Loss of Nashwauk ambulance would affect huge area

PHOTO: Nashwauk Ambulance Association

If you drop a wheel off the side of a county road, you realize how easy it would be to roll into the ditch. That chest pain you feel is probably just indigestion, but what if it was a heart attack? Cutting a fallen tree. Changing your car’s oil. Climbing a ladder to retrieve holiday decorations. Even the simplest thing can lead to an emergency.

The most important taxes we pay provide emergency services. Anyone in the medical field knows that faster responses save lives in the worst of times.

For residents of the western Mesabi Iron Range, a potential move by one small town holds huge implications for surrounding communities. The city of Nashwauk has issued a request for proposals to sell their ambulance service. This could privatize the service. Or, without a bidder, it might dissolve their department and leave the surrounding area to be served by departments in Hibbing and Grand Rapids, many miles to the east and west, respectively.

The request for proposal reads as follows: “The City of Nashwauk seeks to transfer its Emergency Medical Services License to a municipality or private ambulance service to assume ownership, management, and operations of its ambulance service. The goal of the City is to retain ambulance services for the residents of the City and surrounding area.”

While it’s encouraging that the city seeks to continue the service, there are practical concerns about how this will unfold.

Emergency service workers were told that the ambulance service was running at a loss. Nevertheless, an audit conducted by their union shows that the city is currently in a strong financial position with robust reserves. Future meetings will reveal if neighboring towns and townships were consulted about this significant decision, or if alternative funding models are being considered.

Nashwauk is hardly the only small town to struggle with the costs of keeping an ambulance service. For instance, Tower has seen significant debate over its EMS department. Like Nashwauk, Tower serves a small town with a large service area. Last month, state and federal lawmakers held a roundtable in Soudan, each vowing future action to help rural EMS providers.

One problem stems from the fact that most patients are on medical assistance or Medicare, which reimburses at a lower rate. Keeping a trained ambulance staff and up-to-date equipment costs too much to make a profit.

In September, Essentia Health declined an invitation to buy the ambulance service from Nashwauk, leaving the city with a tough decision.

But is making a profit really the purpose of a rural emergency medical service? Is it even possible?

Right now, the Nashwauk ambulance department responds to calls from Itasca County Scenic Highway 7 in the west to Keewatin in the east. They cover a mile south of Togo to the north and Goodland to the south. They also provide mutual aid to neighboring areas when needed.

Some rural townships in this area maintain volunteer first responder units. For instance, I live in Balsam Township, where we have an effective volunteer fire department with first responders. However, most townships don’t have these services. Moreover, none have full ambulances and the life-saving equipment and medications that come with them.

Nashwauk’s location allows them to shave an hour off the time it takes to get a sick or injured person from eastern Itasca County to the nearest hospital. In emergencies, time is everything.

Leann Stoll is a union representative for the American Federation of County, State and Municipal Employees (AFSCME) Council 65. She represents the emergency workers for the Nashwauk ambulance department.

She said workers are concerned that they’ve been left in the dark on the city’s decision-making process. They also complain that the city has been slow in releasing meeting minutes and other information about their timeline for determining the fate of the ambulance department.

“They don’t talk about their jobs,” said Stoll of the emergency workers she represents. “All they talk about are the patients and communities they serve. They’re very concerned about the impact on response times.”

The Nashwauk City Council will next meet at 5:30 p.m., Tuesday, Nov. 28. Though the ambulance decision will not be made at this meeting, citizens should arrive early if they wish to speak or ask questions. They may also contact elected officials or write letters.

Ambulance service for rural residents costs money and taxpayers must do their part. But to remove the service without truly exploring all options is a grave disservice to thousands of people who live on the western Mesabi. Finding a solution must be a priority.

Aaron J. Brown

Aaron J. Brown is an author and college instructor from northern Minnesota’s Iron Range. He writes the blog MinnesotaBrown.com and co-hosts the podcast “Power in the Wilderness” on Northern Community Radio. This piece first appeared in the Saturday, Nov. 25, 2023 edition of the Mesabi Tribune.


  1. My question would be if those other communities are paying anything towards the service in the form of taxation? Virginia is struggling as well because we provide ALS level service to surrounding communities who refuse to pay into a special taxing district to help defeat costs. The cost shouldn’t be solely borne by one community when many communities benefit.

  2. Kimberly Barton says

    This is the most disgusting thing I have ever read. How much profit is your life worth? Fund the ambulance with everything possible, it is one of the most necessary things. I certainly hope nobody has a life threatening emergency for the council to realize this. I see an opportunity to charge communities that use the service a surcharge and also maybe use some extra funding. Quit expecting a profit and just fund it, pretty simple. ***Each and every one of you calculate the time of saving you life***, not so expensive anymore?

  3. Well here is is, ….
    “One problem stems from the fact that most patients are on medical assistance or Medicare, which reimburses at a lower rate. Keeping a trained ambulance staff and up-to-date equipment costs too much to make a profit.”

    I had a friend who recently passed. He was living in Canada. He was able to get cancer treatment within 20 miles of his home. Something citizens up there might have to travel to Duluth to have. I live in Mpls and use Fairview for my medisacal needs, How long willl that last ? Medical care needs rto be moved totally out of the profit model. It always has and never quite gets there, I have to wonder how the lives of the many might have been different id Francis Perkins would have been siuccessful. https://socialwelfare.library.vcu.edu/eras/great-depression/perkins-frances-the-roosevelt-years/

  4. For those complaining about the “profit” model, I would only have one question. Would you come do my yardwork, or build me a house, and just donate your time? My guess is, No. I doubt anyone goes to work to donate their time for the fun of it, but do have a lot of Volunteer Services.
    The talk here, is not, of exorbitant profits for shareholders and executives. It is about operational expenses in the Black and not in the Red, with enough left over to keep services going. Medical equipment, resources, EMS professionals, and so on all cost money. This is not the federal government, with the luxury to operate 30 trillion in debt with continuing deficit spending. They actually have to operate within a budget, and at the same time, try to provide the best possible service to the area. This is a local area service, we are lucky to have, but it does not come from nothing. If you know any local EMS/EMT professionals on the Ambulance Services, just say thank-you, because they are not getting rich doing it.

  5. Lucy Traxinger says

    Make the ambulance a regional utility, with a flat monthly fee of $5.00 for every household, townies and rural.
    As time progresses, and as needed, a small hike in this flat fee utility should go to vote. Online statistical service results need to be provided to the public. Perhaps a a GIS map of ambulatory services rendered per year, per commu ity. This could drive passage of a flat fee increase.

  6. This is a tough one.
    We need ambulance services yet the people are being taxed and taxed right now. The economy is horrible, our county upped taxes and more. Is there some type of sponsorship or fundraising the ambulance might be able to do? It’s hard because insurance rates go up and up but deductibles get higher. But people on MNCARE aren’t really paying. So your charging the others twice. I’m curious to know how many are on what type of insurance. Maybe our state government should have done something to help out the ambulance services and other things that help the rural people instead of blowing our surplus and giving $ to the new pot plant in Itasca County.

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