>> THE FOLLOWING PROGRAM IS A PBS WISCONSIN ORIGINAL PRODUCTION.

>> BABY BOOMERS ARE LEAVING VACANCIES IN CRITICAL HEALTHCARE ROLES, LIKE E.M.S., NURSING, AND AIDES.

SERVICES THAT, AS BOOMERS AGE, WILL REQUIRE MORE OF, LEADING SYSTEMS TO A BREAKING POINT.

I'M FREDERICA FREYBERG.

TONIGHT ON "HERE AND NOW," HOW STAFFING SHORTAGES IMPACTS THE DAILY LIVES OF NURSING HOME RESIDENTS.

THE WISCONSIN HOSPITAL ASSOCIATION SPEAKS TO THE GROWING GAP OF CARE.

STEVEN POTTER REPORTS ON THE STATE E.M.S.

SYSTEM REACHING ITS BREAKING POINT, AND RESEARCHER, MIKE WAGNER, ON POLITICAL DIVIDES CREATING SOCIAL DIVIDES.

IT'S "HERE'S AND NOW" FOR APRIL 14th.

>> FUNDING FOR HERE AND NOW IS PROVIDED BY THE FOCUS FUND FOR JOURNALISM AND FRIENDS OF PBS WISCONSIN.

>> WISCONSIN LOST 42 SKILLED NURSING FACILITIES FROM 2016 TO 2021, A REALITY SEEN NATIONALLY DUE TO A SHORTAGE OF NURSES, IDENTIFIED NURSING ASSISTANTS, OR CNAs, AND OTHER STAFF.

A NEW REPORT FROM THE WISCONSIN HOSPITAL ASSOCIATION SHOWS CNAs HAVE THE HIGHEST TURNOVER IN THE HEALTHCARE WORKFORCE, ALL OF WHICH HAS MEANINGFUL IMPACTS ON THE PEOPLE THEY SERVE.

MARISA WOJCIK HAS ONE COUPLE'S STORY OF THEIR CARE.

WE ARE NOT NAMING THE FACILITY.

>> WE'RE SO SHORT STAFFED.

>> YEAH, VERY SHORT STAFFED.

>> DICK AND LANEA HAVE BEEN IN THE SAME ASSISTED LIVING FACILITY FOR THE LAST SEVEN YEARS.

SINCE THEN, THE FACILITY'S OWNERSHIP HAS CHANGED HANDS MULTIPLE TIMES, AND THE STAFF, MANY MORE TIMES OVER.

WE FIRST SPOKE WITH THEM IN OCTOBER 2021.

>> I HAVE SPINOCEREBELLAR ATA ATAXIA, WHICH IS, ATAXIA MEANS UNCOORDINATED, AND, YOU KNOW, IT GOES INTO ALL YOUR NERVES.

BUT I COULDN'T GET OUT OF BED AND PUT TOOTHPASTE ON MY BRUSH, WHICH SOUNDS VERY SILLY.

>> 2021, AROUND THE TIME DICK FIRST BEGAN FILING GRIEVANCES TO THE STATE FOR WHAT THEY WERE EXPERIENCING IN THE FACILITY.

>> WE HAD A COOK, A MED-PASSER, AND ONE OR TWO AIDES DURING THE DAY.

>> FOR HOW MANY RESIDENTS?

>> I WOULD SAY ABOUT 50 TO 55 AT THE TIME.

>> SO WHAT DOES THAT MEAN?

DOES THAT MEAN SOME PEOPLE NEED HELP AND THEY CAN'T GET IT?

>> RIGHT.

IT MEANT -- >> THEY WAIT.

>> SOME PEOPLE CAN'T GET -- >> THEY MIGHT BE STUCK ON THE TOILET FOR AN HOUR.

>> YOU MIGHT LIE IN BED FOR TWO HOURS WAITING FOR SOMEONE TO HELP YOU OUT OF BED.

ALSO, WE HAD AN INCIDENT THAT HAD QUITE A MAJOR IMPACT, I THOUGHT, WHEN A MED-PASSER COULD NOT FIND CHILDCARE.

AGAIN, I THINK IT WAS A WEEKEND MORNING.

THERE WAS NO BACK-UP PLAN, EVEN THOUGH A MANAGEMENT PERSON WAS IN THE OFFICE THAT DAY AND IT'S SOMEONE WHO HAD PASSED MEDICATIONS BEFORE BUT CHOSE NOT TO GET INVOLVED.

DID FIND -- EXCEPT, OF COURSE, TO FIND A SUBSTITUTE EVENTUALLY, BUT WHEN 8:00 MEDS COME AT 12:30 OR 1:00 OR 1:15, THAT IS REALLY A DELAY.

WE'VE HEARD ALSO OF CASES OF PEOPLE HEARING THEIR NEXTDOOR NEIGHBORS IN THEIR APARTMENTS CALLING FOR HELP AND SEEMING TO BE IGNORED FOR A LONG TIME.

>> DO YOU FEEL SAFE LIVING HERE?

>> ONE BIG FEAR IS FIRE, BECAUSE SO MANY WHEELCHAIRS AND OTHERWISE INCAPACITATED OR PEOPLE WITH REDUCED CAPABILITIES ON THE UPPER FLOOR, WITH JUST ELEVATORS AND STAIRS.

>> HOW DOES IT ALL MAKE YOU FEEL?

>> I AM VERY STRESSED.

>> STRESS LEVEL IS TERRIBLE.

>> THERE ARE PEOPLE WHO DON'T COME TO THE DINING ROOM ANYMORE BECAUSE OF THE STRESS LEVEL, AND A COUPLE OF PEOPLE HAVE MOVED OUT.

>> FAST FORWARD TO PRESENT DAY, NEW CONCERNS HAVE APPEARED.

>> NURSE IN JANUARY CAME AND IMMEDIATELY SAID ABOUT GATHERING VIOLATIVITALS AND SHE LEFT -- ST GATHERING VITALS AND SHE LEFT, SO NO MORE VITALS SINCE THEN, WE WENT FOR MONTHS AND MONTHS, MAYBE WITHOUT A YEAR, WITHOUT HAVING THEM DONE FOR EVERYONE.

BUT THERE SEEMS TO BE NO END TO THE NUMBER OF STAFF WHO ARE WILLING TO WALK OFF THEIR SHIFT AFTER AN HOUR OR TWO AND JUST GO HOME AND LEAVE ONE PERSON IN CHARGE TO TAKE CARE OF EVERYBODY ALL NIGHT.

>> WELL, ONE THING, THEY DON'T PAY THEM ENOUGH.

WHEN YOU GET JUST POVERTY WAGES, YOU'RE NOT VERY INTERESTED IN COMING TO WORK.

>> AND STILL, SOME OF THE SAME ISSUES PERSIST.

>> ONE REAL CONCERN IS THE LACK OF FIRE DRILLS.

>> YES.

BUT BASICALLY, WE'VE BEEN TOLD, WELL, JUST WAIT THERE IN YOUR ROOM AND THE FIREMEN WILL COME.

WE'VE FILED GRIEVANCES WITH THE STATE AS WELL.

NOT LATELY, WE BURNED OUT ON THAT.

OFTENTIMES, THEY JUST CAN'T SUBSTANTIATE WHAT IS SUPPOSED TO HAVE HAPPENED.

>> HOW DOES ALL OF THAT MAKE YOU FEEL AS YOU'RE JUST TRYING TO LIVE YOUR LIFE?

>> DEPRESSED.

I FEEL OUR NEEDS, THAT MANY OF OUR NEEDS ARE IGNORED AND THAT ESPECIALLY THE EMOTIONAL AND PSYCHOLOGICAL, I GUESS YOU'D S SAY.

>> CERTIFIED NURSING ASSISTANTS OFTEN PERFORM MUCH OF THE WORK IN PLACES LIKE ASSISTED LIVING FACILITIES OR NURSING HOMES, AND THE HEALTHCARE WORKFORCE REPORT SHOWS ADDITIONAL CRITICAL SHORTAGES OF OTHER FRONTLINE HEALTH WORKERS ACROSS THE STATE.

FOR MORE ON THE RAMIFICATIONS OF THIS FOR PATIENTS, STAFF AND HOSPITALS, WE TURN TO ANN ZENK, VICE PRESIDENT OF WORKFORCE AND CLINICAL PRACTICE AT THE WISCONSIN HOSPITAL ASSOCIATION.

THANK YOU FOR BEING WITH US.

>> THANK YOU FOR HAVING ME.

>> SO HOW MANY VACANCIES ARE THERE RIGHT NOW FOR CERTIFIED IS NOW UNDER INVESTIGATION ASSISTANTS IN WISCONSIN?

>> NEARLY 1,800 ACROSS THE STATE, AND ADDED TO THAT, NEARLY 4,000 RN OPEN POSITIONS.

>> HAS IT EVER BEEN VACANCY RATES THAT HIGH?

>> YOU KNOW, I THINK BECAUSE OUR HEALTHCARE, HOSPITAL AND HEALTH SYSTEM WORKFORCE IS LARGER THAN IT'S EVER BEEN AND THESE ARE HISTORIC HIGHS, I THINK THOSE LEVELS ARE UNPRECEDENTED ALSO.

>> WHAT HAPPENS WHEN THERE ARE NOT ENOUGH CNAs OR RNs IN A HEALTHCARE FACILITY OF ANY KIND?

>> SO, YOU KNOW, HOSPITALS RIGHT NOW ARE EXPERIENCING A REALLY BIG BOTTLENECK IN THE AVAILABILITY OF LONG-TERM CARE BEDS.

LIKE NURSING HOME BEDS.

THE IMPACT OF THAT IS THAT PATIENTS STAY IN THE HOSPITAL LONGER THAN THEY NEED TO, WHICH STRETCHES STAFFING THINNER AND ALSO CREATES LONGER WAIT TIMES IN THE EMERGENCY DEPARTMENT AS PATIENTS WHO NEED THAT ACUTE CARE BED HAVE TO WAIT FOR ANOTHER BED TO OPEN UP.

>> BECAUSE YOUR REPORT TALKS ABOUT SOMETHING CALLED THE SILVER TSUNAMI, AND AGAIN, THESE NURSING HOME BOTTLENECKS.

DESCRIBE WHAT'S HAPPENING THERE.

>> WE'VE BEEN TALKING AT W.H.A.

AND THINKING ABOUT THE IMPACT OF THE RETIREMENTS OF THE LARGE BABY BOOM POPULATION -- GENERATION, EXCUSE ME, BECAUSE THE BABY BOOM GENERATION IS SO LARGE AND SPANS A COUPLE OF DECADES, WE'RE NOW SEEING THE SILVER TSUNAMI IN WISCONSIN, 10,000 U.S. CITIZENS TURN 65 EVERY DAY AND THAT'S RETIREMENT AGE.

RIGHT?

IN WISCONSIN, ABOUT ONE IN FOUR INDIVIDUALS IS AT RETIREMENT A AGE.

THAT'S EVEN AHEAD OF THE U.S. POPULATION WHERE IT'S ABOUT ONE IN FIVE.

THAT MEANS OUR HEALTHCARE WORKFORCE IS SHRINKING.

THERE'S AN ADDITIONAL CHALLENGE FOR HOSPITALS AND HEALTH SYSTEMS, BECAUSE AS WE AGE, OUR NEED FOR HEALTHCARE INCREASES.

SO JUST AT THE TIME OUR WORKFORCE IS SHRINKING, HEALTHCARE DEMAND IS GROWING.

>> SO WHAT DOES ALL OF THIS MEAN FOR PATIENTS AND HEALTHCARE PROVIDERS THEMSELVES?

>> WE NEED TO FOCUS ON GROWING OUR WORKFORCE FASTER IF WE'RE GOING TO KEEP UP WITH DEMAND, BUT WE ALSO HAVE TO FIGURE OUT A WAY TO INCREASE CAPACITY WITH THE WORKFORCE THAT WE HAVE.

SO THAT MEANS THAT, YOU KNOW, WE HAVE TO GROW FAST, WE HAVE TO MAKE BETTER USE OF TECHNOLOGY, WE HAVE TO MAKE SURE OUR TEAMS ARE OPERATING AT THE TOP OF THEIR SKILL LEVEL.

IF WE DON'T DO THOSE THINGS VERY EFFECTIVELY, WE'RE GOING TO SEE LONGER WAITS IN THE EMERGENCY DEPARTMENT.

WE'RE GOING TO SEE PEOPLE MAYBE HAVING TO LEAVE THEIR OWN COMMUNITY AND GO TO ANOTHER COMMUNITY WHERE THERE ISN'T AN OPEN HOSPITAL BED.

>> HOW BADLY IS THIS PUTTING PATIENTS AT RISK?

>> I THINK THAT TOO, RIGHT NOW, IMPACTING PEOPLE'S TIME AND ENERGY.

I THINK ULTIMATELY THEY GET THE CARE THEY NEED, BUT IT MIGHT BE FARTHER AWAY THAN THEY WOULD LIKE OR THAN THEIR FAMILIES CAN VISIT.

IT MIGHT BE, YOU KNOW, WE FOCUS A LOT ON THE RIGHT CARE IN THE RIGHT SETTING AT THE RIGHT TIME, SO THEIR REHAB MIGHT BE DELAYED IF THEY CAN'T FIND THAT LONG-TERM CARE THEY NEED.

>> YOU TALK ABOUT SOME OF THE KINDS OF SOLUTIONS THAT ARE UNDER CONSIDERATION, BUT WHAT ABOUT THE PAY FOR SOME OF THESE LOWER PAID FRONTLINE WORKERS, LIKE CNAs.

IS THERE A WAY TO ADEQUATELY TO INCREASE THAT AND RETAIN THEM?

>> WE ARE HEARING FROM OUR THOUGHTS AND PRAYERS AND HEALTH SYSTEMS THAT C.N.A.

WAGES ARE INCREASING AS DEMAND INCREASES.

A FEW YEARS AGO, C.N.A.

PAY STARTED AT MAYBE 13 OR $14 AN HOUR.

IN OUR LATEST SALARY SURVEY, THE AVERAGE STARTING SALARY IS AROUND 17 TO 17.50 AN HOUR AND THE MEDIAN SALARY IS AROUND 19.50 AN HOUR, SO THOSE WAGES ARE COMING UP.

>> WE DON'T HAVE MUCH TIME LEFT, BUT I KNOW THAT THERE HAVE BEEN STATE INVESTMENTS AND KIND OF C.N.A.

TRAINING PROGRAMS AND GOVERNOR EVERS IS CALLING FOR $100 MILLION IN HIS STATE BUDGET TO ADDRESS THE HEALTHCARE WORKFORCE SHORTAGE.

ARE POLICY MAKERS, THOUGH, ACROSS THE BOARD HEARING AND UNDERSTANDING THIS PROBLEM?

>> I THINK AS THE WORD GETS OUT, AS OUR REPORT IS PUBLISHED AND SHOWS DOUBLING OF VACANCY RATES IN JUST ONE YEAR, THAT MESSAGE IS STARTING TO GET ACROSS.

>> ALL RIGHT.

WELL, ANN ZENK, THANKS VERY MUCH.

>> THANK YOU.

>> THE STATE'S NETWORK OF EMERGENCY MEDICAL SERVICES IS CRUMBLING AND DANGEROUSLY UNRELIABLE.

THAT'S ACCORDING TO A NEW REPORT FROM THE OFFICE OF RURAL HEALTH.

"HERE AND NOW" REPORTER STEVE POTTER LOOKS AT THE GROWING PROBLEMS AND PROPOSED SOLUTIONS.

>> THIS IS A HEARTBREAK.

THIS IS A TRAGEDY.

>> BECAUSE WHEN YOU CALL 9-1-1, YOU EXPECT AN AMBULANCE TO SHOW UP AND SHOW UP SOON.

(Siren).

>> BUT FOR SOME COMMUNITIES AROUND THE STATE, PARTICULARLY RURAL ONES, THERE'S A GROWING CONCERN THAT EMERGENCY MEDICAL SERVICES WON'T BE THERE TO ANSWER CALLS.

THE PROBLEM, A STAFFING SHORTAGE.

>> WE HAVE A CRISIS NOT UNLIKE OTHER INDUSTRIES, LIKE RETAIL AND OTHERWISE, BUT STAFFING FOR E.M.S.

MEANS LIFE AND DEATH.

IT MEANS SOMEBODY NOT SHOWING UP TO A CALL, AN AMBULANCE NOT ARRIVING.

WHAT WE STARTED TO SEE IN THE LAST COUPLE OF YEARS, DEPARTMENTS HAVE BEEN CLOSING, AND SOMETIMES THERE'S A MUTUAL AID AGREEMENT FOR ANOTHER DEPARTMENT TO COME IN AND HELP OUT, BUT MANY TIMES, TOWNS, CITIES, VILLAGES ARE WITHOUT E.M.S.

THEY HAVE NOBODY.

>> A NEW SUPPER FROM THE UW MADISON OF RURAL HEALTH SHOWS THE EXTENT OF THE PROBLEMS.

MORE THAN 40% OF STATE E.M.S.

AGENCIES HAD STAFFING GAPS WHERE NO AMBULANCE WAS AVAILABLE FOR EMERGENCY CALLS.

AND ALMOST 80% OF E.M.S.

AGENCIES WERE CALLED TO COVER AN EMERGENCY IN A NEIGHBORING COMMUNITY.

>> WE SAW THAT IN 10 COMMUNITIES, THERE WERE SERVICES THAT REPORTED THAT AN AMBULANCE NEVER GOT TO A CALL AT ALL, THAT THERE WAS 9-1-1 CALLS REQUESTING AMBULANCES.

THEY DIDN'T HAVE STAFFING AVAILABLE AND THEY NEVER HAD AN AMBULANCE MAKE IT TO A CALL.

>> AT THE HEART OF THE CURRENT STAFFING STRUGGLES IS THE FACT THAT, FOR DECADES, WISCONSIN'S E.M.S.

OPERATIONS HAVE BEEN BUILT UPON AND ALMOST EXCLUSIVELY BEEN SUPPORTED BY VOLUNTEERS.

>> RIGHT NOW, 79% OF OUR STATE ACTUALLY RELIES ON VOLUNTEERS TO STAFF THEIR 9/11 CALLS, WHICH IS A HUGE AMOUNT IF YOU'RE TALKING ABOUT MAJORITY OF THE STATE RELIES ON VOLUNTEERS, SOME THAT MIGHT GET PAID A STIPEND, MIGHT NOT GET PAID AT ALL, A LOT OF TIMES HAVING TO PAY OUT OF THEIR OWN POCKET, SO WE HAVE MANY RURAL AREAS THAT ARE USING VOLUNTEERS TO KIND OF SUBSIDIZE THE COST OF E.M.S.

>> PAUL BLOUNT IS THE CHIEF OF THE E.M.S.

OPERATIONS FOR THE CAMBRIDGE AREA.

THE COMBINATION MODEL HAS BECOME A POPULAR SOLUTION.

WE HAVE SEVERAL INDIVIDUALS THAT WORK HERE FULL TIME, THIS IS THEIR FULL-TIME JOB, AND THEN SOME PART-TIME MEMBERS AND THEN COMMUNITY VOLUNTEER PAID ON-CALL MEMBERS, AND THAT IS A PRETTY POPULAR STAFFING STRATEGY AND WHAT IT DOES IS HELP ADDRESS THE NEED FOR 24/7/365 AMBULANCE COVERAGE.

>> CHIEF BLOUNT STARTED AS AN E.M.S.

VOLUNTEER HIMSELF YEARS AGO.

HE UNDERSTANDS WHY IT'S HARD TO KEEP ENOUGH VOLUNTEERS TO STAFF AMBULANCES.

>> FAMILY DEMANDS, WORK DEMANDS, AND THEN JUST A STRUGGLE TO JUST FIND PEOPLE TO DO THE JOB AND TO VOLUNTEER ESPECIALLY TO DO THE JOB.

>> THE PRIME EXAMPLE OF THE E.M.S.

STAFFING SHORTAGE IS HAPPENING THEIR IN LAKE MILLS IN JEFFERSON COUNTY.

>> UNFORTUNATELY, A BIT OVER A YEAR AGO, WE REALIZED THAT WE WERE NOT BEING SUCCESSFUL AT RECRUITING AND RETAINING PEOPLE.

WE WERE ALSO HAVING SOME FINANCIAL DIFFICULTIES WITH ALL OF THAT GOING ON BASICALLY, WE HAVE HAD TO MAKE THE DECISION THAT WE ARE GOING TO BE CLOSING OUR DOORS HERE ON JUNE 30th.

BECAUSE WE HAVE BEEN SERVING THIS COMMUNITY, OUR FRIENDS, OUR NEIGHBORS FOR CLOSE TO 50 YEARS, THAT IN ITSELF IS THE -- CLOSING THE DOORS IS JUST TRAGIC.

>> WHETHER YOU'RE A PAID EMERGENCY MEDICAL TECHNICIAN OR EVEN AN E.M.S.

VOLUNTEER, EXTENSIVE TRAINING, EDUCATION AND CERTIFICATION FROM THE STATE IS REQUIRED.

AND ON TOP OF THAT, JIM COLEGROVE NOTES, THE WORK ISN'T FOR THE FAINT OF HEART.

>> THIS IS A DIRTY JOB.

THIS IS VERY DIFFICULT.

YOU ARE DEALING WITH HUMAN BEINGS IN SOME OF THEIR WORST POSSIBLE TIMES AND YOU HAVE TO HAVE A LOT OF EMPATHY FOR THOSE PEOPLE AND YOU HAVE TO BE WILLING BE WORKING IN AN ENVIRONMENT WHERE SOMEBODY IS THROWING UP ON YOU.

YOU ARE WORKING A CODE AND YOU ARE DOING C.P.R.

ON SOMEBODY THAT YOU KNOW WHO LIVES JUST DOWN THE STREET, THAT TYPE OF THING, AND SO IT IS VERY EMOTIONALLY CHARGED, BUT IT IS GENERALLY VERY MUCH A SENSE OF WANTING TO GIVE BACK TO A COMMUNITY.

>> LAKE MILLS IS NOW IN THE PROCESS OF JOINING THE CAMBRIDGE AREA E.M.S.

GROUP.

A NUMBER OF E.M.S.

AGENCIES AROUND THE STATE HAVE ENTERED INTO SIMILAR CONSOLIDATION AGREEMENTS WITH NEIGHBORHOODS COMMUNITIES.

A TEMPORARILY SOLUTION IS ASKING RESIDENTS, THROUGH BALLOT REFERENDUMS, FOR MORE MONEY, BUT FOR A LONG-TERM SOLUTION, E.M.S.

OFFICIALS ARE SEEKING MORE STABLE FUNDING FROM THE STATE.

>> THE STATE REALLY, RIGHT NOW, NEEDS TO STEP N-NEEDS TO PROVIDE PERMANENT FUNDING.

>> DEYOUNG SAYS SUCH FUNDING WILL NEED TO BE SUBSTANTIAL AND SUSTAINABLE.

>> WE'RE TALKING ABOUT $500 MILLION IN A BUDGET EMERGENCY MANAHOPEFULLYFOR A TWO-YEAR BUDE EVERY DEPARTMENT ABOUT WHAT THEY NEED.

SOME WILL GET LESS, SOME MORE, BASED ON ON HOW RURAL THEY ARE.

>> TO MAKE THAT FUNDING DREAM A REALITY, E.M.S.

OPERATORS HAVE BEGAN KNOCKING ON LAWMAKERS' DOORS AT THE CAPITOL.

>> AS FAR AS I'M CONCERNED, POLICE, FIRE EXPEMS, E.M.S.

IS THE NUMBER ONE PRIORITY.

>> OH EAU CLAIRE AREA STATE SENATOR JESSE JAMES HAS WORKED HAND IN HAND ON EMERGENCY CALLS AS A FORMER POLICE AND FIRE CHEER IN ALTONA.

HE SAYS HE KNOWS HOW NECESSARY THESE SERVICES ARE.

>> IT'S ESSENTIAL FOR ALL OF US, WHETHER YOU'RE IN THE URBAN AREA OR RURAL AREA, WE NEED TO HAVE THESE SERVICES AVAILABLE TO SERVE OUR COMMUNITIES.

>> SENATOR JAMES SAYS HE WANTS TO EXPLORE FINANCIAL INCENTIVES FOR SMALLER COMMUNITIES TO CONSOLIDATE THEIR E.M.S.

OPERATIONS, BUT HE'S UNSURE HOW MUCH REPUBLICAN LEGISLATORS ARE WILLING TO GIVE TO E.M.S.

AGENCIES IN THEIR STATE BUDGET.

>> THERE NEEDS TO BE SOME MONEY PUT INTO IT.

I DON'T KNOW IF THEY WOULD REACH THAT $500 MILLION MARK, THOUGH.

>> E.M.S.

OFFICIALS SAY THEY ALSO NEED MORE MONEY FOR RECRUITMENTS EFFORTS TO HELP ATTRACT MORE POTENTIAL EMPLOYEES TO THE FIELD.

ACCORDING TO THE STATE DEPARTMENT OF HEALTH SERVICES, OVER THE LAST DECADE, AMBULANCE PATIENT NUMBERS HAVE NEARLY DOUBLED FROM ABOUT 500,000 PATIENTS PER YEAR TO MORE THAN 900,000.

OVER THAT SAME 10 YEARS, HOWEVER, THE NUMBER OF E.M.S.

PROVIDERS HAS GONE FROM 20,000 TO JUST 21,000, AN INCREASE OF ONLY 5%.

AND, DEYOUNG SAYS, THOSE FIGURES ARE ABOUT TO GET MUCH WORSE.

>> WE ARE ACTUALLY ESTIMATING ABOUT 25, 26% OF ALL LICENSED E.M.S.

PROVIDERS ARE PROBABLY GOING TO LET THEIR LICENSE LAPSE THIS RENEWAL YEAR.

YOU'RE TALKING ABOUT A WORKFORCE CUTTING IT DOWN BY A QUARTER.

>> E.M.S.

LEADERS HOLD OUT HOPE THAT STATE LAWMAKERS WILL RESPOND TO THE NEED.

>> I THINK THAT THERAPIES -- THAT THERE IS INTENT IN THE LEGISLATURE TO TRY TO ADDRESS THIS ISSUE.

IT SEEMS TO BE VERY HIGH PRIORITY.

I'M GETTING CONTACTED BY LEGISLATORS NUMEROUS TIMES A WEEK WANTING INFORMATION ON THE SYSTEM, WANTING TO KNOW SOME OF THE RESULTS OF THE SURVEY AND SO ON.

I DON'T KNOW WHAT E.M.S.

2.0 IS GOING TO LOOK LIKE, BUT WE KNOW THAT E.M.S.

1.0 HAS RUN ITS COURSE.

>> FOR HERE AND NOW, I'M STEVEN POTTER IN LAKE MILLS.

>> MOST OF CENTRAL AND WEST CENTRAL WISCONSIN REMAIN UNDER A RED FLAG EXTREME FIRE DANGER WARNING FRIDAY EVENING.

WARM TEMPERATURES AND GUSTY WINDS DRASTICALLY INCREASE THE CHANCE OF WILDFIRES THIS WEEK, PROMPTING GOVERNOR TONY EVERS TO DECLARE A STATE OF EMERGENCY.

WISCONSIN D.N.R.

HAS RESPONDED TO NEARLY 100 WILDFIRES SINCE LAST FRIDAY, INCLUDING A 3,000-ACRE FIRE IN MUNROE COUNTY THAT CREWS INCLUDING FROM THE WISCONSIN NATIONAL GUARD WORKED TO CONTAIN.

OFFICIALS ARE URGING EXTREME CAUTION UNTIL CONDITIONS SO FAVOR TO WILDFIRES IMPROVE.

>>> DEMOCRATIC WISCONSIN SENATOR TAMMY BALDWIN ANNOUNCED SHE IS RUNNING FOR A THIRD TERM.

AN ANOTHER SCORCHED EARTH CAMPAIGN, POLITICAL VITRIOL AN STEROIDS.

THAT SEEMS TO BE THE WISCONSIN WAY.

IN FACT, A NEW REPORT FROM THE CENTER FOR COMMUNICATION AND CIVIC RENEWAL AT UW MADISON SHOWS WISCONSIN'S POLITICAL DIVIDES ARE BREAKING CITIZENS APART.

CENTER DIRECTOR AND JOURNALISM PROFESSOR, MICHAEL WAGNER, JOINS US WITH DETAILS, AND THANKS VERY MUCH FOR BEING HERE AGAIN.

>> IT'S GREAT TO SEE YOU.

>> SO WHAT ARE THE MOST PROMINENT SYMPTOMS OF WISCONSIN'S POLITICAL DIVIDE?

YOUR SURVEY CALLS THEM CIVIC FRACTURES.

>> YES.

SOME OF THE EXAMPLES WE SEE OF THAT ARE IN HOW POLITICS AND YOUR DEEP COMMITMENT TO OUR POLITICAL IDENTITIES IS IS NOW SHAPING HOW WE ENGAGE EVERY DAY WITH PEOPLE.

WE'VE STOPPED TALKING POLICIES.

WE MIGHT TALK ABOUT THE WEATHER OR THE BADGERS, BUT WE WON'T TALK POLITICS.

ONE IN FIVE HAVE CUT A FAMILY FEBRUARY OR FRIEND OUT OF OUR LIVES BECAUSE OF DISAGREEMENTS.

THAT MIGHT BE BECAUSE WE DON'T WANT TO HAVE TO ENGAGE THEIR IDEAS OR MAYBE THE OTHER SIDE IS TELLING US WHO WE ARE IS INVALID OR MAYBE WE FEEL DANGEROUS IN SOME CONVERSATIONS OR WE MIGHT BE IN DANGER, AND SO IT'S HARD TO KNOW EXACTLY WHAT'S DRIVING THESE THINGS, BUT PEOPLE ARE RETREATING FROM THE KIND OF DELIBERATION THAT IS FUNDAMENTAL TO DEMOCRACY.

>> THOUSAND AND WHY DID THIS HAPPEN?

>> IT'S GOTTEN WORSE SINCE ACT 10.

OVER THE LAST DECADE PLUS, WE'VE SEEN A GROWING FRACTURE IN THESE KINDS OF MEASURES OF OUR CIVIC HEALTH, AND SO 11 YEARS AGO, ABOUT 33% OF WISCONSINITES SAID THEY'D STOP TALKING POLITICS WITH A FRIEND.

NOW IT'S 60%.

IT'S REALLY INCREASED THE WAY THAT OUR LEGISLATURE AND GOVERNOR DEAL WITH EACH OTHER HAS GOTTEN MORE ACRIMONIOUS, OUR POLITICAL ADS HAVE GOTTEN MORE ACRIMONIOUS, NATIONAL POLITICS IS MORE COARSE AND FRAUGHT WITH ALL KINDS OF THINGS THAT ARE BOTH UNCIVIL OR OUTRIGHT DANGEROUS AND DISTURBING ON THE OTHER, AND SO ALL OF THESE THINGS ARE HAPPENING AT ONCE.

>> WHY IS THE MESSAGING THAT MAKES PEOPLE ANGRY, DISTRUSTFUL AND EVEN FEARFUL TO RESONANT?

>> WELL, PEOPLE ARE OFTEN DRIVEN PARTIALLY BY EMOTIONS AND THEIR DECISION-MAKING AND IT'S EASIER I THINK TO TAP INTO PEOPLE'S FEAR AND IT'S EASIER TO SAY TO PEOPLE, YOU'RE NOT THE REASON FOR YOUR PROBLEMS AND IT'S NOT BROAD STRUCTURAL THINGS THAT ARE REALLY HARD TO FIX; IT'S THOSE PEOPLE, THAT GROUP THAT WE DON'T LIKE IS WHY YOUR LIFE IS HARDER, AND SO IT BECOMES EASIER TO DISLIKE THAT GROUP AND SUPPORT THE PEOPLE THAT WERE TELLING YOU THAT THAT'S THE PROBLEM.

>> HOW SURPRISING IS YOUR FINDING THAT 60% OF STRONG TRUMP SUPPORTERS SAY THEY COULD HAVE TO USE FORCE TO SAVE THE TRADITIONAL AMERICAN WAY OF LIFE.

60%.

>> YEAH.

WE ARE INTERESTED IN HOW THESE CIVIC FRACTURES MIGHT LEAD TO ANTI-DEMOCRATIC OUTCOMES LIKE USING VIOLENCE TO ACHIEVE YOUR POLITICAL MEANS, AND FOR MOST REPUBLICANS, THEY SAY, NO, WE DON'T LIKE THIS IDEA, BUT AMONG THE ONE-THIRD OF REPUBLICANS WHO ARE SUPPORTERS OF TRUMP, 60% OF THOSE FOLKS SAY THEY MIGHT ENDORSE THAT DEAL.

SAYING YOU ENDORSE FORCE RATHER THAN ACTUALLY DOING IT IS DIFFERENT, BUT THIS IS AN ALARMING AND DISTURBING RESULT, SO WE NEED TO KEEP AN EYE ON THIS AS A ASSOCIATED THAT THERE ARE OTHER WAYS TO SOLVE OUR PROBLEMS OTHER THAN USING VIOLENCE.

>> THIS REPORT SAYS THAT THIS DIAGNOSIS IS GRIM BUT THERE IS REASON FOR HOPE.

LIKE WHAT?

>> LOTS OF THINGS.

>> FIRST, PEOPLE FAVOR POLITICAL COMPROMISE EVEN OVER STICKING TO YOUR PRINCIPLES EVEN IF NOTHING GETS DONE.

MORE PEOPLE BELIEVE THAT THEIR VOTE WAS COUNTED.

STRONG CONFIDENCE IN THAT.

THERE'S STRONG SUPPORT FOR NON-PART SAT REDISTRICTING, WHICH IS A FAIRER WAY TO ENGAGE IN REPRESENTATION.

AND THERE'S STRONG SUPPORT FOR THE SEPARATION OF CHURCH AND STATE ACROSS POLITICAL PARTIES.

AND SO THERE ARE FOUNDATIONS WE CAN BUILD ON TO IMPROVE DEMOCRACY IN OUR STATE.

>> IT SEEMS HARD TO UNDERSTAND HOW THERE IS 80% OF SURVEY RESPONDENTS BELIEVE THAT THEIR VOTE WAS COUNTED, WILL BE COUNTED.

HOW DOES THAT SQUARE WITH ELECTION DENIAL AND ALL OF THIS MISINFORMATION THAT WE'VE BEEN LISTENING TO FOR 2-1/2 YEARS?

>> WELL, WE'VE HEARD IT COMING REALLY FROM ONE CORNER OF POLITICAL DISCOURSE AND WE'VE SEEN MOST OF THE PEOPLE WHO ARE OPEN TO THAT IDEA ARE THESE TEND TO BE STRONG SUPPORTERS OF FORMER PRESIDENT TRUMP.

HE'S NOT RELENTED ON THAT MANY REPUBLICANS IN GOVERNMENT WILL EITHER AGREE WITH HIM OR WON'T DIRECTLY DISAGREE AND SO THERE'S THIS AMBIGUITY IS THERE THAT LETS PEOPLE FEEL LIKE MAYBE SEEMS LIKE THE ELECTION WAS REASONABLY CONDUCTED BUT MAYBE IT WASN'T OR MAYBE THERE WERE SOME PROBLEMS EVEN THOUGH ALL OF THE AUDITS, ALL OF THE LAWSUITS, ALL POINT TO THE SAME STORY, WHICH IS THAT WE DO THAT REALLY WELL IN WISCONSIN.

>> WHY DID YOUR CENTER EMBARK ON THIS STUDY?

>> WE REALLY CARE ABOUT WAYS WE CAN REKNIT TOGETHER THE CIVIC FABRIC.

THIS IS A STATE THAT HAS ELECTED PEOPLE IN STATEWIDE ELECTIONS FROM BOTH PARTIES.

IT'S A STATE THAT HAS HAD VERY TIBIAL AND VERY CONSERVATIVE LAWMAKERS REPRESENT US AND WE'VE BEEN ABLE TO DO THAT IN WAYS WHERE WE COULD TALK TOGETHER, WORK TOGETHER, TRY TO SOLVE PROBLEMS TOGETHER, AND AS THOSE THINGS FRACTURE, BECOMES HARDER TO DO THAT.

WEPT TO UNDERSTAND THE PROBLEM SO WEB HEM ARTICULATE A SOLUTION.

>> MIKE WAGNER, THANKS VERY MUCH.

>> MY PLEASURE.

>> FOR MORE ON THIS AND OTHER ISSUES FACING WISCONSIN, VISIT OUR WEBSITE AT PBS WISCONSIN DOT-ORG AND THEN CLICK ON THE NEWS TAB.

THAT'S OUR PROGRAM FOR TONIGHT.

I'M FREDERICA FREYBERG.

HAVE A GOOD WEEKEND.

(CLOSED CAPTIONING BY RIVERSIDE CAPTIONING COMPANY)