Strained Budgets, Dwindling Volunteers Pose Challenges For Rural First Responders

Communities, EMS Personnel Seek More Sustainable Model

Danielle Kaeding/WPR

In rural Wisconsin, friends and neighbors often volunteer their time to provide life-saving care to people in their time of need. But some emergency medical services are seeing fewer volunteers and communities are struggling to come up with the money to provide care.

In some areas, residents are served by a hybrid system of professionals and volunteers. On a recent shift, Rayne Edinger and another paramedic headed out from the Ashland Fire Department to help Red Cliff’s volunteer EMS with a patient.

“We’ll step out, grab our gear, climb into their ambulance, receive a report from the EMTs and basically pick up from there,” Edinger explained.

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Rayne Edinger, Ashland firefighter and paramedic, helps a patient and monitors vital signs. Danielle Kaeding/WPR

For the past five years, he’s been paid to fight fires and help save lives in the Ashland area. But that’s not the case for Red Cliff’s emergency medical technicians, who are often responsible for handling important decisions as the first ones on the scene.

Bayfield Mayor Larry MacDonald said he got a firsthand view of that type of partnership several years ago when he had a major heart attack.

“The combination of Bayfield volunteer EMS and the Ashland paramedics doing their intercept is a big portion of what kept me alive,” he said.

MacDonald believes he wouldn’t have been so lucky if the local volunteers hadn’t been there. Ashland Fire Chief Wayne Chenier said volunteers are vital to rural emergency services because his department can’t meet every call for help.

“We cover 400-some miles for EMS and a couple hundred for fire. It is a challenge,” he said.

The Ashland Fire Department’s first priority is to the city and five nearby towns that pay for service. But some of those paying towns, like Eileen, have explored using the less-costly volunteer services. Terry Torkko, a former municipal chairman, said close to half the town’s levy goes to pay for emergency services each year, leaving less for road repairs and other services.

“It became abundantly clear that our five towns have a problem, but there’s a larger problem out there regionally … in that the volunteer fire/ambulance services are starting to decrease in numbers of volunteers,” said Torkko.

Brule volunteer firefighter and first responder Adam Olson said one reason for the decrease is that people are working long hours or two jobs. He said others may shy away from the physical and emotional toll.

It’s tough, Olson said. It may not be easy going to a car accident at 11:30 on a Friday night in a rainstorm. But, if we don’t go, who will?

Lawmakers introduced a bill this month that would ease a state requirement to have two licensed EMTs or similarly trained staff on an ambulance call. Sen. Janet Bewley, D-Ashland, said it allows a first responder like Olson to lend a hand.

“The EMT is a level up. It takes more time, more training. There are fewer of them. It just makes it harder to staff that call, Bewley said. This way, we’re going to be able to make the best use of the time and energy that our volunteers are willing to commit.”

Ray Lemke, the state’s first responder and EMT coordinator, said existing volunteers are getting credentialed with more than one service in their region.

“That’s helped to alleviate a lot of the shortages,” he said.

In Waushara County, EMS Director Brian Donaldson said the county and Wautoma subsidize a regional ambulance service that staffs ambulances at stations spread around the county. He said that cuts back on duplication of services as well as cost.

“Rural EMS has really struggled because of the limited reimbursement on fees for service, Donaldson said.

Rob Puls agreed: “If we get paid, which is a big if.”

Puls is the paramedic coordinator for Great Divide Ambulance Service in Bayfield County. He said they barely break even when patients are covered by BadgerCare, and some don’t have insurance. To bring in more money, Great Divide provides patient transports for hospitals.

“If we took that income away, I’m not really certain our communities could afford to pay professional and mixed people like we do now,” said Puls.

Puls said they may have to find another way to meet cost because more EMS providers are competing for patient transfers to keep their services going as well.