Medical transport benefit lifts rural county recruiting efforts

Key Takeaways

Living in Sublette County, Wyo. has plenty of benefits, with the natural beauty of the Bridger-Teton National Forest high on the list. But that remoteness brings some challenges.

The county seat — Pinedale — carries the motto “all the civilization you need,” but once in a while, what you need is a Level1 trauma center.

“We’ve got a first-rate library, a great hockey team, we have the Pinedale Aquatic Center,” said Commissioner Dave Stephens. “But we’ve never had a hospital. It’s 80 miles to Jackson,” and St. John’s Hospital in nearby Teton County. Even once the county’s planned hospital opens, it won’t meet every medical need in Sublette County. 

June’s Teton Pass landslide in Wyoming illustrated the tenuous connection between rural communities in the West when it added an hour to what was once a 30-minute trip between Jackson and Victor, Idaho.

While Sublette County could offer medical benefits, the emergency options for county employees remained an unsolved problem. But the tide started turning with one new hire. 

Andrea Jean started as the county’s human resources director in 2023 and while comparing compensation packages, she saw an opening for a new benefit — insurance for emergency air ambulance transport, or life flights. 

With treatment for more serious medical emergencies available in Jackson, Idaho Falls or Salt Lake City, aerial transportation can be a game changer in the event of an emergency, but the cost can be an impediment.

“Life flights average around $50,000 to $70,000, so you can imagine that this is a huge financial burden for anyone,” Jean said.

“When a call goes out for an air ambulance, members are not given a choice of which carrier is called. Even if they have an advocate with them or are coherent enough to make the request for an in-network provider, there is no guarantee that an in-network provider is available. 

The second issue that has been faced is that, because we are so rural, what is considered an emergency here is not necessarily considered an emergency at receiving hospitals in bigger cities. 

If the receiving hospital codes to the insurance company as a non-emergency, the insurance company can then deny the claim.”

Although 10,000 people live among the county’s 5,000 square miles, summer months bring what Fire Warden Shad Cooper describes as a “tremendous influx of tourists,” driving the demand for emergency service personnel, particularly for search and rescue operations in the national forest.

“In the colder months, we’re best described as a frontier community, but in the summer, our call volume is nothing like that,” he said. “Some of the rental homes are in very remote parts of the county, and staffing our six stations with firefighters is a challenge.”

So Cooper suggested the Board of Commissioners offer the life flight benefit to volunteer firefighters and their families. 

“It’s really frequent that you have to get up during the middle of the night or leave dinner at the table and go over and respond to the fire station, or you have to leave your kids’ recital or play,” Cooper said. “The firefighters do a lot, but their family oftentimes goes without them, so it’s nice we’re able to extend that benefit to them and give them some added security.” 

Stephens added that the county was able to offer the benefit thanks to revenue from its gas wells and acknowledged that not every county would be able to offer such an expensive employee benefit, but again, not every county has that treacherous of a trip to reach a high-level hospital.

Cooper doesn’t lead with the life flight benefit when recruiting volunteers, but he brings it up later in the process. In the year since it has been offered, one recruit said it made a difference in convincing him to sign on. It remains one in a variety of recruiting tools.

“There’s no silver bullet solution,” he said. “We’re still struggling for volunteers, but anything we can do to improve recruitment incentives that brings firefighters in the door can help.

“It does seem to be making a difference.”