Rural ambulance services looking for another ‘Minnesota Miracle’
Wednesday, February 22, 2017 8:34 AM
Often the numbers don’t add up in favor of rural Minnesota.
For example, rural counties have many miles of highways, but often not the tax base to keep them in perfect shape. Rural Minnesotans have the need for broadband internet, yet not the population density to justify expansion into sparse areas. Rural residents have the same retail needs as all Minnesotans, yet business consolidation trends often leave small towns with their small base of consumers out of the retail picture.
The numbers also don’t favor quality basic services, yet rural residents still expect the same level as people in Minnesota’s more concentrated cities where the numbers do add up.
The reason for this is largely due to the idea known as the “Minnesota Miracle.” In 1971 lawmakers created a new way to pay for local schools and governments, equalizing fiscal disparities among school districts and local government by sharing state tax dollars.
In small communities, the per capita cost of providing basic services and educating children is higher than in larger, more affluent communities. The model made it more viable to live in small towns and rural areas by providing state dollars to help keep the services closer to the same level as metropolitan areas.
It also raised expectations of equal service throughout the state.
However, rural governments are finding it isn’t always easy to provide those services while keeping local taxes within reason. Budgets are being stretched and it is tougher to find volunteers to handle services that are staffed by paid personnel in larger cities.
Ambulance services are the most visible service that is in jeopardy as our news stories have reported city councils in nearly every city in the region are concerned about a shrinking number of volunteer emergency medical technicians (EMTs). Many cities, such as Rushford and Spring Valley, have received permission to use firefighters who are first responders to drive ambulances on calls.
The numbers don’t look encouraging:
• An emergency can happen at any moment, meaning rural ambulance services have to have people on call 24 hours a day, seven days a week. That is 8,736 hours a year to be covered by volunteers from a small population base.
• Volunteers for rural services are paid less than a quarter of the minimum wage and the minimum wage is far less than what these intelligent volunteers, who need to pass complex certification exams, could get from another professional job.
• If cities were to pay their ambulance personnel a going market rate, it would devastate their budgets, requiring massive tax increases.
• Although staffing needs to be 24/7, there aren’t many calls in rural areas to pay for services. Spring Valley had just over 400 runs last year, or slightly more than one a day, while Lanesboro had a record 114 calls last year. In addition, ambulance services have many write-offs due to inability to pay and many rural patients rely on Medicare, which caps the amount reimbursed for calls.
• Consolidation works in many industries, but EMTs are needed close by to respond quickly. People in emergency situations wouldn’t expect to wait 30 or more minutes for an ambulance from a distant city to show up.
• Demographics aren’t favorable either as rural Minnesota is aging. The most dedicated volunteers are older people, but they are retiring and replacements aren’t as willing to step forward and those that do aren’t working nearly the same number of hours.
The numbers may add up to a bleak sum, but it isn’t a crisis — yet. Rural ambulance services are responding to emergencies with qualified personnel meeting the stringent guidelines of Minnesota.
However, the numbers show a note of caution is in order.
There are no easy answers, but State Rep. Jeff Backer, R-Browns Valley, is seeking to financially reward volunteer ambulance personnel once they hit 50 years of age and have at least five service credits. His bill would appropriate $2 million for the Cooper/Sams Volunteer Ambulance Award in the upcoming biennium and $3 million would be appropriated for a trust account in fiscal year 2018.
The payments aren’t a pension, but rather a lump sum. Each credit is worth $447.19, according to the Emergency Medical Services Regulatory Board website.
Backer is a volunteer with his rural ambulance crew and has seen the pressures build on retaining and recruiting volunteers.
Still, it is uncertain how much that will help rural ambulance services across the state even if it became law.
In the meantime, thank a volunteer on your local ambulance service. They are sacrificing their leisure time to ensure rural Minnesota remains at the same standard as our metro counterparts served by fully staffed emergency teams.
Not only are ambulance service volunteers enhancing our quality of life — they are saving lives.