When there’s an emergency in Door County, the county ambulance is not necessarily the first to arrive. Volunteer emergency medical responders (EMRs) are typically first on the scene.
“We do it all in order to assist the county and if we didn’t do it, who would?” said Doug Weimer, chief of the Southern Door Fire Department. “But either these [volunteers] are an integral part of the emergency medical system of Door County, or they’re not.”
Wisconsin municipalities are obligated to provide emergency services, but in the 1980s the county board decided to take over that responsibility.
“It makes sense, particularly in a county like Door County where aside from the city there aren’t any large municipalities,” said Door County’s corporation counsel Grant Thomas. “It would be a real burden on each town to provide an ambulance of its own.”
The county works with local EMR teams, also called emergency medical response teams, to help improve emergency services. When an emergency gets reported to the 911 dispatch center, the county alerts nearby EMRs to the scene.
“These people are the ones that are providing the emergency first aid, taking care of people at accidents, taking care of people that have had heart problems, you name it,” Weimer said.
But although they help the county emergency services, those first response volunteers are not part of the county. They’re not employees, they’re not paid and they recently learned they’re not covered by county insurance.
Weimer was a medical responder when it first began in 1984 until 1998. The volunteer EMR teams were assembled to help the county administer its ambulance service because the volunteers could usually get to emergencies faster than the county ambulance.
The volunteers weren’t paid, except for a $5 check once a year, which Weimer said he thought meant to guarantee insurance coverage.
“The only thing we asked the county for was insurance coverage to protect our families and ourselves from medical liability, malpractice,” Weimer said. “Basically insurance coverage to protect us for doing this for free for the county.”
But in 2006, the county and EMR groups signed an agreement that detailed the relationship between the county and volunteers. Basically, the volunteers would respond to calls from the 911 dispatch center, and the county would replace supplies used by volunteers and provide insurance if it was available through the county insurance provider.
According to Thomas, that insurance coverage had been provided by a case-by-case basis, and for as long as he’s worked for the county – almost 10 years – the county’s insurance plan never actually kicked in to cover a claim from an EMR. Victims’ insurance policies cover most incidents, so Thomas said insurance coverage is rarely an issue.
In January 2013, the county heard from its insurance provider that first responders would never be covered.
“We received notice from our insurance carriers that because the EMR services are separate and distinct entities that the county’s insurance would not provide insurance for them,” Thomas said.
But that news didn’t trickle down to the volunteers until two EMRs filed insurance claims and were denied.
“I am very displeased to find out that according to what they’re saying now, you never had insurance coverage,” Weimer said. “I’m out helping people at all times of the day and night, doing it of my own free will… and now you’re telling me I was putting my family at risk? This was a big problem.”
The volunteers are reimbursed for their time – $20 a call – and are technically employed by towns and villages. Since they became aware the county insurance policy didn’t cover EMRs, the smaller municipalities have had to pick up the tab.
“Personally, in our department, I never did trust the county,” said Steve Schopf, Egg Harbor fire chief. “I’ve been carrying insurance for probably eight years or better.”
Egg Harbor’s EMRs are part of the Egg Harbor fire department, which already has to have insurance. For the few EMRs who aren’t firefighters, Schopf had to add a separate insurance policy that costs the department about $700 a year.
Since the county was told its insurance would never cover EMRs, Thomas has written a new agreement for the county and EMR groups to sign. This time, it recommends EMR groups get general, motor vehicle, workers compensation and medical malpractice insurance.
“It’s not really even an issue of who is going to carry the insurance – the EMR services will carry their own insurance,” Thomas said. “The issue is how do you allocate, for instance, the cost of the insurance… Should the EMR services pay the entire thing or should the county pay for it is an open question.”
That’s the question that will be discussed at the next Emergency Medical Services Committee meeting on Thursday, July 25. Dale Wiegand, chair of that committee, said they’ll likely recommend that the board pay for half of the cost of insuring those EMRs.
There’s another controversial point in the new agreement – it doesn’t guarantee the county will restock supplies volunteers use in an emergency.
“There is no commitment on their part that is down in black and white,” Weimer said. “Everything has an out on it. Even to the point of not replacing the emergency supplies that a [volunteer] used on a county ambulance call – not even a guarantee they would replace the stuff they’d consumed.”
That, Thomas said, is just legalese. The county board decides how the county will spend its funds, and has to choose to spend money replacing EMRs’ equipment, but doesn’t have to be legally obligated to.
“The county has never not replaced equipment and services, it’s just a provision in the agreement that caught people’s eyes and attention,” Thomas said. “Yes, in theory the county could decide not to do that, but it never has.”
There’s one thing Thomas, Weimer, Wiegand and Schopf could agree on – the communication between county officials and EMR volunteers needs work. The relationship between the entities has slipped since insurance coverage came into question.
“That’s the thing that upsets me the most,” Schopf said. “The county never came to us and told us. They just let it slide. Even after these responders were injured they didn’t send out anything that said ‘we messed up’.”
“This is a situation where there appears to be more concern about the entity that is the government of the County of Door than there is about the concern of the welfare of the citizens of the County of Door,” Weimer said. “Is this the citizens serving the county or the county serving the citizens?”