Panel sounds alarm on rural EMS struggles

·3 min read

Sep. 23—MANKATO — Workforce and funding shortages will heap more and more pressure on many rural ambulance and emergency medical service agencies in the coming years, said panelists during a roundtable discussion Thursday in Mankato.

The Minnesota Ambulance Association and Center for Rural Policy and Development organized the event at the Blue Earth County Library, which drew local and state officials along with area ambulance and EMS stakeholders. The center released a research report highlighting rural EMS challenges in April.

Left unaddressed, the funding and workforce issues could negatively impact EMS response times in Minnesota as fewer agencies cover larger geographic areas, said Adam Grant, ambulance director at United Hospital District in Blue Earth.

"You might have to be waiting 20 to 30 minutes instead of five or 10," he said. "It's hard to say, but it's a bad deal if it keeps going the way it is."

Grant was among four panelists Thursday. John Fox of the Minnesota Ambulance Association, Mark Jones of the Minnesota Rural Health Association and Kelly Asche of the Center for Rural Policy and Development joined him, answering moderator and crowd questions.

Asche said labor shortages are and will continue to be major issues in the state. Whether for workers or volunteers, EMS agencies face great competition attracting and retaining people.

"The competition for workforce is general in Minnesota and rural Minnesota is at its highest levels," he said. "It's historic."

It's only going to get harder to find workers, he added, describing it as the biggest issue going forward in rural Minnesota.

Rhonda Ingebritson, director of Lake Crystal's ambulance, was in attendance and shared how difficult it's been to find enough people to cover the municipal service's 500 calls per year.

"Last year we had 25 people on our crew, but half of those are actually people coming from out of town," she said, requiring accommodations like a rental home for EMS crews to use and memberships to the local recreation center.

Much of the problems in funding stem from decades-old policies on how EMS gets reimbursed. The center's report found EMS is essentially treated more like a transportation service than a health care provider, and it isn't funded through property taxes like most police and fire services are.

"Most EMS agencies, especially rural ones, rely on a mix of funding sources that has evolved over the years into a complicated combo of billing for some services but not others, local subsidies, community fundraising, and grants," the report states. "Yet like fire departments and law enforcement, EMS must be ready 24 hours a day."

Ingebritson certainly wants recognition for EMS as a health care provider because of the funding avenues and recognition it would bring.

"It would be interesting to see somebody at a federal level tell me that (driving an ambulance) is my job when I just gave CPR to their mother," she said.

Most EMS funding in rural areas comes from fees for services paid for by private or government insurance. The panelists noted Medicaid and Medicare reimbursements don't come near to covering the full costs for EMS services, while rural areas have a higher percentage of older and lower-income clients on the plans.

For Grant's ambulance service, he estimated about 80% of patients served on the 700 to 800 runs per year are on either Medicare or Medicaid.

Funding the services through property tax levies is a funding option in some cases, Jones said. Another option, he noted, would involve areas setting up special tax districts and treat EMS as a subscription cost of sorts paid by each household in communities.

For more information on the issue, go to www.ruralmn.org.

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