The Safety and Licensing Committee met 07/23/2025. During the meeting they received a 6-month report on the ambulance service Gold Cross provides to the city. Gold Cross has been providing ambulance services in the city since the 1970s. Two years ago, Appleton and Gold Cross formalized their relationship by signing an official contract. Part of that agreement requires Gold Cross to provide updates every 6 months to the Safety and Licensing Committee on their work. This was one of those 6-month updates.
I’ve prepared a transcript of the discussion for download:
Nick Romenesko represented Gold Cross at the meeting and went through the report to the committee.
TRAINING AND EDUCATION – Gold Cross has been working closely with the Appleton Fire Department and have collaborated on training and education. Within the last six months, they worked with AFD to conduct department-wide training on the Whole Blood Administration Program. That was a new program instituted in December. Gold Cross also continues to invite AFD to their quarterly ThedaCare trauma education event. Additionally, as AFD has been moving to put paramedics on all of their fire engines, they worked with Gold Cross on standards of care so that there was good cohesiveness between AFD and Gold Cross, particularly around transfer of care guidelines.
DISPATCH AND RESPONSE TIME GOALS – They broke their calls out in the report between emergency and non-emergency calls. A calls were the lowest acuity calls and E calls were the highest acuity calls. They met their time goals for E calls for every month except February of 2025 when there was one call they were too slow on.
Mr. Romenesko noted there was a gap in reporting with the reporting methodology they were using. About 15-20% of the calls they took were not coded. Those calls did not come directly from patients but instead came from third-party callers, such as the police department or the jail. He would like to see better reporting on those types of calls.
COMMUNICATIONS – Mr. Romenesko said that they wanted to see improvement in their direct contact numbers. They had installed updated radios in all of their ambulances that allowed them to monitor the AFD main channel at all times. Mr. Romenesko said that there was some challenge in that because they received close to 500 total calls in a month but only between 5 and 10 of those calls were AFD actually reaching out to Gold Cross. Their direct contact numbers had gone up but still needed to improve. The goal was 90% and they were only at 72% now.
MEDICAL DIRECTORS – Dr. Rose is the AFD Medical Director and Dr. Bope is the Gold Cross Medical Director. They worked together on the protocol development for the AFDs move to having paramedics on all their engines.
OPERATIONAL REPORT – Their calls were split about 50/50 between emergency and non-emergency calls. They also received private calls which would include nursing home calls and calls made directly to Gold Cross for transfers from one hospital to another hospital.
They continued to expand their coverage in the City of Appleton, increasing the hours the hours their roving ambulance and roving unit patrolled the area.
Gold Cross was also one of only two EMS providers in the state with a whole blood initiative. They were able to give lifesaving whole blood to traumatic patients in the field rather than waiting until they are transported to the trauma center. Mr. Romenesko stated that they had had deployed that over 20 times and had experienced some excellent outcomes. It was not only an initiative specific to Appleton but a regional resource.
2025 MISSION LIFELINE AWARD – Gold Cross was one of only 8 providers in the state to achieve a gold level, the highest level of achievement.
PATIENT CARE METRICS – They started reporting their cardiac arrest date differently. There were two types of patients: (1) those whose hearts have stopped for 15 to 20 minutes, no bystanders provided CPS, and an AED wasn’t deployed, and (2) those whose hearts stopped but CPS was performed by bystanders before the ambulance arrived on the scene and the patient had a shockable heart rhythm. In the first case, there was a very low probability that there would be a positive outcome, but in the second case it was possible for paramedic intervention to result in patients surviving.
ORGANIZATIONAL IMPROVEMENTS – Gold Cross had started training and educating its own staff members in-house and will be applying for their own DHS training center permits to provide EMR and EMT initial training. They also have a partnership with Fox Valley Technical College for initial paramedic training. They trained 7 paramedics in-house last year all of whom passed their national registry boards and are on the streets now. They will have another class of 7 starting in September. Their goal was to create and cultivate their own regional talent because there is a shortage around the country and state right now of qualified paramedics.
Fire Chief Jeremy Hansen was pleased with Gold Cross’s overall work, saying, “We have seen a decline in response times. We have seen an increase in collaboration. We are—we saw a great partnership and alliance when we built our patient care protocols or patient care guidelines, treatment guidelines. So, all good things. We’re heading in the right direction. The one thing that we’ve asked, and this comes to no surprise to Nick I’m sure, is that we would like more paramedics on the ambulance. So that’s something that we’ve been given asking for. They’re working as hard as they can to fulfill that requirement, but it takes some time.”
View full meeting details and video here: https://cityofappleton.legistar.com/MeetingDetail.aspx?ID=1284218&GUID=2F214F46-4990-41A0-8FBC-9C7164057FF0
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