EMS staffing in Wisconsin is at a ‘crisis point’

“In 10 years, I don’t know where the fire, police and EMS service is going to be.”

So says Christopher Garrison, Sun Prairie’s fire and EMS chief.  

Fewer volunteers, more 911 calls and the rising costs of medical care are stressing EMS agencies statewide. It could mean longer wait times for you or a loved one when you need an ambulance.

“It’s a vital service,” said Tyler Byrnes of the Wisconsin Policy Forum about EMS. “More people are trying to use it, and the revenue to pay for it is not growing quite as quickly.” 

EMS activations in the U.S., which include 911 calls and events like scheduled ambulance transports, increased by about 25% between 2021 and 2023, according to data from the National Emergency Medical Services Information System.  

Not addressing funding and staffing challenges may “soon have a real impact on public safety,” according to a report from the Wisconsin Policy Forum published in 2021. Recruitment, difficult for all departments, “is reaching a crisis point for many volunteer and combination departments.”

Alan DeYoung has received reports of some EMS agencies in Wisconsin not responding to as many as 80% of their calls. 

DeYoung leads the Wisconsin EMS Association, one of many groups lobbying the state Legislature to pass a package of bills to address the problems state EMS agencies face. 

When an agency can’t respond, ambulances stationed farther away usually take the call. It stresses the system and can slow response times for everyone. 

A lot of it has to do with volunteers, who have historically made up the bulk of EMS staffing. About 65% of Wisconsin EMS agencies, many of them rural, still employee volunteers, according to a report from the Wisconsin Office of Rural Health.

Volunteers have subsidized the taxpayers for years, DeYoung said. But declining volunteer rates mean something has to give.

That probably means higher taxes to pay for professional EMS responders, or worse EMS service than you used to get, experts say.

Some potential legislation moving through the Wisconsin State Legislature is trying to relieve some stress on EMS. One bill would require the state’s technical college system to provide grants to schools offering EMS courses. It would also create a reimbursement program for the cost of initial EMS coursework and expand funding for technology that gives EMTs real-time video before they reach the scene, said state Sen. Howard Marklein (R-Spring Green), one of the bills’ sponsors. 

Another bill would encourage communities to develop regional EMS systems that can cross county boundaries. 

These regional systems would be exempt from state-imposed levy limits, meaning they can more easily raise funding for EMS agencies through property tax increases. It would especially help communities that straddle county borders, Marklein said.

Regional systems could also reduce costs if the agencies within the system consolidated administrative work, training and purchasing, said Steve Hansen, chief of the Racine Fire Department. 

Equipment like defibrillators can cost as much as $55,000, Hansen said, nearly twice the price from six years ago. The price of supplies has doubled or tripled in roughly the same time frame. 

A third bill would give agencies a larger government reimbursement for 911 calls that don’t result in a patient transport. 

A lot of these calls are for “invalid assistance,” where the patient is not injured but may have no one else to call for help, Hansen said.

Joshua Weber, a division chief in Racine, said his agency has responded to more than 5,000 fire and EMS calls this year. Of those, more than 1,600 weren’t transported, and 11 repeat callers accounted for 212 of the total number. 

The Republican-sponsored bills have received Democratic support but have yet to get floor votes in either chamber of the state Legislature. 

Some agencies have begun to adapt. Others have simply closed. 

Lake Mills EMS is a case in point. 

A nonprofit service, Lake Mills EMS provided 911 coverage to about 10,000 people across multiple communities, according to its now defunct Facebook page. 

The nonprofit kept the cost to municipalities “arbitrarily low” for years, said Jim Colegrove, the service’s former vice president. But volunteerism “dropped off significantly,” and the nonprofit had to find ways to pay its staff. 

But the municipalities that supported the nonprofit were unwilling to bear increasing costs. And in 2023, it closed with a budget in the red. Now, a for-profit ambulance service covers most of the area at a cost much higher than what Lake Mills EMS had asked for, Colegrove said. 

“What I’m describing is the same thing that is happening around our state, especially up north,” Colegrove continued. 

Just a few miles to the northwest, Sun Prairie EMS has had to adapt to a rapidly growing population and a surge in call volume. It’s seen a 75% increase in 911 calls since 2018, the Wisconsin Policy Forum writes. 

Garrison, the fire and EMS chief, explained the agency is projected to respond to 6,300 calls in 2028, which is about a 26% increase from 2024. 

The “biggest issue” is the availability of volunteer and part-time staff, Garrison said. It’s a generational difference, he continued. Younger generations simply place a higher premium on work-life balance and family.

The job is demanding, intense and the schooling required for paramedics is “ridiculous,” he continued. “We see death every day. It’s hard on people.” 

Ideas exist to relieve some pressure. 

Some of them include charging repeat 911 users a “utilization fee,” promoting EMS as a profitable career with benefits and paying volunteers.

Paramedics with Racine’s fire department also make house calls to patients who recently suffered a stroke through its Mobile Integrated Health program. With additional funding, Weber would like to see the program serve residents who frequently call 911 as well as provide for non-emergency complaints relating to heart failure, COPD and diabetes. 

It’s an opportunity to provide care, educate the community on the proper use of emergency services and potentially reduce the number of 911 calls. 

As communities grow and change, so do the fire and EMS services,” said Weber. But whatever the case, “We are going to do the job, and we’re going to do it well.”

The Badger Project is a nonpartisan, citizen-supported journalism nonprofit in Wisconsin.

This article first appeared on The Badger Project and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.