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Elkhorn emergency services plagued with problems

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Photo by Dan Plutchak

Elkhorn's Fire Department and EMS services are located behind city hall downtown. EMS is struggling from a shortage of volunteers and an antiquated billing system.

ELKHORN — The Emergency Medical Services Division of the Elkhorn Fire Department sometimes can’t muster enough volunteers to respond to calls, forcing the use of backup private ambulance services.

The division also is carrying more than $469,000 in uncollected ambulance bills from the past three years because its bill collecting system reportedly is cumbersome and archaic.

“As of Nov. 23, 2010, we were behind in data entry and billing by approximately six to eight weeks,” according to an Elkhorn Fire Department report released this month. “No outstanding debts had been sent to our collections agency for over a year.”

Elkhorn EMS relies solely on service-generated revenue. No taxes are used for operating costs.

Many small fire departments and their ambulance services “are finding it more difficult to get people to respond,” City Administrator Sam Tapson said.

Fire Chief Rod Smith and Emergency Medical Services Assistant Chief Dave Fladten authored a report on their findings about the troubled EMS division.

The fire officials recommended actions they say would increase revenue 25 to 30 percent and improve staffing and response times.

The Elkhorn Public Safety Committee will discuss the issues at its regular meeting Tuesday.

Fladten’s portion of the report states the EMS division, commonly known as Elkhorn Rescue Squad, has experienced a decline in volunteer participation over the last several months.

As a result, requests for emergency services went unanswered by EMS members.

Tapson said the inability to staff some shifts prompted the use of Fladten to evaluate the city’s EMS.

Unanswered calls were blamed on the inability to assemble properly staffed crews. On occasion, higher-trained and licensed members failed to respond.

If that happened, a private ambulance service or a mutual aid agency was called to respond,

To identify reasons for the decline in volunteer response, a survey was distributed among the volunteers.

Survey respondents overwhelmingly identified lack of leadership and direction of the EMS as reasons for the decline in responses.

The majority of EMS calls were handled by less than 30 percent of its volunteers, Fladten reported.

He found that most unanswered calls happened during late night, during early morning before 6 a.m. and during weekends. Fladten, who has 30 years of EMS experience, said it was normal for declines to happen in volunteer departments during those periods.

Elkhorn EMS covers the area of Elkhorn and the townships of Geneva, Lafayette and Sugar Creek. The response area is one of the largest for an EMS division in Walworth County, Fladten reported.

Elkhorn EMS is one of the busiest municipal EMS’s in the county, but the chief, clerk and assistant chief are the only paid positions. The rest of the staff is paid on-call.

Elkhorn is the only EMS in the county that does not staff its station, and it’s one of two EMSs that do its own billing.

Elkhorn uses a volunteer shift sign-up sheet, but most available shifts remain uncovered, according to the report.

Fladten determined that enticements for guaranteed call coverage were needed.

Options include:

-- Stipend payments for people to sign up for shifts.

-- Paid on-premises staff during certain hours.

-- Contracts for mutual aid services to provide coverage.

New volunteers are bolstering their EMT education. It’s anticipated that those volunteers would eliminate many of the non-responses.

Elkhorn now allows volunteers who live in outlying areas to respond directly to emergency scenes instead of having to first report to the station. They carry life-saving equipment that mitigates many medical emergencies.

In the event no EMS volunteers respond to a call, the Walworth County Sheriff’s Office automatically dispatches Paratech Ambulance Service.

If a full crew cannot be assembled, volunteers can call for assistance from other EMS agencies, depending on call locations.

Mutual aid agencies include Delavan Rescue Squad, Lauderdale-LaGrange Rescue Squad and Town of Delavan Rescue Squad.

Fladten recommended billing be outsourced by March to EMS Medical Billing, which offered to waive its $1,200 start-up fee.

“By changing our billing practice, our net receipts should show an increase of $85,000 to $100,000 per year,” Fladten wrote.