Carlton Ambulance Service begins planning to ensure sustainability

The city of Carlton held a meeting to start the discussion on changes to the Carlton Ambulance Service and possibly increasing funding from the municipalities it serves.

Carlton Fire Chief Derek Wolf, right, speaks to those in attendance of a meeting to determine the future of the Carlton Ambulance Service on Wednesday, Jan. 25.
Dylan Sherman / Cloquet Pine Journal

CARLTON — As expenses take a toll on the Carlton Ambulance Service, officials held a meeting to discuss how to resolve the issues with the municipalities it serves on Wednesday, Jan. 25.

More than 40 people attended as Carlton Fire Chief Derek Wolf started the discussion about the ambulance service and where its currently sits with its finances.

"It is not an easy conversation for us. We ultimately don't have any other answers. That is why we're here," he said.

The meeting centered around a study done by OakPoint Inc., a consulting organization, that dug into the service's revenues, expenses and provided a recommendation for its sustainability and reliability.

Mark Jones, CEO of OakPoint, said he was tasked by the city of Carlton to figure out how to optimize the ambulance service and make it reliable. The ambulance service is staffed by 60 paid, on-call employees, which means the service is not considered their primary employment.


The service also has an ambulance manager that works 10 hours a week, a level officials say is not adequate for the current amount of calls the service receives.

Jones said the paid, on-call staffing model has become outdated and the Carlton Ambulance Service is looking to hire a full-time manager and EMT.

Attendees listen to information provided by the Carlton Ambulance Service during a meeting covering the service's future, Wednesday, Jan. 25.
Dylan Sherman / Cloquet Pine Journal

The current model is not something sustainable for the service, Jones said. If officials opted to keep the current model, Jones said he believes there could be staffing problems that impact reliability, making it difficult to answer calls for service.

While the service does have mutual aid agreements in place, Jones said it is not something that should be relied on as a first option.

Carlton Ambulance Service finances

The main reason for the meeting was for officials to begin planning for the service's sustainability, as its budget for 2022 ran a $26,712 deficit.

Jones said if the staffing changes happen in 2023, the budget would run a $174,036 deficit if funding was not increased.

One of the main reasons Jones said full-time staff would be important is covering calls during the work week, when it is difficult to get paid, on-call staff to cover shifts. Jones shared that it is great that the service has so many on-call staff, but trends across the state show decreasing levels of staffing in the emergency services field.

When it comes to revenues, the ambulance service receives reimbursement for calls it goes on, however it is not an exact match.


For every call the service is reimbursed roughly 40% from the total billing, which Jones said is considered a "good" rate.

While Jones said the reimbursement percentage is not something new or unique to the area, the issue the service faces is making up the difference from what it charges the municipalities it covers.

The municipalities include: Carlton, Wrenshall, Atkinson Township, Blackhoof Township, Mahtowa Township, Silver Brook Township, Thomson Township, Twin Lakes Township, Wrenshall Township, Sawyer Township and Black Bear Casino.

Not all municipalities are fully covered by the service. For example, Thomson Township is covered by both Carlton Ambulance Service and the Cloquet Area Fire District.

According to the study, a total of $87,000 is requested from municipalities, which was a number set by officials in 2007 and does not take into consideration of increased wages.

Another issue with the amount requested from municipalities is that it is based on a volunteer system and not all that is requested has been collected from the municipalities. The study lists that the service's budget for 2022 received $37,570 from levies, which is less than half of the $87,000 requested.

Wolf said the meeting was called to discuss ideas with the stakeholders of the ambulance service.

"We only have x in the savings account before it runs out," he said. "We don't know what to do, which is why we are here."


He added that the ambulance service is looking for support or ideas from the various township board and city councils to create a plan that keeps the service around in the long run.

Implementing Jones' recommendation would result in changing the requested $87,000 to $250,000 from the municipalities.

Jones said the number would be evaluated each year depending on other revenues the ambulance service brings in — meaning it could be higher or lower in the years to come.

While not a final decision yet, after responses from those in attendance, Jones said he would plug in the new amount into the current net tax capacity for each municipality to see how their total contribution would rise. He said we would also provide a graph that would show the required contribution from each municipality based on net tax capacity and call volume.

Moving forward

While it was mainly a discussion-based meeting, Jones said he would get numbers to all municipalities on what their tax contribution would be by Thursday, Jan. 26.

Both township, city and ambulance service representatives wanted to get the process moving so townships have an idea of the impact of the changes before their annual budget meetings in March.

The initial response from township representatives to the meeting was positive; those who attended said they appreciated the information.

Diane Felde-Finke, board chair for Twin Lakes Township, said she thought the presentation was done with numbers to back up what the service was asking for. She added that she believes not many people in the area know about the financial issues the ambulance service is facing, and that when they learn about it they would be open to increasing their taxes.


"They don't want to lose their ambulance service," she said.

Felde-Finke said the issue was already brought up on the Twin Lakes Township Board, and she said the board was in support of the recommendation from Jones.

Ruth Janke, board chair for Thomson Township, shared the same appreciation that the presentations were informative. However, she said the Thomson Township Board would need to discuss its options before making a decision on any tax increases.

Carol Conway, Carlton's clerk and treasurer, said the city is looking for direction and input on how to move forward and is not limited to just Jones' recommendation.

"Everything is on the table," she said.

Dylan covers the local governments of Cloquet and Carlton County, as well as the Esko and Wrenshall school boards for the Cloquet Pine Journal.
What To Read Next
Get Local