Legislative auditor suggests more oversight of Minnesota ambulance services

The auditor of Minnesota’s state government has recommended more oversight of ambulance services in the state.

In a new report issued Friday, the Office of the Legislative Auditor said stronger oversight and more support of ambulance services is needed and the board that regulates ambulance services in the state needs to improve its operations.

The report said 277 ambulance services were licensed to operate in Minnesota in July 2021. In Fiscal Year 2021, those services responded to around 540,000 calls, which is nearly 2,000 calls each. However, the geographic areas they serve aren’t frequently updated, which can leave overlaps and gaps.

The auditor’s office urged the Legislature to retain primary service areas, restructure how those areas are created, modified and overseen, and create a process to periodically review those areas and allow them to be redrawn, if necessary, by the Emergency Medical Services Regulatory Board (EMSRB). The office added that local governments should be able to provide input about the care they need in their area.

Several other recommendations were made by the auditor’s office, including:

• Urging the Legislature to adopt more stringent statutory requirements for renewing ambulance service licenses instead of the “practically automatic” renewal process it claims is currently in place.
• Having the Legislature direct EMSRB to develop and enforce performance standards for ambulance services instead of leaving it up to the service to identify all problems and internally address them.
• Exploring options for improved ambulance service sustainability across Minnesota, possibly through pilot programs. The report noted ambulance services typically aren’t primarily supported by taxes, unlike police and fire services, and many ambulance services face revenue challenges.
• Making the EMSRB improve its oversight of its executive director and ensuring it fulfills its responsibilities. The auditor’s office said the board “has been largely ineffective,” hasn’t created or implemented any statewide plans for EMS, hasn’t updated EMS regulations to account for technology and service provision changes, failed to investigate many complaints from 2017 to 2020 and has taken only limited action to address staffing and sustainability issues.
• Considering making structural changes to the EMSRB and clarifying what constitutes a conflict of interest for board members.

The auditor’s office noted the EMSRB agreed that its report “raises several serious ad important issues” and stated that the board is currently working to address those concerns.

The EMSRB gave the following statement to 5 EYEWITNESS NEWS:

“The EMSRB is appreciative of the efforts of the Office of the Legislative Auditor in highlighting challenges facing EMS in the state of Minnesota. The EMSRB for over a year has been diligently working on making improvements, that are within our authority, to the administration of the EMS System as is highlighted in our formal response to the OLA. We look forward to partnering with the Minnesota Legislature in making modernizing updates to existing law to better support the dedicated EMS providers and organizations in our state while also taking steps to ensure the financial sustainability of EMS agencies in today’s complex healthcare environment.”

Emergency Medical Services Regulatory Board (EMSRB)

The report noted that 61% of outstate ambulance service directors reported difficulty in staffing over the past month, and many service directors weren’t confident they’d be able to meet community needs in five years.

Click here to read the auditor’s full report.