County committee OKs critical coverage pay to get EMT coverage
Taylor County will get its ambulance shifts covered, but it will come at a premium cost to area taxpayers.
At the March 10, law enforcement and emergency services committee, members voted to give ambulance administrator Bob Kirkley the authority to fill ambulance shifts under critical care coverage levels. This carries with it a much higher rate of pay for the ambulance crew members to serve as an incentive to take shifts.
Committee chairman Lester Lewis noted that this is a short-term solution.
“This is not the answer to the problem,” Lewis said, noting that long term they need more people willing to come forward and become paid on call volunteers and expressing concern that it could lead to faster burn out for people taking the shifts.
Kirkley agreed saying they would be continuing with recruitment to try and get more staff. He noted they have an interview scheduled for someone who lives in the Gilman area.
Committee member Chuck Zenner See COUNTY on page 4 raised concerns about the cost. “I agree it shouldn’t be about the money,” he said, however he noted the county was already in the process of looking at ways to trim the overall county budget by $500,000. “Where will you get the money from?” he said.
Under the contract with the county, in addition to paying for the ambulances, the county covers 45% of the total cost of the service after revenues are taken out.
Lewis said this goes to the county tax rolls and is not part of the county’s state-imposed budget caps. The county has already seen a large increase in the subsidy paid for the ambulance service in recent years. In 2022, the subsidy was $397,000 and the subsidy approved for payment at Friday’s meeting was $643,835. The increase was due to the county authorizing Aspirus to hire additional full-time ambulance crew members to cover shifts last year. The critical care coverage of shifts approved at Friday’s meeting could make the subsidy for 2024 potentially much higher.
The action came after a lengthy discussion with members of the Gilman community renewing concerns about lack of coverage in the area including a recent incident in which they said delays in response from crews resulted in the death of a local resident.
Gilman resident Derrick Romig spoke to committee members saying he was expressing the view of community residents who are upset about the ambulance staffing.
Romig, who also serves as the assistant fire chief in Gilman, said Gilman was paged out for an ambulance call recently only to have dispatch be informed there was no one available and have Medford dispatched. Romig objected to having to wait for the ambulance to arrive from Medford rather than immediately calling out a crew from Thorp or Cornell.
“Why are we playing politics with patient care?” Romig asked.
“My friend ended up dying because of politics Aspirus is playing,” Romig said, of another call where there was no coverage in Gilman and Medford was called out. He said the call came out that someone was having a hard time breathing and then came back that the individual had called with chest pain and finally was a “pulseless non-breather.”
“If we would have had staffing we would have saved that man,” Romig said, questioning why the Medevac unit had not been pulled to be in Gilman if it was known there would not be coverage in that area that day.
“Give the Gilman community a fighting chance,” Romig said, reading from a letter from a local resident, stating that it is faster to load someone to meet the ambulance than it is to wait for an ambulance to arrive.
“Why is Medford coming where we have closer entities?” Romig asked. He said he timed it from other nearby ambulance services saying from Cornell, Gilman is 16 minutes. From Thorp to Gilman is 17 minutes. From Sheldon to Gilman is 19 minutes. He said this compares to 36 minutes from Medford.
Kirkley responded that while those travel times are accurate, ambulances in those other communities are staffed with on-call EMTs and there would be additional time for them to travel from their homes to get the ambulance before they could go to a response scene.
By comparison, the Medford crew is full-time at the ambulance garage and able to respond immediately. Kirkley said that in the specific instance Romig cites, the first page came at 8:03 a.m. At 8:08 a.m. the Medford crew was on its way to Gilman. They arrived at 8:34 a.m. and left the scene at 9:13 a.m. He said the advanced life support team was also dispatched leaving Medford at 8:12 a.m. and paramedic care was at the scene at 8:42 a.m. that day and was there until 9:14 a.m.
He said the reason there hadn’t been coverage in Gilman that day was because the EMT who had been covering most shifts there was in a training in Wausau that day and that the call came relatively early in the shift when the crew which would have been moved to Gilman was completing tasks in Medford.
While recognizing that it is a tragedy that the individual died, Kirkley defended the crew members noting that while there have been a lot of complaints there are also a lot of positive changes in the Gilman base and other areas that have occurred including working to bring people back who have left the services.
“We can’t beg people to come back or force them to come back,” he said.
He said it is up to the committee to decide what level of staffing is acceptable and at what expense.
“What is the level of response we want in Gilman? Do we want to have full-time staffing? The more staffing you have, the more it is going to cost,” Kirkley said.
He said they are working to fill the spots and have multiple staff members working 96 hours per work. He said this is not physically possible for people to continue for extended time. He expressed concern that if they burned out the person they have who is taking most of the shifts, they will be left with his holes.
“If we had staff we would put them there,” Kirkley said.
“We have known for a long time that we have had a problem across the county with the ambulance,” Lewis said, noting that the issue is driven by not having people willing to take shifts and that it is not only a problem in Taylor County but a problem nationally in rural communities.
Lewis praised the past volunteers who worked on ambulance crews, saying they cannot be thanked enough. However he said that for whatever reason they are not getting the volunteers. “This isn’t a local phenomena, this is nationwide,” he said.
“We are kind of screwed,” Romig said, noting that Gilman is a bedroom community that has people in ages of 47-50, who are not likely to want to respond to ambulance calls. “We don’t have a lot of young people in the Gilman area,” he said.
“We haven’t got enough people,” Lewis said, citing that as one of the major problems.
Romig said that members of the fire department had talked about going through emergency responder training in order to at least be able to offer some level of care when on a scene. However, he said that they are not going to go through until the COVID vaccination mandates are lifted. He referenced a recent editorial in The Star News which stated waivers were easy to get, noting that his waiver request on religious grounds had been denied describing it as being a “kick in the nuts.”
“As soon as the religious exemptions get easier to get I will go through with the training,” Romig said.
“Our citizens deserve better than what they are getting,” said Lynn Rosemeyer, who represents the area on the county board. “You need to figure this out,” she said to the committee.
Those at the meeting discussed if an automated external defibrillator was available. While there are a number in the village, the Gilman police officer does not have one in his squad car. Sheriff Larry Woebbeking noted that all the county squads have them and that in this instance the Gilman police officer had called for a county squad to bring one, but it was not in a position to get there in time.
Committee member Lori Floyd referenced the county’s contract with Aspirus to operate the ambulance service saying it says that Aspirus shall provide coverage. She also said she felt the county made a mistake when allowing the licensing agreements to go for Rib Lake and Gilman as separate licenses noting that legally now they only need to have an ambulance in Medford.
Kirkley said they would be able to fill shifts under the critical service designation, but cautioned committee members that would come with a cost. He said they needed to be aware of this so that they can’t come back and say the service is spending too much in its budget. He estimated that the additional cost could be about $1,100 per week per EMT.
Romig said that if Taylor County has to raise their taxes a little due to having to pay a little more he would be OK with that. “I would fork that money out right now,” he said, noting his father and grandfather aren’t getting any younger and the service is needed.
“This is not a problem you can solve by throwing money at it,” Lewis said, noting it takes having people willing to be volunteers and to take shifts.
Woebbeking asked if it would help to have sheriff’s deputies get additional first responder training. Often the deputies are the first one on calls and could begin providing care.
“They could fill in the gap until when an ambulance gets there,” Zenner said.
Lewis said that while it was a great idea it does not solve the problem of not having people to be EMTs.
Kirkley said he would be willing to provide training to deputies, which while they would not get certification they could have training to help.
Floyd asked about the possibility of the fire department taking over the ambulance in the Gilman area. “We wouldn’t be able to afford it,” Romig said, noting that they don’t have the staff to outfit the ambulance either.
In approving to fill spots on a critical care level, committee members also directed that Kirkley work to immediately establish coverage agreements with neighboring ambulance services so that if there was a gap, it would be covered. These agreements already must be in place by June under state rules, but the committee’s action was to send a message that they want them in place as soon as possible.
In other business, committee members rejected a request from the emergency management coordinator Daniel Gellert for his department to purchase a used sheriff’s department squad for his dedicated use. Gellert currently either uses his personal vehicle and gets reimbursed for mileage or uses a shared county vehicle. He said they could make the purchase without having an impact on the department budget. Zenner said he was hesitant doing it because while the increase would not be there the first year, it would come down the road. Floyd agreed and said that the mileage being driven by Gellert did not justify having a dedicated vehicle.