TOWER— Changes are likely coming to the management of the Tower Area Ambulance Service based on the preliminary results of a new business plan for the service, which the city council got its first look at on Monday.
Among the biggest changes is a push to bring the TAAS into compliance with state law on ambulance licensing. Among a long list of requirements, ambulance services are required to maintain a written on-call schedule, 24 hours a day, 365 days a year.
“The city of Tower never adopted this,” said Clerk-Treasurer Victoria Ranua, who worked with ambulance director Dena Suihkonen and business consultant Betsy Olivanti to develop the business plan.
“The current model doesn’t match the statute for the state of Minnesota,” said Olivanti. “We want to get it in alignment so that TAAS is providing the service that’s required.”
Olivanti said rural and small-town services often struggle to maintain staffing and Tower’s has experienced those challenges as well, which is likely one reason the service hasn’t maintained a full written on-call schedule. The business plan, as currently written, includes an examination of three different staffing models, including a continuation of the high-wage, partial paid on-call system that’s been in place since 2018, or a shift to a full paid on-call system with generally lower pay for on-call hours. That’s a system that’s currently in place with both the Cook and Orr ambulance services.
The TAAS launched in 1958 as an all-volunteer service, operating as an all-call service, which means all staff are, in effect, subject to call at any time. But the TAAS has gone through a number of changes over the decades, including increasing rates of compensation, in an effort to boost participation— with limited success. Among the most recent changes was a shift to a partial paid on-call system in 2018, noted Ranua, although that system only provided 40-50 percent scheduled coverage, rather than the 100 percent required by law. The TAAS also paid much more than other similar services for on-call personnel, which pushed payroll costs sharply higher and created other unanticipated consequences, such as a big jump in worker’s compensation costs and potential overtime liability.
While the TAAS will need to develop a full on-call schedule, it will also likely have to adjust the pay rates to maintain financial viability. Suihkonen said that likely means a shift to pay rates similar to Cook and Orr, of around $3 to $5 an hour for periods in which staff are on-call, but a higher rate when staff members actually respond to a call. Currently, TAAS on-call staff are paid between $10.50 and $11.50 an hour. At full coverage, such a rate of pay would push payroll costs just for the on-call staff to nearly $200,000, noted Ranua. Activation pay would add considerably more to that amount.
The high rate of pay in Tower had been sold to the city council on the promise that the on-call personnel would pay for themselves by enabling the TAAS to undertake more inter-hospital transfers, which typically pay more than 911 emergency calls. But Ranua noted that the on-call staff is supposed to be utilized solely for emergency calls, not for transfers.
Council member Dave Setterberg asked if the transfers could be operated as a kind of secondary business for the TAAS, that would be undertaken by staff on a solely pay-per-call basis. He even suggested the TAAS utilize a separate ambulance, paid for with city funds, to facilitate the transfers.
“That’s a good idea,” said Mayor Orlyn Kringstad.
By utilizing an ambulance purchased solely by city funds, the idea would presumably eliminate the concerns expressed by area townships, which have been concerned by the additional miles that transfers have put on TAAS rigs. The area townships pay into a fund for ambulance replacement and the city recently agreed to township demands to institute a mileage charge of $1.66 for every mile incurred on a TAAS ambulance during a transfer. Those funds go into the city’s dedicated ambulance replacement account. Olivanti said that she and Ranua and Suihkonen could develop that concept as a fourth scenario for the council to consider.
In a related discussion, Olivanti briefly outlined partial financial projections which, at this point, suggest the TAAS could generate substantial profits under any of the scenarios they examined. But the projections reach that conclusion by assuming a sizable increase in revenues over any previous year. “The revenue, as planned is $615,000,” said Olivanti, without providing a clear explanation of how that figure was determined. It represents a $75,000 increase over revenues in 2019, during which the TAAS saw a record number of calls. In 2020, after runs dipped in the spring due to the COVID-19-related shutdowns, the TAAS is expected to generate about $495,000 in revenue.
Ranua noted that the financial projections do not yet include depreciation costs. A separate analysis she generated suggested that that expense could top $90,000 annually, although it’s an expense for which TAAS officials have not previously accounted.
While the city appears likely to move to adjust its on-call pay, it remains unclear how staff will be paid when they actually respond to calls. The business plan explores a flat rate of $50 per run for 911 calls or an hourly rate of $25. The plan notes that 911 calls typically take two hours. Ranua and Suikhonen said they plan to discuss that issue with ambulance personnel in February before making a final decision on which way to go. Some city council members plan to attend that discussion as well, which would require posting the discussion as a special council meeting, tentatively set for Feb. 15. The council could have a finalized business plan for the ambulance service approved as early as March.
In other business, the council approved a resolution making committee appointments and other designations for 2021. Setterberg will remain as acting mayor, in case of Kringstad’s absence. The council left four seats on the charter commission vacant for now, given that there’s no suggested charter changes pending. The resolution adds Steve Wilson and Wayne Dahl, of Embarrass, to the city’s forestry board and also adds Dahl as a forestry board representative to the Gunderson Trust. Council member Joe Morin agreed to replace council member Sheldon Majerle on the Tower Economic Development Authority after Majerle assured him that TEDA’s executive director does “99 percent of the work.”
Kringstad’s motion to solicit requests for proposals from engineering firms failed for lack of a second, although council members agreed to take another look at the idea at some point in the future.
Majerle questioned the appointment of Clifford Koski as zoning administrator, and he later voted against the overall resolution, presumably over that issue.
The council designated the Timberjay as the official newspaper once again. The Timberjay’s quote of $3.25 per column inch for display ads beat out the $4 per inch offered by the Tower News.
In other action, the council:
• Authorized the clerk-treasurer, deputy clerk-treasurer, and councilor Morin to take training for overseeing future boards of appeal and equalization.
• Approved a motion acknowledging that the city had made “deductions in error” from ambulance personnel pay beginning in 2016, for PERA. The council directed Ranua, who discovered the error by the previous clerk-treasurer, to notify ambulance personnel of the situation and give them the opportunity to roll over any accumulated funds into a state deferred compensation plan or take a cash distribution. Ranua said that PERA has agreed that the city won’t have to make any matching contributions, so the error won’t impact the city financially.
• Heard from Joan Broten under public input, who requested that the council issue findings of fact regarding the Dave Rose RV park. She said the council was supposed to issue such findings in 2016 but never did so.