Star Tribune
An Iron Range region could lose ambulance service
DULUTH — A 650-square-mile region carved out on the western Iron Range is in danger of losing its ambulance service.
The city of Nashwauk has handled operations for its own 1,000-resident town and seven other townships or cities, some at least 30 minutes away, since 2000. But its reimbursements from Medicare and Medicaid only cover a portion of each run, Mayor Calvin Saari said, putting the city in debt and raising the eventual threat of bankruptcy.
Ending service would be a tragedy for our community, Saari said. “So we’re looking for some way to keep things afloat.”
It’s something ambulance services across the state are struggling to do, as operational costs — but not reimbursement rates — escalate. It’s especially problematic in greater Minnesota, where lower call volumes and a lack of volunteers mean less revenue than in metro areas.
“It’s just not a sustainable business model,” said Erik Simonson, a lobbyist for the Coalition of Greater Minnesota Cities.
Nashwauk’s budget is about $1.8 million. Through mid-November, the city had lost $120,000 to uncovered ambulance costs in 2023.
The city is considering several options, from a private company taking it over to creating a tax district with the other cities and townships who use the service, but each option has drawbacks, he said.
The last resort is returning the license to the state, which would divide up the service area to Grand Rapids to the west and Hibbing to the east.
That division would lengthen ambulance travel time, with some routes taking as long as 90 minutes. That’s something the Nashwauk workers can’t even fathom, said Leann Stoll, a union representative for AFSCME Council 65, which represents Nashwauk’s seven emergency service workers.
The ambulance workers in Grand Rapids and Hibbing are strapped, she said, and would struggle if their service area grew.
“We have to make sacrifices and decisions over what is most beneficial,” Stoll said. “And emergency health services really should be close to the top of that list.”
Duluth-based Essentia Health runs seven rural ambulance services in northern Minnesota, including the Iron Range’s Buhl. Nashwauk officials approached the health system about taking over service, but it declined, said Joe Newton, director of emergency services for Essentia Health.
“We would face the same challenges in that area as every ambulance service does,” Newton said, including workforce shortages and the payment model for pre-hospital emergency care. “It’s unsustainable to provide the care that citizens deserve and in no way covers the cost of providing those services.”
Saari said it costs the city about $1,600 per ambulance run, and for those patients who have Medicaid or Medicare — more than 70% of patients — the city is reimbursed $470. Some have supplemental insurance, but many don’t, he said.
The Minnesota Emergency Medical Services Regulatory Board released a financial evaluation of the state’s ground ambulance industry last month. It found that ambulance services statewide reported $1.2 billion in insurance billables in 2022 but received about $450 million in insurance payments. More than 70% reported financial losses.
“The report underscores the harsh reality that ambulance services often fail to recover the actual costs of providing their services,” the evaluation says.
Simonson said that is deeply felt in rural Minnesota. The coalition’s priority in the next legislative session is one-time money for ambulance providers, followed by reform efforts, he said, noting previous attempts by the Legislature to provide aid had stalled.
Nashwauk officials have asked for proposals from potential operators interested in its license, but the city has only received a few phone calls and no proposals, Saari said.
It also could consider fewer employees or reverting back to its former paid on-call model of operations, which limits availability because of scheduling conflicts with other jobs. The city is discussing the formation of a tax district with the other entities in the service area to share the costs now borne only by Nashwauk. City officials will meet with leaders of those communities in the coming days.
If a tax district model were adopted, Nashwauk would lose jurisdiction over the ambulance service, Saari said, because a joint powers board would be formed to oversee it.
Some residents who spoke at a recent Nashwauk City Council meeting advocated for a tax district, spreading the cost of emergency care across all who benefit from the service. Nashwauk Township resident Rick Hipsag said he doubts many would protest higher taxes for something that all residents could potentially need.
The Nashwauk ambulance service helped save his daughter’s leg in 2019, after a horrific car accident that took the life of his 2-year-old grandson.
Not only did his family know who the workers were — which gave them comfort on that traumatic day — the response time was mere minutes, crucial because his daughter needed extensive care in Duluth nearly two hours away. Longer wait times would be hard on first responders trying to keep people alive until an ambulance arrives, he said.
“If you have to wait for up to an hour and a half, if you’re a heart attack victim — you’d be losing lots of lives,” Hipsag said. “You can’t put a dollar amount on that.”
Northern State 35, Concordia (St. Paul) 34: Wyatt Block’s 2-yard TD run and the PAT with 10 seconds remaining lifted the Wolves past the host Golden Bears. Block’s touchdown capped an 11-play, 72-yard drive by the Wolves, who trailed 24-7 in the second quarter. Jeff Isotalo-McGuire’s 34-yard field goal with three minutes, 32 seconds remaining gave the Golden Bears a 34-28 lead.
Winona State 31, Bemidji State 28: Cade Stenstrom rushed for two TDs and passed for 150 yards and a TD to help the host Warriors outlast the Beavers. Stenstrom’s 1-yard TD run and the PAT with two minutes, 10 seconds remaining gave the Warriors a 31-21 lead. The Beavers responded with an 11-play, 93-yard drive to pull within 31-28 with 18 seconds remaining but the Warriors recovered the ensuing kickoff.
Div. I-AA
North Dakota State 59, Murray State 6: The top-ranked Bison built a 42-3 lead in the first half and went on to defeat the host Racers in Murray, Ken. CharMar Brown ran for 97 yards and three TDs for the Bison.
South Dakota State 20, South Dakota 17 (OT): Amar Johnson’s 3-yard TD run in overtime lifted the host Jackrabbits to the victory. The Coyotes opened the OT with a 40-yard field goal.
Youngstown State 41, North Dakota 40 (OT): The host Penguins went first in OT and scored and then stopped North Dakota’s two-point conversion to hold on for the victory. The Penguins sent the game into OT on a 35-yard field goal with 12 seconds remaining.
Div. III
Augsburg 35, St. Olaf 34 (OT): The host Auggies stopped a two-point conversion in overtime to outlast the Oles. The Auggies went first in the overtime and scored on a 25-yard pass from Ryan Harvey to Tyrone Wilson. It was Harvey’s fifth TD pass — the fourth to Wilson. After the Auggies’ PAT, the Oles scored on a 25-yard TD pass from Theo Doran to Braden Menz. But the Oles’ pass attempt for the conversion failed.
After splitting their two-game West Coast trip to begin the season, the Wolves improved to 2-1 with a 112-101 win over Toronto in their home opener. It was a wire-to-wire win that featured some strong bursts of play from the Wolves and other times when their decision-making was suspect. But those moments when they were on, specifically the start of the game and most of the third quarter, were enough to carry them against a shorthanded Raptors team that was without RJ Barrett, Bruce Brown and Immanuel Quickley.
Julius Randle had 24 points while Anthony Edwards had 24 on 21 shot attempts. Donte DiVincenzo had 16 off the bench. Nickeil Alexander-Walker left the game in the fourth quarter and did not return, though he was in the bench area for the final minutes after going to the locker room briefly.
The Wolves’ starting lineup had its best stretch of basketball on the season after that unit started off sluggish in the first two games. Mike Conley, who was 3-for-16 to open the year, hit two early threes to set the tone, though Conley would finish 2-for-8.
Donte DiVincenzo replaced him at point guard halfway through the quarter and continued the hot shooting from the point guard slot with three threes of his own. The Wolves forced five Toronto turnovers and had a 32-18 lead after one.
Coach Chris Finch toyed with some different lineup combinations in the first half as he had Conley and DiVincenzo begin the quarter together while having Joe Ingles run the point later in the quarter. It led to an uneven second, and the Wolves led 56-44 at halftime.
But the Wolves played inspired coming out of the break. Jaden McDaniels, who didn’t take a shot in the first half, had nine points in the opening minutes of the third. Edwards hit a pair of threes as they pushed their lead to 22. The Wolves weren’t sharp closing the night, and the Raptors had the game within right inside of two minutes, but the Wolves had built enough of a cushion.
Rudy Gobert. Gobert had 15 points and 13 rebounds and was the beneficiary of some lobs from his teammates like Edwards, Conley, Nickeil Alexander-Walker and Joe Ingles. Gobert also finished with four blocks.
Gobert had two blocks on one possession in the fourth quarter that got the crowd off its feet and Gobert pounding his chest. Gobert blocked D.J. Carton and Jamison Battle.
Star Tribune
Trump denigrates Detroit while appealing for votes in a suburb of Michigan’s largest city
NOVI, Mich. — Donald Trump further denigrated Detroit while appealing for votes Saturday in a suburb of the largest city in swing state Michigan.
”I think Detroit and some of our areas makes us a developing nation,” the former president told supporters in Novi. He said people want him to say Detroit is ”great,” but he thinks it ”needs help.”
The Republican nominee for the White House had told an economic group in Detroit earlier this month that the ”whole country will end up being like Detroit” if Democrat Kamala Harris wins the presidency. That comment drew harsh criticism from Democrats who praised the city for its recent drop in crime and growing population.
Trump’s stop in Novi, after an event Friday night in Traverse City, is a sign of Michigan’s importance in the tight race. Harris is scheduled for a rally in Kalamazoo later Saturday with former first lady Michelle Obama on the first day that early in-person voting becomes available across Michigan. More than 1.4 million ballots have already been submitted, representing 20% of registered voters. Trump won the state in 2016, but Democrat Joe Biden carried it four years later.
Michigan is home to major car companies and the nation’s largest concentration of members of the United Auto Workers. It also has a significant Arab American population, and many have been frustrated by the Biden administration’s support for Israel’s offensive in Gaza after the attack by Hamas against Israel on Oct. 7, 2023.
During his rally, Trump spotlighted local Muslim and Arab American leaders who joined him on stage. These voters ”could turn the election one way or the other,” Trump said, adding that he was banking on ”overwhelming support” from those voters in Michigan.
“When President Trump was president, it was peace,” said one of those leaders, Mayor Bill Bazzi of Dearborn Heights. ”We didn’t have any issues. There was no wars.”
While Trump is trying to capitalize on the community’s frustration with the Democratic administration, he has a history of policies hostile to this group, including a travel ban targeting Muslim countries while in office and a pledge to expand it to include refugees from Gaza if he wins on Nov. 5.
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