County sees shift in ambulance staff

Taylor County may see a shift toward more full-time ambulance staff rather than on-call emergency medical technicians and drivers.

Jason Keffeler, system director for Aspirus MedEvac and Taylor County EMS Manager John Deal cautioned members of the Taylor County Law Enforcement committee at their meeting on December 10 that a change would be needed to provide adequate staffing coverage with the reduced number of EMTs.

Ambulance services in Taylor County are run through an agreement between the county and Aspirus. The county owns the ambulances and provides an annual subsidy for the service, but the service is operated and staffed by Aspirus.

Keffeler reported to committee members that through the Aspirus system’s acquiring Ascension and facilities in the region, there has been an increase of efficiencies in providing emergency services with both ground and air units. He said he sees further efficiencies being developed in the future.

When it comes to Taylor County, Deal explained the current model has relatively few career staff with the bulk of the emergency medical services (EMS) being covered by volunteers who are paid a stipend for their on-call hours. He said the EMS personnel had dropped from 60 to being currently at 44. Deal said this has been due to a number of factors including age, physical ability, fatigue due to the ongoing pandemic, and concerns over the COVID mandates on healthcare providers. It was also noted that a few of those who left were on the rolls, but had not taken any shifts in some time.

“We are looking at where we are and what we are doing,” Deal said, noting that while they officially have 4.6 full-time employees for ambulance services, the department is closer to being 9.28 full-time equivalent (FTE) positions with the additional hours being put on EMS.

Deal said, they would be looking in the future to offi cially adding 3.8 FTEs to what is currently authorized to ensure coverage in rural areas of the county during peak times. He noted that the bulk of the hours would still be covered by volunteers.

Deal said they would look at shifting some of the paid on-call wages to the career wages area to lessen the impact to the county. Deal reviewed the call volumes noting that they are continuing to increase. In addition, with hospital beds in short supply due to COVID-19 related admissions, transports are having to go farther to get patients care. Through early December, there have been 1,221 calls for ambulance services in the county in 2021. Those numbers are expected to increase.

Committee member Ray Soper raised concern about the EMS losing 25% of its staffing since the beginning of November. He questioned how many were due to the federal COVID mandates.

Deal said that four of the 16 people cited that as the specific reason. Others he said didn’t have time for it or were aging out of doing it. Deal said many of those who left the ambulance service were in the mid 60s to early 70s and were looking to have more free time to do other things.

“They didn’t want to be in health care anymore and walked away,” Deal said, noting that an area of concern is with the declining number of younger people coming into the field. He said programs at the technical colleges don’t have the same numbers of students as when he previously taught at Chippewa Valley Technical College.

Soper further questioned the impact of the COVID-19 mandates and where they were coming from. He cited the court recent decisions that put a pause on some of the federal mandates for private employers.

Keffeler explained that over 70% of patients at Aspirus are on Medicare or Medicaid requiring them to follow federal rules that are imposed or jeopardize funding. He noted that Aspirus has been working to meet the federal requirements including vaccination opt-out processes.

Committee chairman Lester Lewis said that while COVID has affected the numbers, it is not the only reason people have left the ambulance services. He noted that with the shortage in workers, many private sector employers are not allowing workers to respond during their work days. “There are some places of employment that won’t allow them to leave for ambulance or fire calls,” Lewis said.

Committee member Scott Mildbrand questioned if there was a shift to more full time employees, if the existing paid-on-call crew members would feel slighted or that they are getting worse shifts.

Deal said at this point, many of the crew would just enjoy having a break from needing to be available to respond at all times. Deal and Keffeler said they would be bringing a formal request to the committee for the additional FTE positions to a future committee meeting.

In other ambulance business, committee members approved starting the process to purchase a new ambulance to replace one purchased in 2009. The projected price for the new ambulance is $255,000 with delivery expected in December 2022.

The new ambulance will likely have a truck chassis versus a van chassis. Keffeler explained that the vanbased ambulances are virtually impossible to find as the industry has largely shifted to the truck chassis.

County finance director Larry Brandl explained the county typically looks to replace an ambulance after seven to 10 years of services. “You don’t want to let the fleet get old,” he said, noting this is the right time frame for the replacement of the ambulance.

It was noted that in the past, six months from when an ambulance is ordered to delivery was normal, but that now 12 months may be optimistic. According to Brandl, the ambulances are purchased up-front by the county and then depreciated out over a period of time with the hospital charged with the depreciation as an operational cost of the system.

“I think that ambulance response is one of the things that people pay taxes for,” Mildbrand said in support of starting the process to seek bids for a replacement ambulance.

In other business, committee members:

_ Received an update on COVID-related grant funding from the Emergency Management Director Colleen Handrick. She noted the state has questioned some of the grant reimbursement requests for items including a new webcam for the court system. She continues to work with the state for the funding.

_ Received notification that there will be an intruder drill at Gilman Schools in the next two weeks in cooperation with emergency government and the Taylor County Sheriff’s department. “What provisions are being made for the type of drill so that it isn’t overly traumatic for some students?” Soper asked.

Handrick said they would tailor it to be appropriate to the age of the students and would be working with teachers in an individual setting.