State Senator Sarah Keyeski attended County Board Meeting

It was a crowded County Board Room as the Richland County Board of Supervisors met last night (Tuesday) to discuss County Emergency Medical Services. Among those in the audience to speak during public comment was State Senator Sarah Keyeski. She admitted that the state is not supplying enough funds for mandated local requirements.  Keyeski stated, “No one here is at fault. It’s systemic.

Following public comment three entities presented there proposals to cover EMS Service for the county. Chris Everson, Emergency Services Director at Emplify by Gundersen in La Crosse, shared five reasons why Gundersen would be a good fit for Richland County. They were: they were already operating in Richland Center with proven crews and real performance data; they have an established relationship with the Richland Hospital since 2022; they have a deep experience in similarly-sized rural markets, including Sparta, West Union, Prairie du Chien; the service upgrade from advanced emergency medical care and transportation (AEMT) to Paramedic-level ALS, or advanced life support at no incremental cost to residents; and they are backed by an integrated health system with a depth of resources no standalone service can match. The cost for Emplify to supply service to Richland County would be $215,000 annually, all inclusive.

Micheal Kreuger from Lifestar based in West Bend was next to give a presentation about what they could offer to the county for emergency services. The proposed model includes: two fully staffed ambulances operating 24/7 /365 days a year; they have one additional backup ambulance; primary stationing would be in Richland Center for optimal coverage; and staffing with trained professionals at the paramedic level. Krueger stated that this approach ensures rapid response times by using paid hourly staff allowing out the door times in approximately one minute. Lifestar would integrate closely with local public safety systems by: coordinating dispatch through the Richland County Sheriff’s Office; supporting Emergency Medical Dispatch (EMD) systems; participate in mutual aid and regional emergency response frameworks; and tracking and reporting performance metrics, including response times and call trends. The proposed annual subsidy from Lifestar is $404,000, covering all staffing, equipment, vehicles, administration, and insurance. Lifestar is open to flexible contract terms of three to five years, and service adjustments to align with county priorities and financial considerations.

Richland County Ambulance Director, Barb Scott, gave a presentation of the proposal for the Richland Ambulance Service. Lieanna Pick, Barbara Scott and Tricia Clements all met to create a sustainable budget for the county ambulance service moving forward. Richland County would continue with their current structure, which includes a full-time service director, captain, administrative assistant working 32 hours per week and five additional full-time staff.  Additionally, there would be part-time and on call casual employees.  The service level would be AEMT. The budget amount included is $1.1 million. All three agree this is a realistic budget.  If there is an increasing trend, this number would be adjusted in the future.  The service currently has three ambulances and would like to continue with three.  The purchase of two remount ambulances in 2027 and keeping one of the three was built into this budget.  A cycle of replacing one ambulance every three years is also being looked at.  Each ambulance would be in rotation for nine years.  A remount ambulance cost would be no more than $300,000, fully outfitted.  The plan lays out budget numbers that are based on current trends, reflecting what expected costs will be over the next five years. 

The County is under no statutory obligation to provide EMS services. The County’s Ambulance Service was created to serve certain municipalities within the County, many of which have a statutory obligation to provide EMS services. The Richland County Ambulance Service currently provides, and has historically provided, EMS services to about 60% of the County. The financial model for the County’s Ambulance Service has historically been designed to require no tax levy contribution from the County and instead operate on funding provided by the participating municipalities through a contract between the County and the participating municipalities. The County’s Ambulance Service does not currently serve all residents within the County. The municipalities served by Richland Ambulance Service have indicated to the County a desire to continue contracting for EMS service and, to the extent possible and allowable, have the County levy a tax outside the statutory levy limits to support the cost. The recommendation from the consultant engaged for purposes of the study was for the County to levy outside of the levy limit and contract with a third party provider to provide EMS services. The problem brought forward by many is the fact that the county as a whole would be affected by the increased tax levy, even those not serviced by the County Ambulance Service.

Board Supervisor, Marc Couey asked if the question could go to referendum in November. He feels its the fairest way to move ahead and gives everyone the opportunity to voice their opinion, rather than just the board members. Corporation Counsel Andrew Philips informed the board that a resolution has to be adopted for the constituents to either approve or disapprove, it can not be an advisory question.

Following a short recess, County Board Chair, Kerry Severson, shared a study report done by the UW. It basically says that when a county or municipality begins to try to run like a business, it is problematic. Government policies and actions are always under scrutiny. He stated that after the many times that the county has looked at an EMS service, he feels the county should form an Ambulance District with local funding. He added that it should be ran until 2028 as that is when the current board of supervisors would be up for re-election. 

Board Supervisor Rod Perry motioned to postpone the resolution to choose one of the three ambulance providers until the next board meeting. Supervisor Richard McKee seconded the motion. After much discussion, Perry asked to rescind his motion. Corporation Counsel stated that Perry could not rescind the motion, it would have to be voted down. The board then voted against the postponement.

Attorney Philips was then asked by Chair Severson to explain how an EMS District would work. A district model would create additional ways of funding for the municipalities through a levy as well as state grants that are available.

Vice Chair, Larry Engle, then motioned to amend the resolution to continue supporting the Richland County EMS until April 2028 while municipalities explore developing an Ambulance District. Richard McKee seconded the motion. Supervisor Dave Turk then made a motion to extend the date to December 31, 2028 and was seconded by Engle. The amendment then passed by a majority voice vote. The board then voted on the amended resolution for the county to continue supporting the Richland County EMS January 1, 2027 through December 31, 2028, while municipalities explore the possibility of forming an Ambulance District with the help of the county. The amended resolution passed unanimously.