Minnesota Cities Magazine
More from Jul-Aug 2017 issue

Two-Way Street: Does Your City Contract or Provide Its Own Ambulance Service?

Carol Conway, Clerk-Treasurer, City of CarltonCAROL CONWAY
Carlton (Population 996)

The City of Carlton provides its own ambulance service. Carlton Fire and Ambulance provides a basic life support ambulance service that started in 1970 as a volunteer service. Due to increasing medical calls, it implemented a paid on-call system for medical services in 2007. We staff one ambulance with two emergency medical technicians (EMTs) around the clock. In the event of a second call, our second ambulance is staffed by volunteer EMTs.

Service area
Our mostly rural primary service area of 163.4 square miles includes the cities of Carlton and Wrenshall, and seven area townships. In the last 10 years, the call volume has almost doubled, and we now respond to over 700 calls a year.

The municipalities in the service area can volunteer to contribute to the paid on-call wages. The amount is determined by a formula based on the net tax capacity, number of calls in the preceding year, and the annual amount of paid on-call wages paid in 2014. If they choose not to participate, the base rate and mileage rate are higher for their residents because they are considered “out of district.”

We added a part-time ambulance manager in 2016 to handle the day-to-day operations and maintain records to ensure all licensing requirements are met. The position was necessary because of the increase in service calls.

Our staff is made up mostly of young EMTs under the age of 35. Many of them are nurses or paramedics, or are working toward a career in the medical field. We are fortunate to have many colleges in our area with students who are willing to serve the community. The down side is that we often have high turnover as students graduate and their careers develop.

Keeping up with the times
The service has worked to keep up with advances in technology and to maintain a high level of patient care with continuous training. For example, our EMTs are prepared to respond to calls related to psychiatric care, as well as alcohol and drug abuse. Just recently we have started supplying the prescription drug Narcan to treat opioid overdoses.

Members of the Carlton Ambulance Service are always looking toward the future and how they can provide the best quality care to their patients.

Joe Sertich, owner of Chisholm ambulance serviceJOE SERTICH
Chisholm (Population 5,006)

The City of Chisholm has contracted with Longyear Incorporated for 34 years to provide ambulance service. The structure is simple in its design, with the city holding a license from the state Emergency Medical Services Regulatory Board (EMSRB), and owning two ambulance vehicles and the communication equipment. The contractor is responsible for all other aspects of operating the service.

Structure and control
The City of Chisholm reports to the EMSRB, and Longyear has a split organization chart with one side taking care of the business responsibilities such as accounting, administration, and payroll. The other half puts the day-to-day operations in the hands of the emergency medical technicians (EMTs) and an elected board. It allows the staff to have a say in determining standard operating procedures.

This model allows the city to maintain control of its service. Rates and payments are set by the city, and a member of the City Council is appointed to serve as a conduit to Longyear.

Transition from public safety department
Prior to 1980, the city had a full-time public safety department that provided its ambulance service. That year, during a public hearing held by the Minnesota Department of Health, the city was challenged to find a different model—or risk losing its service. The community supported a volunteer model.

After months of input and research, a taskforce decided to find a contractor that would use volunteers who served as parttime paid, on-call responders. That first company experienced growing pains, including an inability to make payroll, and city leaders decided to look for another contractor.

Current company formed in 1983
Three EMTs stepped forward in 1983 and formed Longyear to take over operations. By 1991, there was one owner/operator.

In 2014, an operations manager was hired to maintain response times during the day shifts and on weekends, and fulfill the increasing regulatory responsibilities. The service has about 20 on-call EMTs.

This model provides service to Chisholm and the surrounding area of about 10,000 residents. City leaders feel it serves the community well, and they have a 10-year contract to continue the partnership.

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