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STEVENS POINT, Wis. — Consolidation of emergency medical services is becoming an increasingly necessary solution for many rural areas struggling with declining volunteerism, increasing costs and increased response times.

The Northwoods EMS District, formed by four towns in Vilas County, Wisconsin – Boulder Junction, Presque Isle, Winchester and Manitowish Waters – is a case study for EMS leaders and local government officials. A recent panel discussion at the conference highlighted the district’s formation process, challenges faced and key takeaways for other municipalities considering similar consolidation efforts.

Identifying the need for consolidation

Rural EMS services across the country are facing declining numbers of volunteers and overworked personnel. In far northern Wisconsin, like many rural locations, response times were often non-compliant with state regulations, some stretching to 90 minutes or more. The four towns involved recognized the need for change after community feedback revealed that two-thirds of residents were dissatisfied with current EMS service levels. As a result, local government officials began exploring consolidation as a means of improving service reliability and sustainability.

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Hiring a consultant to guide the process

John Hanson, chairman of the Town of Manitowish Waters, along with the leaders from the other towns, decided to hire Dana Sechler, an experienced EMS leader and consultant. The towns also received data and technical assistance from the .

Sechler’s experience in system design played a crucial role in guiding the towns through the consolidation process. He gathered and analyzed data from the participating agencies and identified critical issues, such as the inefficient deployment of EMS personnel and the fragmentation of services.

Some important data informed the town stakeholders and elected officials:

• Response time averaged mid-30 minutes, with some outlying times of 90 minutes or more.
• Eighteen volunteers completed all the responses between 4 services in the past year. Even though 64 total people were rostered, only 32 people responded to calls, because many of those people belonged to multiple services.
• The four towns ambulance services responded to 600 calls collectively, but because of multiple dispatch requests for an ambulance, there were really 376 individual 911 calls.
• All four services failed to provide continuous service during the year.

A year-long study resulted in a 70-page report, providing actionable recommendations to the towns. Sechler’s objective was to offer data-driven solutions while acknowledging the passion and dedication of existing EMS providers.

Steps toward consolidation

The study revealed stark realities – volunteer burnout, long response times and fragmented services, while also confirming that the existing services were on the path from failing to failed. The four towns took the following steps to create the Northwoods EMS District:

1. Public engagement. Each town held informational meetings and public hearings. After presenting the consultant’s findings, the town boards passed resolutions to officially create the Northwoods EMS District by the end of 2023.
2. Shared funding. The total cost of creating the district was $400,000, distributed equally across the four towns. A tax levy based on assessed property value per $100,000 provides permanent funding for the Northwoods EMS District. The final levy is being finalized and will soon be approved by each town’s board.
3. Leadership recruitment. One of the district’s first tasks was recruiting key personnel. Jason Joling was hired as EMS chief, with Jesse Mabie serving as deputy chief. Both are tasked with administrative responsibilities to the launch the district. Once the service is operational both will be expected to also respond to some 911 calls.

Initial challenges and key successes

Joling explained that forming a new EMS district is not without challenges. The district lacks a mission, motto or patch. The district also needs to obtain vehicles, equipment and hire staff. They’ve made progress toward staffing two 24/7 ambulance stations, including:

• Staffing plan. The Northwoods EMS District will operate two paramedic-EMT ambulances 24/7/365, responding from two stations. The district needs to fund 35,000 hours of coverage annually.
• Salaries and benefits. To attract and retain full-time staff, the district is budgeting $18/hour for EMTs and $25/hour for paramedics, along with benefits such as participation in the Wisconsin Retirement System and health insurance.
• Community presence. While the Northwoods EMS District will eventually handle all transports, the four towns will maintain an emergency medical responder (EMR) presence to serve as first responders. The district hopes to train and cross-credential the EMRs for future roles within the consolidated system.

Conclusion

The Northwoods EMS District is a testament to the importance of proactive leadership, community engagement and expert guidance in navigating the complex process of EMS consolidation. For other rural communities facing similar challenges, consolidation may be the key to building a more resilient and effective EMS system.

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