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National EMS Week: Rural EMS crews in Michigan’s U.P. face growing challenges

by Sophia Murphy
May 21, 2026
A A

LANSING, Mich. (WZMQ) – For paramedics in Michigan’s Upper Peninsula, emergency response often means navigating long distances with limited resources.

During National EMS Week, state Rep. Dave Prestin (R-Cedar River) is highlighting the growing challenges facing rural EMS crews across the region, including staffing shortages, aging populations, and declining access to healthcare facilities.

Prestin still maintains his paramedic license and described the Upper Peninsula as a healthcare desert, where emergency responders are increasingly being asked to do more with fewer resources.

“It’s challenging. Healthcare in the UP is challenging. It’s a healthcare desert. We have a healthcare desert. It’s just getting worse,” Prestin said.

Prestin said one of the largest barriers for rural emergency responders is distance. Many communities in the U.P. are located hours from higher-level trauma care centers, creating significant challenges during medical emergencies.

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“We continue to lose critical care access points,” Prestin said. “We continue to only have one level 2 trauma center, no level ones. Closest level ones are really downstate Michigan, and Milwaukee or Madison.”

The issue is especially concerning in communities that have already lost local hospital access. Prestin pointed to Ontonagon as an example of how long transport times can directly impact survival rates during emergencies.

“Now you translate that over to Ontonagon, you know, where they lost their hospital,” Prestin said. “If you have a witnessed heart attack out in Ontonagon, your ability to get to the hospital and survive is almost not there.”

Prestin recently introduced legislation creating what is known as an adaptive care license for ambulances. The proposal would allow ambulances to operate at different levels of care depending on the certifications of the crew staffing the vehicle.

“So what my bill does is it allows the rig to license at a higher level, but operate on either level, basic life support or advanced life support, dependent upon who’s in the rig,” Prestin said.

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Prestin said the legislation could help smaller EMS agencies maximize staffing flexibility in areas where recruiting and retaining paramedics remains difficult.

He also said broader healthcare and economic challenges continue to affect emergency response across the region. Prestin said lower reimbursement rates and difficulties attracting specialists to rural areas are placing additional strain on healthcare providers.

“One of the biggest challenges that we have is drawing specialties up into the UP to serve,” Prestin said.

The adaptive care legislation continues moving through the Legislature with support from the state’s EMS division, according to Prestin. He said lawmakers are continuing to explore ways to improve healthcare access and emergency response capabilities in rural parts of Michigan.

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