Serving Northern St. Louis County, Minnesota

Ambulance, townships at odds over new contract

Marshall Helmberger
Posted 11/19/19

TOWER— A contract between several area townships and the Tower Area Ambulance Service that provides nearly $39,000 in annual subsidy for the purchase of ambulances and other equipment is set to …

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Ambulance, townships at odds over new contract

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TOWER— A contract between several area townships and the Tower Area Ambulance Service that provides nearly $39,000 in annual subsidy for the purchase of ambulances and other equipment is set to expire at the end of the year, without a new contract in place and with township officials increasingly frustrated over a lack of financial transparency and other concerns.
None of the townships involved, Greenwood, Vermilion Lake, Breitung, or Eagles Nest, appear willing to accept a request made earlier this year by TAAS Supervisor Steve Altenburg to substantially increase the township subsidy to fill an anticipated funding shortfall for ambulance purchases. While some township officials had appeared amenable to a phased increase in the subsidy, the city has not yet presented such a contract to the townships for consideration.
Yet township officials contacted by the Timberjay are expressing increasing skepticism about the direction of the TAAS since the adoption of 24-hour staffing Monday through Friday and an increase in the number of non-emergency transfers that the TAAS is now accepting to help pay the cost of a sizable jump in payroll and other expenses.
Altenburg continues to insist publicly that the TAAS remains highly profitable, but his statements don’t line up with the city’s most recent financial data, which shows TAAS could well finish the year in the red— even though it won’t take delivery of its new ambulance until sometime early next year. Prior to the adoption of paid staffing, the TAAS typically generated annual surpluses of $100,000 or more.
Township officials have a number of concerns, including:
 In excess of $600,000 in previous TAAS surpluses were transferred to pay for other city operations or projects without being repaid. That has increased the need for an increase in ambulance subsidies to help cover ambulance replacement costs that might otherwise have been paid for out of reserves.
 Whether township subsidy payments have been transferred to other city uses, rather than being earmarked solely for ambulance and equipment replacement.
 Whether the TAAS should be running three ambulances based on current call volume.
 Whether the increase in transfers is putting excess miles on the ambulances, thereby requiring more frequent ambulance replacement.
A recent analysis of run data, prepared by Vermilion Lake Township Treasurer Steve Lotz, which has made the rounds of area township officials, nearly two-thirds of the miles currently being put on TAAS ambulances are for non-emergency transfers. While such transfers generate significant revenue for area ambulance services, they are not required and are generally not considered part of the mission of a local ambulance service.
According to Lotz’s analysis, which includes run data from Jan. 1-Sept. 30 of this year, the TAAS put an estimated 13,782 miles on its ambulances while responding to 303 emergency calls within its service territory. At the same time, the TAAS put an estimated 24,844 miles on its ambulances while conducting 104 transfers.
Lotz said Vermilion Lake supervisors had requested the mileage information from Altenburg earlier this year, but that Altenburg had not followed through on the request. “He would never give any financial accounting of the subsidy money,” said Lotz.
Even basic financial information has been difficult for townships to obtain. While Altenburg touted an increase in revenues during a financial report he gave at an ambulance commission meeting last month, his report did not include expenditures, which have jumped sharply since he took over management of the service. At the same time, township officials, like Lotz, have pressed Altenburg for a complete breakdown of the costs associated with running the additional transfers. While Altenburg has accounted for the additional costs of payroll and most costs associated with the rental and maintenance of quarters for the paid ambulance crews, he has resisted calls by township officials to factor in the costs of accelerated ambulance replacement because of the additional miles. “It’s an accounting disaster,” said Lotz. “How can a town board responsibly make a decision under those conditions?”
Greenwood Township officials share that concern. At a town board meeting earlier this month, supervisors agreed to issue a check to pay the second half of their subsidy to TAAS for 2019, but opted not to send the check until the city can provide more clarity about the use of subsidy funds. “They should be able to document where the money was spent from the subsidy collected,” said supervisor Mike Ralston. “Until we see something like that, we should hold out on any increases, for sure.”
Greenwood Treasurer Pam Rogers agreed. “Their accounting is very lacking. When Steve Altenburg was here, he was not very clear.”
Township officials note that Altenburg’s claim that non-emergency transfers generate significant amounts of revenue undercuts his argument for an increase in the ambulance subsidy. “We want to talk to Steve Altenburg. If the transfers are making that much money, they should transfer some of that revenue to the ambulance replacement fund,” said Breitung Town Board Chair Tim Tomsich. Several township officials indicated that they see that as a sensible approach given that the transfers are now generating the overwhelming majority of the miles put on TAAS ambulances.
For now, Tomsich said he doesn’t expect his board will approve any contract proposal the city has put forward to date. He said the board has discussed possibly approving a contract on a year-to-year basis, at least until the city is able to provide more financial transparency. “The information isn’t there yet,” said Tomsich. “We need more accountability.”
Other township representatives believe Altenburg has not yet made the case for operating a third ambulance, or for maintaining 24-hour staffing given the current call volume. Larry McCray, who served as a career firefighter for 15 years and with a volunteer department for another 30 years, represents Eagles Nest on the ambulance commission. He said he’s asked repeatedly for information that would help Eagles Nest officials assess whether the TAAS actually needs a third ambulance. “The questions I’ve had are how many miles per year are being put on the ambulances? Are they being rotated on a regular basis? What is the number of overlapping calls, and how many times are three ambulances needed at once? He [Altenburg] has never provided any of that.”
Altenburg and Tower Clerk-Treasurer Victoria Ranua responded jointly to similar questions posed by the Timberjay. In their response, the two city officials stated that the current system for tracking ambulance usage does not track data in such a way. However, they stated that “three [ambulances] have been deployed at once or two have been deployed while one was being repaired.”
McCray said he expects his board will grant a one-year extension of the ambulance subsidy, with a 25-percent increase. “But that’s it,” he said, until TAAS provides much more information than has been offered so far. “The ball is in their court,” McCray added.

A history of good relations at risk
The concerns expressed by township officials are new and reflect an erosion of trust in TAAS leadership on the part of township officials in the past two years. For years, the townships maintained good relationships with the TAAS and were usually more open to increases in the ambulance subsidy. For the townships, the subsidy payments, which are currently set at $15 per capita annually, have always been optional. Under their state licensing agreement, the TAAS is obligated to respond to emergency calls within its coverage area, whether or not townships make a contribution toward the service.
The late TAAS supervisor Ballard Turnbull had made the case to area townships nearly 20 years ago that their contributions would strengthen the ambulance service by ensuring a stable source of revenue for ambulance replacement.
Township officials still generally agree that it’s important to continue that contribution. “We’re in an aging township, so the need is there,” said Larry Anderson, a longtime supervisor in Eagles Nest Township. But Anderson, who served for several years as the township’s representative on the ambulance commission, echoed other area officials in his frustration with the current state of financial information from TAAS. “The first thing that our township wants to know is where is the money going?” said Anderson. “When Matt [Tuchel] ran it, we knew where we were at. It was a real open and well-run department. I have nothing personally against Steve [Altenburg], I just feel we have not been given enough data and we don’t know where we’re at.”
Altenburg’s credibility has also suffered from claims he made to area townships during presentations earlier this year as part of his effort to get townships to accept an increase in the ambulance subsidy. On at least one occasion, he told the Greenwood town board that other townships had already approved the increase in the subsidy, when none of them have approved the request to date.
Township officials have repeatedly raised questions about the use of their subsidy payments for other city funding needs. While the city did, in the recent past, transfer township payments for city cash flow purposes, recent financial data provided by the city shows the subsidy account, which is tracked separately, has been restored to the full amount. The same cannot be said of the regular ambulance account, much of which the city has been unable to restore due to its ongoing financial problems.
So far in 2019, the city has collected only about 39 percent of the subsidy payments due from the townships with just over a month to go in the year. Final payments from the townships are due as of Dec. 31.
Meanwhile, Eagles Nest’s Anderson said he remains concerned about the decision by TAAS not to replace its ambulance garage, which was destroyed by fire five and a half years ago. “We have equipment that is taking it hard being left outside,” he said. That’s a complaint that some on the Tower council have made as well. Yet the $140,000 insurance settlement that the city received from the fire went into the city’s general fund and has since been spent for other purposes.

Other approaches being considered
The situation has city officials in Tower open to consideration of alternatives forms of management for the ambulance service. The Tower City Council voted unanimously on Nov. 12 to ask Virginia Ambulance Supervisor Allen Lewis to give a presentation on ambulance issues, which could include a regional concept for managing EMS services in northern St. Louis County.
In Breitung, Tomsich said he’d like to see what Lewis has to say before the town board decides how to proceed with the latest proposals from TAAS. “That would certainly be another option to listen to,” he said.

Comments

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C1son

Another option would be to bring in GoldCross ambulance service to replace TAAS.

Thursday, November 21
Lee Peterson

The new three year "contract" that area townships are expected to sign is in dire need of a re-write. The wording is the same as the current contract except that the numbers asked for in the subsidy payments have gone up significantly.

1. The townships need to insert language that defines and protects the ambulance fund accounts. For example, it needs to be stated that the City Council cannot transfer money out of the ambulance accounts to pay for unrelated City projects and City expenses as has been past practice. Don't sign a contract without it. So much for trust.

2. Profits from the City's newly begun "non-emergency transfer business" need to be proportionally spent toward the purchase and repair of the extra ambulances that the City is going to require for this business. Vermilion Lake Township Treasurer Steve Lotz lays out the facts and figures quite well in his research.

3. It has been said that the townships' subsidy is only to be spent on buying new ambulances. That language is not included in the existing or in the presently proposed three year contract.

4. The City needs to provide written monthly financial reports detailing the income, the expenses, and the current status of the Ambulance Service accounts. This reporting needs to be spelled out in the new "contract" with the townships. Had this been done in the past, the City probably wouldn't be in the financial mess that it is in now. Transparency, like it or not, is a good thing for taxpayers.

5. The townships' supervisors, along with help from the member townships' attorneys, need to come forth with a comprehensive Ambulance Service contract, which I am sure will include more than the provisions I have recommended above. This isn't a re-invention of the wheel. I'm sure that the Greenwood Twp. attorney, for example, has references available that cover several ambulance service agreements between member entities.

Saturday, November 23