North Dakota
Amid Rural EMS Struggles, North Dakota Lawmakers Weigh Solutions
North Dakota lawmakers are exploring using telemedicine technology to ease staffing strains on rural emergency medical services, a potential solution to a growing shortage of paramedics and volunteer responders across the state.
Though some solutions were floated and passed during the 2025 legislative session, lawmakers are working to understand the scope of the problem before proposing additional legislative changes in 2027.
The state has been facing a societal decline in volunteerism, which strains traditional volunteer firefighter and emergency medical services that support rural communities, said Sen. Josh Boschee, D- Fargo. Adding to pressure, when a rural ambulance service shuts down, the responsibility falls to neighboring ambulance services to answer calls in the defunct ambulance service’s coverage area.
How could telemedicine ease strains on rural EMS staffing?
One idea presented to the Emergency Response Services Committee on Wednesday to potentially alleviate some of the stress on rural ambulances is expanding access to technology in the field for emergency medical personnel.
Emergency medicine technology company Avel eCare presented to the committee its system, which allows ambulance personnel to be connected by video with emergency medicine physicians, experienced medics or emergency nurses in the field wherever there is cell reception. The company already operates its mobile service in South Dakota, Minnesota, Nebraska and Kansas, according to the company’s presentation.
Avel eCare said this allows medics and paramedics to have any questions they have answered and provides a second person to help document actions taken when there is only one person in the back of an ambulance with a patient, which they say is increasingly common in rural areas. This allows one medic or paramedic to put more focus on the patient.
The company said it is innovating the ability to also bring medical personnel into the call from whatever care center the ambulance is heading to, allowing the care center to better prepare for the ambulance’s arrival.
Lawmakers said they were interested in the system and could see how it would provide a benefit to thinly stretched EMS personnel.
Boschee said the state should consider funding the system, citing its potential to support local EMS providers and help retain volunteers.
Avel eCare did not provide a cost estimate for North Dakota, but offered South Dakota as an example. That state used general fund dollars to provide the Avel eCare service free of charge to agencies. The state paid $1.7 million in up-front costs for equipment — enough to outfit 120 ambulances — and an annual subscription cost of $937,000 to provide their services to 109 ambulances serving 105 communities in the state.
“I think specifically … how affordable that type of solution is for us to not only support our local EMS providers, but also to keep volunteers longer,” he said. “Folks know that they have that support network when they’re in the back of the rig taking care of a patient. That helps add to people’s willingness to serve longer. And so I think that’s a great, affordable option we have to look at, especially as we start going in the next couple months and continue to talk about rural health care transformation.”
Rural EMS shortages go beyond pay, state officials say
There are 28 open paramedic positions in the state, according to Workforce Services Director Phil Davis’ presentation. The difficulty in filling these positions is not just about money, though that certainly plays a factor in recruiting people, his report said.
“I’ll just speak from my experience with my own agency,” Davis said. “After 18 years, it’s very hard for us to even recruit individuals into Job Service North Dakota because of the lower wages.”
Davis showed that 2024 salaries for emergency medical technicians were fairly even across the eight regions Workforce Services breaks the state into, with a roughly $6,500 gap between the highest and lowest averages. Law enforcement officer pay varied by about $8,320, while firefighter salaries were the biggest outlier, with a $20,000 difference between regions. While state wages may lag nationally, other factors are making rural recruiting particularly difficult.
Davis said it was largely a lifestyle change; people are not seeking to live rurally as often.
“We’re starting to see the smaller communities, for the most part — not all — starting to lose that population. And it is tougher to get individuals to move there or to be employed there,” Davis said.
Job Service North Dakota is holding job fairs to try to recruit more emergency services personnel, with some success, he said, and has nine workforce centers across the state working directly with small communities to help with their staffing shortages.
Davis advocated for more education in schools about career paths in emergency services and the openings that are available in the state.
© 2025 The Bismarck Tribune (Bismarck, N.D.). Visit www.bismarcktribune.com. Distributed by Tribune Content Agency, LLC.
North Dakota
Trump invites former ND first lady Kathryn Burgum to help lead national addiction recovery effort
WASHINGTON — The wife of former North Dakota Gov. Doug Burgum will help lead a national initiative to further prioritize addiction treatment and recovery.
Kathryn Burgum and husband Doug Burgum,
now U.S. Secretary of the Interior,
were part of an executive order signing at the White House on Thursday, Jan. 29, to launch the Great American Recovery Initiative.
The initiative will be co-chaired by Kathryn Burgum and Health and Human Services Secretary Robert F. Kennedy Jr.
She spoke briefly at the event, beginning with thanks to President Donald Trump who was seated near her.
“Your leadership today, relative to this announcement about the Great American Recovery, is a gift to all Americans who are suffering from the brain disease of addiction,” she said.
Inspired by Kathryn as she advocates to remove the stigma around the disease of addiction. Her courage sharing her story is transforming lives and proving there is hope in recovery.
Grateful that @POTUS is driving this important work forward—this initiative will save lives! https://t.co/6dnjUYr3y3
— Secretary Doug Burgum (@SecretaryBurgum) January 29, 2026
Kathryn Burgum spearheaded addiction recovery efforts in North Dakota
through the Office of Recovery Reinvented while her husband was governor.
She began speaking openly about her own battle with alcohol addiction that she said started in high school.
“I was a blackout drinker from the start,” Kathryn Burgum said at the White House event, now marking more than 23 years of sobriety.
Forum file photo
Over her husband’s eight years as governor, the couple hosted Recovery Reinvented events,
with speakers and activities focused on ending the stigma
around the disease of addiction.
“I was asking people to share their stories openly about addiction, so we can eliminate the shame and stigma, so more people would reach out for help, and more lives could be saved,” she said from the Oval Office.
The Great American Recovery Initiative will create stronger coordination across government, the health care sector, faith communities, and the private sector, the White House website said.
Kathryn Burgum said it represents a fundamental shift from reaction to prevention, fragmentation to coordination, stigma to science, and short-term fixes to long-term recovery.
“For the first time, we’re aligning federal leadership across health, justice, labor, housing, veterans, social services, the faith office and education around one single shared truth: When addiction is treated early and correctly, people recover and families heal,” she said.
Kylie Cooper/ Reuters
A comment from Trump during the ceremony drew laughs from those gathered, when he hinted he had chosen Doug Burgum to serve in his Cabinet because Kathryn had caught his eye.
At Oval Office event on drug addiction, Trump praises Kathryn Burgum, wife of interior secretary, who spoke about her experience in recovery.
TRUMP: I saw them riding horses in a video and said, who is that? I was talking about her, not him … I said, I’m going to hire him pic.twitter.com/nMo9MgMLdP
— Dan Diamond (@ddiamond) January 29, 2026
“You know, I saw them riding horses in a video. And I said, ‘Who is that?’ I was talking about her, not him,” Trump said, the audience chuckling.
“And I explained it, I said, ‘I’m gonna hire him,’ because anybody has somebody like you to be with, it’s an amazing tribute. And it’s a great couple,” Trump said.
North Dakota
Port: On the demise of an important cultural bridge to North Dakota’s past
MINOT — It’s hard to describe how important a cultural event the Norsk Hostfest was.
I say “was,” using the past tense, because news this week is that the annual event, which had just completed its 46th year, is coming to an end.
The event was important to me as a descendant of Scandinavian immigrants. My maternal great-grandparents came to America from Norway, and homesteaded a farm near the Ryder area. The Hostfest was a way for me to connect to their cultural traditions, from food and music to the history of the Norwegian diaspora.
Click the image above to view the PDF document.
The event was also important to my family. We spent years attending and working at the event. We were a host family for Scandinavian performers who traveled to Minot to entertain at the event. We even got some local media coverage in 2004 about four generations of my family volunteering.
I have so many memories from the Hostfest. For a while, when I was a paperboy for the Minot Daily News, I would go out to the festival early in the morning to sell newspapers door-to-door in the RV campgrounds. My grandma would tell me stories about her immigrant parents.
And the food! I once ate so much
rommegrot
— a Norwegian dessert pudding — that the resulting gastro-intestinal pyrotechnics are still a thing of family lore.
I even met famed political consultant Karl Rove at the Hostfest one year.
He was there to be inducted into
the Scandinavian-American Hall of Fame,
and was being escorted around by former Attorney General Wayne Stenehjem. Apparently the two of them were friends from their College Republican days. They ran across me working at a booth. I was a part-time political blogger then. I hadn’t yet begun my full-time writing career.
I have so many happy memories from the Hostfest.
Now, it’s over.
“In recent years, the festival has faced significant increases in the cost of nationally recognized performers, as well as insurance, facilities, labor, and logistics,”
a press release from the Hostfest board said.
“At the same time, attendance levels have not rebounded to pre-pandemic levels, creating ongoing financial challenges that cannot be responsibly overcome.”
The pandemic certainly didn’t help the festival, and I think we can fairly blame some mismanagement, too. As the generation the event originally catered to began to die out there was little effort made to draw the interest of younger generations. It was expensive, too, making it cost prohibitive for younger families to begin the traditions of attendance that cultural event like the Hostfest depends on.
But it’s hard to ignore the involvement of Epic Companies,
which took over management of the event
for a couple of years post-pandemic before the company’s spectacular financial collapse prompted its exit from the arrangement. Epic had tried to take the event in a new direction, away from its cultural roots and toward some sort of a modern music festival, and it just didn’t work.
After years of failing to adapt to modern audiences, the impact of the COVID-19 pandemic, and poor management by Epic Companies, Minot and North Dakota are losing a treasure.
A bridge to our past.
A preservation of an important part of our state’s history.
I’d like to think that the Hostfest will be replaced with something new that will continue to preserve Scandinavian heritage in our area, but it probably won’t be. To be clear, some preservation continues. The
Scandinavian Heritage Association,
which maintains the Scandinavian Heritage Park in Minot, will endure, and that’s a good thing. They do wonderful work.
It’s just not the same.
It feels like we need things like the Hostfest now more than ever. So many in our society, nearly all of them descendants of previous waves of immigration, have adopted a pronounced hostility to new generations of immigrants. They’ve committed themselves to making it clear that those new immigrants aren’t welcome. Which is why it’s important for us to remember our own immigrant past. The joys and the struggles and the warts.
The Hostfest was a part of that. Now it’s gone. So it goes.
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