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Rural fire, EMS crews serve communities at little cost

WABASHA — At 4:59 p.m. on Sunday, dispatch called the Wabasha Ambulance Service about a motorcycle accident on Minnesota Highway 60, just west of the city. Three motorcycles went down as they rounded a corner. Within three minutes, a pair of volunteer emergency medical technicians was on the road.

By 5:05 p.m., the ambulance crew — both volunteer emergency medical technicians, paid per call — had arrived on the scene about 4 miles away. Thus began another chapter of volunteers rolling to the rescue across Minnesota.

On many roadway accidents, Wabasha Police Chief Joe Stark said his folks are usually the first on the scene. But when there's a medical emergency, the EMTs from either the fire or ambulance crews take over when they arrive.

"The training in both fire and ambulance is nonstop," Stark said. "It's a big commitment. We're good if there's a CPR situation, but most of the time we're very relieved when they come, and it's us assisting them."

For the crash Sunday, two of the bikers were treated on the scene, and one was transported to St. Elizabeth's Medical Center, where he was treated and later released.

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State of volunteers

Most ambulance services — especially outside of the Twin Cities area — are staffed on a volunteer basis, said Tony Spector, executive director of Minnesota's Emergency Medical Services Regulatory Board.

"Quite a few of these services are volunteer," he said. "These are folks who don't make a living at this."

Across Minnesota, there are about 4,000 EMTs and emergency medical responders (certified first responders), on the roster of affiliated ambulance services, Spector said. That doesn't include all the EMTs and EMRs on fire and police rosters across the state.

The same is true of fire departments in Minnesota. Of the state's roughly 20,000 firefighters spread across 780 fire departments, about 18,000 are either full volunteer or paid on-call firefighters, said Minnesota State Fire Marshal Bruce West.

The Wabasha Ambulance Service is one of the few in the region — outside of Gold Cross Ambulance — with paid personnel. In February, the Wabasha City Council approved a $100,000 increase to the ambulance service budget in order to hire two full-time and two part-time crew members.

The service receives hundreds of calls annually to transport patients from St. Elizabeth's to hospitals in the Twin Cities, Rochester, Red Wing or La Crosse, said Amanda Murphy, interim director of Wabasha Ambulance Service. When an on-call crew is taking a transport call, it is not available for emergencies.

John Fox, the previous director of the ambulance service, said Wabasha Ambulance was turning down about $80,000 a year in transfer runs. That, he said, comes on top of three straight years where the service saw double-digit increases in the number of calls.

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In addition to the vacant director position and the four paid positions, Wabasha Ambulance has 14 on-call volunteers. "The people who volunteer, 95 percent of them have full-time jobs and they have families," Murphy said. "And their kids have after-school activities. So for them to work another 48 hours of on-call a month, that's a lot."

Little or No Pay

Those volunteers are also paid, somewhat. Each gets $2.75 an hour while waiting on call, and the pay goes up somewhat when they leave the station on a call. For volunteer ambulance services across Minnesota, that's a lot of money.

"There's a common saying in the ambulance service," said Chris Arendt, director of the Eyota Volunteer Ambulance Service. "You're one broken ankle away from closing. Since we can't offer these people a livable wage, it's becoming more and more difficult to find the volunteers."

Arendt, a clinical pharmacist in the heart and lung transplant department at Saint Marys Hospital in Rochester, is one of 28 Emergency Medical Responders and EMTs who cover the 170 or so calls a year for Eyota. All are "full volunteers," he said, meaning they don't get paid at all for their work.

That can make staffing the ambulance service a challenge. By law, an ambulance service must have two EMTs on each call, Arendt said. For Eyota, that means putting one of Arendt's "out of town" crew members in the ambulance center on a shift and pairing that person with someone who lives in or around Eyota.

On The Cheap

In addition to the ambulance crews, Eyota's ambulance service runs on volunteers in other ways. When the new ambulance building was built, a local citizen offered to plant grass seed around the building, Arendt said. Other folks come pull weeds, mow the grass and help with scheduling for the building, which also serves as a meeting hall in town.

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"I have a small cadre of people who will help with cleaning the facility, putting training materials together and scheduling," he said.

All this volunteerism is a matter of necessity. To pay a full-time crew and buy a new ambulance when needed, the Eyota Ambulance Service would need a budget of $480,000 a year. Instead, it runs on an annual budget of less than $60,000.

The ambulance service gets funding from two main sources, Arendt said, insurance and community levies or donations. "Many private insurers will pay 90 to 100 percent of the bill (for a call)," he said. "But with Medicare, we're lucky to see 60 percent of the bill."

Those funds cover everything from gas in the vehicles and keeping the lights on at the ambulance barn to training materials and medical supplies. Arendt recently bought a twin pack of EpiPens for $800. It also recently paid for a new electronic billing system. With insurers kicking back claims for minor paperwork errors, Arendt said he thinks that's one expense that will pay for itself.

The Whole Community

Tony Nelson, a member of Eyota's city council and its volunteer fire department, said emergency services don't just show up for car wrecks and fires.

"During the flood in 2007, we were pumping out people's basements," he said. "Most of us worked two or three days solid. It's people helping their neighbors. Everyone took time off from work."

That's true in any community. Kenyon Fire Chief Scott Miner said that when a call comes, his boss understands letting him go is for the good of the city.

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"My boss pays me for the time I'm gone," he said. "He understands how important it is for the community."

His predecessor, John Lee, said it's always a matter of what's going on and who might be needed. Lee works for the local power utility, so if the emergency has something to do with a power outage, he'll stay at work. Otherwise, his boss, who talked him into joining the Kenyon Volunteer Fire Department, lets him go.

"I've watched the trucks drive by before if we're out of power," said Lee, who added he'd rather be out helping his community when the call comes in. "But that's few and far between."

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Amanda Murphy

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