County educator warns rural emergency medical services face reliability, staffing and funding gaps

A regional university Extension educator told the Dunn County Community Resources and Tourism Committee that emergency medical services and volunteer fire departments across the county and region are showing signs of systemic strain and that local leaders should begin planning now for shared or alternative service models.

Garrett Zasteful, regional community and leadership development educator for Chippewa, Dunn and Eau Claire counties, told the committee that Wisconsin has roughly 360 ambulance agencies and about 800 fire departments and that ambulance runs statewide total about one million a year — roughly 2,700 runs per day. He said town governments are statutorily required to provide ambulance service and that a 2023 law (Act 12) added certification and monitoring requirements for agencies and departments.

Why it matters: Zasteful said statutory obligations and certification create a legal expectation of 24/7/365 coverage, but demographic and workforce trends are eroding the capacity to meet that standard in many rural areas. "The system is failing," he said, arguing that local leaders must treat the problem as structural rather than a failure of individual volunteers.

Officials and data cited by Zasteful: - Dunn County currently has two career ambulance departments, seven volunteer ambulance departments and one emergency medical responder (EMR) group. Menomonie operates a combined career/volunteer fire department; 11 other Dunn County fire departments are primarily volunteer. - Across Wisconsin, about 41% of EMS providers are considered unreliable; among rural providers that share rises to roughly 55%; in the northwest region the figure cited was about 64%. - Staffing math: keeping one ambulance staffed 24/7/365 with two personnel requires about 17,000 hours per year — the speaker described that as approximately 8.5 full-time-equivalent positions.

Zasteful named several drivers: competition for trained personnel with hospitals and paid municipal services; declining volunteerism and aging volunteer ranks; increased training requirements that are harder for volunteers to meet; and growing call volumes for medical needs (falls, assisted-living transports) tied to local demographics.

He described responses other counties are exploring: countywide levies or emergency medical districts to provide stable funding; internships and paid positions to create a more reliable workforce; community paramedic roles that combine emergency response with community health tasks; and regional coordination of dispatch and triage to prioritize resources by call severity instead of strict response-time targets.

Committee members described local examples of shrinking rosters and the financial tradeoffs town boards face when deciding which provider to contract with. Zasteful said some towns choose less expensive providers even when they are not the nearest agency, and that a legal and financial review is needed to identify options that meet statutory requirements while creating a sustainable delivery model.

The committee did not take a formal action but discussed next steps including supporting the town of Elk Mound’s grant application to plan local solutions; potential county-level conversations about levy authority and service districts; and Extension’s offer to convene stakeholders and assist with planning if the county is interested.

Ending: Zasteful offered to share national and state reports and to work with local leaders on planning; committee members asked him to continue the outreach and to provide comparative examples and options for county-level deliberation.