By Audrey Korte
The Chippewa Herald
CHIPPEWA COUNTY, Wis. — Staffing for local ambulance services is approaching a crisis level across Wisconsin, and Chippewa County is no exception. First responders, legislators, health officials and municipal leaders are trying to decide what to do about it.
Over half of the EMS agencies in Chippewa County report they are “concerned they’ll be unable to staff their response by next year,” according to data gathered by UW-Madison Extension researcher and community and leadership development educator Garret Zastoupil.
In Chippewa County, 62% of volunteer-based EMS and 16% of paid EMS services are operating with six or less staffers. Researchers say this is a big concern for the future of such services.
Departments with fewer than seven full-time staffers are “at risk of failing,” according to James Small, the Wisconsin Office of Rural Health’s EMS outreach manager.
What puts an agency at risk of failing is the number of people doing 80% of the calls, Zastoupil said. If the number is too low, there is nobody to step in if something goes wrong, like if someone gets sick or injured.
‘Imminent issues’
Some departments have enough workers, but the bulk of the work is done by a handful of people. This might be because some workers are paid and others are volunteers or any number of other reasons.
“We’re looking at Cornell, which has an active roster of 11. Three people are doing 80% of the calls. Cadott has a roster of 20 people but three people are doing 80% of the calls. In Boyd , six people are doing 80% of the calls with a roster of 26,” Zastoupil said.
Two transporting agencies in the county are dependent on three volunteers. Three non-transporting agencies are dependent upon three volunteers as well.
“This is very predictive, I think, of either current or future reliability issues,” Small said. “Like, imminent issues.”
On Wednesday, about 75 people attended the Chippewa County EMS Association meeting at Cadott High School.
It was an opportunity to share feedback on a local survey of EMS availability, to listen to local EMS agencies’ concerns and hear about statewide approaches to such issues.
Before any sweeping decisions are made, local departments need to know where they stand.
A variety of organizations have collaborated to assess their capabilities to determine what is needed to keep ambulance services and emergency response functioning.
Marcy Trubshaw works in the sheriff’s office in the Division of Emergency Management. She helped coordinate the meeting, alongside the UW-Madison Extension Office.
“Tonight we’re talking about strengthening EMS in the county, where it’s at now, and what our status is, and strengthening it. We’re talking about options,” Trubshaw said. “The money part can come later.”
Chippewa County EMS survey
In collaboration with the county administrator’s office, local EMS officials and UW-Madison Extension, a survey was distributed in November to all county EMS services to better understand current challenges and long-term issues.
It was sent to all transporting and non-transporting EMS agencies.
More than half of the EMS and emergency medical responders reported they are “concerned they’ll be unable to staff their response by next year,” Small said.
“While Chippewa County’s urban areas benefit from professional EMS services and rural regions rely on committed volunteers, data suggests that ensuring sustainable emergency medical coverage for all residents may require new partnerships and innovative solutions,” Zastoupil told The Chippewa Herald.
Chippewa County EMS Agencies
TRANSPORTING
Paramedic
- Chippewa Falls Ambulance
- Chippewa Fire District Ambulance
EMT
- Bloomer Ambulance
- Boyd -Edson-Delmar Ambulance
- Cadott Community Ambulance
- Cornell Rescue Squad
NONTRANSPORTING
- Anson First Responders
- Bloomer Area First Responders
- Eagle Point Fire Dept . First Responders
- New Auburn Area Fire Department First Responders
- Stanley Fire Department
- Tilden Fire Department First Responders
- Wheaton Fire & Rescue
- Eau Claire Fire and Rusk County also serve portions of Chippewa County.
First responders in the county respond to 13,500 calls a year in which people in need are transported to hospitals or other facilities.
Another 1,200 calls are answered each year by non-transporting agencies, according to Zastoupil.
“We see that some organizations are responding to over 1,000 calls in a given year. We know that about half our organizations are responding to 500 to 1,000 calls, and then fewer than that are responding to under 500 for our ambulance services, for EMR,” he said.
Most non-transporting departments respond to fewer than 500 calls per year.
More calls, fewer resources
Ron Patten is fire chief and EMS director of the Boyd-Edson-Delmar Fire District , and he’s the county coroner. He’s also president of the county’s EMS Association .
On Wednesday, Patten told the association that he and his colleagues have been discussing transportation and the lack of coverage for area municipalities for about two years.
He said a lack of funding for staff, equipment and ambulances is difficult particularly for towns and rural areas. Increased calls are also a problem and they continue to rise each year.
“When I started as ambulance director in Boyd 15 years ago, we had about 330 calls a year, and we were doing transfers at that time. Now we don’t do any transfers. In 2024 we did none. Paramedic services did them. We’re still at 744 calls for the year,” he said. “I’m the only full-time employee there. So obviously, with all the extra work, the volunteers have to take on a lot of it, and we do appreciate them a lot.”
Last year, Patten said he and other association members decided it was time to get the public involved, to gather input and “see what we do, if we do anything.”
He said calls are getting answered, but his department is just doing mutual aid.
“If some services can’t make the call, the next one does, or maybe two services don’t make the call, and it gets done, but a lot of times, people have to wait an extended length of time for an ambulance to get there,” he said.
Joni Gilles, EMS trauma injury prevention coordinator for Mayo Clinic Health System, said the HSHS St. Joseph and HSHS Sacred Heart Hospital closures in March 2024 are complicating an already burdened system.
“EMS have longer transport times. Chippewa, we love seeing you guys, but I’m so sorry it takes you so long to get back and forth,” Gilles said.
She said Mayo is working to make sure it is able to quickly relieve paramedics of patients they are dropping off, “but we are busy.”
Ashley Carothers with the state EMS Association told the crowd Wednesday that the worst-case scenario is the loss of 911 medical response.
“There is no law that directly states that when you call 9-1-1 for medical response that they must show up. If your local EMS service closes, your residents will be left without 911 medical response. Relying on your neighboring EMS service for mutual aid is not a viable long-term option.”
‘Risk of failing’
Small said it takes 7.5 full-time equivalent positions to staff a single ambulance 24 hours a day, 365 days per year.
“Sixty-two percent of your volunteers and 16% of your paid services were operating at six or less,” Small said. “There’s a very significant connection between having six or less people doing most of the work because there’s no margin (for error)… When you’re using six or less people to do that, you’re four times more likely to have reliability issues.”
Small is concerned about a small percentage of responders doing the bulk of the calls in Chippewa County. But, he said, that is fast becoming the norm.
“We found that 21% of the services overall in the state had two to three people doing 80% of the work. And then the next 20% were four to six people,” he said.
Small’s 2023 The Reliability of Wisconsin’s 911 Ambulance Response report highlighted several key issues, including that EMS reliability is a statewide issue, EMS agencies are struggling to consistently staff services and that EMS agencies lack the financial resources to sustain their organizations.
He said when talking about if a service is at risk of failing or currently failing, he’s looking at reliability and how many times an ambulance did not go out in the last year.
”That number has to be zero. That’s what you’ve signed up for with a provider license. That number needs to be zero,” he said.
“Looking at sustainability, getting back to the 80% matrix, if that number (of employees) is less than seven, that’s at risk of failing,” he said. “In most cases, there’s not a whole lot of services that are doing great.”
Small said that is not a commentary on those doing the work.
“I want to make a very strong distinction, and that’s not passing judgment on the people doing the calls,” Small said. “They are not failures. In most cases, there’s three or four people who are doing everything possible in their lives to make sure those wheels keep turning.
“A lot of times, when you start working on these projects, the municipal leaders will blame those people for it. Those people aren’t the problem. These people are going to the end of the Earth to try to make sure that this is working, and it just can’t anymore.”
County Administrator Randy Scholz brought the issue up to the Chippewa County Board of Supervisors on Nov. 26 . He also spoke at the meeting Wednesday.
“The challenges associated with EMS services is something all counties in the state of Wisconsin are struggling with. The Wisconsin Counties Association has been working with legislators on this issue,” his memo stated.
Scholz said Wednesday that his office “met with the EMS group earlier this year“ and told them “the county is here to help in any way we can.”
But he said he does not think the county “really wants to take on the EMS services.”
The way EMS services are handled vary from county to county.
One of the main challenges is how to fund the services, Scholz said.
“Municipalities are not allowed to tax outside of their levy limits for these services, but counties can. Ideally, it would be helpful if legislation was passed to allow municipalities to tax outside of their levy limits. That would provide a much more sustainable solution,” Scholz stated.
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