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Madison EMS seeks new 12‑hour peak coverage, community paramedicine captain and ambulance replacement
Summary
Chief Hilstrom told supervisors EMS call volume rose ~19% from 2023–2025 and proposed a 12‑hour peak shift ($163,000) plus a community paramedicine captain position (~$111,000) and ambulance capital replacements; staff intend to pursue grants and non‑transport billing to offset costs.
Emergency Medical Services Chief Hilstrom told the Board of Supervisors that call volume for Madison EMS has grown steadily over the past three years—an increase of about 349 calls (roughly 19.2%) between 2023 and 2025—creating persistent staffing pressures, higher overtime and accelerated vehicle wear.
To match daytime demand patterns, Hilstrom proposed a 12‑hour peak‑coverage shift to target the busiest hours (roughly 7 a.m. to 9 p.m.), estimating an annual cost of about $163,000 if the hours are implemented as regular scheduled coverage rather than strictly voluntary signups. He stressed recruitment and retention challenges: many recent hires come straight from training and require extended onboarding, and most staff currently commute long distances to Madison.
Chief Hilstrom also outlined an expansion of the department’s community paramedicine program: promoting the current lieutenant (Tiffany) to a captain to manage community paramedicine and related administrative duties. The full community‑paramedicine package—staffing, follow‑up visits and program support—was presented with an estimated net fiscal effect of roughly $111,000 annually, though Hilstrom and staff said those costs could be substantially offset by a federal/state grant they expect to pursue and upcoming policy changes that may allow non‑transport billing revenue.
On capital needs, Hilstrom reported the county’s ambulance fleet is aging and that frontline ambulance replacement pricing has risen (current market ranges cited between $460,000 and $511,000 per unit) with delivery lead times up to a year. One ambulance is already under contract for FY27; another is slated for spring 2027 delivery and will require appropriation. He also enumerated smaller capital requests (cradle‑point data links for eKG transmission, pharmacy locker, powered lifting belts, a UTV/side‑by‑side for difficult terrain responses) and noted an RSAF grant (50% matching potential) with an application due March 16 could cover roughly half of a $527,562 package.
Board members probed the likely operational savings from community paramedicine—chiefly avoided transports and reduced ambulance wear—and asked for clarifying data (projected avoided runs, revenue assumptions, grant likelihood). Staff committed to return with more detailed cost‑saving projections, grant timelines and the exact delivery schedule for ordered ambulances.
The board did not take immediate binding action; the EMS requests will be considered within the broader FY27 budget process and grant opportunities will be pursued.
