As the City of Lake Mills weighs its options for the future of emergency medical services, it’s clear that one of the key considerations is the cost to residents.
Other considerations that city and EMS leaders see are staffing models and whether to have EMS housed together or separate from the fire department.
The cost of Lake Mills EMS, which provides service to the City of Lake Mills and parts of the townships of Lake Mills, Waterloo, Milford and Aztalan, is $15 per capita.
Recently retired city manager Steve Wilke said he expects the cost of EMS in future years to be closer to $40 per capita, while Wisconsin EMS Association Executive Director Alan DeYoung said a reasonable rate is somewhere between $25 and $30.
LMEMS previously charged $7 per capita, but rising costs for equipment and staffing meant the nonprofit wasn’t meeting its bottom line, forcing a rate hike to $15 at the end of 2021.
The previous LMEMS model operated almost exclusively with volunteers, but the department today mostly uses two types of part-time staff. Director Dave Larsuel is the only full-time employee in the department.
Wilke and DeYoung agreed that a proposed city department would need to operate using a combination of full-time and part-time employees due to the nationwide shortage of EMS volunteers.
LMEMS covers about 9,600 people across the five municipalities, including about 6,000 residents in the City of Lake Mills, Larsuel said, for an estimated cost of $96,000 for the city and $142,000 for all five municipalities.
But with the Town of Lake Mills, about 2,000 people, in conversation with Cambridge Area EMS to move some of its residents to be covered by the CAEMS, the per capita rate LMEMS charges may have to increase for the other municipalities.
LMEMS Vice President Jim Colegrove said the Town of Waterloo is also considering completely joining the City of Waterloo for EMS coverage.
“If the Town of Lake Mills goes with Cambridge and Waterloo decides to go with the city (of Waterloo), we’re losing all these people and that means now the per capita for the city residents will go up,” Colegrove said. “We’ll still have the same cost, but a lower number of people paying into the game.”
Colegrove said if LMEMS’ current agreement with the five municipalities continued, the rate would realistically need to increase to between $21 and $25, well below the $40 rate Wilke said he expected.
DeYoung said Colegrove’s estimate was about right, saying he would expect a smaller city like Lake Mills to charge between $25 and $30.
“For a smaller city, being in the $25 to $30 range seems realistic,” DeYoung said. “It all depends on the service area and the number of runs, but that’s a good range.”
He added that the $7 rate LMEMS was previously at was a bargain, calling a per capita rate under $10 a surprise.
“Nowadays, it’s going to be more than $10 per capita,” DeYoung said.
DeYoung went on to explain that the EMS service rates are rising across the state for two main reasons: a shrinking population of workers and an increase in the cost of supplies and equipment.
He said the cost of supplies and equipment is rising by a minimum of 30%. Additionally, staffing a department costs a lot more than it did a few years ago because the number of people volunteering is declining and the EMS workforce itself is aging, with fewer young people deciding to join EMS.
In fact, DeYoung said the state has dropped from between 18,000 and 19,000 licensed EMS officers in 2018 to about 16,000 today.
“We’ve lost over 10% of the entire workforce, just in our state alone. And I’m sure nationwide, it’s easily 10 to 20%,” DeYoung said.
Due to the staffing shortages, DeYoung said city leaders need to understand that costs are going up and they need to pay whatever it takes in the interest of public safety.
“Whatever they (the city/EMS providers) think they should charge, they should probably double it,” DeYoung said. “Even if you push for more funding, we’ll still have the staffing issue and we just don’t have enough people, so you have to do everything you can to keep staff happy, including paying them.”