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Serving Northern St. Louis County, Minnesota

Ambulance solutions

As paid staff costs rise, new funding models are need for area services


Last week’s healthy discussion by the Tower Ambulance Commission on possible changes in the funding model for the city’s ambulance service was welcome and we hope that it leads to further analysis. Small town ambulance services are struggling everywhere, which suggests that the current funding model in place in much of the region is outdated.
It’s been a long time since ambulance services in the area have been able to survive financially solely on the revenues generated from ambulance calls. Most now rely on a more diverse funding stream to finance operations and cover the cost of ambulance replacement. The rising costs of new vehicles, fuel, and supplies, suggest that the financial demands of operating such a system will only rise this year.
Last week, the ambulance commission discussed the possible creation of an ambulance district through a joint powers board. Others have raised the possibility of a larger district, that might encompass a number of neighboring services. It’s not as if Tower’s ambulance service is the only one in the area facing challenges, after all.
We recognize that the Tower service has baggage that continues to frustrate its efforts to move forward. Unwise financial decisions a few years ago, which have saddled the service with higher-than-typical staffing costs, continue to be a major drag. Concerns by Greenwood officials about indemnification language in the ambulance replacement fund contract, along with the city’s failure to meet its obligations under the current ambulance replacement fund contract are certainly muddying the waters. However, these are not issues that should hamper the ability of reasonable local officials to find a path forward.
If residents in the Tower Ambulance service area wish to see a continuation of the existing service, or the upgrade of the existing service to advanced life support capabilities, it will require a different approach that could change the relationship between the service and the area townships. In a joint powers model, for example, all the parties would share responsibility and liability for the ambulance service they would oversee. A new funding model, which would likely include a modest tax levy, could be designed to cover the cost of replacing ambulances as well as fund ALS service.
Greenwood officials ordered their own feasibility study of a regional service this week, but that’s work that should be overseen by a broader entity, like the ambulance commission. A single township, without any authority over the existing ambulance service, is hardly in a position to implement any change. A regional proposal, with buy-in from multiple jurisdictions and stakeholders, is the approach that will ensure credibility.
While there is certainly interest in upgrading the Tower Ambulance Service to ALS capability, residents need to recognize that it wouldn’t come for free. Revenue from ambulance calls barely covers the cost of basic life support service and can no longer fund ambulance replacement. Realistically, upgrading to full-time ALS, as some have advocated, would more than double the current staffing costs of the ambulance service. Paramedics are in high demand around the country and maintaining a reliable crew of them will entail full-time jobs with benefits. Communities could make that more financially viable by looking beyond emergency medical care. A regional emergency services system could entail both ambulance and fire, and possibly even police.
We’ve been fortunate in this area to have dedicated folks who have made it possible in the past to operate ambulance services in places like Tower without a significant levy. In other sparsely populated parts of the country, such services are heavily-supported by local taxes.
That shouldn’t be a surprise. We don’t expect fire protection and police to pay for itself. We used to get by when it came to ambulance services because insurance, whether public or private, provided a decent revenue stream and because we had volunteers willing to help when the call came. The transition to a paid staffing model— a reflection of the fact that volunteers are tough to find these days— has rendered that funding stream insufficient to cover costs. A new staffing model, whether it provides a BLS or ALS service, requires a new funding model. It appears members of the Ambulance Commission are recognizing that fact. Hopefully, they’ll roll up their sleeves and start to explore the options.


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