Report: EMS operations across the state struggle with costs, personnel

Wisconsin’s emergency medical services agencies are battling a shrinking pool of potential employees and volunteers as they face growing fiscal strains, a report released Wednesday finds.

The Wisconsin Policy Forum, which issued the report, suggests that local EMS departments may need to consolidate in order to address the challenges they face. It also concludes state policymakers may need to intervene to provide added support.

Shortages of EMS personnel, particularly in rural areas, have prompted two pieces of proposed legislation early in the Legislature’s 2021-2022 session, but EMS professional groups opposed both of them.

One bill, which would relax some of the requirements for certification as a first responder, passed the state Senate in April, although at a public hearing a majority of witnesses opposed it. A second bill, which would lower staffing requirements, received a mixed response in an Assembly public hearing and later passed out of committee on a divided vote. Neither bill has advanced since the spring.

For its report, the Policy Forum drew on information that it has collected over the last eight years covering 30 fire and EMS providers. The research was part of a dozen service sharing studies the organization conducted, primarily in southeast and south central Wisconsin as well as La Cross County in the western part of the state.

EMS and fire services “are among the most essential and costly [services] that local governments deliver,” the report states — putting taxpayers at risk for financial expense and people who need emergency services at “the even more sobering risk of a response that is slow and unsuccessful.”

The report observes that “many fire and EMS agencies are finding it harder to operate each year due to increasing service calls from an aging population and staff recruitment and retention difficulties.” At the same time, it adds, “Lagging state aid and state-imposed limits on local property taxes often compound the problem, creating a difficult road ahead for many local governments throughout Wisconsin.”

The report highlights more consolidation among EMS agencies as a potential response to the problems that beset them. But it also acknowledges that “implementing such an option is almost always much harder than it looks.” The resulting savings may take a long time to achieve, and consolidation often has to overcome resistance in the communities that it would affect.

Other possible responses that the report lists include direct grants or loans from the state to cover education and licensing for fire and EMS personnel; allowing part-time fire and EMS personnel to enroll in the health care and retirement plans for state employees; increasing Medicaid reimbursement for ambulance transports to the amount provided by Medicare; relaxing revenue and expenditure limits for local governments that are trying to bolster their fire and EMS operations; giving counties or regional groups a role in governing and setting standards for EMS and fire protection agencies, accompanied by state aid so they can monitor and meet standards.