‘We are getting pushed around by Oneida County’

A meeting will be held in October as the Vilas County Board of Supervisors continues to look into the possibility of establishing a county ambulance service.

During last month’s county board meeting, Vilas County board chair Jerry Burkett put Sheriff Joe Fath in charge of organizing the meeting. 

Burkett issued the directive following a 50-minute discussion about the county’s struggles with volunteer ambulance services. 

“This has been a hot topic for a multitude of years,” he said in remarks to begin the discussion. “I have put this on the agenda for discussion only. If we go further, we will find out the committee of jurisdiction and see if that committee will further this along. I believe that ... it’s one of the most important issues to arrive before the county board. It affects all of us. It especially affects all of us if you need an ambulance.”

Getting pushed around

The discussion was focused on issues townships in the county are having in maintaining volunteer ambulance service. 

There was also mention of the issues a few Vilas County towns, such as Arbor Vitae and Lac du Flambeau, are having with paying increasing fees to Oneida County, which has full-time ambulance personnel. 

In 2023, the town of Arbor Vitae agreed to pay Oneida County $110,000 for ambulance service compared to $85,000 in previous years. 

In April, at the town’s annual meeting, town chairman Frank Bauers said a 2024 contract proposal for $227,303 had been received from Oneida County. 

Also impacted is Lac du Flambeau, which, prior to 2023, had contracts with Oneida County to provide supplementary ambulance service for an average of $55,000 a year. 

The town board reached an agreement in January with Oneida County on a contract for a little more than $178,000. 

That was a reduced amount from $240,000 Oneida County originally sought for 2023. 

For 2024, the proposed contract for Lac du Flambeau, sent in April by Oneida County Sheriff Grady Hartman on behalf of the Oneida County public safety committee, is $291,514. 

In addition, several Vilas County towns have seen increased charges from Oneida County for “intercepts,” situations where advanced life support (ALS) care from Oneida County ambulance crews can be provided upon patient transfer from a volunteer ambulance crew that doesn’t have the level of training necessary to provide that next level of care. 

The Oneida County public safety committee has cited increased costs its ambulance service has absorbed from Aspirus Health Care as the main reason for the increase in charges to the towns. 

Consequently, it’s resulted in calls from some town officials to have Vilas County take a more serious look at the situation as a whole. 

One of those town officials is Lac du Flambeau town supervisor Bob Hanson, who is also one of three Lac du Flambeau representatives on the Vilas County board. 

“We have pretty close to a dozen Vilas County towns that rely on Oneida County Med 5 (based at Howard Young Medical Center) for advanced life support services,” Hanson said. “Some towns have their own ambulance, like Lac du Flambeau ... but some have no ambulance at all and rely entirely on Med 5.”

In Lac du Flambeau’s case, Hanson said the $291,514 figure in the proposed 2024 contract with Oneida County is a reduced figure from $385,000 which he said is “getting close to half of our annual town budget.”

“They’re giving us a discount because we have our own ambulance,” he said. “I shudder to think what we’d be paying if we didn’t.”

Lac du Flambeau, Hanson said, is the only Vilas County town with its own ambulance service (it has two) while other towns without an ambulance service pay Oneida County “on an a la carte basis” for ALS service, a reference to the intercept service.

“$300 a run plus a $400 fee for the Oneida County Sheriff’s Department, which makes absolutely no sense to me,” he said. “The (Oneida County) sheriff’s department is not coming into Vilas County. They’re not involved in ambulance runs and yet there’s a $400 fee per run for them. What I see is we’re being subjected to predatory behavior by Oneida County. They’re looking to get Vilas County towns to pay as much of their ambulance budget as they can extort from us. The bottom line message is ‘Pay our fee or let people die. We won’t show up.’ That’s inexcusable.”

County supervisor Leah Trojan, an Arbor Vitae representative on the board, said she would “echo what Bob said.”

“Arbor Vitae is in the same situation,” she said, adding that the town has no recourse but to go to Oneida County “for anything.”

“They can and have been charging us whatever they want to,” Trojan said. “I will reiterate this. I did say at a town board meeting ‘We are getting pushed around by Oneida County.”

She mentioned the four Vilas County towns — Manitowish Waters, Winchester, Presque Isle and Boulder Junction — that are in the process of exploring the establishment of an ambulance district. 

The purpose would be to address issues that are causing problems for many volunteer ambulance services, lack of personnel being one of them. 

The Boulder Junction town board, at its Aug. 22 meeting, was the last of the four town boards to approve a resolution to continue to work together to gather information toward a possible four-town ambulance district. 

Trojan relayed a personal story related to one of the issues volunteer ambulance services, as well as the general public, face: response time. 

“In my personal experience, I drove myself to the hospital, having a severe heart issue,” she said. “I did not call an ambulance because I did not know how long that was going to take.”

Members of the Arbor Vitae town board, Trojan said, have asked what the county can do and have expressed the need for a county-wide ambulance service. 

“We’re basically kind of struggling in Arbor Vitae right now,” she said. 

County supervisor Joe Muelbach, who represents Conover, Land O’Lakes and Phelps and is a member of the Conover town board, said his town’s emergency medical technician (EMT) service “is adequately staffed.”

“Very few communities can say that,” he said. 

The problem there, he said, is the ambulance itself, which he said is over 20 years old and near the end of its time as a certified ambulance. 

“We have an ambulance but I believe it was bought used over 20 years ago,” Muelbach said, adding if “the discussion were to progress,” he would be interested in participating. 

“I was a first responder for over 25 years,” Muelbach said. “It’s an area I have a great deal of interest in.”

County supervisor Marv Anderson who, along with Hanson, pushed to have the county-wide ambulance discussion at the August meeting, gave a summary of meetings conducted with town fire chiefs and ambulance personnel as well as hospital personnel by an ad hoc committee consisting of himself, former county supervisor Chuck Hayes and former county emergency management director Jim Galloway, now a member of the Boulder Junction town board. 

“In a nutshell, we came up with a very preliminary plan to have two sites within the county that would be available 24/7 with paramedic service that would be there to do one of two things,” Anderson said. “Directly respond to an incident, whatever that is, or operate as an intercept.”

He said the approximate cost, as of two years ago when an analysis was done, was in the $1 million to $1.5 million “to start.”

“Equipment, people and so on,” Anderson said. “I won’t go into any more details about our relationship and discussion with the Aspirus folks about who would do the training, who would do the certification, who would hire all of those folks to do this work.”

He said the subcommittee met informally with representatives of all of the Vilas County towns as well as the city of Eagle River about the county-wide ALS issue as well as the Vilas County Fire and EMS Council. 

“Our final report that was brought to the board from the committee was very simply this,” Anderson said. “There were not enough townships ... that felt as though they would go along with doing this at that time.”

Among the reasons offered, Anderson said, were some towns had “a very viable” EMS staffing situation and the substantial cost to establish a county-wide ambulance service. 

“Some towns didn’t think people would agree or go along with significant, additional costs,” he said.

County supervisor Joseph Wildcat, Sr., another Lac du Flambeau representative on the county board, said he was “very encouraged with the idea of having a county-wide service of this type.”

“We’re trying to help the entire county with needs that everyone has to have,” he said. 

Burkett opened the floor to members of the audience and the county board heard from Lac du Flambeau town chairman Matt Gaulke and Cloverland town chairman Scott Maciosek, both of whom indicated they were in favor of having the county look seriously at establishing a county-wide service. 

The county board also heard from Presque Isle EMT director Donna Jukich, who echoed the sentiment previously expressed that things have changed over the past several years in relation to the volunteer situation. 

“Those changes are critical,” she said. “To say there are departments in Vilas County that have good staffing, that is minimal. I know of only one or two departments that can rely on their staffing. That’s not acceptable.”

County supervisor Pat Weber, a member of the Eagle River fire department for 50 years including time as its chief, said he still carries a radio so that he can monitor calls. 

“It’s just a habit,” he said. “I have seen where response times have skyrocketed ... 90 percent of (the calls) are not life-threatening but there’s still a need for an ambulance to go there and check the person out, help the person out and as we all know, our county has one of the oldest populations so a lot of those calls are for people who have fallen and just need assistance getting up but it still taxes the volunteers that respond with those ambulances.”

As he wrapped up the discussion and advised Fath he’d like to have a meeting of stakeholders in October, Burkett asked county finance director Darcy Smith, a former Oneida County finance director, what that county’s ambulance budget is. 

“They have a county-wide ambulance service and it was over $1 million a couple years ago when I was at Oneida,” Smith said. “Today, it’s over $2.9 million.”

Smith also confirmed for Burkett the county could levy taxes over the levy limit for a county-wide ambulance service. 

Smith estimated a tax increase of at least seven percent if a county-wide ambulance service was established, which prompted Burkett to say, in his final comments on the issue, that he believes there would have to be a county-wide referendum to “let the people decide.”

Letting Fath know who he’d like to be invited to the October meeting, Burkett also said “let’s do what serves the people and let’s do what serves the county.”

Where the money goes

Oneida County sheriff Grady Hartman, who oversees the Oneida County ambulance service, later told The Lakeland Times the revenue from the contracts and agreements with the Vilas County towns goes to offset costs for the Oneida County ambulance service. 

He stressed that none of that money goes toward the purchase of new squad cars or other equipment for the sheriff’s office. 

Hartman confirmed the Oneida County ambulance/EMS budget for 2023 is $2.9 million. 

“When they’re charging $300,000 to Lac du Flambeau or whatever the number is, I would say it goes back to cover that portion of the county ambulance budget,” he said. 

Brian Jopek may be reached via email at [email protected].