First responders seek help as funding dwindles

BRAINERD — First responders, the people who may be the first on the scene following a 911 call, are looking for help themselves.

The critical life-saving service faces reduced funding — meaning fewer resources, programming and supplies — ironically because more Minnesotans are using their seat belts.

The declining revenue stream from seat belt violation fines may put those services in need of life support themselves as officials say money isn’t there to sustain services in the region. At issue is a funding source that continues to dwindle, meaning the emergency medical services supporting first responders are now funded at levels not seen since the 1980s.

Those first responders are typically on the scene treating injuries and health emergencies after a 911 call and, as the name says, are typically there before other help arrives in rural areas, giving people a better chance to survive.

If funding isn’t stabilized, and soon, EMS providers say it means fewer emergency resources for area residents and visitors to the lakes region.

Emergency medical service providers were recently before the Crow Wing County Board of Commissioners saying they have qualified first responders willing to volunteer and serve the area but no way to purchase the medical gear they need. Programs have been suspended. Staff vacancies have gone unfilled. Regional education, programs and equipment grant projects reduced.

Minnesota has eight Emergency Medical Services regions. The Central Minnesota EMS Region supports pre-hospital EMS agencies across an 11-county member area, including Crow Wing, Cass, Mille Lacs, Morrison, Todd and Wadena counties, among others. The region describes itself as a mixture of volunteer and paid departments, first responders, firefighters, law enforcement officers, EMTs and paramedics.

“We serve first responders, fire departments, law enforcement agencies and ambulance services,” Marion Larson, Regional EMS coordinator, stated in a written report to the County Board presented Feb. 21. Larson said the organization serves those who “answer the call to 911.”

The eight EMS Regions across Minnesota continually struggle to obtain stable and adequate funding as options, one after the other over the last 40 years, are depleted, Larson said. A state audit in 2022 also limited EMS Relief Fund dollars from being used to support programming, services, coordination efforts and operational expenses. Larson said that change will create a budget shortfall starting in July, for the next fiscal year.

“Without additional funding (Central Minnesota EMS Region) will be unable to continue its current operations and will have to drastically reduce services and programs,” Larson stated.

Josh Waagmeester, representing one of the first responder zones in the lakes area, accompanied Larson in presenting their funding dilemma to commissioners. First responders from what was called Zone 2 in the county’s First Assessment District serving the area between Brainerd and Nisswa, have been responding to emergency calls for more than 20 years, Waagmeester said. Zone 1 is anything south of Brainerd. Zone 3 is the Pequot Lakes, Breezy Point and Jenkins area. Zone 4 is the northeast corner of the county.

Waagmeester said for years they worked like robbing Peter to pay Paul, getting equipment from fire departments and then getting relief supplies from North Memorial Health after responding to calls. In the last year, when people asked to join Zone 2 and offer their help, Waagmeester said they decided to officially become a nonprofit as a state-recognized medical response unit.

“Since that time, we've jumped from eight first responders, which were strictly firefighter first responders that were either in Nisswa Fire or Mission, and we've gone to 18, within a matter of about six to eight months,” Waagmeester said, adding the 10 additional people just want to be first responders and aren’t necessarily tied to a fire department. Now, Waagmeester said they have willing people but not the equipment they need. It costs about $7,500 to equip a first responder — radios, pagers, equipment and training, Waagmeester said.

When Waagmeester reached out to Larson, she informed him of the situation Central Minnesota EMS had in terms of state funding. The local issue he thought he was facing was actually statewide.

Area first responders have used fundraisers, such as calendar sales, to help. Zone 1 tried to fill the gap with mailers, online campaigns and going door-to-door. Last year, they brought in $5,500. Waagmeester said last December, first responders from Zone 1, from the Fort Ripley area — which was able to upgrade equipment using grants available during the COVID-19 pandemic — generously donated used gear to their group such as medical bags.

Seeing additional need for services, Zone 2 first responders rebranded to Lakes Area Rescue and is expanding into East Gull Lake. Waagmeester said with new residents coming into the area, and first responders who live on the Highway 371 corridor, they can easily serve those locations as well.

But the issue of getting equipment to those willing to be first on the scene in an emergency remains.

In the lakes area, that means there are two issues — how to equip local trained volunteers who are willing to be first responders and how to ensure the nonprofit organization that supports them is able to continue.

Waagmeester said first responders in his group are volunteers serving without compensation. Some of the first responders associated with fire departments do receive some support to cover fuel cost and training.

In terms of what the Crow Wing County Board could do, Waagmeester asked for used equipment, such as radios, as the sheriff’s department upgrades.

He said AEDs were needed as they don’t have any of the units for the additional 10 first responders added to Lakes Area Rescue. All are state certified as Emergency Medical Responders, Waagmeester said, and some go well beyond that with EMTs, paramedics and registered nurses part of the group.

“An AED is, in my opinion, one of the most critical things that we can carry,” Waagmeester said. “So if somebody goes into an abnormal rhythm, hitting that AED on them in a critical time can be a matter of life or death.”

Without it, Waagmeester said they are doing chest compressions, which may not provide the end result possible with the AED’s effect on the heart rhythm. Beyond that, Waagmeester was asking the county to consider donating a squad car, which could deliver more advanced medical equipment such as a LUCAS device for mechanical chest compressions in the event of a cardiac arrest. Waagmeester said the LUCAS device can be critical for rural areas where first responders may be on the scene for a longer time before an ambulance arrives. He noted Essentia Health agreed to give them three AEDs, which may arrive in late summer.

Commissioner Steve Barrows, who sits on the Central Minnesota EMS joint powers board, said the presentation pointed out two issues — an ongoing funding problem for the organization that will really raise its ugly head in 2024, and the requests for county donations of used equipment.

“So what we're hoping for is that we can get the state to step up to the plate and fund the (eight) emergency EMS groups … give them a steady funding source that they can rely on every year,” Barrows said of the first effort.

The EMS groups keep people certified and up to date on training and serve a great purpose in the central Minnesota corridor, Barrows said.

“If Marion's organization does not get the budgeting and the funding that they need from the state that affects every first responder organization within central Minnesota, as well as the other districts, as they mentioned, right,” Waagmeester said, noting the first responder groups seek reimbursement for training from the EMS organization. “They are kind of a lifeline to some extent for us.”

Waagmeester said they were hoping for used equipment in radios, AEDs and potentially the squad car, although he received no positive response from commissioners on the squad car donation.

“So help us in the short term,” Waagmeester said. “And then let's figure out how we partner together and take this to the state level. Because it's not just a local issue. I'm here on behalf of my zone, when I also have members in the audience here from other zones, they're experiencing the same exact thing.”

Crow Wing County Administrator Tim Houle said before the county steps in and replaces state funds, when the state of Minnesota has a record surplus it seems the county should have a conversation with the state.

“I would suggest this is a nonpartisan issue that they ought to be able to sink their teeth into and resolve,” Houle said.

On the local level, Houle said letting used equipment like the AEDs, radios and other such items go to first responders is probably a good disposition and he believed it was an allowed contribution. The squad car raised another issue. Waagmeester said the first responders would go to the scene in their own vehicles, but a donated squad car, which would rotate in the area, could serve as a response vehicle with a LUCAS device or more advanced medical equipment.

In a Feb. 28 Crow Wing County Board meeting, Houle reiterated the issue that the Central Minnesota EMS Region will run out of money to supply equipment and training to first responders in two to three years. Houle said it is unusual that the state would fund life-saving pieces of equipment by charitable gambling and fundraising.

“This is life-saving equipment, it should be funded by the state out of the general fund with whatever revenue streams they have that are stable and ongoing,” Houle said.

The board approved sending a letter to area legislators including Rep. Josh Heintzemann, Rep. Ben Davis, Rep. Ron Kresha, Sen. Justin Eichorn and Sen. Nathan Wesenberg to advocate for that stable funding for EMS teams.

Larson’s report noted the early funding in the 1980s came from federal block grants. As federal funding dropped, the state of Minnesota created the EMS Relief Fund to offer support using a highway appropriation and while funding fluctuated, highway dollars provided $115,000 annually to each EMS region. In 2000, the state Legislature basically stated the EMS funding did not benefit the highway system so funding was moved to the state’s general fund.

Currently, the EMS fund is fueled by money collected from seat belt violations. The funding was unchanged for 20 years and has decreased since 1989. Larson stated the EMS fund allocation “has remained stagnant since” fiscal year 2015 at $73,125. A one-time funding bump of $100,000 for fiscal year 2022-2023 was approved by the Legislature, but expires in June. After that, the EMS fund will return to $75,125 annually, Larson stated.

Seat belt violation fines, a funding source that once provided the Central Minnesota EMS Region with $226,648 in fiscal year 2011, dropped about 80%. Education and other efforts appeared to be successful as more people buckled up. In fiscal year 2021, the seat belt fines brought in $44,817 for the central EMS region.

Larson stated there are four main programs — equipment grants, training grants, critical incident stress management services and EMS coordination.

“Our fire departments, law enforcement agencies, first responder organizations and ambulance services all need equipment to respond to medicals and to communicate with one another,” Larson’s report noted. “Equipment purchased from funds distributed from CMEMS include, but is not limited to: medical bags, patient care supplies, ARMER radios, and automated external defibrillators (AEDs). This equipment directly improves patient care that is provided by our responders. Since 2012, CMEMS has provided over $100,000 in equipment grants to our stakeholders.”

Between 2012 and 2020, Central Minnesota EMS provided equipment grants of $6,833 to Cass County, $12,622 to Crow Wing County, $7,365.73 to Mille Lacs County, $9,000 to Morrison County, $5,970 to Todd County and $3,727 to Wadena County. In the 11-county area, including the regional counties, the organization provided $100,121 in equipment grants over those eight years.

The organization provides local resources in case of a natural disaster or mass casualty event, or in a case of such as the need to move people from a nursing home that lost power. If the organization disbands, those resources would need to be made up as each individual county is able to respond, Larson said, and the consensus is that it would be a hardship for each county to offer the same services.

“You don't always have the resources to do that sort of big response locally,” Larson said when she appeared before the Crow Wing County Board last month.

Last year, Central Minnesota EMS started a pilot program to train EMTs partnering with a college for a hybrid course. Central Minnesota EMS used grant dollars to pay tuition costs and coordinated the class. Successfully graduating students with a national EMT certification, the plan is to expand the training access across the region as a way to help with a shortage of pre-hospital EMS providers.

The Central Minnesota Emergency Medical Services Region serves fire departments, first responder groups, law enforcement agencies and ambulance services throughout Benton, Cass, Crow Wing, Kanabec, Mille Lacs, Morrison, Pine, Stearns, Todd, Wright, and Wadena counties. More than 200 agencies are served.

The region was established in 1981 as the Central Minnesota Emergency Services Council, a nonprofit private EMS development corporation serving 14 counties.

In 2001, the 14 counties in central Minnesota were awarded a competitive grant from the EMS Regulating Board and the Central EMS Region has operated as a joint powers board since then. Chisago, Isanti and Sherburne counties left to collaborate with Metro EMS Region between 2014-2019.

Renee Richardson, managing editor, may be reached at 218-855-5852 or renee.richardson@brainerddispatch.com. Follow on Twitter at www.twitter.com/DispatchBizBuzz.