This
past Saturday morning I got a call from a local restaurant owner who
asked me pointedly, “What's going on with our ambulance service?”
She then began to relate to me that one of her customers was in need
of medical assistance and had laid on the floor “for nearly an
hour” before an ambulance arrived. If you read this past week's
Chetek Alert you may have caught the article Short of EMTs, Nov 7
medical 911 calls had longer response times (Section A, Page 5)
which gives a more detailed account of the particular circumstances
that led to the unique situation of an unconscious man waiting nearly
50 minutes before medical personnel arrived. What gives, you ask?
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Read all about it (Chetek Alert)
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Well,
first let's be clear: The City of Chetek does not run the
ambulance service. We
do not run the fire department either. Both entities are run by
commissions made up of representatives from the city and the
surrounding townships which contract with the ambulance and the fire
department for services. Chief Ryan Olson is not
a city employee, either. The only departments that we truly own are
the police department and the department of public works. Otherwise,
we're a paying customer just like the other neighboring townships
are.
Given
the fact that our subsidy for ambulance services was north of $40K in
2020 and looks to be a little more than $46K in 2021, shouldn't we
expect 24/7 emergency services? I had a conversation with Chief
Olson this morning about the ambulance service in general and about
November 7 in particular.
According
to Olson, nation-wide volunteer departments like Chetek's are in the
same boat scrambling to fill their shifts. There are just not as many
EMTs out there as there once were. At the present time there are 23
individuals on his roster all of which are part-time. That is,
driving the ambulance or riding shot-gun is not their full time gig.
Many of these same individuals are already working in the health care
field and are often picking up extra hours at their present place of
employment. Only three of the twenty-three live within the city
limits. The rest hail from around the county and, in one case,
another state.
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| The log says it all |
Due
to the demographics of our current roster, the main challenge for Olson is filling evening or weekend shifts. As The
Alert
reported, on the weekend of the 7th
our own ambulance service was out of service (on account of lack of
staff to work the weekend). At the time that the 911 call was placed
for the patron at our local restaurant, there were already four
ambulances in Chetek responding to calls between 9:30-10 a.m.:
Marshfield Medical Center (Rice Lake), Mayo (Barron), Bloomer
Community (Bloomer) and Rusk County (Bruce) (and therefore the
48-minute wait time before help arrived). It was, if you will, a
“perfect storm.” All total there were 11 EMS calls made this past
weekend where help had to come from elsewhere to assist those here
with medical care.
Olson
explained to me that by ordinance the Chetek Ambulance Service does
not triage care. That means that if a 911 call comes in for a student
with a broken arm at the school and shortly afterward a call comes in
on account of a major accident out on Highway 53, they respond to the
incident at school as it is literally 'first come, first serve.' Only
dispatch can re-direct them otherwise.
And
I haven't even mentioned how the reality of Covid-19 is placing even
greater stress on an already undermanned force. In the last week
alone there were 30 calls just for Meadowbrook alone. The ice, as it
were, is getting pretty thin.
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20% of the time
CAS is out of service |
In
my conversations with local commissioners they assure me that what
happened last weekend won't happen again but given the reality of the
current health emergency we are all living with I'm not sure they can
promise that. In the meantime the city is exploring its options
regarding contracting with another ambulance service. That's not
meant to be a threat. But the fact that 65% of our population are
senior citizens, generally the most medically frail in our community,
we should do what we can to make sure that the very best service we
can afford is available when someone picks up the phone and dials
911.
If
you would like to speak with Chief Ryan Olson of the Chetek Ambulance
Commission (CAC) you may do so by calling 715-764-5788.
If
you would like to speak to the City's representative on the CAC,
please call Alderman Mark Edwards at 715-914-9122.
As
always you may call the Mayor to lodge your concern about this matter
and any other matter by calling 715-925-6078.
Out of curiosity, what is the expectation for ambulance coverage? Is it 24/7/365 coverage? Do you have an expectation of staffing that with two EMTs, 1 EMT and 1 Paramedic, or 2 Paramedics? Is there a response time requirement (for example most life threatening calls are responded to within 9 minutes 90% of the time)? While I am aware you are in a different area, many urban areas will budget around $1million/year for one ambulance that provides 24/7/365 coverage with EMT/Paramedic staff and a 9 minute response time. Your current budget of $40-$46k/year will barely cover salary alone for one EMT (without benefits). You all are not alone in your challenges, though. EMS is not declared an essential service in most areas, therefore securing consistent funding for them is challenging. Many areas have to contract service, or rely on mutual aid and often times that can lead to extended response times or compromises on coverage/staffing/response times. I wish you all the best of luck and hope you can find a solution soon.
ReplyDeleteYou actually think $46K should buy you 24/7 ambulance coverage?
ReplyDeleteAre you kidding?
That probably doesn't even cover fuel for the trucks.
$46k is the salary of 1 EMT in SE Wisconsin. You need two for a legal squad, or one EMR and one EMT. Start going into the advanced levels of care (paramedic) and the costs skyrocket exponentially.
You get what you pay for, and if $46k is all the citizens are willing to pay, then they are paying for an hour wait. I've been involved in EMS for over 30 years and it's always the same story- "Maybe we can find some volunteers to run our service."
Have people attend over 150 hours of training... for free
Have people commit to 24-30 hrs of refresher training a year... for free
Have people give up sleep, birthdays, vacations, health...for free
Have people go some of the most dangerous situations imaginable...for free
Carry the mental and physical scars of an extremely emotional and physical job....for free
Oh, let's not forget- constant exposure to a potentially lethal virus....for free
This is a crisis in America right now that needs to be dealt with realistically
Thank you, John, for your response. Keep in mind, the $46K is only the city's contribution to a bigger pot made up of the surrounding townships. I won't argue your point. But as an elected official I'm responsible to be a part of a conversation that tries to assess if the city's needs are being met adequately. I'm not faulting any EMT. With the exception of one individual, the rest of our roster is made up of part-time employees who are already working their regular full time jobs. We are grateful for your service.
Delete"A bigger pot" which is still woefully inadiquate.
DeleteThe City of Chetek benefits from 23 EMTS who, until two years ago, only numbered 14 EMTs and were paid about $8.50 (or less) an hour for their service to the community and covered only 60% of the shifts each week. The method of payment was based upon on how many runs the ambulance crew performed. If there were no runs, the EMT was paid $5.50 an hour. In the past two years, the coverage has grown to over 90% of the available shifts when the shift payment was changed to a flat $72 per 8-hour shift regardless of runs. EMTs then knew exactly how much they were paid and took more shifts than ever before. Perhaps the City will find it less expensive to support an Ambulance Service with Full Time Employees at a rate commensurate with Mayo and Marshfield at $16 per hour but I don't think so. Apparently, the City is now well aware of the response time between having a local ambulance and one from farther away. The good news for the City of Chetek is that on a per run basis, the City subsidy was less that $100/run while the Town of Sioux Creek was paying over $600/run in subsidies. Other towns are paying between $400 and $500 per run. Hopefully, all these things are being presented to the local councils and Town Boards by their representatives on the Commission. I would ask that City Councils and Town Boards look at not how much it costs them in dollars but how little it costs them by the number of runs in their communities. At $100 of subsidy per run, the City of Chetek is getting more bang for the buck than any other municipality in the area. I would finally point out that the Chetek Ambulance Service has more than just tax payer money to fund its operations. The CAS bills insurance companies and Medicare as other forms of payment. Unfortunately, the law requires that the Ambulance Service not invoice the government (Medicare) the full cost of its work. If the Ambulance Service could invoice Medicare at the full cost of services it provides, there would be no subsidies paid by any municipality. While it is true that every tax payer dollar should provide a service to the community it serves, the CAS has been successfully serving the 6 municipalities because of the QUALITY of its EMTs AND the DEDICATION of the CAS volunteers. In the AGE of COVID, volunteers who serve the community for $9/hour should be appreciated. And the management of CAS operations by the CAS Commission should be honored for the service they provide.
ReplyDeleteThank you, Dale, for your contribution to this conversation. I have no argument with your last sentence. This post was generated because a local restaurant owner had one of their customers laying on the floor for nearly 50 minutes before the cavalry showed up and they wanted to know "Why?" Also, I continue to be apprised by some members of the commission who have concerns how the service is being administrated.
ReplyDeleteTo outsource a truck from Mayo or LMC and have them placed here 24/7 would cost around a million dollars. That's one truck, and they would still operate on a first-come-first-serve basis. 46k will pay one employee full time, and it takes two to run a truck. That's only 40hrs of coverage, and there are still 128hrs in the week after that. As this article states, it's a paid volunteer service. That's why Chetek is paying only 46k. I also believe that with recent changes at Chetek in the last two years, the coverage has significantly improved. Now the other townships kick in, but it certainly isn't enough to pay two people at a time for coverage. There are 168hrs in a week, and you have to have two people on.
ReplyDeleteAs an elected official, I think it would best to understand how an ambulance service works before they go off all half-cocked. A transport to Rice lake will take an hour. This doesn't take into account treating the patient onsite. Whoever calls first will get treatment first. You clearly state you are faulting someone, but not any of the volunteers. The Mayor taking shots at the Director of the service when he doesn't understand how it works? That's a great look for Chetek.
Based on everything you have listed in this blog and the four calls that happened in 30 minutes, nothing could have been done. Before we talk about mismanagement, we should take about the Chetek Cafe and how that deal blew up? Over a $200,000 loss? That could fund Chetek's contribution for over four years....
Thanks, OwenB, your comments and your perspective. For the record, the information I shared in my post came directly from Ryan Olson. Now it could very well be that I misheard what he explained to me but the fact remains that we have some issues to work through as an ambulance service.
ReplyDeleteYou should know that all services in the area are having this issue. LMC runs one truck for Rice Lake for 8,0000+ people. They run a second one out of Cameron. The Camron truck is there less than 20% of the time because it is on transfers. Cameron is without coverage of at least 80% of the time. At one point this year, LMC's second truck didn't have a crew. They lost so many paramedics they could barely run Rice Lake's service. If you went back two and three years ago, the coverage in Chetek has significantly improved. At this point, I think Ryan Olsen has done an excellent job, and for you take issue with him shows your lack of knowledge in this area. You did call him out in your replies: I'm not faulting any EMT.
DeleteThis was your statement: With the exception of one individual, the rest of our roster is made up of part-time employees who are already working their regular full-time jobs.
How? How do you not know how EMS works?! You sir, NEED to know how EMS works.
Delete