U.S. Senator Tina Smith Leads Efforts to Address the Rural EMS Crisis with Statewide Tour

MINNESOTA [4.16.24] - As access to emergency medical services continues to be a top issue for leaders in the Minnesota State Legislature, U.S. Senator Tina Smith (D-Minn.) has been active in working toward federal solutions to the crisis. She and her staff have held meetings across Minnesota, from Hibbing to Barnesville, Blackduck, and New Richland, where local EMS leaders conveyed that first responders are in dire financial straits. Senator Smith has been urging Congress to act on this crisis and is an original cosponsor of a bill to provide Medicare reimbursement for care provided by EMS when no transportation to the hospital is provided, called the Emergency Medical Services Reimbursement for On-Scene Care and Support (EMS ROCS) Act.Senator Smith stressed that joint efforts with state and local governments will be essential to fully address this crisis and is committed to ensuring all Minnesotans can live safe and healthy lives wherever they choose to live.

In recent years, several states have passed laws to make EMS an essential service - Minnesota is not one of them, meaning the state government isn't required to fund them. At the Minnesota State Legislature, there is a bipartisan EMS Task Force that is working to address the EMS crisis at the state level.

"Everyone deserves a timely, fully equipped response in times of crisis. EMS workers also deserve a fair and decent wage, regardless of where they live," said Senator Smith. "While the Minnesota Legislature continues to work toward state solutions, I'm going to keep pushing for more federal support for our first responders. It's going to take a whole-government approach, and I look forward to working with the state EMS task force and local officials to keep EMS services available for all Minnesotans."

International Falls Mayor Harley Droba shared he thinks they're approaching a "breaking point" during a meeting with Senator Smith earlier this year. The same sentiment was echoed on two separate occasions by Leech Lake Band EMS Director Terence O'Connor and Perham EMS Director Rebecca Huebsch, who said they're "bleeding out." During Senator Smith's visit to Hibbing, Fire Chief Erik Jankila shared that nearly 85 percent of their ambulance calls are from Medicare and Medicaid patients, where low reimbursement rates significantly impact the station's budget.

Many rural communities face challenges in accessing timely emergency medical services - especially for Medicare beneficiaries, who make up about 40 percent or more of patients treated by EMS. In Barnesville, 80 percent of their patients are on Medicare or Medicaid. Right now, Medicare does not reimburse for on-scene care when transportation to a hospital is not needed. This means when a Medicare beneficiary calls 911 for emergency help and is able to be successfully treated at their home, it's the local EMS provider that is footing the bill for that service. This is exacerbating an already dire financial situation, where rural providers are facing the possibility of having to shut down.

"We need reimbursement from Medicare and Medicaid to keep up. If that happens, it's a whole different story for EMS," said Perham Area EMS Director Rebecca Huebsch at the meeting in Barnesville.

Senator Smith was one of the original cosponsors of Senators Peter Welch (D-VT) and Bernie Sanders' (I-VT) EMS ROCS Act, which would require Medicare to pay for EMS services, regardless of whether a person needs to be transported to a hospital. She also previously introduced the EMS Staffing and Support Act, which would provide $500 million to establish a grant program in the Health Resources and Services Administration. This grant funding would provide critical support for EMS providers by bolstering departments in hiring, volunteer recruitment, training, equipment, facilities, and regional collaboration.