By Senator Howard Marklein
June 9, 2017
Clearing the Way for Emergency Service Providers
While we continue to work on the state budget, we are also working other legislation through the legislative process. The Senate Committee on Revenue, Financial Institutions & Rural Issues, which I chair, recently heard two bills related to emergency medical services that are especially relevant to rural Wisconsin.
Rural Wisconsin faces unique challenges when it comes to emergency medical services. Unlike urban areas like Madison, Milwaukee, even Janesville, we have fewer people trained, significant geography to cover and a daily fluctuation of people in and out of our communities for work. I have heard the jest that you should try not to have a heart attack before 5 pm on a weekday in some of our communities because there aren't any rescue squad members in town until they finish their work day elsewhere.
Now, I know that this is an exaggeration and that there are many trained, committed volunteers and paid staff who work hard to protect the health of our communities. I also know that emergency responders are almost always available. However, it is also true that sometimes, emergency response might have to come further and wait a little longer before they get to you in a rural area.
As we seek to improve emergency services in our rural communities, it has become clear that there are current laws that place unreasonable burdens and obstacles in the way of allowing qualified, trained people to provide aid efficiently and effectively.
Two such issues were presented to the Senate Committee on Revenue, Financial Institutions & Rural Issues this week:
Senate Bill (SB) 238 extends the scope of the Emergency Medical Services Financial Assistance Program (FAP), a reimbursement program that pays for emergency medical technician (EMT) training and exams. Under current law, FAP only reimburses for EMT-related training and exams. This bill would allow reimbursement for First Responders training. Many rural services operate with a combination of emergency medical responders and EMTs to staff ambulances.
This bill will support the creative, problem-solving approach being employed throughout our communities. The idea for this change is a product of the 2016 Legislative Study Committee on Volunteer Firefighter and Emergency Medical Technician Shortages. I appreciate the collaborative nature of these committees and the forward-thinking solutions that we have been able to pursue as a legislature.
SB 239 will change the law to allow a trained EMT to do what they are trained to do without being restricted by the licensure on their ambulance. Under current law, ambulances are licensed as either EMT Basic or EMT Intermediate/Advanced. If a department licenses an ambulance as Intermediate/Advanced, that vehicle must have someone who is trained as Intermediate/Advanced on board before it responds to an accident.
As a result, some ambulances have to wait for an intermediate/advanced person to arrive before they can leave. Conversely, some departments decide to license all of the vehicles at the basic level, which then ties the hands of the trained professionals who respond. So, if someone is trained as an advanced EMT, but they are on a Basic ambulance, they are legally prevented from using all of their training to respond.
Imagine this scenario, an ambulance arrives to the scene of a terrible accident. Because the ambulance is from a small community where they have limited numbers of EMTs, they have opted to license their ambulance as a basic ambulance. However, Joe, a licensed paramedic in a larger city, is also a volunteer on his hometown’s department. He is off today, so when his pager sounds, he goes on the call.
Joe isn’t able to administer an IV or provide certain lifesaving medications, even though he is trained for these things. One of the victims is suffering from severe dehydration and needs fluids immediately, but Joe can’t administer them without breaking the law.
SB 239 changes the law to require a department to only advertise an ambulance service level that they can provide 24/7. However, if there is an advanced EMT on board a basic ambulance, they will be able to do everything that they are trained for, rather than being tied to the training level of the vehicle and vice versa.
It is ludicrous that we would tie the hands of a trained professional who could save someone’s life or prevent an ambulance from responding when there are trained professionals available who can give enough care to help. This bill will improve the law.
There are other issues related to rural emergency medical services we need to address and I will continue to work with constituents and professionals to insure that we remove obstacles that make their jobs more difficult.
If you are a member of an emergency medical team and you have ideas, please do not hesitate to contact me. The best legislative ideas come from those who are in the field, doing the work. I need your help to protect the lives of all Wisconsinites.
For more information and to connect with me, visit my website http://legis.wisconsin.gov/senate/17/marklein and subscribe to my weekly E-Update by sending an email to Sen.Marklein@legis.wisconsin.gov. Do not hesitate to call 800-978-8008 if you have input, ideas or need assistance with any state-related matters.