With a 260-square-mile radius to cover, 3,300 people to serve and lagging response times, Carlton ambulance service made changes in January 2007 to better serve area residents. That included switching to a system where emergency workers are paid $3.50 per hour to stay at the fire station and respond to 911 calls during set shifts.
"It used to take five to six minutes just to get an ambulance en route and now over half our runs are under way in one minute or less," said Carlton Fire Chief Steve White, who oversees ambulance operations. "That time difference is crucial. It can mean life or death for some of the people we serve and especially the ones farthest away from us."
Cutting the time it takes to get on the road is critical when a 911 call comes from Holyoke, for example, 28 miles away.
There seems to be no dispute thus far that the new on-call service works better. Not only have response times decreased, the changes have also helped recruit much-needed professionals to work in emergency services.
It's funding the service that has become increasingly difficult. And with little in the way of a funding increase from the county and a decrease in funding by health insurance companies - specifically Medicare - operating has become a losing proposition, according to Carlton Mayor Dennis Randelin.
ADVERTISEMENT
"We've paid for the service since it began in 1970," said Carlton Mayor Dennis Randelin. "We just can't do it anymore."
So, the city has turned to the communities it serves, asking for financial assistance to pay for the $3.50 per hour wages, which add up to about $75,000 per year.
"We went to all the districts to ask them to pick up that cost, and the war began," Randelin said.
Part of the problem is that those communities are not legally required to pay Carlton anything for ambulance service, according to Carlton County Auditor Paul Gassert. Carlton, on the other hand, is mandated to provide ambulance service to the district created by the state of Minnesota.
This year, seven communities chipped in financially using a formula based on taxable property values. One of those communities was the city of Wrenshall. They paid $3,193 and plan to ante up $3,671 in 2009, according to Deb Hill, treasurer for the city. Six other communities also contributed for a total of $38,839 with Twin Lakes Township paying the bulk of it, some $20,000.
The six remaining communities balked at paying, most because they did not agree with the formula, according to Wrenshall Township Supervisor Jeanine Pauly.
"We're not in disagreement to help," she said. "But we're concerned about the percentage we're paying - we don't think it's fair to charge us based only on our land. Many towns have an abundance of land that is not taxable, like Jay Cooke State Park."
She said in other townships, like Atkinson for example, only a third of the area receives ambulance service from Carlton, yet Carlton is charging them as if they serve the entire township, a fact corroborated by Gassert.
ADVERTISEMENT
Randelin said the formula for billing is not important to the city of Carlton, just that other communities contribute.
"We're asking for wages only - not training, physicals, uniforms or anything else," he said. "They can split it up however they see fit."
That may prove to be an unsolvable problem, according to Gassert, who has provided alternative financial formulas to townships for consideration.
"A splinter group has met to try and devise another [financial] plan, based on population or the number of ambulance runs, etc.," he said. "But, some townships will come out better than others depending on which factors are used in the formula, and that will make achieving consensus difficult."
Communities that do contribute, which for 2008 include Wrenshall, the city of Thomson, Thomson Township, Twin Lakes Township, Clear Creek Township and Sawyer Township, pay less for ambulance runs. Residents needing the service will pay a base rate of $650 plus $15 per mile.
Residents in the non-paying townships of Atkinson, Blackhoof, Holyoke, Mahtowa, Silver Brook and Wrenshall will be charged a $2,000 base rate for any ambulance call plus $30 per mile.
For 2009, the city of Carlton is hoping more communities will help bear the cost burden with them. Their projected ambulance expenditures are $261,000, according to C.J. Van Guilder, Carlton city administrator. Revenues are projected to be $256,499 - if everyone from patients to insurance companies to the communities chips in. Without support from the communities, the projected revenue is $220,339, leaving a significant shortfall.
"The number of [ambulance] runs is only climbing and costs will continue to climb as well," Van Guilder said. "We've been a good neighbor since 1970. We're just trying to keep the service afloat and we're asking communities [that have not] to do their part."
