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Ambulance service facing rough road

Ambulance service facing rough road Ambulance service facing rough road

The ball is in the court of former ambulance crew members in Western Taylor County about if they want to come back and serve their communities as oncall ambulance staff.

That was the message from ambulance service regional director Bob Kirkley who was formally appointed as the county’s ambulance services director at the January 13 Taylor County Law Enforcement and Emergency Services Committee replacing John Deal in that position. In addition to working directly with Taylor County, Kirkley oversees other regional directors including their helicopter units.

He said the goal in the future would be to have more of a working supervisor in place in the county who will eventually take the place of a local manager.

“There is a lot of turbulence in the department right now,” Kirkley said, explaining that his immediate goal is to address those concerns and move forward with maintaining coverage as specified under state guidelines.

Committee chairman Lester Lewis notified committee members that a formal complaint had been filed with the state Department of Health Services over staffing issues alleging that staffing was inadequate at times.

“We have maintained and always maintained coverage within state guidelines,” Kirkley said responding to questions on the complaint.

He said they have been dealing re- See AMBULANCE on page 4 cently with people calling out sick from shifts and said that when there is a shortage in one area, his first step is to take the inter-facility transport truck out of service and shift those personnel to other areas as needed to maintain adequate emergency response staffing.

According to Kirkley, Taylor County, like many other rural areas across the country, are facing a shortage of people willing to take on-call emergency medical services spots.

“We are dealing with a lot of on-call staffing issues,” he said, noting that one of the biggest barriers has been that you cannot make a living being on-call. These individuals are largely volunteers who have other jobs and other commitments and who can’t always be available to cover shifts. When there are not enough on-call personnel, he said they have to bring in full-time crew members who are paid at a premium rate to cover these shifts in addition to their regular shifts. The result of this is additional cost to the Ambulance Service and to the county taxpayers.

Committee member Lori Floyd raised concerns that she has heard from former ambulance crew members particularly in Western Taylor County who said they were let go for refusing to get COVID-19 vaccines. She suggested the lack of volunteers in the Gilman area was due to that mandate.

Kirkley explained that while the vaccine requirement is still in place, there are exemptions for religious and medical reasons that are easy to get and that he would be happy to work with anyone interested in order to help them get them.

“It was their decision to leave,” Kirkley said of the on-call individuals who left the ambulance service.

Floyd then asked if Kirkley felt the county needed 12 full time EMS positions working here. “I don’t think that is the best way to run the system,” Kirkley responded saying he has a different opinion on staffing than his predecessor.

One of the challenges is that the Medford area has a much higher number of total calls than the bases in Gilman and Rib Lake do. He noted that there may be two to three calls a week in Gilman. However, he said it is necessary to have a crew based in Gilman because of the distances and time involved.

“It makes more sense to have a truck in Gilman for better response times,” Kirkley said. He said his preference is that when staffing is needed elsewhere he would not keep two trucks in Medford but instead have them work to cover other areas that are further away from the hospital.

“I am trying to maximize coverage,” Kirkley said, Floyd also raised questions about why the service was combined from three locations into a single license. Kirkley and Lewis explained this was done because the county was in danger of losing the licenses to run services from Gilman and Rib Lake due to staffing. By having all three bases under the same license it is easier to shift staff to cover shortfalls in other areas as needed.

“We were in danger of falling below that,” Lewis said. As far as bringing people who have left the service particularly in the Gilman area back, Kirkley said that to his knowledge there have not been any who have applied for the open positions stating he would assist them through the process to get them on board.

“I don’t think we need 12 full time people,” Floyd said, noting the cost of the service went up $300,000 last year.

“Do you want the service or do you want the cost?” Kirkley said, noting that the industry average is $500,000 in expense for every ambulance in operation. For the four ambulances in the county’s system the expected operational cost is about $1.5 million. “That is the baseline,” he said the option is to provide those services or shut down bases.

“We don’t need 24-hour service in Gilman or Rib Lake,” Floyd said.

Lewis clarified they do need full time service over all the days of the week, but that they may not need fulltime staff to cover those hours. What is not covered by full-time staff is covered by on-call personnel.

Lewis noted that the Gilman area in particular had some great volunteers who worked with the ambulance service, but he said many of them have aged out of the system and that the problem is nobody had come up to replace them.

Lewis said more needed to be done with recruitment to encourage people, even at the high school age, to get their certifications and become part of the ambulance service.

Kirkley noted that even for those on the service, it is a challenge to get some to take shifts. “We have staff members who haven’t picked up a shift in three months,” he said.

“You either want to work or you don’t,” he said. Floyd questioned why Aspirus was pushing to have people who were drivers in the past to get their full EMT license. Kirkley explained that under state rules they need a set number of licensed people to make a call. Having someone who is only a driver requires them to get another person on-call to fill the necessary number of EMT spots.

“We have to have a standard where we have to be able to transport a patient,” Kirkley said.

Floyd said she felt people were out there who would want to come back to being in the ambulance service. “I think they are out there,” she said.

“If they want to apply, get me their names and I will get them through the process,” Kirkley said.

Committee member Ray Soper also said he has heard complaints about the ambulance services. He said “far and away” the biggest area he hears complaints about is with the ambulance service whenever he is out in the public.

“There seems to be a great diversity in what the community thinks is happening and what is happening,” Soper said.

Kirkley invited Soper to give people who complain his contact information and have them get in touch with him so that he will know what the concerns are and get them addressed. He also noted they have an online anonymous reporting system within Aspirus that people can use to share concerns.

Soper said one of the biggest misunderstandings in the general public is the idea that if people “quit over not getting the jab they are not welcome in the system and you are saying that is not true.”

Kirkley said within his department they have had four people come back and get reemployed. “They are welcome back,” Kirkley said.

“We need a better way of communicating this with people,” Soper said.

Committee members then raised questions about being able to have access to financial information and billing so that they can have an idea of what the actual costs are through the year rather than just the summary given as part of the annual subsidy request.

“We want to know what the actual cost is, the actual billing is versus what was billed and what as received,” Lewis said.

While at the meeting, Kirkley called up the financial data from December for the department as far as cost of things like wages, fuel and other expenses and the amount billed out and reimbursed. He said he would be able to get that information to the committee on a monthly basis.

Committee members circled back to calling for more recruitment efforts to be done addressing the primary concern of not having enough on-call crew members.

In other business, committee members:

  Received an update from emergency management coordinator Daniel Gellert who reported local governments were approaching $200,000 in damages from last month’s ice and snow storm which took down many trees and blocked roads around the county. He said he was working with municipalities to compile the costs to submit to the state in the hope of getting Wisconsin Disaster Fund money to help cover up to 75% of the costs.

  Approved asking for the county board chairman to create a subcommittee and appoint members to it for the purpose of reviewing the needs for the emergency operations center (EOC). The current EOC is a cart of materials in the corner of the sheriff’s department training room. Gellert asked for the committee to be formed to look at what was needed so that it wasn’t just him coming in continually asking for things.

  Took no action on a request to assign a policy squad vehicle leaving service to be used as a vehicle for the emergency management department instead of having the coordinator use his own or a county pool vehicle. Gellert explained this would allow him to keep everything in place when responding to an emergency or doing follow up. Committee members called for more research to be done about cost going forward.

  Approved allowing the sheriff to hire a second individual as part of the current hiring in anticipation of an upcoming jail vacancy instead of waiting and doing a separate hiring at that time.

  Approved changes to the base job descriptions for deputies to bring the language up to date and in the same format as other county job descriptions.