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Serving Northern St. Louis County, Minnesota

Ambulance funding

Joint powers and taxing proposal worth serious consideration


Communities around the region are increasingly aware that the old model of funding ambulance services exclusively through the insurance payments generated by users is no longer viable. As services have shifted from largely volunteer organizations to paid on-call models, operating expenses have jumped sharply, and those increases have come at the same time that the costs of purchasing and equipping ambulances are skyrocketing as well.
The ad hoc ambulance committee appointed by the Tower Ambulance Commission has spent the past several months looking for solutions and they released their final report just last week. In it, they recommend the creation of a joint powers board comprised of representatives from the city of Tower and the neighboring townships located within the coverage area of the Tower Area Ambulance Service, or TAAS. That’s no surprise since members of the committee have talked openly of the idea at meetings of the ambulance commission. It’s also a commonly used means of achieving the goals of the ad hoc committee, which have been to provide a stable funding mechanism for the Tower ambulance as well as increase the buy-in and sense of ownership in the service by surrounding townships. A similar joint powers board has been in place in the Ely area for the past few years, although that board hasn’t yet established a taxing district.
It appears a joint powers model, combined with a taxing district, would provide an affordable means of funding the gap between the operational and capital costs of operating the TAAS and its potential revenue. According to the committee report, a property tax levy of between $11-$15 per $100,000 of property value, spread across the townships in the area, would generate the needed revenue to keep the TAAS in the black while dedicating sufficient reserves to pay for capital purchases, like new ambulances. With such a levy, which would come from the special taxing district overseen by the joint powers board, area townships and the city of Tower would no longer need to make their per-capita payments, currently set at $15 per resident, from their own local levies. The proposal deserves serious consideration by all the local governments within the TAAS coverage area.
The committee report shows that the cost to taxpayers would double if Greenwood Township refused to take part, which is certainly possible. Greenwood refused to participate in the ambulance replacement funding last year and, while they were invited, they declined to take part in the ad hoc committee’s work, which was unfortunate.
Those who may object to the committee’s recommendation should at least offer a viable alternative. We know the status quo is no longer sustainable due to the high cost of paid on-call staffing. While some have suggested turning to a private provider, there’s no evidence to suggest that’s a viable option for the TAAS coverage area, given its rural nature and lack of a hospital to generate inter-facility transfers. Those are points recently made by an ambulance consultant hired by Greenwood Township, which rejected the option of a private provider given the service’s current lack of profitability and limited prospects for generating additional revenue. The consultant also dismissed the likelihood of regionalization, that would combine multiple services in the region into one.
The consultant did suggest that Greenwood could hire its own paramedic who could work in coordination with the TAAS, and that’s an idea that the ad hoc committee appears open to pursuing as long as Greenwood is willing to fund it. It would be reasonable, however, to expect Greenwood to join the taxing district at the same time, particularly given that they generate more than a third of the 911 calls within the TAAS service territory. Asking residents of Tower, Soudan, and other area townships—where average incomes are substantially lower than is the case in Greenwood— to pay twice as much as they otherwise would so Greenwood can get a free ride is hardly justifiable.
Greenwood officials say they are dissatisfied that TAAS does not currently offer its own advanced life support (ALS) service. Yet their own consultant highlighted the high cost of maintaining paramedic-level staffing 24/7. Refusing to support the existing basic life support care offered by TAAS simply endangers a service that currently meets needs of the overwhelming majority of its patients, including those in Greenwood, and puts the prospect of ALS service that much more distant. Let’s not let perfect be the enemy of the good. All the area townships in the TAAS coverage area should come to the table and be part of a solution that provides a stable and affordable funding mechanism and the continuation of an emergency medical service recognized for its high quality performance.