Wis. considers regionalization to address first responder staffing shortages
The Dodge County Executive Committee understands the staffing need, but is still uncertain what the county’s role in the process should be
JUNEAU, Wis. — A long-term shortage of emergency medical service, and eventually firefighter, volunteers will severely impact Dodge County municipalities both large and small in coming years, according to county officials.
And while mutual aid can help minimize the impacts of that shortage, fire and EMS organizations have been preparing for the future. Dodge County Emergency Government is the most likely organization to take the lead in that planning, according to its director Amy Nehls.
Nehls said Dodge County has 23 services that provide emergency medical services. Some have emergency medical – or first – responders, without ambulance or transport. Those areas contract with communities that have emergency medical service and ambulances. Two fire-based services (in Watertown and Beaver Dam) have trained paramedics, which is the highest level of service. There also are private ambulance services which provide paramedic service.
“Eighty-seven percent of Dodge County units are volunteer-based,” said Nehls. “In other words, this is not their full-time job. This is what they do to help their community.”
The limits of volunteer staffing first appeared in Lebanon, where a proud and accomplished service of many years had trouble filling its roster. They started talking to the emergency government office, which helped them to redesign their response protocols.
“When the system was designed in the 1970s people lived and worked in their communities,” Nehls said. “A lot of employers let their employees leave work to respond to fire and EMS calls. The reality of modern living has changed, but the structure of how we provide EMS services has not.”
Smaller agencies often partner with larger ones, and pay a fee for the additional services needed.
“Many agencies are struggling to find volunteers and to keep staffing their services,” Nehls said. “The bottom line is that you’re going to have to start paying people to fill these positions.”
A work group was formed to address the problem, and one of the biggest challenges is finding the funds to pay for needed services while remaining within prescribed tax levy limits.
Further meetings were held, with no clear model for how to progress.
“Wisconsin is home rule, so if you look at 72 different counties you’ll find at least 72 different ways to do it,” said Nehls. “Some leave it at the municipal level. Some are county run. Some are regionalized. It can be any way people can think of.”
The EMS work group, involving many of the county’s municipalities and townships, asked if the county might request an outside study looking at how things are currently done (both in Dodge County and elsewhere), and to make recommendations for change.
“It may be 10 years down the line before we adopt a new system, but we also want to know what we can do in between to get to a sustainable model,” said Nehls. “We’re hoping for a three- to five-year, and a five- to 10-year outlook.”
All this may seem far-fetched to the average citizen, or even a recipient of the services provided.
“Our communities, even our citizens, don’t know where that ambulance, police or fire truck is coming from,” said Nehls. “They don’t care what color it is or where it’s coming from. They just want it there. In their greatest time of need they just want someone to show up.”
According to Nehls, the Dodge County Executive Committee understands the need, but is still uncertain what the county’s role in the process should be. As the county provides centralized dispatch, that might dictate the county’s role in leading the process.
“Every call from every municipality comes here already,” said Nehls. “Our dispatchers know to send the closest resource – but if there isn’t a resource who do they send next? If one piece in the system is taxed, so are all the others.”
Law enforcement often responds, but that may not be the best use of the resources available.
The county is considering hiring a consultant to propose needed changes and updates. That proposal can be used not only by the county, but also by the municipalities and townships as they respond to the challenges ahead.
Fire protection is perhaps farther away than EMS response, largely due to demand.
“We used to get more fire calls than EMS calls, but that has flipped over the years,” Nehls said. “We’re starting with EMS, but probably within the next 10 years the same discussion will be held regarding fire protection.”
Work to determine the next step is ongoing, with the Dodge County Executive Board hoping to get more cost figures before proceeding. Beaver Dam and Watertown are already in the midst of conducting studies to see what their specific future needs will be.
“The idea of regionalization is not just local, but one that is being felt all across the United States,” said Nehls. “It’s finally gotten to the point where all of us are seeing that we cannot sustain our current model, and that we have to look at what’s best for the future.”