TOWER- Ely-Bloomenson Hospital CEO Patti Banks had a receptive audience here on Monday when she spoke to the Tower Ambulance Commission about the results of the SafeTech Solutions study, which calls for a single area ambulance service run by the hospital that would serve the Ely, Tower, and Babbitt area. The commission has been grappling for years with the financial challenges faced by the Tower Area Ambulance Service.
Banks acknowledged that the rollout of the study to the public hasn’t always gone smoothly. But she noted that the hospital is a private nonprofit, operated by a volunteer board, whose goal is to maintain the organization’s independent operations. She works at the direction of the board, she told commission members.
“This may be why there have been some stumbles with our communications,” Banks said. “I have to follow our bylaws.”
Banks admitted the plan has a big hill to climb, especially with the hospital’s “contentious relationship” with the Ely Area Ambulance Service.
“It’s been tough to communicate when there is staff turnover, conflicting rules, and regulations. We are not talking to the same person all the time,” she said.
The hospital board chose to skip a subsidy payment to the Ely Ambulance Service last year, instead using that funding to pay for the SafeTech study.
Banks emphasized that having a financially-stable ambulance service is just as important to the hospital, as the local communities who need reliable ambulance service and hospital transfers.
“Change is required,” she said. “We can’t just keep doing the same thing over and over again, that won’t work.”
Banks said that state and federal legislators have urged the hospital to come up with some innovative solutions.
“We need to find a different approach to emergency medical transportation,” she said.
The option from the study, commissioned by the hospital, that made the most sense was the single license model, which would allow the hospital to leverage more funding, specifically from the federal government.
She admitted the plan being presented at this time does not include detailed financial data, for two reasons. Firstly, SafeTech did not receive enough financial data from both the Ely and Babbitt services. Tower, on the other hand, was very responsive and did share all requested information. Secondly, they were concerned that publishing incomplete financial data in the study would focus too much attention on that aspect of the study, and not on the overall conclusions.
“Cost-wise,” she said, “I can tell you that for every dollar the hospital would invest in the ambulance service, we would be reimbursed 60 cents. I want to be upfront about that.” And while Banks said the hospital is allowed to charge 101-percent of their costs, that doesn’t mean they receive that much back in payments.
“We would still need some type of community support,” she said. “But there is no way to predict what that would look like.”
The Tower Area Ambulance Service, according to Ambulance Director Dena Suihkonen, is only getting 40 cents on the dollar reimbursement.
An ambulance service run by the hospital would save money on drug costs, supplies and staffing, Banks said. There would also be the option to use on-call staff in the hospital, and for community-based health visits that could prevent the need for a hospital visit.
Banks said the hospital board is seeking to create a new vision, but it will not work unless all the entities involved are supportive.
If the joint plan does not get approved by the three ambulance services, Banks said the hospital would look into staffing their own ALS ambulance, to do transports.
“That would kill the Ely Ambulance,” said TAAS commission member Matt Tuchel.
“This is not what we want to do,” she said. “There is no guarantee it would be sustainable.”
But the hospital, she said, needs to have reliable transfer service, and the joint plan would create opportunities for new services such as paramedicine, community medicine, and telemedicine perhaps installed right on the ambulance.
The hospital’s main focus is providing emergency medicine, along with wilderness medicine, and their doctors are specially-trained in these fields.
“This is a requirement of our licensure,” she said. “Our role is to triage, stabilize, and get people to the appropriate level of care. Sometimes they can stay with us. But we will never be doing cardiac surgery.”
“We depend on ambulances,” she said, and patients have been disappointed with the long wait for transfers to Duluth, often around six hours. Helicopters can only fly during certain weather conditions and are often not the first choice for patients in stable condition needing a transfer. “ALS is often the safest way to get a patient where they need to be,” she said.
Commission members had plenty of questions for Banks, including questioning the study’s conclusion that only one ambulance needed to be stationed in Tower.
“We can look at that,” said Banks.
John Bassing asked if this plan could get funded as part of the pilot project being funded by the state Legislature, but Banks said that wouldn’t be an option. Banks said she is meeting with the University of Minnesota, which is funding their own pilot program, that might involve getting telemedicine resources onto an ALS ambulance, which would mean paramedics would be in real-time communication with medical experts and be able to bring patients exactly where they need to be to receive the highest level of care.
Banks said there would be start-up funding available, but for the plan to work, there would need to be a longer-term influx of funding of some sort from the area being served.
Tuchel urged the hospital to work with SafeTech to come up with a plan that includes more financial information.
“No one is going to sign up without seeing numbers,” Tuchel said.
Tuchel, a longtime ambulance staffer and former director, said he would like to see some of the innovations that are in the plan.
“Even if we have one ambulance here,” he said. “If we go out on a call, another ambulance area can fill in.”
“People won’t have an issue with paying a little more for a higher level of service,” Tuchel said. Tuchel added that a joint service would provide better training for its staff, which would mean a higher level of service for the area.
“That’s my two cents,” he said. “And I’ve been doing this for a very long time.”
In answering another question, Banks said the ambulance would transport patients to whatever hospital made the most sense, not just to Ely.
The decision to support the plan would be made by the city of Tower, who holds the state licensure, but ambulance commission members said that input from the area townships would also be important.
“We would need to have everybody, or a majority, on board,” Suihkonen told the Timberjay after the meeting. “I know not everyone will be in favor of this. But EMS needs to have something happen.”
The Tower Area Ambulance Service has been operating at a deficit, which is being subsidized by the city of Tower.
Suihkonen said while the Tower service has been able to respond to their calls, some area services are struggling with staffing, which might be due to lower paid on-call rates, she said.
“I see longevity with the Ely plan,” she said. “I don’t know if I see that if our service stays in Tower.”
Banks will be doing a similar presentation to the Babbitt Safety Commission on Aug. 19. Then they still need to meet with the Ely Ambulance Service.
In other news, the commission heard that Tower Ambulance’s new rig will be delivered in mid-August. The commission will meet next on Monday, Aug. 26 at 5:30 p.m. at the Lamppa Civic Center in Tower.