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•  Commitment is big, volunteer pool is small
• Finding enough people to serve on ambulance crews is a constant concern in rural communities.
• "We do not have enough volunteers," Hericks said. "Staffing is always an issue. There are a few dedicated people who devote a significant part of their time to be able to provide the ambulance service to the surrounding area. Burnout is always an issue."
• For an ambulance service to maintain its license, two people have to be on call 24-7. Some towns, like Clark and Britton, have adequate numbers on their roster, but few people available to respond to emergencies during the day.
• "Daytime jobs get in the way," said Laurel Behnke, director of the Marshall County Ambulance. "They don't want to leave because they can earn more at their place of work, or the employer doesn't want them to leave."
• The Gackle Ambulance currently has enough volunteers (though they would welcome more), but that's not always been the case, according to squad leader James Owen. "There have been three separate times where staffing was at a critical low and options to discontinue or merge with another service were considered," he said. A partnership with Medina was in the works a few years ago but not finalized due to legalities. The service has been able to continue since then by bringing in outside help, which is hard to find since other towns struggle with low numbers also.
• People commuting to work elsewhere, the aging of rural communities and the business of people's lives are some of the reasons for the lack of volunteers, Owen said.
• But perhaps the biggest deterrent for volunteers is the big hurdle they have to jump before they can be EMTs: Hours of training. In North Dakota, 110 hours are required; in South Dakota, the training requirement is a minimum of 186 hours.
• EMTs also have to do ongoing training to keep their certification. "With how busy everyone is, it is harder to find someone who can take the extra time to get certified and go through the process of keeping their certification," said Pam Grensberg, Clark County ambulance administrator. "One must work 30 hours every two years to keep their EMT license."
• Currently, those courses have to be taken wherever they are offered, which is a greater burden for rural residents.
• "In Faulkton … anyone who wants to be an EMT on our ambulance service has to go to, say, Aberdeen for his or her training," Hericks explained. "They hold classes every Tuesday and Wednesday night from 6 to 10 p.m. Well, for anyone from our area, that class is actually from about 5 to 11 p.m., since we have two

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