Here & Now

EMS Agencies Describe a System in Crisis

Frederica Freyberg:

The state’s network of emergency medical services is crumbling and dangerously unreliable. That’s according to a new report from the Office of Rural Health. “Here & Now” reporter Steven Potter looks at the growing problems and proposed solutions.

Jim Colegrove:

This is a heartbreak. This is a tragedy.

Steven Potter:

Because when you call 9-1-1, you expect an ambulance to show up and show up soon but for some communities around the state, particularly rural ones, there’s a growing concern that emergency medical services won’t be there to answer calls. The problem, a staffing shortage.

Alan DeYoung:

We have a crisis not unlike other industries, like retail and otherwise, but staffing for EMS means life and death. It means somebody not showing up to a call, an ambulance not arriving. What we started to see in the last couple of years, departments have been closing, and sometimes there’s a mutual aid agreement for another department to come in and help out, but many times, towns, cities, villages are without EMS. They have nobody.

Steven Potter:

A new survey from the UW-Madison Office of Rural Health shows the extent of the problems. More than 40% of state EMS agencies had staffing gaps where no ambulance was available for emergency calls. And almost 80% of EMS agencies were called to cover an emergency in a neighboring community.

James Small:

We even saw that in 10 communities, there were services that reported that an ambulance never got to a call at all, that there was 9-1-1 calls requesting ambulances. They didn’t have staffing available and they never had an ambulance make it to a call.

Steven Potter:

At the heart of the current staffing struggles is the fact that, for decades, Wisconsin’s EMS operations have been built upon and almost exclusively been supported by volunteers.

Alan DeYoung:

Right now, 79% of our state actually relies on volunteers to staff their 9-1-1 calls, which is a huge amount if you’re talking about majority of the state relies on volunteers, some that might get paid a stipend, might not get paid at all, a lot of times having to pay out of their own pocket, so we have many rural areas that are using volunteers to kind of subsidize the cost of EMS

Steven Potter:

Paul Blount is the chief of the EMS operations for the Cambridge area.

Paul Blount:

The combination model has become a popular solution. We have several individuals that work here full-time. This is their full-time job, and then some part-time members and then community volunteer paid on-call members, and that is a pretty popular staffing strategy and what it does is help address the need for 24/7/365 ambulance coverage.

Steven Potter:

Chief Blount started as an EMS volunteer himself years ago. He understands why it’s hard to keep enough Paul Blount volunteers to staff ambulances.

Paul Blount:

Family demands, work demands, and then just a struggle to just find people to do the job and to volunteer especially to do the job.

Steven Potter:

The prime example of the EMS staffing shortage is happening there in Lake Mills in Jefferson County.

Jim Colegrove:

Unfortunately, a bit over a year ago, we realized that we were not being successful at recruiting and retaining people. We were also having some financial difficulties. With all of that going on basically, we have had to make the decision that we are going to be closing our doors here on June 30th. Because we have been serving this community, our friends, our neighbors for close to 50 years, that in itself is the — closing the doors is just tragic.

Steven Potter:

Whether you’re a paid emergency medical technician or even an EMS volunteer, extensive training, education and certification from the state is required. And on top of that, Jim Colegrove notes, the work isn’t for the faint of heart.

Jim Colegrove:

This is a dirty job. This is very, very difficult. You are dealing with human beings in some of their worst possible times and you have to have a lot of empathy for those people and you have to be willing to be working in an environment where somebody is throwing up on you. You are working a code and you are doing CPR on somebody that you know who lives just down the street, that type of thing, and so it is very emotionally charged, but it is generally very much a sense of wanting to give back to a community.

Steven Potter:

Lake Mills is now in the process of joining the Cambridge area EMS group. A number of EMS agencies around the state have entered into similar consolidation agreements with neighboring communities. A temporary solution is asking residents, through ballot referendums, for more money, but for a long-term solution, EMS officials are seeking more stable funding from the state.

Alan DeYoung:

The state really, right now, needs to step in, needs to provide permanent funding.

Steven Potter:

DeYoung says such funding will need to be substantial and sustainable.

Alan DeYoung:

We’re talking about $500 million in a budget hopefully for a two-year budget here but that’s really to provide every department about what they need. Like I said, some will get less, some more, based on how rural they are.

Steven Potter:

To make that funding dream a reality, EMS operators have begun knocking on lawmakers’ doors at the Capitol.

Jesse James:

As far as I’m concerned, out of police, fire and EMS, EMS is the number one priority.

Steven Potter:

Eau Claire area State Senator Jesse James has worked hand in hand with EMS providers on emergency calls as a former police and fire chief in Altona. He says he knows how necessary these services are.

Jesse James:

It’s essential for all of us, whether you’re in the urban area or rural area, we need to have these services available to serve our communities.

Steven Potter:

Senator James says he wants to explore financial incentives for smaller communities to consolidate their EMS operations, but he’s unsure how much Republican legislators are willing to give to EMS agencies in their state budget.

Jesse James:

There needs to be some money put into it. I don’t know if they would reach that $500 million mark, though.

Steven Potter:

EMS officials say they also need more money for recruitments efforts to help attract more potential employees to the field. According to the state Department of Health Services, over the last decade, ambulance patient numbers have nearly doubled from about 500,000 patients per year to more than 900,000. Over that same 10 years, however, the number of EMS providers has gone from 20,000 to just 21,000, an increase of only 5%. And, DeYoung says, those figures are about to get much worse.

Alan DeYoung:

We are actually estimating about 25%, 26% of all licensed EMS providers are probably going to let their license lapse this renewal year. You’re talking about a workforce cutting it down by a quarter.

Steven Potter:

EMS leaders hold out hope that state lawmakers will respond to the need.

James Small:

I think that there is definitely intent in the legislature to try to address this issue. It seems to be very high priority. I’m getting contacted by legislators numerous times a week wanting information on the system, wanting to know some of the results of the survey and so on. I don’t know what EMS 2.0 is going to look like, but we know that EMS 1.0 has run its course.

Steven Potter:

For “Here & Now,” I’m Steven Potter in Lake Mills.