MILWAUKEE -- The private ambulance companies that help the Milwaukee Fire Department answer the growing number of 9-1-1 calls have been asking for help for years, and it may soon be coming from both the city and state levels.
It appears it will come just in time, as one of the three ambulance companies is set to leave the city's 9-1-1 agreement in October.
The companies Bell Ambulance, Curtis Ambulance and Midwest Medical, which owns Paratech Ambulance Service, help answer 9-1-1 calls deemed Basic Life Support, meaning the patient is in less danger of dying from their injuries if medical attention is not given immediately.
It frees the MFD's paramedics to handle Advanced Life Support calls, in which a patient is more likely to die in the time between answering the call and getting them to the hospital.
But the private ambulance companies struggle to staff their ambulances, something they've been telling the I-Team for years. It's gotten to the point where Paratech decided to exit the agreement it has with the city last spring. The company is officially out in October.
The heads of the remaining companies, Chris Anderson of Bell and Jim Baker of Curtis, tell us they are not equipped to pick up that remaining call load. It will likely fall on the fire department, which has already set up two ambulances to help with the growing BLS calls.
"There is an accrue shortage of EMS personnel," Baker said. "Part of that is caused by the pandemic with the COVID. Part of that is there is a labor shortage overall in the area, including nursing, so we're seeing a lot of EMS people that used to work on ambulances such as this are now working in hospitals or urgent care centers."
Part of the reason they are struggling is based on how ambulances get paid by government insurance providers.
"For the last several years, we've actually been losing money on every 911 call that we take for the city," Anderson said. "Which as you can imagine is not something that we are able to do forever."
For a $525 BLS-Emergency ambulance ride, the state of Wisconsin is paying the companies $185 per ride, if the patient was insured by Medicaid.
That rate will be increased at the start of next year, to $291 per ride, still less than what the federal government pays them for Medicare patients.
"Even so it still falls short of what the Medicare rate is, but it's still a drastic improvement," Baker said.
"I wouldn't say it's the fix, it certainly helps," Anderson said. "It certainly gets us closer to where we need to be to make this sustainable. But I hesitate to say it's the fix."
For one, the companies need to get to January before they see the increased revenue. The fire department is working with the city to find funds to help keep the companies afloat until the rate increase starts through a sort of subsidy. It approached the Ambulance Service Board with its proposals earlier this month.
"We believe that with some financial support from the city again to make this sustainable, we believe we could expand and cover more of that (Paratech's) area over time, perhaps even all of it.," Anderson said. "That remains to be seen, but that would be the goal."
Part of that goal would go beyond dollars and cents. The companies also face a major hurdle in attracting candidates to the EMS industry and staffing their ambulances.
That's why Assistant Chief Joshua Parish says money alone won't solve the problem.
"The key goal here is to not use that conventional method of, just pay people more," Parish said. "It's really to say, how do we increase the supply of available people to actually work those jobs?"
Parish says MFD and the private ambulance companies could work with local colleges and universities to attract healthcare students to EMS, possibly even hiring them while they're in school.
"A lot of the items that are core concerns in nursing, that are core concepts in healthcare, when you're talking about looking at cultural competency, looking at social determinants of health, actually looking at cross-culture communication and high-stress communication, those are all skills we practice in EMS on a daily basis," Parish said.
Other proposals would look at getting to students even earlier, while they are in high school.
"It's something we want to invest in now to see if we can actually build something functional in 2023-2024," Parish said.
The private ambulance companies are eager to get to work, especially as the list of available companies will drop from three to two in about a month.
"If it's done correctly and all these pieces come together in the right way, we really believe that's the answer and still will sustain this system going forward," Anderson said.
The private companies hope these proposals will be heard and approved soon, eyeing late September.