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Start working on the ambulance situation now

Opinion editor’s note: Editors represent the views of the Star Tribune Editorial Board, which operates independently of the newsroom.


Seconds and minutes matter when there is a medical emergency. It is imperative that lawmakers take the same time-is-of-essence approach when it comes to resuscitating the state’s ailing emergency medical care system.

The fact that trained responders and an ambulance show up quickly after calling 911 should not depend on where Minnesotans live or are at the time. Yet rural communities in particular struggle to provide this essential public service as populations shrink and the cost of providing this care continues to exceed reimbursement. Historic labor shortages in Minnesota and elsewhere have exacerbated the problem.

“The problem is so acute in my district and across northern Minnesota that it is almost harder to find communities that don’t face challenges than it is to find communities that do,” said Sen. Grant Hauschild, DFL-Hermantown . “It’s almost everyone once you get north of Cotton.” Cotton is a small community in St. Louis County, about 36 miles north of Duluth.

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The challenges are not limited to northern Minnesota.

“This is something health care providers, law enforcement and county commissioners talk to me about regularly,” said Sen. Jordan Rasmusson, R-Fergus Falls. “There would be situations where it could take 45 minutes for an ambulance to arrive in a rural community. To me, that’s just not an acceptable level of care and it ignores the expectations that my constituents have.”

This struggle is not new. A sharply critical 2022 report from the respected Office of the Legislative Auditor spotlighted the dire situation, noting not only “ongoing staffing and funding issues across the state” but also a system that lacks “meaningful oversight ‘ was missing.

The report concluded that the state’s Emergency Medical Services Regulatory Board (EMSRB) has been “largely ineffective in its regulation” and that the board’s then-composition and its responsibilities created “risks for conflicts of interest.” Changes have taken place at the EMSRB since then, with improvements to administrative and performance measures outlined in an update a year ago and now posted online alongside the audit report.

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These improvements are welcome, but the ongoing challenges in ambulance care in Hauschild and Rasmusson counties underscore that there is still much more work to be done. Although lawmakers are charting a less ambitious course this session after the sweeping agenda passed in 2023, that is no excuse for inaction on this critical issue in 2024.

Fortunately, the Legislature’s Medical Assistance Task Force understands this. Its members, including Rasmusson and Hauschild, are doing commendably well to implement sensible reforms this year. The membership list illustrates one advantage of having a citizen legislature. Several of the other members bring deep expertise in this area because they are current or former medical providers, including Sen. Judy Seeberger, DFL-Afton, Rep. John Huot, DFL-Rosemount, and Rep. Jeff Backer, R-Browns Valley. .

The task force held field hearings across the state, with the last meeting scheduled in mid-February and a report with recommendations expected later this year. Legislative action often takes place after the report’s release, but “there are things we can start doing now that will address immediate needs while we work on longer-term solutions,” Seeberger told an editorial writer.

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Among the short-term reforms that deserve attention:

· Redesign of the EMSRB. One promising proposal would have the board reporting directly to the governor’s office. That would hopefully improve accountability and give a higher profile to this part of the health care system in the competition for additional public resources.

⋅ Establishing “innovation zones” across the state to evaluate new models for providing emergency medical care.

⋅ Ease the process for Minnesota residents who have had their emergency medical license expired but want to renew it.

⋅ One-time funding for communities where the emergency response crisis is particularly acute.

The bipartisan work of the EMS Task Force members is an excellent example of political teamwork in the Capitol. Their colleagues in the House of Representatives and the Senate should heed their grim assessment of the system’s vitals and begin work to restore it now.

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