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Serving Northern St. Louis County, Minnesota

Draft study raises more questions than answers

Jodi Summit
Posted 1/18/23

GREENWOOD TWP- A township committee here got its first look at a draft copy of an ambulance study the town board commissioned several months ago, and members of the committee didn’t sound …

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Draft study raises more questions than answers


GREENWOOD TWP- A township committee here got its first look at a draft copy of an ambulance study the town board commissioned several months ago, and members of the committee didn’t sound pleased. Committee members raised questions about the study’s limited scope and its lack of focus on any possible region-wide solutions to the rising costs of rural ambulance service.
The proposal for the study, prepared by the McGrath Consulting Group at a cost of $55,475, was titled: “Regional Opportunities for EMS: Review of Service Providers.” The township wanted a comprehensive assessment of greater cooperative opportunities in providing emergency medical services (EMS) in Greenwood Township and surrounding areas of St. Louis County. Township officials had indicated they hoped the study could help find a feasible means of providing Advanced Life Support (ALS) service for residents in the area.
Instead, the draft study, titled “EMS Options to Improve Response Times and Enhance ALS Delivery,” focused on establishing a community paramedic (CP), who would work to increase access to primary and preventive care and decrease the use of emergency departments, and who would work under the direction of an ambulance medical director. It set forth four options including setting up a partnership with Bois Forte’s Vermilion Clinic where such a CP could be based, or having Greenwood hire their own staff. Other options presented were creating a contract with the Virginia Fire Department to move an ALS ambulance more centrally located in Greenwood Township (an option the Virginia Fire Department has already dismissed due to limited staffing), or to partner with another ALS provider.
The McGrath study noted that they had not reached out to Bois Forte officials in preparing their suggestion to use tribal facilities to host paramedics.
Bassing questioned why the study didn’t look at the option of having Tower release their license to a private provider, such as Essentia.
“I think we need to explore that avenue,” Committee Chair John Bassing said.
Supervisor Rick Stoehr said it was just a matter of time that big organizations were going to be running ambulance services.
Jeff Maus said the report did not look at how the current hospital structure in the area, with the smaller rural hospital feeding patients to specialists in Duluth, was increasing demand for hospital-to-hospital transfers.
The committee also noted that the wage cost estimates for paramedics in the study was not realistic.
“People are making $120,000 a year at Minntac,” said Committee member Lee Peterson. “We need to pay paramedics enough to live here.” Peterson said the study’s financial projections showed if Greenwood hired their own staff, it would be paying around $22 per hour, which was unrealistic.
Paramedics receive two years of training before becoming certified, Committee member Jeff Maus said.
“People in this township are willing to pay for good medical service,” said Stoehr.
Maus wondered why McGrath, which is a national firm, did not find any examples of a model that would work in this area.
“Wouldn’t that make sense?” Maus asked.
The McGrath study does note that Greenwood Township is contained within the Tower Area Ambulance Service (TAAS) area, but it made little mention of TAAS and never mentioned any options for adding additional support to TAAS to achieve Greenwood’s goal of ALS service.
Members of the committee have expressed their desire to have the territory of the TAAS changed, to provide the possibility of more options for service from other areas. But the report did not discuss this option. Ambulance service areas are defined by a state body, the EMSRB board, which is overseen by the state Legislature.
The study stated that they were unable to get all the data requested from other ambulance services or governing bodies in the region, yet a review of the information request put out by McGrath by the Timberjay found it to be extremely lengthy and of variable relevance to the region. In any case, it sought an enormous amount of information from entities that had no input into Greenwood’s decision-making and that, in some cases, could be harmed by decisions Greenwood might make.
Greenwood officials have taken a go-it-alone approach, declining to support an ad hoc committee formed by the Tower Ambulance Commission, that includes representatives from area townships that are seeking their own regional solution.
Despite questions about whether Greenwood’s study delivered what was promised, a representative of McGrath told members of the town board they needed to approve the draft report by Jan. 17. The town board had only been given the draft copy the week prior, and town board members balked at the quick turnaround required to review and comment on the 50-page report.
“There wasn’t any time limit set forth in the contract,” said Peterson. “I think they just don’t want input from the public.”
The draft was initially supposed to be completed by the end of December.
“It wasn’t the township’s fault it was delayed,” said Peterson.
The committee instructed interim town clerk JoAnn Bassing to contact McGrath to let them know their review of the plan would not be completed on McGrath’s timetable.
“I asked that we have until Jan. 23,” said Town Board Chair Sue Drobac. “He said that was not acceptable.”
Drobac said McGrath finally did agree to give the board until Jan. 23, but with the committee still reviewing the draft, and the need for review by the full town board, that deadline will surely be missed.
“What are they going to do,” said Drobac. “Take our birthday away?”
“I am not even sure what we are supposed to decide on,” said Drobac.
The committee set some major goals for the review process: to review the report for inaccuracies, to remove items in the report they feel are not relevant, and to bring additional options into the report.
Two people at the meeting relayed stories of their own medical emergencies, when standard Basic Life Support (BLS) ambulance service would not have resulted in positive outcomes. In both cases they had family members with medical backgrounds that made sure they were transported immediately to an area hospital, instead of waiting for the local ambulance to arrive, because the EMTs on board would not have been able to provide the level of care required. ALS ambulances are staffed with trained paramedics, who can do more advanced medical care prior to arriving at the hospital. The ambulances themselves are also outfitted with more medical equipment. They also relayed a story of a seriously-ill township resident who required a tracheotomy, something that EMTs are not able to provide.
Almost 70-percent of townships residents are age 60 or older (with a median age of 69.1).
The committee set a second meeting for Monday, Jan. 23 at 6 p.m. at the town hall. The meeting is open to the public, and the committee is interested in hearing from other township residents on this issue. The committee set some major goals for the review process: to review the report for inaccuracies, to remove items in the report they feel are not relevant, and to bring additional options into the report.
Township members on the committee include John Bassing, chair; Lee Peterson, vice-chair; Julie Stoehr, secretary; Supervisor Rick Stoehr, Town Chair Sue Drobac; Bev Peterson; Interim Clerk JoAnn Bassing, Fire Chief Jeff Maus, and Marjorie Miller. The township is set to receive a $25,000 grant from the IRRR to offset some of the cost of the study.


2 comments on this item Please log in to comment by clicking here

  • jlbunkhill

    A study for $55,000 to tell you what you already knew. You have the BEST Ambulance Service in the area. Don't ya think that the KIND thing to do would be to pay your PAST DUE Subsidy payments? Give these kind folks a break who donate their time for your well-being.

    Thursday, January 19 Report this

  • jbassing

    Mr. Hill,

    In Greenwood some of us feel we can provide a higher level of service for our citizens. To not explore all scenarios to achieve that end would be foolish. It must always be what is best for the patient.

    John Bassing

    Greenwood Township

    Thursday, January 19 Report this