January 20, 1999

Governor Tommy Thompson
P.O. Box 7863
Madison, WI 53707-7863

Dear Governor Thompson:

It has come to our attention that plans are being made to begin charging Wisconsin Emergency Medical Technicians for obtaining licenses. The Wisconsin EMS Association wishes to communicate our opposition to this initiative along with the reasons for our opposition.

The Wisconsin EMS Association understands that it is common practice for many health care professionals in Wisconsin to be charged a fee for obtaining their health provider license. However, all of these health care professionals are engaged in the full-time occupation of providing health care. The vast majority (we estimate over 80%) of Wisconsin EMTs do not earn a living as an EMT. This defines a clear difference in an Emergency Medical Technician and any other health care provider.

While we understand that current statutes prohibit charging a fee for the license of any EMT-Basic that volunteers their services for a municipal ambulance, there is a significant amount of volunteer EMTs that do not volunteer for a municipally-administrated service, as well as a significant number of EMTs that perform above the EMT-Basic level.

Many of Wisconsin's volunteer ambulance services operate as a non-stock, non-profit organization under current Wisconsin statutes. These EMTs, while performing the exact same functions as other volunteer EMTs fitting exemption under the law, would be required to pay for their license. Wisconsin is currently facing a crises of available and willing EMTs to volunteer their time and talent. Several other legislative initiatives have and are being pursued to address this problem. It does not make sense to us that while part of Wisconsin government seeks to provide support to volunteers, the Department of Heath and Family Services seeks to further hinder volunteerism by charging EMTs for the right to volunteer.

The Governor-appointed, state EMS Board has, for the past several years, encouraged the advancement of skill levels to EMT-Intermediate and EMT-Paramedic. Under current law, these providers could be charged for their licenses. Again, this will not encourage ambulance services or individuals to advance with additional training due to increased operating costs. Additionally, many of Wisconsin's EMT-Intermediates and some of Wisconsin's EMT-Paramedics operate as volunteers. The reward we will give these dedicated individuals for obtaining additional training is to charge them for their license.

We question how licensure under a new system with some EMTs paying and some EMTs not paying for a license could even work. Some EMTs operate for more than one ambulance service. How would an EMT demonstrate what type of license (fee or no fee) they are applying for? What would be done in the case of the same EMT needing a fee license and a no-fee license? If ambulance services are to bear the cost of licensure, who would pay in the case of the EMT operating with more than one service? How would DHFS differentiate between the nearly ten different types of provider including fire-based, hospital-based, volunteer, third service, etc.?

Wisconsin allocates nearly $2.2 million to help support and fund the operations of Wisconsin ambulance services. The proposal to implement licensure fees on EMTs directly, or upon Wisconsin ambulance service providers, contradicts current policy. On one hand the state is investing in community-based ambulance services and on the other hand the State proposes to tax or assess fees on those providers or EMTs. The message ambulance service providers (municipalities, counties, hospitals, ambulance services and fire departments) seems convoluted by the State's desire to provide assistance to these community organizations and the desire to generate program revenue.

During the past years, DHFS and the EMS Board have successfully demonstrated themselves to be friends and supporters of Wisconsin EMS and EMTs. Again, creating a new fee structure on EMTs or ambulance providers seems to contradict the efforts of the EMS Board and the population they serve.

The Wisconsin EMS Association urges you not to create and implement a new fee structure that would affect Wisconsin's EMTs, or ambulance service providers. The implementation of a new EMT or ambulance provider fee contradicts the efforts communities have instituted to generate volunteerism and to control costs associated with providing necessary services to local Wisconsin communities.

If you have any questions, please feel free to contact me at the number provided or the Wisconsin EMS Association lobbyist, Forbes McIntosh.

Sincerely,

Richard F. Meeker
President

CC:
Susan Jablonsky
John Kiesow
John Morgan
EMS Advisory Board Members