REGIONAL- Ely-Bloomenson Community Hospital (EBCH) CEO Patti Banks accepted some of the responsibility this week for the delay in the completion of the long-promised regional ambulance study commissioned by the hospital from a prominent health care consultant.
“It’s part due to my schedule, (the consultants) schedule, and the Legislature,” Banks said in a phone interview on March 30.
Banks has since promised local officials associated with the ambulance joint powers board that the study will be completed by the end of April.
Banks, who serves on the board of directors of the Minnesota Hospital Association, has been in St. Paul frequently since the beginning of the legislative session lobbying on behalf of hospitals. She will return to St. Paul in that role for two more weeks yet this month.
In addition to her own time crunch, Banks said EBCH’s consultants have also played a role in the delay due to their own busy schedules. “Safe Tech works with clients nationally. Most of their staff consults and works in emergency medical services,” she said.
Banks also mentioned that the schedules for both her and the consultants have been mutually incompatible at times. “Coordinating our schedules has been the biggest challenge,” Banks said. The schedule mismatch causes problems with the EBCH’s review of the study. “The hospital will get the preliminary results. It must then be reviewed to desensitize data and results to meet the (federal privacy) regulations.”
The study
After multiple requests to continue contributing funds to the Ely Area Ambulance Service (EAAS), the EBCH board of directors decided last year that it wanted a better solution to the funding problems at EAAS. The ambulance service has been suffering many of the same problems shared by other rural ambulance providers throughout the country— diminishing revenues, insufficient local volunteers and pay for staff, declining governmental and insurance reimbursements rates, and inflation.
“The hospital was asked to donate increasing amounts of money,” Banks remarked. As a result, the board decided to look for outside input for a better solution, rather than continuing to fund “the same old thing that isn’t working” as a business model. “The board wanted to investigate doing something different to innovate and collaborate, to find ways to work better together to meet the area’s EMS needs.”
In August 2023, EBCH hired Safe Tech Solutions of Isanti, Minn. to conduct a $70,000 fixed fee study on “how to set up an ambulance service for success.” At the time, Banks told members of the joint powers board that the study would “look beyond Ely for that answer, potentially encompassing other area services in northern St. Louis and Lake counties.” Banks confirmed this week that the scope of the study has not changed since last year. She did confirm that Safe Tech has interviewed and gathered data from the EAAS, and the two other ambulance services with “primary ambulance service areas” assigned by the Minnesota Emergency Medical Services Regulatory Board.
Suspicions
Despite several denials from EBCH that the study is a ploy to wrest control of local ambulance services from the existing providers, suspicions continue to circulate.
EMS professionals approached by the Timberjay, excluding the EAAS, declined to speak on the record. Speaking on conditions of anonymity, one local paramedic expressed concern that the study would push for a regional model or takeover of small community ambulance service by a commercial service like Mayo, leading to a decline of quality in effective area coverage, patient care and response times. “Either way, it’s a lose-lose for us and our local residents.”
Another local EMS professional at a different ambulance service remarked that the study wasn’t completed yet because its conclusions didn’t “mesh” with what the hospital wanted to hear, though what those conclusions might be wasn’t explained.
The evidence of mistrust and misunderstanding is much easier to verify than the rumors and suspicions that continue to circulate.
Not every ambulance provider contacted by Safe Tech shared the suspicious view of the consultant or study. Tower Ambulance Supervisor Dena Suihkonen reported a positive experience with Safe Tech. “They are doing a good job, not rushing through things,” Suikonen told the Timberjay. “Rather, they are putting in the time and effort to do a thorough job.”
Suihkonen said she was impressed by Safe Tech’s professional demeanor and efforts to look at five years of operating data. “What they asked for says they are looking pretty deep,” she added, relating that the consultant wanted details on rosters, experience, certification levels, service areas, call volumes, the types of calls, when those calls come over time, and other matters needed to profile an ambulance service.
“I know they got behind” Suihkonen remarked, “because some of the [providers] they contacted didn’t get them their information [promptly].”
Delay worsened mistrust
The delay in the completion of the study has not helped to quell suspicions or bridge misunderstandings. At the last JPB meeting on January 29, Banks said the study would be done in time for the Feb. 26 JPB meeting. That meeting was canceled when the study wasn’t done and the JPB had no EAAS financial items to discuss. The hospital didn’t issue an update on the delayed study before last week, a lag of two months with no news.
“What’s taking so long? … It was supposed to be presented to the JPB in January,” said EAAS board chair Chuck Novak. “Then there was no study in February and no study in March. Now there won’t be a study until next month … Is the consultant firm not as good as they were portrayed to be?”
The study created other opportunities for miscommunications to spread. For example, Safe Tech interviewed EAAS staff in late 2023, according to EAAS executive director Dustin Moravitz, who spoke to the Timberjay in mid-February. “Then, they got back to us wanting to know the same stuff,” Moravitz said. “It seems like one thing after another.” The repeated information regarded the roster, staff certification levels, and other routine items like the population of the service area.
Banks appeared to confirm the ongoing requests for information at the January JPB meeting. “When I checked in with Safe Tech Solutions, they had received the final information from the Ely ambulance service as of Tuesday or Wednesday last week (Jan. 23 or 24),” she said at the time. When the Timberjay asked Banks about the repeated information requests, she stated that the initial information provided in 2023 wasn’t complete because Safe Tech wanted data for more than one year.
Talking to Novak, a third version of events emerged. Novak said Moravitz initiated the communication with Safe Tech on Jan. 24, not the other way around, as documented in Moravitz’s notes, and Safe Tech told him that they didn’t need more information at that time. With three versions of what may have happened between Safe Tech and EAAS, this reporter notes it is easier to document the miscommunications than it is to uncover what really happened.
Regarding the miscommunications and trying to work with EAAS, Banks admitted, “it is a strained relationship.”
EAAS finances looking improved
While everyone is still waiting for the study, the EAAS has seen an improvement in finances. “(EAAS) has the cash flow to meet their payroll and expenses,” JPB chair Marlene Zorman told the Timberjay. “The new collections service is helping a lot.”
The EAAS replaced its former billing service last year because of poor performance. Upon investigation, the EAAS board uncovered that “ten other ambulance services” had similar issues with this firm’s underperformance, according to Novak, which is a nice way to say the old billing firm wasn’t doing its job.
“The new company for collections is great,” Novak commented. “They have a conference call every week with our executive director and check in frequently if there are any issues.”
As for the former firm, Novak mentioned at the last JPB meeting that EAAS and the other ambulance services were considering legal action when they finished investigating the problem. When the Timberjay interviewed Novak this week, he said that next week, “I will be crafting a letter to the Attorney General of Minnesota requesting the state take action.”
The Timberjay will continue to follow this developing story.