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
Behind the Badge – Why North Dakota?
Why North Dakota?
District Game Warden Noah Raitz
I admit that when I was first thinking about getting into conservation enforcement, I was not thinking about moving to North Dakota. Not because I didn’t like the state or had a reason not to move here. It was the opposite. I lacked the knowledge of what North Dakota had to offer. I was also in high school, so I had no idea what my plan was other than going to college.
I was just talking about this with another warden and the recruitment of candidates for our game warden positions. Sure, we hire wardens born and raised in North Dakota, but that’s not a requirement for the job. As proof of that, I grew up 30 minutes from the North Dakota border but didn’t start to think of it as an option until college.
I attended the University of North Dakota and one summer I worked for the North Dakota Game and Fish Department as a fisheries seasonal in Devils Lake. I enjoyed the work, but it also showed me the fishing opportunities the state offered that I had never explored before.
I also helped with sharp-tailed grouse surveys in college, which showed me the upland hunting opportunities that, again, I had never explored.
I grew up hunting waterfowl, but not in North Dakota until college, when I was introduced to field hunting. As you can guess, this showed me the prized waterfowl hunting so many people are passionate about in North Dakota.
I say all that because North Dakota’s habitat and natural resources are worth appreciating. It might not be flashy mountains or cabin-packed lakes, but that doesn’t mean we don’t have a lot to offer. We have the prairie, badlands, the Missouri River system, and many other unique landscapes throughout the state.
What do those have in common? They are made up of large areas of undeveloped landscapes for anyone to enjoy. Or in my case, to work in. That’s my office, the habitat for our fisheries and wildlife resources. I may not have a fast-food restaurant or big shopping mall down the road, but I do have various hunting and fishing opportunities within 5 minutes of my house.
I was asked recently what the favorite part of my job is, and it wasn’t very difficult to answer. It’s the interactions I get to have with the public. Getting to listen to a young angler tell me about the big fish they caught, or a new hunter showing off their first duck. It’s also the older generation telling me about hunting or fishing stories from before I was born.
To circle back to where I started, I did not expect to end up in North Dakota, but I am sure glad I did. Enforcing game and fish regulations is easy when the majority of our interactions don’t end in a citation, but instead a hunter or anglers’ story about that day’s success or defeat.
North Dakota
North Dakota Attorney General’s Office issues a warning on asphalt-paving scams
BISMARCK — The North Dakota Attorney General’s Office is cautioning homeowners to be on the lookout for asphalt-paving scams.
Homeowners may be approached by unannounced illegitimate contractors claiming to be “working in the area” with “excess material” for purchase at a discounted price, with same-day decisions encouraged, a news release stated. Contractors may demand a large upfront payment, in which case they may simply leave town or begin working immediately, insisting on payment as soon as work is completed.
The work will be low-quality and easily identifiable as a scam, the release said. False contractors may even use intimidation or threats for quick payment before work can be inspected.
Homeowners should be cautious of anyone offering unsolicited paving work, especially if they claim to have leftover material at a discounted price.
The office provided the following tips to avoid falling victim to a scam:
- Research any contractor before hiring
- Ask detailed questions about the business
- Get all estimates and terms in writing
- Avoid making full payment up front
- Avoid using cash and mobile payment apps
“Pay attention if your intuition tells you that an offer appears too good to be true, because it likely is,” North Dakota Attorney General Drew Wrigley said in the release.
Consumers with questions or who suspect they may have been targeted by an asphalt-paving scam should contact the Attorney General’s Consumer Protection Division at (701) 328-3404.
Our newsroom occasionally reports stories under a byline of “staff.” Often, the “staff” byline is used when rewriting basic news briefs that originate from official sources, such as a city press release about a road closure, and which require little or no reporting. At times, this byline is used when a news story includes numerous authors or when the story is formed by aggregating previously reported news from various sources. If outside sources are used, it is noted within the story.
North Dakota
North Dakota voters to decide on single subject rule for ballot measures
FARGO — As North Dakota voters cast their ballots for the June primary election, choosing candidates won’t be the only decision they’ll face.
Voters will also decide whether future ballot measures must be composed of just a single subject.
The Legislature placed the matter on the ballot in 2025, when it passed
Senate Concurrent Resolution 4007.
Some lawmakers argue the measure, if passed, will work in favor of voters by making future amendments more digestible and less jumbled for voter comprehension.
Senate Majority Leader David Hogue, one of the lawmakers in favor of the measure, said it would prevent any “bait and switch” tactics to pass unpopular amendments against the wishes of unassuming voters. Hogue sponsored the legislative resolution that placed the measure on the ballot.
The Seante passed the resolution with outspoken support, only one lawmaker voted no. However, the resolution faced more resistance in the House, passing in a vote of 57-36.
If passed, the resolution would require the Secretary of State’s office to verify that future amendments meet the single-subject requirement.
One outspoken voice in opposition of the resolution is House Minority Leader Zac Ista, D-Grand Forks, who said he voted against the resolution fearing it would introduce a “layer of bureaucratic review” to the ruling process. Ista also added there is not clear criteria for determining what meets the requirement.
“I think in North Dakota, if we entrust the secretary of state and attorney general of being the sole arbiters of what is and is not a single subject, that’s really going to handcuff voter initiatives in the state,” Ista said.
Contrary to this, Hogue feels the resolution would not require any complex review to determine whether or not future amendments meet the single rule requirement.
“I don’t think it’s a legal judgment. I think if you’re trying to pass two different measures in one, that’s a common-sense judgment.” Hogue said.
Measure 1 is the first of four constitutional amendments on the North Dakota ballot for this upcoming election cycle, three of which won’t be voted on until this November.
Early voting in some counties begins Tuesday, June 2. Election Day is Tuesday, June 9.
How Measure 1 will appear on the ballot
“This constitutional measure would amend and reenact section 9 of article III and section 16 of article IV of the Constitution of North Dakota, relating to requiring each resolution adopted by the legislative assembly proposing a constitutional amendment and each initiative petition and measure proposing a constitutional amendment be comprised of a single subject. The proposed amendment is summarized as follows: constitutional amendments would be limited to one subject. The Secretary of State shall not approve an initiative petition for circulation if the Secretary determines that the proposed amendment comprises more than one subject. Additionally, the legislative assembly is required to limit proposed amendments to the constitution to one subject.
“The estimated fiscal impact of this measure is none.”
Text via the North Dakota Secretary of State’s office.
Brennan Collins is a reporting intern who started at The Forum in May 2026.
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