An emergency deferred

The 2024 session of the Minnesota Legislature provided all the overwrought drama and political resentments we’ve come to expect, but lawmakers managed to do one thing right. 

A new law passed with bipartisan support provides $24 million in short term emergency aid for rural emergency medical service (EMS) providers. The measure also funds an experimental mobile medic program in three rural counties, including St. Louis County. The “sprint medic” system aims to take pressure off rural departments by deploying patrolling paramedics in underserved areas.

State Sen. Grant Hauschild, a DFLer representing the Arrowhead region, is a member of the EMS task force and one of the authors of the bill.

“Our EMS network is facing a dire financial situation throughout the state, threatening the ability of Minnesotans to get the urgent care they need,” said Hauschild. “It truly is a life or death situation for thousands of people especially in Greater Minnesota.”

Since last fall, I’ve written about the deteriorating situation for northern Minnesota EMS. Our dedicated corps of volunteers, paid on-call EMTs and paramedics could tell you better than I could. Funding for the Nashwauk ambulance service remains in limbo. Owners of MEDS-1 in Grand Rapids recently sold to North Memorial of Minneapolis, citing costs and burnout.

Federal reimbursements for Medicare and Medicaid patients — a vast majority of all rural patients — run too low to cover expenses. Volunteerism is down. Local governments don’t have the tax base to close the financial gaps. Finally, not enough people seek the training necessary to keep advanced life support services going. Burnout, stress and cost of living drive away new recruits.

Rep. Jeff Backer, a Browns Valley Republican, is a longtime volunteer EMT. He said this year’s legislative push for rural ambulance services fell “woefully short.” 

“To fix the problems facing ambulance services in Minnesota, we need to focus our efforts on recruitment, retention, and reimbursement,” said Backer. 

Hauschild agreed that his bill didn’t go far enough, but was an important first step.

“We all know that this is only a band-aid and that over the long term we must find a sustainable funding model for EMS services,” said Hauschild. “This influx of aid and the important changes we are making to our EMS system are vital steps forward, but I will continue to push for robust investment that will ensure the long-term stability of EMS in Minnesota.”

It’s hard to solve a crisis that stems from our convoluted American healthcare system, the most expensive and least comprehensible system in the world. Small, incremental fixes like these cannot stave off a looming disaster in in rural health because rural health is not profitable. It will take a much bigger reckoning to realize that this is no reason for rural people to suffer. 

At the federal level, reimbursement rates must be increased to reflect the inflationary pressure on the cost of maintaining EMS. Here in Minnesota, gap funding is helpful. Sprint medic systems sound promising. But the state must help serve areas where private providers won’t go, and where cities and townships can’t afford to keep up.

Locally, some of this is on us. We must demand our local governments do all they can to build and maintain effective EMS departments. This might involve paying more taxes for those services, but we could limit tax hikes if more people volunteered to serve their local communities as EMTs and first responders. 

No one policy is enough to solve the whole problem. No one party’s preferred solution is actionable on its own. Ultimately, this requires all of us, working together. 

So, yes, it’s good that the Legislature addressed the urgent needs of rural EMS providers. But a sigh of relief only lasts one sigh. Tonight someone will need an ambulance. Their life depends upon whether one is available. This will remain true tomorrow, and for all the days to follow.

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, May 25, 2024 edition of the Mesabi Tribune.