WHERE THE NITRATES COME FROM.
>> DIRECTORS OF EMERGENCY
MEDICAL SERVICES ACROSS
WISCONSIN ARE WARNING OF A
SYSTEM ON THE BRINK.
THIS IS ACCORDING TO OUR NEXT
GUEST WHO SAYS THERE IS NOT
ENOUGH MONEY AND NOT ENOUGH
PEOPLE TO PERFORM THE LIFESAVING
WORK.
AND THAT EMS HAS RELIED TOO
HEAVILY ON VENAL TIERS FOR TOO
LONG.
JAMES SMALL IS THE RURAL
OUTREACH MANAGER FOR THE
WISCONSIN ASSOCIATION OF RURAL
HEALTH.
HOW IS THE EMS SYSTEM ON THE
BRINK?
>> RIGHT NOW IN MANY COMMUNITIES
AROUND THE STATE AND AROUND THE
COUNTRY THIS ISN'T JUST A
WISCONSIN ISSUE, IT IS A
NATIONAL ISSUE THAT'S GOING ON.
THERE IS MANY COMMUNITIES THAT
HAVE HISTORICALLY DEPENDED ON
VOLUNTEERS OR NEAR VOLUNTEERS
WHERE THEY'RE BEING A PAID A
SMALL AMOUNT BUT NOT A FULL-TIME
WAGE FOR PROVIDING EMS RESPONSE.
AND WHAT WE'RE FINDING IS THAT
WE'VE HAD A DECLINE IN THE
NUMBER OF PEOPLE AVAILABLE TO DO
THAT.
AND THERE IS NOT THE FINANCIAL
RESOURCES TO REPLACE THEM WITH
FULL-TIME STAFF.
SO AS YOU LOOK AROUND THE STATE
AT WHAT THE SYSTEM LOOKS LIKE,
ABOUT A THIRD OR MAYBE A LITTLE
OVER A THIRD OF AMBULANCE
SERVICES IN WISCONSIN TODAY ARE
NOT ABLE TO STAFF 24/7, 365 LIKE
THEY ARE REQUIRED TO.
SO ONE IN THREE LET'S SAY.
IN ADDITION TO THAT, THERE IS
ANOTHER THIRD THAT ARE CONCERNED
THAT THEY CAN'T DO THAT THROUGH
2023.
SO WITHIN THE NEXT YEAR THEY MAY
HAVE SYSTEM OUTAGES.
ONE OF THE CHALLENGES IT PLACES
THE BURDEN ON THE NEIGHBORING
SERVICES TO HANDLE THEIR CALLS
AND EVEN BEEN SITUATIONS WHERE
SOMEBODY HAS CALLED 911 AND THE
AMBULANCE NEVER MADE IT TO THE
HOUSE BECAUSE THEY COULDN'T GET
AN AMBULANCE FOR THEM.
>> DO YOU FEEL AS THOUGH
STAKEHOLDERS, LAWMAKERS ARE
AWARE OF WHAT YOU'VE DESCRIBED
AS A CRISIS?
>> YES.
IN THE DISCUSSIONS I'VE HAD IN
THE LAST FEW MONTHS WITH THE
LEGISLATURE, I BELIEVE THEY'RE
VERY AWARE THAT THERE IS A
CRISIS AND ARE PLANNING ON
WORKING TOWARDS A SOLUTION TO
THAT IN THE NEXT LEGISLATIVE
SESSION.
>> DOES THE SOLUTION TO THAT, IS
IT MONEY?
IS THAT WHAT MUNICIPALITIES
NEED?
>> OH, THAT'S PROBABLY FIRST AND
FOREMOST AREA WE NEED TO GO DOWN
IS INCREASING THE FUNDING TO
LOCAL MUNICIPALITIES.
RIGHT NOW THE FUNDING THAT COMES
FROM THE STATE THROUGH THE
SHARED REVENUE PROGRAM IS THE
SAME AMOUNT IT WAS IN 1993.
TO PUT THAT IN PERSPECTIVE.
IN 1993 IS WHEN I GOT MY EMS
LICENSE ORIGINALLY AND I'M
ELIGIBLE TO RETIRE IN THREE
YEARS.
SO I COULD CONCEIVABLY HAVE
WORKED MY ENTIRE CAREER UNDER
THE SAME AMOUNT OF SHARED
REVENUE AS WHAT IS OUT THERE
TODAY.
>> HOW LONG HAS THE ISSUE WITH
EMS BEEN A SITUATION?
>> IT'S BEEN GROWING FOR
PROBABLY 20 YEARS AT THIS POINT.
IT JUST REACHED A CRISIS POINT.
SIX YEARS AGO THE LEGISLATURE
DID A LEGISLATIVE COUNCIL STUDY
COMMITTEE WHICH LOOKED AT ISSUES
AND WHAT SOLUTIONS RELATING TO
THIS BUT NEVER GOT ANY TRACTION
IMPLEMENTING ANY OF THE IDEAS
BROUGHT FORTH FROM THAT
COMMITTEE.
I THINK NOW WE'RE IN A DIFFERENT
POLITICAL ENVIRONMENT WHERE
MAYBE SOME OF THOSE IDEAS CAN BE
BROUGHT FORTH AGAIN.
>> IS THERE A REGION OF THE
STATE WHERE THIS IS MOST ACUTE?
>> IN THE MORE RURAL AREAS IT'S
MORE ACUTE FOR THE MOST PART.
BUT I THINK THAT AS YOU GO
AROUND THE STATE, YOU WILL FIND
THAT MOST REGIONS HAVE AREAS
THAT ARE HAVING DIFFICULTIES.
RIGHT NOW WE'RE CONDUCTING A
STUDY OF THE STATEWIDE SYSTEM
AND WE'RE SEEING REPORTS FROM
ALL OVER THE STATE DESCRIBING
SYSTEM OUTAGES AND LACK OF
STAFFING AND SO ON.
>> IS THERE A DOLLAR FIGURE FOR
WHAT IT WOULD TAKE TO TRY TO
REPLACE THE AGING VOLUNTEER
POPULATION WITH FULL-TIME PAID
STAFF?
>> I WOULD IMAGINE THAT'S IN THE
HUNDREDS OF MILLIONS OF DOLLARS.
I DON'T KNOW EXACTLY WHETHER
IT'S 200 MILLION OR 500 MILLION
OR UPWARDS OF THAT.
BUT IN ADDITION TO THE EMS THERE
IS ALSO THE FIRE RESPONSE ISSUES
WITH THE VOLUNTEER FIRE
DEPARTMENTS THAT ARE VERY
SIMILAR.
LAW ENFORCEMENT HAS SIMILAR
ISSUES ALSO WITH FUNDING AND NOT
ENOUGH PEOPLE.
SO PUBLIC SAFETY AS A WHOLE IS
HAVING A LOT OF CHALLENGES RIGHT
NOW THAT WE NEED TO FIGURE OUT
SOLUTIONS FOR GOING FORWARD SO
WE CAN AT LEAST STOP THE
BLEEDING AND START BUILDING
THINGS BACK TO WHERE WE NEED TO
HAVE RESPONSE CAPABILITY.
YOU KNOW, YOU LOOK AT SOME OF
THESE TRAGIC INCIDENT THAT
HAPPEN AROUND THE COUNTRY.
IF ONE OF THOSE HAPPENED IN
CERTAIN AREAS OF OUR STATE RIGHT
NOW WE DON'T HAVE THE CAPABILITY
OF RESPONDING TO THOSE
INCIDENTS.
>> SO WHAT IS THE SITUATION LIKE
FOR PEOPLE LIKE YOURSELF WHO
DEDICATE YOUR LIFE'S WORK TO
SAVING OTHERS?
>> IT'S CHALLENGING.
I THINK THAT WHAT WE'RE SEEING
IS THAT PEOPLE ARE BURNED OUT.
YOU KNOW, YOU HAVE NUMEROUS
SERVICES AROUND THE STATE THAT
ARE BEING OPERATED ON 3 OR 4
VOLUNTEERS TRYING TO COVER 24/7,
365.
IT IS A HUGE BURDEN TO PUT ON
SOMEBODY THAT ALREADY HAS A
FULL-T
FULL-TIME JOB.
THESE PEOPLE HAVE DONE ANYTHING
IN THEIR POWER TO MAKE IT WORK
BUT THEY CAN'T ANYMORE.
IN SOME CASES, THE SYSTEM
FAILURES ARE HAPPENING BECAUSE
OUR DEDICATED EMPLOYEE HAS
PASSED AWAY SO THEY'VE LOST THAT
CONTRIBUTION BECAUSE THEY WORKED
UNTIL THEY DIED.
THERE ARE SERVICES THAT HAVE AN
AVERAGE AGE ON THE ROSTER OF
OVER 70 YEARS OLD.
IT IS NOT SUSTAINABLE WHERE
WE'RE AT AND LOOKING AT A
COLLAPSE OF THE SYSTEM IN
REGIONS AROUND THE STATE.
>> THAT'S SOUNDING THE ALARM.
JAMES SMALL, THANK YOU VERY
MUCH.
FOR MORE ON THIS AND OTHER
ISSUES FACING WISCONSIN, VISIT