communities to use, especially when they face staffing shortages,” Machine said.

Melching said all of the townships and cities in the county are in the process of becoming members. She said that, when that happens, when a call comes in to 911 that requires assistance, the dispatcher will send a special call for MABAS partners statewide, and any manpower or equipment requests could be honored by any of those partners.