ST PAUL, Minn. — The struggling emergency medical services system in Minnesota won't fix itself. And it will get worse without some kind of state intervention.
That's the overall take from members of the EMS Task Force that met for the final time at the state capitol Friday. The bipartisan group has been listening to EMTs and paramedics across the state to get a better handle on the issue and decide how that could translate into legislation.
"The question that was posed at the beginning of this back in December was, 'Is EMS an essential service in our state?' And I say you betcha! It’s part of the social safety net we have in our state!" Rep. Jeff Brand, a St. Peter Democrat, told colleagues.
"We’re limited to how much money we can spend because of the (budget) forecast, but this is one of those key areas in Minnesota, especially in Greater Minnesota. If we fail to do something this year, we fail to stabilize Greater Minnesota in a way we really could make a big impact."
The task force chair, Sen. Judy Seeberger, an Afton Democrat, is recommending that the state develop a system of "sprint paramedics" to help reduce the number of ambulance runs and trips to overcrowded hospital emergency rooms.
"A responder who will immediately be dispatched to these calls, while the volunteer BLS service or ambulance service is assembling personnel, we’ve got an ALS medic on the way," Sen. Seeberger explained.
"That person can be first on scene, be an initial responder, assess that patient, and if that patient needs care and transport, they can start providing ALS, advanced lifesaving care."
Seeberger serves as a volunteer paramedic in the Lower St. Croix Valley Fire Department. In fact, she shared that she pulled a paramedic shift Thursday night after she left the state capitol. She spent the night in a fire station before returning to the Capitol to preside over the meeting.
"If we can begin to address those needs upstream, perhaps we can reduce the number of calls that are placed upon our ambulance services," Seeberger told fellow lawmakers.
The staffing shortages and burnout issues slamming the economy have been especially felt in the EMS arena.
"The Brown County Ambulance Service as I speak has no EMTs. They have not had an EMT during the day shift all week," Rep. Jeff Becker, a Browns Valley Republican who has spent 29 years as an EMT, explained.
"That’s because I’m down at the capitol and my brother’s down at Louisville."
He said the state should consider incentivizing private business owners to allow their employees to serve as volunteer EMTs and paramedics, as one way to help with recruitment and retention.
EMS services have also been rocked by low Medicare and Medicaid reimbursement rates; payments set by the federal government. In areas with higher concentrations of patients that rely on those government health plans; the ambulance services are losing even more money.
"You’re getting on a good day 42 cents on the dollar on your runs, and that’s one of the higher ones. You get as low as 22 cents a dollar on your runs," Rep. John Huot, a Rosemount Democrat and former paramedic, told colleagues.
Rep. Huot recommends making the Emergency Medical Services Regulatory Board a full state government department that answers directly to the governor rather than to a state board. He said that would raise the importance of EMS and help coordinate various providers across the state.
"EMS has to have its own place in government here. If you’re asking us -- and we have the bill -- it’s asked for $125 million of state money. It now becomes our business because you are asking us for a large sum of money."
Rep. Dave Lislegard, an Aurora Democrat, said some of the smaller community EMS services will need to consider mergers and consolidation, just as smaller school districts across the state joined forces to remain viable.
"We’re at a tipping point and a tipping point that needs to be addressed. I want to tell you I believe there’s a lot of pride in smaller communities," Rep. Lislegard remarked. "We may be at a point where we need to offer short-term funding, until we can get to a long-term solution that is truly going to meet the needs."
Lislegard said the statewide EMS structure will need to be revamped in the long run in order for ambulance services to be sustainable into the future.
"If we just throw money at something and we don’t change some sort of structure we’re going to come back year after year after year looking for a funding source and we’re not fixing the problem."
Sen. Jordan Rasmusson, a Fergus Falls Republican, said he agreed with Lislegard on the need for consolidation in smaller services. He said the state should consider one-time grant money to help pay for the professional evaluations of how those mergers would work.
He also recommended changes in what EMS functions qualify for payment.
"Even when EMS isn’t transporting someone to an emergency department at a hospital, they are still creating value by answering the calls and doing assessments on scene, maybe helping with a lift assist for a Minnesotan who has fallen," Sen. Rasmusson told colleagues.
"We need to look at how we can have a reimbursement structure to actually compensate providers for that important work that they’re doing in the communities."
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