Local ambulance service continues strong in face of challenges

If you’re unlucky enough to need an ambulance, you’re lucky if it happens in North Big Horn County. According to North Big Horn Hospital’s EMS (Emergency Medical Services) Coordinator Scott Murphey, with the exception of a few EMS services within the more populated areas in Wyoming, rural hospitals that still provide an ambulance service lose money on that service. For that reason, 10 providers of EMS services in Wyoming have shut down in the last decade alone. Others have combined service areas. Very few services are profitable, especially in sparsely populated areas.

“We’re essentially paying for readiness,” explained Murphey. “We have to be ready to respond, whether we get a call or not.”

The service through North Big Horn Hospital in Lovell responds to about 500 EMS calls per year, within its 2,700 square-mile service district. That’s a relatively low number of calls compared to services in more populated parts of the state and nationwide. To offer an EMS service, it must be staffed 24/7 and fully equipped to handle the calls that may or may not come in. North Big Horn Hospital employs three paramedics and maintains four ambulances. It maintains four different levels of EMS responders. It also employs specially trained nurses and providers to treat patients once they arrive at the hospital.

“Any time you have to have a service available 24/7 it’s going to be very expensive,” explained NBHH CEO Eric Connell. “The dollars add up quickly just with staffing costs. Then you add equipment like ambulances on top of that and medical supplies. The bills may seem high, but they don’t cover our costs. It ends up being something we subsidize as an organization.”

As with everything these days, the costs are going up, Murphey noted. 

An ambulance that cost $80,000 in 2003 costs close to $300,000 in 2025, he said. 

In spite of these challenges, the hospital has developed its EMS service and considers it one of its most essential services to the community. In contrast, government entities consider it a transportation service and are unwilling to pay a premium for what’s necessary to provide medical services while aboard the ambulance.

“There’s no question that we need EMS service in our community,” said Connell. “It’s the right thing to do and so we’re going to do the right thing. We’re just grateful that the community supports us by choosing to come here for their care.”

Since the hospital took over the service in the early 1970s, the service has grown into a sophisticated, fine-tuned operation capable of handling even the most complex emergency transports. According to Connell, that’s due to the highly trained, extremely dedicated staff and a community that trusts and supports them.

“I would say that there have been responses to events over the past three years that have demonstrated the dedication of the EMS staff and the community,” he said “For our team, every call demonstrates an act of strength and service. It also shows the love our responders have for the community. It’s friends and neighbors and family caring for friends and neighbors and family. That’s the kind of service you get in a very small town like Lovell.”

Whether you’re a hunter, a hiker or a homeowner, an ambulance can get to you in a matter of minutes if you’re within North Big Horn’s service area. In the last year alone, emergency medical staff transported victims of gunshot wounds, car crashes, severely burned victims, heart attack victims and more. Murphey noted that, as emergency staff increase their education and skills, survival rates for patients increase, as well.

History

According to local historian Karen Spragg, the early history of the service is not clear, since most of the people involved with ambulance services prior to the 1970s have passed on. In the early 1980s, she and her husband Wayne served on an ambulance operated by, at the time, a newly formed all-volunteer search and rescue operation.

“Before we formed search and rescue, I’m not sure what people did if they found themselves in trouble in the mountains,” she said. “We made a lot of trips up there.”

Spragg said most of the SAR (Search and Rescue) team members had become emergency medical technicians (EMTs), in order to best serve on the ambulance crew. She was one of the first women to serve in that capacity. She noted that the hospital was also in the early stages of operating an ambulance service, and many members of the fire department and search and rescue teams also worked for that service.

Jeff Pearson was one of those people. Though he never got around to getting his EMT certification he did act as a driver for the hospital’s ambulance service.

“I remember a few rough trips to Billings back then,” he recounted. “Back then the road was very bumpy, so we had a person ride in the back just to hold the patient on the gurney. If the person survived the trip they were probably going to be OK. We’ve come a long way since those days.”

Murphey became a driver in the early 2000s, he worked simultaneously in the family business as a mechanic and a car salesman. He recalled wearing coveralls at work to keep his clothes clean should he get an ambulance call. And, according to Murphey, there were quite a few calls.

“I never thought I’d end up working in the medical field,” he said. “Like a lot of other people, I got started in this just because I wanted to help the community.”

Eventually, Murphey got his EMT certification. In 2014, he became the first paramedic in Big Horn County. He now coordinates the entire EMS operation for the hospital.

“By industry standards, we (the hospital) started the service pretty early on in the 1970s,” he explained.  “It was a time when some people were coming back from the war and felt they had a better chance of surviving in Vietnam than when they came back home. 

“The history of EMS is an amazing story. In rural areas like ours, it started with volunteers through the fire department. Some communities used old funeral home hearses. I’m not sure if that was the case here in Lovell.

“The services were subsidized by the federal government at that time. Eventually, that funding was pulled. That left all these services that had started with federal dollars on their own. Of course, at the time, everything was volunteer. At first, the hospitals would buy the equipment and it would be run by volunteers. Later, the hospital hired and trained staff.”

Murphey put in roughly 3,800 hours of education to get his paramedic license. Currently, the hospital employs three paramedics and has four ambulances. The hospital recently invested $3.5 million to not only improve the emergency room itself, but also the ambulance bays. The newly remodeled emergency room has two trauma bays that are easily accessed by emergency transportation staff.

“It’s a whole different ball game now,” said Spragg. “We were quick back in my time, but the response time is so much better now. They have so much training now. I think we’re very lucky here now. The response time is amazing. Their knowledge is amazing.

“The paging system they have now is a big plus. Back then, we carried a pager around until it buzzed. You had no idea what you were getting into. Later it was more of a walkie-talkie that we used. They’re much more prepared now.”

Connell noted instances where staff members come in to offer help, even when they’re not on call. Sometimes there are so many wanting to help, he said, they have to be sent away.

“It’s a challenge when people come in on their day off and we have to tell them we have enough help,” said Connell. “Sometimes we have so much help, we end up having that conversation. It’s a testament to the kind of people who live here, to how they were raised and the people they’ve become as adults. They care that deeply. I trust them with my life or a family member. I would feel in good hands in any kind of emergency.” 

Spragg noted that, for as long as she can remember, helping has always been a tradition in Lovell.

“Back in our time it was just a bunch of volunteers who are caring people,” said Spragg. “We didn’t care if we got paid or not. I think to a certain extent, it’s still like that now. There are a lot of caring people in this community who just want to help others.”

Connell said the hospital is committed to maintaining a top-notch EMS service that is well-equipped with highly motivated staff.

“It takes a team to provide this kind of service, and we have that team right here at home,” he said.