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A regional approach to area ambulance service is on “pause” and could remain there indefinitely.
Discussion involving area leaders, lawmakers and representatives of both Ely-Bloomenson Community Hospital and the non-profit Ely Area Ambulance Service offered little indication of movement toward a consultant’s recommendation that the hospital take ownership of ambulance operations in Ely, Babbitt and Tower.
“Currently right now were pausing the regional model to regroup, but we still are paying attention,” said EBCH’s Colin Yahnke, during the Dec. 16 Ely Area Joint Powers Board annual meeting at the Grand Ely Lodge.
Meanwhile, Joe Baltich, who chairs the EAAS board, said the non-profit group’s fortunes have improved dramatically in the last year.
“We see a light at the end of the tunnel,” said Baltich.
Baltich offered no indication that the EAAS desired, or needed, to give up ownership and management of the ambulance operation.
“Our goal is to improve our service to patient care,” said Baltich. “For the most part, the Ely Area Ambulance Service, I’m really positive about. We’re going to work with the hospital and the community to provide the best service we can.”
Baltich said that a change in billing companies has “improved our cash flow dramatically,” and has eased many of the financial woes that existed a year ago, when the service needed cash infusions from local governments to stay afloat.
That prompted action by EBCH, which engaged SafeTech Solutions to review emergency services in the region.
That group recommended during the spring that the area switches to a regional approach with hospital ownership and full-time, around-the-clock service in Ely, Babbitt and Tower.
SafeTech cited EBCH’s standing as a critical access hospital, and indicated hospital ownership would allow ambulance operations to capture greater shares of federal reimbursements.
The concept has been met with mixed support and calls for more detailed cost estimates and the need for potential subsidies.
It’s not clear when, or even if, further exploration will take place.
EBCH announced a “pause” in December and said then it “will continue to work on its initiative to address patient transport needs. We hope to resume collaboration sometime after the first of the year.”
Interfacility transports were one of several issues that came up as a result of the SafeTech study, with the firm noting that EAAS is unable to complete 11 percent of needed transfers to other care facilities.
Baltich presented a more positive spin during the Joint Powers meeting.
“The study did say 89 percent of all transports are being met,” he said. “Our goal is to complete that (remaining) 11 percent as well. To do that it’s going to take more people and we’re going to have to make some efficiencies and changes.” Action by the state legislature this year will also pump an additional $290,000 into the EAAS coffers, but Baltich said those funds have not yet come in and that they’re not the reason for the service’s improved financial picture.
While Baltich did not request further state funding during the Joint Powers session, ambulance funding has been identified as a priority for leaders of local governments.
State Sen. Grant Hauschild (D) acknowledged the issue and the challenges during the Joint Powers discussion.
While improved reimbursement rates are a federal issue he noted that “if we are going to think of a state formula, to think of state funding for EMS services, that is sort of like crashing through a wall.”
“That’s a new thing,” said Hauschild. “That philosophically has been a local government thing.”
Yet EMS funding “is inequitable,” according to Hauschild.
“What you have is all the urban places in the seven- county metro making money, with the services being held by private companies, hospitals, private non-profits,” said Hauschild. “Meanwhile the ones losing money are held by local governments, which is a total disservice to those of us who live in rural communities. The long and the short of it is we need to have a hard conversation about revenue stream.”
Hauschild floated ideas ranging from a fee on cell phone bills to taxing insurance companies and asked for local buy-in.
“The idea is we’re getting money to places that are losing money like Ely, Babbitt, Tower, International Falls, yet it is a fee,” said Hauschild. “But more of the people who will pay it will live in the area of the Twin Cities, and the money won’t go to the areas that are making money. The money will go to services that are losing money like in our region. It’s a net transfer to our region.”
Consultants have told area officials that either “volume or subsidy” are needed to pay for ambulance service, and the SafeTech plan for hospital ownership called for full-time staff to operate ambulances in all three communities in a system that with some flexibility allowing for continued coverage.
Attracting and retaining ambulance staff is a current challenge and the new model calls for full-time staff with higher wages and benefits.
The new model also comes with much higher costs, and the next phase of talks was expected to include more detailed estimates including the amount of subsidy that may be sought by way of tax dollars from area communities.
At least for now, it’s not clear if the hospital and local governments will take that next step.
Yahnke said EBCH wants to make sure its transport needs are met.
“If there was another way to do it without the hospital owning the license, we’d be more than happy to support that,” he said.
