STEVENS POINT, Wis. — Strengthening emergency medical services is becoming an increasingly necessary solution for many rural areas facing declining volunteerism, rising costs and increasing response times.

The Northwoods EMS District, made up of 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 group discussion Wisconsin Association of Cities the conference highlighted the district’s formation process, the challenges it faces and key takeaways for other municipalities considering similar consolidation efforts.

Identifying the need for consolidation

Rural EMS services across the country are facing dwindling volunteer numbers and overworked staff. In far northern Wisconsin, like many rural locations, response times often fell short of state regulations, with some reaching 90 minutes or more. The four cities involved recognized the need for change after community feedback showed two-thirds of residents were dissatisfied with current levels of EMS service. As a result, local government officials have begun to explore consolidation as a means of improving service reliability and sustainability.

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Hiring a consultant to guide the process

Manitowish Waters Town President John Hanson, along with other town leaders, decided to hire Dana Sechler, an experienced EMS leader and consultant. Cities also received data and technical assistance from Wisconsin Office of Rural Health Office of EMS.

Sechler’s expertise in systems design played a crucial role in guiding the cities through the consolidation process. He collected and analyzed data from participating agencies and identified critical issues such as ineffective deployment of EMS personnel and fragmentation of services.

Some important data informed city stakeholders and elected officials:

• Response time averaged 30 minutes, with some peripheral times of 90 minutes or more.
• Eighteen volunteers completed all responses between 4 services in the past year. Even though a total of 64 people were registered, only 32 people answered the calls because many of those people belonged to multiple services.
• Ambulance services in four cities responded to 600 calls collectively, but due to 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 cities. Sechler’s goal was to provide data-driven solutions while recognizing the passion and dedication of existing EMS providers.

Steps to consolidation

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

1. Public involvement. Each city held informational meetings and public hearings. After presenting the consultant’s findings, city councils passed resolutions to officially create the Northwoods EMS District by the end of 2023.
2. Joint funding. The total cost of creating the district was $400,000, spread equally among the four cities. A tax based on assessed property value at $100,000 provides permanent funding for the Northwoods EMS District. The final tax is being finalized and will soon be approved by each city’s council.
3. Recruitment of leaders. One of the district’s first tasks was recruiting key staff. Jason Joling was hired as EMS Chief, with Jesse Mabie as Deputy Chief. Both are charged with administrative responsibilities for launching the district. Once the service is operational, both will also answer some 911 calls.

Initial challenges and key successes

Joling explained that forming a new EMS district is not without its challenges. The district lacks a mission, motto or patch. The district must also acquire vehicles, equipment and hire staff. They have made progress in staffing two 24/7 ambulance stations, including:

• Staff plan. The Northwoods EMS District will operate two paramedic-EMT ambulances 24/7/365, responding from two stations. The district must fund 35,000 hours of coverage annually.
• Wages and benefits. To attract and retain full-time staff, the district budgets $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 ultimately handle all transports, the four towns will maintain an emergency medical response (EMR) presence to serve as first responders. The district hopes to train and cross-accredit EMRs for future roles within the consolidated system.

Conclusion

The Northwoods EMS District is a testament to the importance of proactive leadership, community involvement and expert guidance in navigating the complex process of strengthening EMS. 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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