By TRISTAN GEHRING
Staff Writer
Area Emergency Medical Service (EMS) leaders met with staff from the office of U.S. Senator Tina Smith on April 9 at New Richland’s City Hall, to provide information about the status of emergency health care in south central Minnesota. Smith’s staff informed leaders she intends to use the information they share as she defends a new law she is co-sponsoring, the Emergency Medical Services Reimbursement for On-Scene Care and Support (EMS ROCS) Act.
Present at the meeting were three members of Smith's staff – Southern Minnesota Outreach Director Jeanne Poppe, Miranda Morgan Lilla, and Sara Silvernail; directors from three area ambulance services – Sarah Sundve of New Richland, AJ Gengler of Dodge Center, and Tyler Wilson of Blooming Prairie; Waseca County Sheriff Jay Dulas; Freeborn County Commissioner Bill Groskreutz; Waseca County Commissioners Brad Milbrath and Doug Christopherson; Blooming Prairie City Administrator Melanie Aeschliman; and EMS educator and volunteer member of New Richland Ambulance, Jennifer Lacey.
Currently, Medicare does not reimburse EMS providers for their services when the patient is not transported to a hospital, which Senator Smith's office posits leaves rural EMS providers, who are often called upon to provide care on the scene without transporting, “struggling to balance budgets and stay afloat.” This would change under the EMS ROCS Act, allowing for reimbursement in more cases, and, Smith claims, aiding struggling agencies and expanding access to care for Medicare patients who may hesitate to call for an ambulance under current billing and reimbursement structures.
The meeting began with a summary of the current state of EMS in the area. Reports provided the call and transport statistics for Wells, Blooming Prairie, and Dodge Center. All three agencies estimated that between one third and one fourth of their calls did not include a transport, with 40 to 70 percent of those calls being for Medicare patients. Ambulance directors estimated their average call took 2 to 2.5 hours.
As discussion continued, there was a clear consensus that EMS departments are not sufficiently funded. Staffing is one important way this shortage manifests itself. The ambulance services represented at the meeting are run largely on a volunteer basis – in some cases there are stipends paid or a few paid positions, but according to Sundve, “It doesn't add up.” Blooming Prairie would like to create a paid director position to help address its staffing issues, but doesn't have the funding to do so. Volunteer departments in general, it was said, help people get their start in EMS by supporting them through training, then lose those people in short order to full-time paid positions or higher hourly pay in better-funded departments. New Richland Ambulance is one such volunteer department, and asks that anyone interested in learning more about volunteering contact City Hall.
Gengler pointed out another financial shortfall follows from billing people who cannot pay; he said the Dodge Center ambulance service sent out about $1.5 million in bills for its services, but ended up writing off about $900,000 of that amount–the portion that Medicare would not cover. The remaining $600,000 represented most of the operating budget for the year in Dodge Center, a circumstance that was echoed by other ambulance staff at the meeting. Subsidizing through local government is also a complex issue – each of these rural ambulance services provides coverage for a multitude of small towns and townships, which leads to problems coordinating funding efforts. “We're trying to handle locally what is a state or federal issue,” one of the directors said in summary. “We operate and are funded like a business,” said Gengler, “and are viewed as a public service. And it should be.”