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.
HORACE — The city of Horace is having a problem with what people are flushing down their toilets.
And it’s creating a big-time mess for crews to clean up.
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DICKINSON — The end of January marks a critical time for teams across Southwest North Dakota. Wins are starting to become premium value, and standings are starting to take shape across all sports.
South Heart @ Hettinger-Scranton — Boys Basketball — Friday, Jan. 30
The Eagles are in the middle of the pack in the District 7 standings, sitting at fifth in the conference with a 1-1 record. South Heart is coming into Friday’s contest winning its last two outings, earning its first District 7 win over New England, 69-49, and then a tight non-conference win over Trenton, 67-58.
The game against New England was a back-and-forth first half, but the Eagles took control in the final 16 minutes, outscoring the Tigers 44-24. Garett Bargmann put up 29 points, which led all players on the floor.
The Nighthawks are heading into Friday’s game dropping their last two games, with the most recent being a close 59-56 loss to Divide County. Hettinger-Scranton led at half time, 25-23, but couldn’t pull away with a win. Gavin Parnow and Aidyn Fisher had strong performances in the game, with 19 and 18 points respectively.
Tip-off is slated for 7 p.m. MST at Scranton High School.
Trinity @ Killdeer — Girls Basketball — Friday, Jan. 30
Jacob Cheris / The Dickinson Press
The Titans and Cowboys have played some really close games in the past. But the first meeting between the two clubs was a
lopsided affair that saw the Titans escape with a 55-36
win at the Knights of Columbus Activities Center.
Now the scene will shift to Killdeer in the final contest of the season-set. The Titans have been in some extremely tight games recently and have come out on both sides of the table. Trinity narrowly defeated Shiloh Christian, 46-44, to improve to 6-2 in Region 4 play and 8-6 overall.
The Cowboys are still searching for some consistency. Killdeer is riding a two-game losing skid and has losses in four out of its last five games.
Tip-off is slated for 7 p.m. MST at Killdeer High School.
Devils Lake @ Dickinson High — Girls Hockey — Saturday, Jan. 31
Jacob Cheris / The Dickinson Press
The last time these two teams met, the Mavericks won in a 2-1 overtime decision. Saturday’s contest is the back half of a back-to-back home weekend, where DHS will take on Grand Forks on Friday.
Saturday’s game is the best chance DHS has to get in the win column. The Firebirds are currently sitting in last place in the conference and don’t have a win this season. They’ve also struggled to put the puck in the back of the net, scoring just 10 goals through 13 games.
Dickinson (4-10, 1-10-2) was in a tight first period with Bismarck Century last Friday, but things once started to turn sideways in the second period, when the Patriots scored two goals on 19 shots and held DHS to three.
Puck drop is slated for 1 p.m. MST at the West River Ice Center.
Jacob Cheris covers a variety of high school and college sports. A graduate of Penn State University’s class of 2023, with a degree in broadcast journalism, he covered Penn State Men’s Hockey for three years. Jacob also covers Big Ten Hockey for College Hockey News.
North Dakota Supreme Court Justices, from left, Douglas Bahr, Daniel Crothers, Jon Jensen, Lisa Fair McEvers and Jerod Tufte hear arguments Dec. 18, 2023, in a case involving Summit Carbon Solutions and landowners. (Photo by Kyle Martin/For the North Dakota Monitor)
BISMARCK, N.D. (North Dakota Monitor) – A committee has forwarded six candidates to Gov. Kelly Armstrong to be the next justice of the North Dakota Supreme Court.
The court seeks a replacement for Justice Daniel Crothers, who announced late last year his plans to retire in February after 20 years on the bench.
The six contenders are:
- Philip Axt, a Bismarck resident and solicitor general for the North Dakota Attorney General’s Office
- Mark Friese, a Fargo defense attorney
- Michael Hurly, a judge for Northeast Judicial District in Rugby
- Ryan Norrell, a Bismarck attorney who served as counsel to former Gov. Doug Burgum
- Jacob Rodenbiker, an assistant U.S. attorney who lives in Fargo
- Kirsten Sjue, a judge for the Northwest Judicial District in Williston
Armstrong, a Republican, can appoint someone from the pool of six, ask the committee for more nominees or refer the matter to the election ballot for a public vote.
The committee could have forwarded up to seven names. A total of 12 candidates applied.
The voting members of the nominating committee are Justice Jerod Tufte, Eric Lahlum, Taylor Olson, Laura Mihalick, Paul Forster and Garth Rydland.
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