06-03-2025
Jamestown Area Ambulance facing staffing, reimbursement issues
Mar. 6—JAMESTOWN — Jamestown Area Ambulance is facing issues with staffing and reimbursement prices for ambulance transports, according to Ken Krupich, general manager for Ringdahl EMS.
"We've got a reimbursement issue, which means we have a revenue issue, which means we have an employee issue," said Andrew Berkey, operations manager for Jamestown Area Ambulance.
The cost of operating an ambulance service has increased by 66% over the last decade, according to Adam Parker with Werfel, Moore & Kelly Law Group.
"I believe reimbursement over that same period has increased 12%," said Parker, who advocates for ambulance services across the state.
Parker said insurance reimbursement rates have not grown in the ambulance industry.
He said a federal study that was recently completed shows the average cost of an ambulance transport is about $2,670. The average reimbursement for that was about $1,140.
"We only get paid for transport in most scenarios," he said. "So if we respond to somebody who called 911 and we don't transport them, many insurance providers don't reimburse for that call."
Parker said the federal government sets the Medicare rates and commercial insurers set the reimbursement rates.
Community leaders attended an emergency medical services town hall at Jamestown Area Ambulance on Tuesday, March 4. The informational meeting was held to inform the community about any changes that could occur in the operation of Jamestown Area Ambulance.
"The purpose of today is to talk about where we currently are as an ambulance service, some of the challenges that we faced over the last few years that continue to deliver a little bit more of a hardship and complication into how we run our operation, and then to discuss with people who are stakeholders in that health care community on what the path forward is, what options do we have on the table, and how do they impact our communities, our services and our health care partners," Berkey said.
Krupich said Jamestown Area Ambulance is not in a crisis. Ringdahl EMS operates Jamestown Area Ambulance.
"We are not closing. We're not making immediate changes," he said. "However, a lot of ambulance services across the state, across the nation and within our service area in Casselton, Lisbon, Fergus Falls (Minnesota), Pelican Rapids (Minnesota), have had to make those changes. What we're trying to do ... is get you guys around the table before we have to make changes or if we have to make changes so that we can work together as a community ... ."
Options to resolve the financial and staffing issues at Jamestown Area Ambulance included creating an ambulance district, which requires voter approval, and transitioning its license status from advanced life support to basic life support.
An advanced life support ambulance requires a paramedic on the first ambulance when responding to a call for service. A basic life support ambulance only requires emergency medical technicians.
"What that does for us is takes that requirement (to have a paramedic) away that the very first ambulance out the door has to happen, and ... it is that we're no longer held to that," he said, referring to transitioning Jamestown Area Ambulance's license status from advanced life support to basic life support. "If that were a direction we were to go, the objective remains the same: Get as many medics on the schedule as you absolutely can, put as many of them in the trucks as you can, but this gives us more freedom and flexibility to use the advanced life support resource the way we want to use it."
He said Jamestown Area Ambulance is in a position to hire three paramedics.
"We take them in a heartbeat, but they're just not there," he said.
Jamestown Area Ambulance increased wages 7% for paramedics and 12.5% for emergency medical technicians, Berkey said.
"If you look at the services in our area that are similar size, similar volume, it's safe to say we are competitive with them and trying to be competitive with our bigger neighbors in Fargo and Bismarck," he said.
Berkey said accrual rates for paid time off were adjusted.
"(We're) just trying to do things that make Jamestown ambulance look as attractive as it possibly can to outside employees in hopes that we can start recruiting more people to our community," he said.
He said Jamestown Area Ambulance invested $45,000 to send its own emergency medical technicians to paramedic school.
"That's worked very well for us," he said.
Berkey said Jamestown Area Ambulance also implemented a response protocol in January 2024 that allows it to use paramedic resources in a more flexible way. He said state law currently requires a paramedic to be on the first ambulance that responds to a call for service.
"So now a paramedic can go out in the quick response unit, and if another call comes out that is deemed more advanced life support, they can move around because they're not tied to that truck," he said. "It's been very successful for us, and honestly, really vital for us to continue to do what we're doing."
Berkey said it's now routine for Jamestown Area Ambulance to have one advanced life support ambulance and a basic life support ambulance.
"That just fluctuates based on who we were able to get on the schedule and how we're sitting for that day," he said.
Jamestown Area Ambulance is continuing its recruiting efforts through social media, Indeed, other platforms and internal emergency medical technician courses. Berkey said other recruiting efforts include a sign-on bonus and supporting employees in furthering their education or their license.
Community leaders discussed the possibility of creating an ambulance district to help with funding. The creation of an ambulance district would require voter approval.
"One avenue that addresses some issues is ambulance districts," Parker said.
He said an ambulance district is a political subdivision that follows the response boundaries of an ambulance service.
"So it can cover multiple counties," he said.
An ambulance district would have its own elected board that is responsible for ensuring that service is provided and adequate, Parker said.
He said the district would then have the ability to levy tax dollars to support the ambulance service.
"It would support payroll to attract and retain the best EMS professionals," he said.
The tax dollars could also be used to help with operational costs. Parker said a new ambulance costs around $250,000, which doesn't include the equipment inside it.
"Probably 10 years ago or 15 years ago, a new ambulance was probably about $110,000," Parker said. "When we look at the total cost increase over the last several years, it's just very difficult to sustain ambulance operations."
Stutsman County Commissioner Jerry Bergquist said a lot of work has to be done to get an ambulance district approved by voters. He said the community knows it needs Jamestown Area Ambulance's service.
"If you want my recommendation, I really would like to see you guys move forward with that," he said.
The Barnes County Ambulance Service got the Barnes County Commission on board with the idea of creating an ambulance district so they can educate the public to get voter approval, said Andrea Suhr, an administrator with Barnes County Ambulance Service.
"They were like a great liaison for us," she said
