Jefferson EMS to offer higher levels of medical care
JEFFERSON — When the unexpected happens and a person needs the level of life-sustaining care only available from a paramedic, it’s no joke.
In Jefferson County, many communities rely on the Paramedic Intercept Program run by Fort HealthCare to provide those skilled paramedics.
Beginning at 7 a.m. Thursday, Feb. 1, Jefferson EMS will take ownership of the program.
The Paramedic Intercept Program, known among local emergency personnel as 799 (the rig number of the vehicle), was started by Fort HealthCare in 2000. At the time, paramedic services basically were nonexistent in the region. The program was designed to assist the local emergency medical services (EMS) by providing a paramedic level of service when appropriate.
Jefferson Fire Chief Ron Wegner and Jefferson EMS Director Sue Reinen explained that, in February 2017, Fort HealthCare had let Reinen know of its interest in moving the program out into the field.
“Our world is a specialty, just like their world is a specialty,” Wegner said, referring to the specific expertise provided by entities such as fire departments, EMS businesses and emergency rooms. “We’re taking that paramedic specialty and putting it in with its (field).”
Jefferson EMS works closely with and is housed in the same building as the Jefferson Fire Department, although they are separate departments within the City of Jefferson.
During the July 18, 2017, Jefferson Common Council meeting, Fort HealthCare President and CEO Mike Wallace said he felt like the Paramedic Intercept Program being run out of Fort Memorial Hospital was “getting in the way of the EMS programs becoming all they can be.”
There are four levels of EMS certification nationally: emergency medical responder (EMR), basic emergency medical technician (EMT), advanced emergency medical technician (AEMT) and paramedic.
In Wisconsin, an EMR license requires 49 hours of education; an EMT, about 180 hours; an AEMT, an EMT license and an additional 170 hours beyond the Basic EMT course; and a paramedic, at least 1,000 hours of education.
Generally, paramedic programs require that a person already be licensed as an EMT, if not as an AEMT, and have at least some work experience. Depending on the program, becoming a paramedic can take up to two years and cost upward of $10,000, on top of the cost of getting an EMT license.
“Paramedics aren’t growing on trees,” Wegner, who is licensed as an EMT, noted. “Even to get, as I refer to it, Joe Lunchbox, to be able to come out today and help their community, that is an enormous commitment now.”
The chief said that when he and Reinen, an AEMT, got started in their fields in 1988 and 1982, respectively, there “wasn’t that demand of education.”
“It was teaching you how to triage, first aid, package and transport to the hospital,” Wegner explained. “EMS has transitioned today so that we’re bringing the emergency room to your livingroom or to your car out in that ditch on the side of the road.”
Both the Jefferson EMS and the fire department rosters include a combination of EMTs and AEMTs, two of whom are in training to become paramedics. Jefferson EMS also employs nine licensed paramedics consisting of two full time and seven paid-in-station.
The Jefferson Common Council approved hiring the two full-time and six of the paid-in-station paramedics during its Jan. 3 meeting. The ninth licensed paramedic has been with Jefferson EMS for a while, but has been unable to provide service above the AEMT level due to the department’s state license level.
Currently, Jefferson Fire and Jefferson EMS have a “dual-license” for three of the four departments’ ambulances — one of which is the fire department’s Heavy Rescue Squad 6, which is a licensed ambulance with no transport capabilities.
The primary ambulance carries an AEMT level license, while the other three carry a Basic EMT level license.
That means that the primary rig always must have at least one person with an AEMT-level license on board when it responds to a call, according to Reinen. The other three can be run at the Basic EMT level or the AEMT level.
The state approved a paramedic-level license for Jefferson EMS in early December 2017, but it won’t go into effect until Feb. 1. That license will be for the “chase car” that will transport paramedics to the scene to assist the ambulance service that is caring for the patient(s).
The primary ambulance will maintain its AEMT license level.
Because of the time and expense of becoming a paramedic — and therefore the salary expectations — not every community can afford to transfer to a paramedic level of service, Wegner and Reinen said.
Currently, the Paramedic Intercept Program serves the areas covered by the cities of Jefferson, Lake Mills, Whitewater and, if Ryan Brothers Ambulance Service is unavailable, Fort Atkinson EMS services. Also, it services coverage areas of the villages of Cambridge and Palmyra.
“(Fort HealthCare) is helping us to get this program off of the ground out in the field,” Wegner explained. “With cost and time, it’s extremely difficult for every community to decide that they’re going to go to paramedic level and to take on this burden, financially, on their own. Fort (HealthCare) realized that and they were willing to help us make that transition.”
As part of an assistance package, Fort HealthCare provided $18,000 to Jefferson EMS in 2017, and will provide $75,000 in 2018 and $75,000 in 2019. Jefferson EMS is able to use the funds to cover inventory, vehicle repairs/replacement, staffing or training.
In addition, Fort HealthCare will give $35,000 to help replace the current Paramedic Intercept Vehicle.
However, by 2020, the program essentially will have to be self-sustaining.
“We’re definitely going to be dependent upon the communities that have been served by 799 historically to be able to continue to utilize these services,” Wegner said. “That is paramount. There will be a cost-sharing for the use of that service going forward.”
Under Fort HealthCare, communities were able to utilize the Paramedic Intercept Program free of charge.
“EMS in general — think of it as this giant umbrella over the top of the State of Wisconsin — is an extremely dynamic situation entity right now, all across the State of Wisconsin,” Wegner said. “A decrease in volunteers, increase in educational requirements and an inability to pay for it from municipal governments.
“Over the state, there are a lot of things going on that EMS has not seen historically that are changing the landscape for EMS operations every single year,” he continued. “It’s no longer one of those every three- or five-year changes; it’s an every 12-month change, if not sooner.”
Jefferson EMS has been doing “very well,” Reinen said. However, other services “have not survived or have combined.”
“One of the things that we really look at here is you either have to lead, follow or you’re going to end up shutting the doors,” Wegner said. “We want to be on the leading edge of what we’re doing.”
Wegner and Reinen said they felt Jefferson EMS was a “very good fit” for the Paramedic Intercept Program because it has the facility and geographic location to be able to accommodate it.
“It’s a big deal for Jefferson EMS because we believe, from a business perspective, we have worked very hard to position Jefferson EMS to be a sustaining emergency medical service for not only the citizens of Jefferson and the surrounding communities we serve, but also to be in a position to be able to assist neighboring communities,” Wegner said. “We put the building blocks in place with the number of vehicles we have, the number of personnel, the license levels. We built a building to be able to accommodate all the vehicles, a training facility, substantial dormitory to be able to handle staffing.
“Operationally, we have tried to position ourselves over the last five years so we’re ready to face any challenge that’s brought forward to us,” he continued. “We’ve come a long way from being an ambulance housed in a garage in 2001 to an 11,000-square-foot building with dormitories and truck bays and now looking at the Paramedic Intercept Program.”