EMS service in rural communities stretched thin according to ambulance director

In small towns and rural communities across Minnesota, a crisis has been brewing for years. And it impacts the health and welfare of everyone who lives outstate.

"It’s a tragedy waiting to happen, it really is," Rhonda Ingebritson told FOX 9. "It’s a serious tragedy waiting to happen."

Ingebritson is the Ambulance Manager of Lake Crystal, a town southwest of Mankato. They have one ambulance, and during business hours, Ingebritson runs it.

On-call volunteers cover the other hours, but they don’t have enough. Which means in the next two weeks, Ingebritson is covering the gaps.

"I’m also putting in 155 hours over the next two weeks because we don’t have staff. We just don’t have the staff to cover all those hours," she said.

That sense of current hardship and impending crisis is what brought her to a town hall meeting in Mankato to talk about the challenges and potential fixes for rural EMS service. It’s complicated and solutions aren’t simple, either.

"We just started to realize this whole system is kind of broken. EMS itself is having a hard time surviving," said Kelly Asche, who is a researcher for The Center for Rural Policy and Development, also based in Mankato. "And so that’s not a good looking future for a lot of rural areas in terms of being able to provide medical care."

Asche authored a report published this spring that identified the major challenges facing rural ambulance services. Top among them is simply the volume of calls. Rural areas are aging and calls are increasing, double in some cases from 20 years ago. And the distances are increasing, too.  

In other words, more calls that also take much longer.

But, he says, while calls have gone up enough to burn out volunteers, they’re still not high enough to justify the cost of more full time EMS employees.

"In the next couple years," said Asche, "if we don’t make significant changes, we’re going to start hearing more and more stories of people calling 911 and the ambulance either being super delayed or not showing up at all."

In rural areas, medical systems are consolidating, a necessity when there’s so much more technology that’s cost prohibitive to have in every small clinic or doctor’s office. That’s the reason for longer ambulance trips, a time commitment that makes it tough to attract or keep volunteers to staff small town ambulances.

"We transport patients between hospitals more now than we ever did," said Mark Jones, executive director of the Minnesota Rural Health Association. "Urgent cares didn’t pop up on every street corner in rural Minnesota, so the options for accessing rural health care are fewer and far between. And the ambulance service is most often the only transportation some people have."

The hope is to encourage more funding from both state and federal levels, to allow small towns to attract more ambulance crews.  Pooling resources between services has to be looked at, too.

For now, Rhonda Ingebritson is just hoping to attract more on-call volunteers.  She used to have 24, but is down to 14.  On top of all the other reasons, the pandemic added to the problems.

"COVID literally killed our service," she said. "It burned everybody out. It’s killing healthcare. it just burned everybody out."