Possibilities for Enhancing EMS Collaboration in Milwaukee County
Report analyzes options for municipal fire departments to improve services, gain efficiencies
Opportunities exist to enhance the already considerable levels of coordination between the municipal fire and county departments that provide emergency medical services (EMS) in Milwaukee County, a new Wisconsin Policy Forum report finds.
Milwaukee County fire and EMS officials have expressed interest in exploring enhanced collaboration between departments and even consolidation of certain service elements, and this report is meant to assist them in that effort. Their interest stems from factors including both human resources and financial challenges, as well as the view that service levels might be improved and efficiencies gained.
The Forum report is not intended to point local officials to a specific course of action. Rather, it is meant to provide sufficient analysis to allow them to consider potential improvements, by analyzing options for further EMS service sharing between the 12 municipal fire departments that provide those services in Milwaukee County, and between those departments and the county’s Office of Emergency Management (OEM).
Listed in order of staff size, the departments are: Milwaukee, West Allis, North Shore (which serves seven North Shore municipalities), Wauwatosa, Oak Creek, Greenfield, Franklin, Cudahy, South Milwaukee, Greendale, Saint Francis, and Hales Corners.
We also examine service sharing options for those departments and Milwaukee County’s OEM, which currently oversees the EMS system as a whole and provides these departments with administrative and other support. The departments currently maintain a robust system of mutual aid and regularly provide resources to back up one another when call volumes are high. There also is collaboration in less public-facing areas, such as the sharing of backup ambulances.
“The coordinated approach to EMS in Milwaukee County has worked very well over the years, earning national acclaim,” the report finds. “Fire and EMS leaders deserve credit for not resting on these accomplishments and considering new ways to build upon that success.”
Similarities, existing collaboration
Some important similarities exist among the county’s 12 municipal fire departments. Despite the wide range of department sizes, all have professional staff and none rely on volunteers. Also, the fire departments do not split firefighting and EMS duties among their staff; each employee is trained to be both a firefighter and an emergency medical technician (EMT), with many also trained up to the level of paramedic.
We find that areas where service sharing might be enhanced among these departments include collaborating on administrative tasks like supply management, equipment maintenance, and billing, or working out an arrangement with OEM to administer those services. Pursuit of those options would be unlikely to generate significant financial savings for the municipal departments. But they could ease their administrative burden and free up resources for activities more directly related to EMS response and quality.
Opportunities in Mobile Integrated Healthcare
One key, growing element that could yield service sharing opportunities among these departments is Mobile Integrated Healthcare (MIH). This is a practice wherein EMS teams proactively work with high utilizers of EMS – often residents with chronic conditions — to prevent medical emergencies or circumstances in which the individual may be inclined to call 911 for medical help.
In recent years, Milwaukee County has seen an increased volume of EMS calls, and fire departments are looking to reduce those that may not necessitate an emergency response. All of the fire chiefs interviewed by the Forum for this report agreed on the value of such interventions as a means of helping to reduce emergency call volumes.
Three Milwaukee County fire departments – Milwaukee, West Allis, and Greenfield – have formal MIH units within their departments, while the other departments have less advanced programs or are not currently engaged in MIH. Potential options for MIH consolidation could include regionalizing it by establishing joint MIH programs for groups of municipalities. It may also be worth a look at the potential benefits of transforming it into a countywide service offered by OEM, which could have more substantive financial benefits.
Separation of Fire and EMS
Our report examines the experience of Wake County, North Carolina, where fire response and protection and EMS are conducted by separate agencies. Using that as a potential model, we envision what such an approach might look like in Milwaukee County’s North Shore, and also provide thoughts and insights on how such separation might work in other parts of the county or countywide.
Ultimately, we do not consider the complete separation of EMS from fire response services in Milwaukee County to be politically viable and affordable at this time. However, there may be value in contemplating such an approach as the municipal fire departments and OEM become more interconnected in both their administration and provision of EMS. Alternately, leaders may determine that it would make little sense to radically change a combined fire and EMS approach that is meeting the community’s needs — and instead may wish to continue their focus on identifying opportunities to improve the current framework.
Click here to read the full report.
NOTE: This press release was submitted to Urban Milwaukee and was not written by an Urban Milwaukee writer. While it is believed to be reliable, Urban Milwaukee does not guarantee its accuracy or completeness.
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