It’s National Emergency Medical Services (EMS) Week.
It’s the 50th anniversary of honoring EMS professionals for all they do.
But EMS officials on the Iron Range today have more questions than answers about a $30 million EMS aid package approved by the 2024 Minnesota Legislature.
“I haven’t seen what stipulations are tied to it,” Tiffany Larson, city of Chisholm ambulance director and emergency manager said. “It’s interesting, but it’s not something I’m going to be holding my breath for. Extra money is nice, but it’s a finger in the dam or a band-aid.”
EMS services across the state, especially those in rural areas, are in a world of hurt.
Medicare and Medicaid reimbursement rates for EMS patients haven’t kept up with the cost of services.
That’s led to ongoing deficits in EMS operations.
Chisholm, like many rural Minnesota EMS operations, serves a large geographic area, but is funded only by the city of Chisholm and its residents along with reimbursements.
“We have 420 square miles we cover,” Larson said. “And we’re funded by three square miles.”
The EMS aid package provides $24 million to EMS providers who serve rural Minnesota.
Another $6 million will jump-start a sprint medic program.
Under the sprint medic program, authorized medical staff would respond to emergency calls and determine whether an ambulance is necessary rather than having an ambulance immediately.
The theory is the sprint medic program would prevent unneeded ambulance responses that may not be reimbursed.
However, Iron Range EMS officials say they don’t know much yet about how the $24 million would be distributed, how much their EMS service would receive and what the funding could be used for.
The $30 million total is one-fourth of the $120 million that had been sought.
“I don’t know how they’re dividing it up,” Erik Jankila, city of Hibbing fire chief said. “I have no idea what it means or how it’s going to break down. Any dollar is better than nothing, but it’s not even close to the answer. The answer is federal. Medicare doesn’t cover the costs.”
Hibbing EMS, like Virginia, responds to calls in a wide geographic area, but doesn’t receive any funding from governmental units outside their cities.
“We’re running at a net loss, but so is every other EMS on the planet,” Jankila said.
Virginia Fire Chief Scott Fredrickson said the original $120 million request was based on 2022 rural EMS losses across the state.
Now, there’s 2023 and 2024 losses on top of that, Fredrickson said.
“I share the disappointment,” Fredrickson said of the $24 million in funding. “In talking to other people and local officials, it’s a drop in the bucket.”
Virginia EMS serves a 640 square-mile area while the city itself is 19 square miles, Fredrickson said.
Like Hibbing, Chisholm, Nashwauk, and others, surrounding governmental units served by Virginia EMS don’t contribute to the cost of Virginia EMS service even though the governments and citizens could choose to, Fredrickson said.
Fredrickson said he’s calculated that the city’s portion of the $24 million might cover about 40 percent of Virginia EMS losses from 2022.
“It’s not going to fix anything here,” Fredrickson said. “But I’m an optimistic guy and I hope this is the foot in the door for further conversations.”
Clinton Township Fire Chief Jim Theodore said he also hasn’t heard any details on how the funding would be distributed.
“I don’t have any details on what they’re going to give and who they’re going to give it to,” Theodore said. “In my opinion, it won’t be enough to help.”
As just one example of financial pressures, Theodore and Jankila both point to the cost of buying a new ambulance.
“Years ago we would order an ambulance and it was $80,000,” Theodore said. “Now, it’s $300,000.”
“We just got an ambulance we ordered,” Jankila said. “It took two years to get it and the costs now are $250,000 to $300,000.”
In Nashwauk, the ambulance service either needs surrounding governmental units it serves to help pitch in with costs, or the service will face closure, Mayor Calvin Saari said.
“We were $120,000 in debt in 2022,” Saari said. “We continued to have that level of debt in 2023 and it appears we’re on target for the same in 2024.”
Saari said the state funding won’t have a major impact on struggling EMS operations.
“We’re extremely disappointed they didn’t come up with more money,” Saari said. “We’re very disappointed in what came out of it and we’re going to have to move forward with our recommendation (for other communities to help support the service). If it doesn’t work, we’re going to have to turn in our license.”
A local task force meets next Wednesday to continue discussing how to make the Nashwauk service viable, Saar said.
Saari said the future of the ambulance service is on the line.
To continue, the service needs to operate like a business, Saari said.
“We have to make a decision because Nashwauk can’t continue on like this,” Saari said. “It’s going to bury us.”
Passage of the $30 million aid package was an issue agreed upon by both Democrats and Republicans at the legislature.
Sen. Rob Farnsworth, R-Hibbing, said the state can only supplement funds for rural EMS.
Federal government reimbursement rates are failing to cover the total cost of care, Farnsworth said.
“Reliable emergency medical services are a basic service that every Minnesotan deserves,” Farnsworth said in a news release. “The challenges we are facing needed this emergency aid just to stay afloat. While there is more work to be done, the sprint medic pilot program, regulatory changes, and certification reforms are meaningful changes that should help us address the long-term issues at a state level.”
Sen. Grant Hauschild, DFL-Hermantown, said the aid will help stabilize EMS and ensure people throughout Minnesota continue to get the care they need.
“We all know that this is only a band-aid and that over the long term we must find a sustainable funding model for EMS services,” Hauschild said in a news release. “This influx of aid and the important changes we are making to our EMS system are vital steps forward, but I will continue to push for robust investment that will ensure the long-term stability of EMS in Minnesota.”
Sen. Justin Eichorn, R-Grand Rapids, says the aid package will help, but federal reimbursement rates remain the issue.
“Our state has been facing an ongoing rural EMS crisis,” Eichorn said in a news release. “This package delivers access to these critical services for Minnesotans across the state and will be a lifeline that prioritizes Greater Minnesota communities.”
Back in Chisholm, Larson said she hopes citizens become more aware of EMS issue and learn about the status of the EMS operation that serves them.
“For what we are up against and the amount of (EMS) services closing their doors, I wish more people would go out and find out where their ambulance service is at,” Larson said.
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