Capitol Update
by Senator Howard Marklein
October 11, 2019


Supporting Rural EMS Volunteers

Sen. Marklein holds four summits to gather input from rural EMS volunteers


Emergency Medical Services (EMS) departments are staples of our rural communities. However, many rural volunteer EMS departments are struggling with recruiting new members and retaining current members. I recently held four Rural Volunteer EMS Summits across the 17th Senate District to answer the question “What can the state do to encourage volunteers and help with recruitment and retention of rural volunteer EMS?” Rural voices and opinions are often overshadowed in Madison. For this reason, I wanted to hear directly from my rural EMS volunteers. We had great turn-out for these discussions!
Nearly 70 EMS volunteers, representing almost 30 different departments, attended. They provided me with productive and informative feedback. I heard about the burden of the National Registry of Emergency Medical Technicians (NREMT) exam, received input on initial training and refresher requirements, learned about the burdensome process of applying for the Funding Assistance Program (FAP), and discussed the challenges that rural departments face finding people to fully staff their ambulances. I am currently in the process of drafting legislation to address what I heard.
One of the themes that I heard echoed over and over was the difficulty of the NREMT exam. Since 2011, this exam has been required for initial EMS licensure in Wisconsin. I heard that the test is difficult, expensive and doesn’t always test for relevant information. A participant at the Darlington summit lamented that one of the questions was: “What should the tire pressure be on an ambulance in the mountains of Colorado?” Questions like this have no relevance to rural Wisconsin!
I also heard about several individuals who would be great Emergency Medical Technicians (EMTs), but they have test anxiety. These volunteers can save your life, but they don’t perform well on standardized tests.  We need to fix this. Many departments told me they would have two, three, or even eight more members if the NREMT exam was not a required part of the initial licensure process. For this reason, I will be introducing legislation to make the test optional for new volunteers. Individual departments will be able to decide whether the NREMT test is required.
In order to maintain our high standards and safety for our communities, I will work with the Wisconsin Technical College System (WTCS) to ensure consistency among the training courses and exams across WTCS institutions statewide. I will also be working with them to increase flexibility for class offerings and make-up classes.  Initial training to become an EMT now requires 180 hours. While most volunteers were comfortable with the current requirements, they do not want the number of hours increased in the future and they asked for more access to consistent training.
We also discussed the FAP, which distributes state funding to transporting ambulance services through a population-based formula. Departments use FAP to pay for training courses and equipment. However, every year each department must collect in-person population verification signatures from the clerks in each municipality the department serves. Rural departments cover a lot of territory and some have to collect a dozen or more paper signatures each year! I will introduce legislation to streamline and reform the signature collection and population verification process for this important program.
Throughout each summit, the need for more volunteers was at the top of everyone’s mind, especially related to the ambulance staffing requirements. I am examining the current ambulance staffing requirements and will push for ways to ensure that each department has the staff to respond to calls at all hours of the day. Unfortunately, I heard many departments say that they “hope and pray” the pager doesn’t go off during the work day because they don’t have enough people to staff an ambulance while many of their volunteers are working.
However, several departments are working directly with local businesses to allow employees to respond to calls during the day. Many businesses and several school districts across the 17th Senate District already do this! There are teachers at the Argyle and Potosi School Districts who serve with full support from their school!
In addition to the highlights, we also discuss:

  • Increasing collaboration between EMS departments, WTCS, and high schools
  • Tax credits and their general inability to motivate behavior
  • Increasing the Medicaid reimbursement rate for ambulance transports
  • Clarification of previous legislation related to rural EMS departments and volunteers
  • EMS as an essential service
  • Concerns about alignment of the Wisconsin scope of practice standards with the national standards, which could reduce the role of, and alienate, rural volunteer departments.

Throughout the summits, I was impressed by the passion that our volunteer EMS personnel have for their communities and for helping others. I will continue to fight for our rural communities and will provide further updates as my EMS legislation makes its way through the legislative process.
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.

Marklein represents the 17th Senate District, which includes all or parts Grant, Green, Iowa, Juneau, Lafayette, Monroe, Richland, Sauk and Vernon counties. Marklein serves on the legislature’s budget-writing Joint Finance Committee and is Chair of the Senate Committee on Agriculture, Revenue & Financial Institutions.