An ongoing ambulance service discussion between local governments broke open last week on social media, leading to comments, views, and uncertainty on the part of residents potentially impacted by it.
The online conversation continued one that had been going on the past few months between the independent but mutually intertwined governments of Cottage Grove, Newport, St. Paul Park and Grey Cloud Island Township regarding ambulance service, provided by the City of Cottage Grove to the others.
Said by Cottage Grove Mayor Myron Bailey to be operating at a deficit, the ambulance service models relies on a primary service area (PSA) ambulance provider having a service monopoly, balanced in turn by the guarantee of access for others. A total of 26 PSAs cover the Twin Cities Metro area, with other local or nearby providers including Woodbury Public Safety, MHealth Fairview, Lakeview, and Allina Health EMS.
Cottage Grove Mayor Myron Bailey laid out his views on the ambulance service matter in a Wednesday, Nov. 12 post to Facebook.
“As mentioned about two weeks ago, I want to share some information around our current EMS/Ambulance Service and the possible change of coverage with our neighboring communities of St. Paul Park, Newport, and Grey Cloud Island,” Bailey said. “As I am sure many of you are aware, the cost of providing medical services is extremely high. The biggest challenges of these costs are due to the lack of adequate funding of Medicare and Medicaid reimbursement for those who use our EMS/Ambulance services who have this insurance. An average run for service, costs around $2,800. Of that amount, Medicare/Medicaid only pays $537.
“Since the city of Cottage Grove runs this EMS service, the citizens of Cottage Grove are paying the full cost of these losses coming from St. Paul Park, Newport, and Grey Cloud Island (as well as Cottage Grove). We are running the ambulance service at a lossThat means in order to keep the service going, we have to subsidize this service to keep it solvent. To put that into perspective, for 2026 Cottage Grove’s tax increase is two percent higher to pay for the debt service for providing our EMS service to St. Paul Park, Newport, and Grey Cloud Island (2 million dollars). Just to be clear, we are not asking for the entire 2 million. Matter of fact, significantly less than that amount. We provided each city with a formula that amounts to the following - St. Paul Park - $51,734. Newport - $49,064. And Grey Cloud Island $7,104.
“I have met with the Mayors/Town Chair of each of these communities. We have also presented to the respective City Councils and City Staff and most of the Board Members of Grey Cloud. At this point, we have not heard back that they are interested in covering some of these costs. So, we are now left with a decision to make. Do we continue to just eat the losses, or do we sub out these 3 communities to a different ambulance service company?
“The City of Cottage Grove has asked for clarification by early December. Should a community not want to keep our services, we will begin the process of reassigning the coverage area to a private ambulance service.
“The average run time - that is the time from (when) we get the 911 call to when we arrive on scene for our EMS service is between 6-8 minutes. (This average is over the entire service area - all cities included). I wanted to share this date with you to understand what will happen if we end coverage for our neighboring communities.
“The two main private ambulance services that would/could take over this area will be located in Saint Paul and South St. Paul. If these ambulances are out on a call, the next area they will be dispatched from is Eagan and Maplewood. Based on their data, the response time will be over 20 minutes. Most likely over 30 minutes.
(Cottage Grove EMS services will remain only in Cottage Grove under 6 minutes)
“The other point I want to make is when a 911 call comes into us, we provide full ALS coverage 100% of the time (Advanced Life Support) The 2 other services mainly run BLS (Basic Life Support). They will not and cannot guarantee advanced life support.
“I do NOT want to end the coverage of our amazing EMS services to the residents of St. Paul Park, Newport, or Grey Cloud Island, but I cannot honestly justify the Cottage Grove taxpayer continuing to pick up the cost of these losses coming out of our neighboring communities. If any of these communities were in our shoes, they would understand the reason for our request. We have open books. The numbers are the numbers the cost are the costs. We have zero to hide.
“I am willing to answer questions. Our City Staff is open for questions.
“I hope we can all come to a positive resolution to a temporary fix for the next 2 years and discuss other ideas between all our communities to keep this amazing EMS service going into our neighboring communities now and into the future.
Myron”
Bailey’s social media post quickly garnered views and comments, with Newport Mayor Laurie Elliott and St. Paul Park Mayor Keith Franke each weighing in with their take on things.
Franke shared as follows.
“Let me start by saying we appreciate and are thankful for the great work and partnership that C.G. public safety employees provide to the City of St. Paul Park!” Franke said. “C.G. owns the PSA (primary service area) which covers all 4 cities involved SPP, Newport, Grey Cloud, and CG. They took on this endeavor/business in the 90's, this is a pay for service business model. We used to have a 4 city partnership called SOWASHCO AMBULANCE SERVICE. Some years money was made some years, more recently it is harder due to Medicare/Medicaid reimbursement rates. The years that money was made none was returned to any of our Cities. “(Former SPP Mayor and Newport police officer Don ‘Moon’ Mullen told me shortly before he sadly passed that CG agreed to always provide EMS service to their neighbors if the Cities did not dispute them taking control when the MN legislature changed to PSA services back when.)
“As far as response times; in the information provided to us by CG at our meeting the actual average response time for SPP is over 15 minutes ( not the 6-8 min). Furthermore, CG already subs out our service to neighboring PSA holders as pictured above as MHealth Ambulance at Carbones in SPP just the other day. In one week I saw 4 different responding agencies in SPP: Allina, MHealth, Woodbury, and CG. So to think we are always getting CG service is false. I would also add that as the area grows (especially the MAJOR growth in CG slated over the next few years) we will be subbed out more and more.
“The figures that have been provided are all over the place between what CG shared and the report provided by a consulting firm hired by CG to help craft their narrative.
As to their proposed contract, in my opinion it has many flaws and is very one sided. Which I had not seen until given at Mayor's meeting in October after our preliminary tax levy was set by law for next year's budget.
“Just a few points on that:
* It increases automatically by 9% in year 2 and no amounts or promise of service after that. We would have to agree all amounts to be set solely by CG
* there is a clause that CG will be held not liable if they fail to provide service! (what?)
* No promise that they won't sub out anyway should their ability to provide any service change, we would still have to pay them.
* CG retains sole rights to set the costs as they see fit. (in my opinion this gives them a round about taxing ability over our City with no input or negotiation on our part.)
“As far as our responsiveness to them, at our October meeting Myron said we had until January, then the following week or so, he changed that to early December. We have nothing to respond at this point. We have been taking the time to figure out our options with our neighbors in the same boat. Meeting with State and other local leaders trying to do our due diligence.
“At our mayors meeting in October, Newport and SPP stated to Mayor Bailey that our preliminary budgets have been set and this expense was not included and we don't have the money. Also the fact that SPP in the last year lost our City Administrator, Finance Director, Police Chief, Public works Director and we were just getting back on track. We were told too bad. The CG council has decided that we need to sign the contract and pay up or we're out. Myron said they needed help paying for the new ambulance, so wanting to work together I offered that maybe we could take some money from our Capital equipment fund to help a little with that for now, and that I was unsure how that would work and try to get SPP council to approve that if possible, giving all cities and councils time to work together on options and/or contract language for next budget season, collaborate together on other options and again I was told no, sign the contract and pay the money. I also offered that maybe we go back to a 4 city taxing district where we all have say and again was met with no. It's hard to be responsive to those that are unwilling.
“Almost everyone and everything I love are in and about this City. The way that fear and divisiveness was introduced into this process before the due diligence was done is not helpful, or my style.
SPP does not have the staff or resources to move as quickly or do as much as our much more affluent, growing and getting much larger neighbor. There is still a lot of information that we need our council to see from the work we have been doing in partnership with Newport, and Grey Cloud.
“Ask yourself- If this was a private entity (that owns and runs a PSA like Allina, Mhealth etc.) and they said pay us tax money for ambulance service? As these PSA districts were set up as/for a business model and not a taxable model, plus we are going to also charge people when we respond, what would your reaction be?
“There is still a lot to be done in a short time and we will keep you updated as we move forward.
I would also add Newport Mayor Laurie Elliot, to my understanding is also releasing a statement to social media. I encourage you to check that out as she is an absolute Rockstar at research and presentation. (much better than me).”
Answering in turn, Newport Mayor Laurie Elliott responded to the EMS ambulance service matter with a post to the Newport city website, reproduced below:
“As some of you may be aware, Mayor Myron Bailey of Cottage Grove posted on Facebook November 12 regarding their EMS service to the cities of Newport, St. Paul Park and Grey Cloud Island Township,” Elliott said. “In his post he quoted costs, response times, and service levels. I would like to share some information that Cottage Grove shared with the three communities’ leadership regarding these issues and other comments made.
“Cottage Grove Committed to Providing EMS Service
“In the 1990’s, Minnesota transitioned to a Primary Service Areas (PSAs) model for EMS. Cottage Grove willingly accepted the PSA for the four communities, and with that comes both benefits and challenges. This designation also grants them the authority and responsibility to provide EMS services to the entire PSA, including their right to contract out all or a portion of the service area. During years when EMS operations generated surplus revenue, no revenue-sharing occurred with the other communities. Similarly, now that costs are higher, they retain the authority, responsibility, and managerial control of these operations and the PSA.
“Response Times
“Mayor Bailey stated the average response time within their EMS service area is 6-8 minutes. Below is the response time chart provided to us by Cottage Grove, with data prepared by Fitch & Associates, a consultant hired by Cottage Grove.

“According to this information, the average response time to Newport is 16.3 minutes, or 11.5 minutes if dispatch time is removed, which is handled by the county’s dispatch center. In either case, the response time is significantly longer than the 6-8 minutes referenced by Mayor Bailey.
“Mayor Bailey also raised concerns about potential response times if Cottage Grove were to contract with another EMS provider. Minnesota Statutes do not establish response-time requirements. The metro-area is served by numerous EMS agencies and hospital-based systems, and predicting future response times, or which agency the County 911 center would dispatch if a contracted provider were unavailable, is speculative. “Ultimately, the goal in any medical situation is to ensure the patient receives timely, appropriate care.
Community members have likely seen ambulances from Woodbury, Healtheast, Allina, and M Health Fairview in the three communities. These mutual aid responses are routine and reflect the priority shared by all EMS agencies ensuring residents receive timely medical care.
“Costs
“The three communities have been presented with a wide range of potential cost figures, some as high as $2 million and others closer to $50,000, with even lower amounts for Grey Cloud Island. The chart below, taken from the Fitch & Associates report, outlines the identified budget deficit attributed to each community in the “2025 Cottage Grove
“EMS budget.

“Identified Budget Deficit
“Newport = $53,594
“St Paul Park = $48,584 Grey Cloud = $6,408 Cottage Grove = $291,623
“The chart below, provided by Cottage Grove, shows how reimbursements fall short of covering costs. The ‘write offs’ represent the debt that Cottage Grove was unable to collect.

“Below is information from Cottage Grove’s Annual Financial Report for the year ended December 31, 2024. The report shows changes in the EMS net position over the past 10 years, reflecting an average annual loss of about $25,000/year.

“As a Newport resident, you should also be aware that the 2026 EMS tax levy for Cottage Grove residents is $70,000. The contract Cottage Grove provided to Newport requires a payment of $49,064 in 2025, and $53,480 in 2026. For context, the Newport population is roughly one-tenth the size of Cottage Grove. We also lack the robust housing, economic development and growth of Cottage Grove.

“It should be noted, but is unverified, that Cottage Grove may account for EMS debt, equipment, and vehicles through their general fund, which is supported by their property tax levy, rather than through the separate EMS levy. Newport uses a similar budgeting approach for our Fire Department. Public Safety operations are budgeted separately; while building debt, equipment and vehicle costs are reflected in other sections of the “General Fund.
“Additionally, a Cottage Grove staff report dated April 16, 2025, shows EMS gross revenue for 2024 at $6,875,298, with net revenue of $2,132,408 million after write offs.
Given the wide range of EMS cost figures, and differing sources of information, it is difficult to reconcile the numbers with complete certainty. At this point, the most reliable figures appear to be those identified by “Cottage Grove’s independent consultant, Fitch & Associates.
“Service Levels
“Much of the metro area is served by private EMS providers offering both basic life support (BLS) and advanced life support (ALS). As part of the 911 dispatch process, the level of service needed is determined based on the nature of the call. To speculate that the service provided by a third party would be substandard, is premature and not grounded in the information we have available to us.
Cottage Grove has chosen to staff only ALS-trained personnel. This is a higher level of service, but it also comes with higher staffing and operational costs. Many EMS systems operate with a mix of BLS and ALS to match resources to needs, ensure adequate coverage, and manage costs effectively.
“Fire Mutual Aid
“Newport currently provides fire response to Cottage Grove and other communities at no cost. This is the ‘mutual’ in mutual aid. We assist other communities when they call, just as they assist us when we need support. As shown in the chart below, Cottage Grove represents roughly half or more of our mutual aid fire calls. This is a valuable partnership, and we fully intend to continue regardless of the outcome of the EMS discussions.
Some residents may wish to see financial data associated with these mutual aid responses. However, as a small city with limited staff and resources, we are not able at this time to compile a comprehensive analysis of the overall costs of providing this service.

“While we could argue that Newport taxpayers should not shoulder the cost of responding to so many calls in Cottage Grove, the reality is that mutual aid generally balances out across communities. It also helps Cottage Grove avoid the need to build an additional fire station and staff it accordingly. In that way, our EMS and Fire mutual aid partnerships remain a practical and mutually beneficial arrangement.
"The Contract
“The contract submitted to the three communities (handed to us as we were walking out the door of our last meeting) raises several significant concerns. It contains provisions Newport would be ill-advised to accept in its current form, including:
• We were told the agreement was intended to help pay for a new ambulance, with 77% of the cost assigned to the three communities, even though we account for roughly 30% of the calls.
• The 2025 required payment comes after the communities have finalized their 2025 budgets, and the 2026 payment comes after preliminary levies for that year have already been set.
• The agreement includes a 9% escalator in year two, despite the ambulance cost being fixed (it was ordered several months ago).
• There is no provision for revenue sharing or refunds if insurance reimbursements, state funds, and/or the community contributions exceed expenses.
• The contract states Cottage Grove is not liable for failing to provide services described in the agreement.
• There is no assurance that Cottage Grove will not collect funds from the communities and still choose to contract out EMS services. Under the current language, they could collect funds on December 1 and transition to a contracted provider on January 1.
• Similarly, there is no guarantee that Cottage Grove intends to provide EMS services for multiple years into the future.
• Although the agreement includes a 30-day termination clause, state law requires Cottage Grove to ensure EMS coverage for the entire PSA regardless of whether a contract is in place.
• The contract states that Newport already has an existing flat-fee EMS agreement with Cottage Grove. We have been unable to locate such an agreement, and no copy has been provided to us.
“Responsiveness
“In his post, Mayor Bailey described the three communities as unresponsive. At our October meeting, he indicated that Cottage Grove wanted an answer by January. In his post, he shifted that to early December. In either case, both dates were still several weeks away at the time of his post. Characterizing the communities as unresponsive at this stage is not accurate.
It is also important to note that Newport has attended four meetings with Cottage Grove on this topic and has made ourselves available whenever requested.
“In closing
“Most concerning though, is the approach Cottage Grove has chosen to take. They could have simply communicated that their rapid growth is creating challenges in providing high-quality service across the entire PSA. The possibility of contracting out a portion of the service area was being considered due to cost concerns, but that they would work diligently to identify a good EMS provider if a transition became necessary. Instead, the public communication came in the form of a social media post that relied on fear-based messaging, suggestions of service reductions, and a confrontational tone that serves no one well.
Grey Cloud Island Township had no official comment on EMS services with Cottage Grove when contacted by the Journal.
“We are not making any comments at this time!” Grey Cloud Town Chairman Phil Dupre said.

Bailey later posted a followup to his initial post on EMS services as things continued to develop.
“I am happy and encouraged to see the various responses from the residents of Cottage Grove, St Paul Park, and Newport, as well as the mayors of St Paul Park and Newport! I love seeing all the questions and requests for more information. It's important to understand what is going on with EMS services.
“This issue is a national issue for EMS provided services. The situation that the City of Cottage Grove is facing is no different than any other EMS/ambulance program across the country. This issue needs to be dealt with nationally. At the moment, we have to deal with it locally.
“Ambulance billing costs? - The $2,800 number is dependent on the level of care you get. But to break out the cost - here is where the money goes:
74% goes to the cost of the medics. Of course this includes salaries, training, etc.
19% goes towards commodities used within the ambulance.
7% is the cost of the ambulance and maintenance of the ambulance.
“The EMS program did operate with a profit in the early days of the original SOWASHCO program. This is true. What I have been able to confirm is that any monies that had been paid/provided during the early days of SOWASHCO, and since then, were kept in the EMS fund. Even when SOWASHCO was dissolved, and Cottage Grove took over the PSA area, that money stayed with that specific fund. This money was not used for anything but for EMS related costs. As the years went by, and the costs of providing services has increased, the fund continued to decline. You couple that with yearly write-offs in the hundreds of thousands of dollars (or more), you can see where this is heading. You now couple that with less Medicare and Medicaid payments in an ever-increasing aging population, and you can see we are heading for a pivotal moment in time. A time to decide which direction we need to go.
“I also want to set the record straight on the EMS discussions. We began these discussions well before any city budgets were being discussed or adopted. We presented to the various cities staff, some at open council meetings, and open workshops, as well as a mayor/township chair gathering. The Grey Cloud Township Chair even said at our meeting that we had been discussing this since April of 2025. I have a copy of the presentation I sent to Mayor Franke in April of 2025. Cottage Grove has been fully transparent with the numbers. We provided our budgets and open books on the entire EMS/City Budget to each city. Our staff and I have been made available to answer questions or attend meetings should they decide to learn more.
“I have never said “sign here” or else you lose service. We presented a variety of ways/options to help offset some of the costs of EMS program to all cities/township. One particular comment back then was "it was our problem to deal with."
“One of the ways was provided in my original post. That amount is significantly less than the actual write-offs for Medicaid/Medicare from each community.
“We know our neighboring cities are not as big as Cottage Grove. We know they have limited taxing capacity. What was shared with them was what we planned to do with those funds. It was to be put towards a new ambulance that is currently on order. The total cost of that ambulance will be over $400,000 with all the lifesaving equipment you need to outfit it. As you can see by what I posted, and the same numbers Mayor Elliott posted, those amounts do not add up to $400,000.
“Mayor Elliott correctly mentioned our ‘budget add’ number for EMS. What she also mentioned is that it may not be all of what is covered for the EMS fund”. This is correct. Part of the EMS budget is coming out of the general fund and the equipment replacement fund. In the past, we did not need to add a line item to our budget, equipment, or personnel. Again, things have changed over the years. This means our citizens are now directly paying for all losses coming from the EMS fund which also includes the losses from our neighboring communities.
“Now both Mayors would not know about the change to the 6–8-minute average response time. For that I apologize. That is because our consultant provided a rough draft which I provided to the mayor’s and township chair at our meeting. The 6–8-minute average is the correct number. Washington County recently shared some data with us about the way some calls are transmitted from dispatch. Now mind you…Some calls may be more due to location, events, and other factors at a specific time. I will say that the data provided to them at that time of our meeting was not correct. This data is being updated. So, I apologize for the incorrect data that was given to my fellow mayors. The response times from agencies outside of our PSA area are accurate as we got this data from these entities, based on current run times.
“Lastly, I saw some comments from my neighboring mayors about looking at other options, including a special EMS taxing district. This process would spread the costs evenly across all communities. It would be somewhat similar to the original SOWASHCO service, managed by a board and not by one specific city. We are open to this idea. I had mentioned this idea at our meeting, and we even spoke about stationing a third fully staffed ambulance either in St Paul Park or Newport to improve response times. So that sounds encouraging. Maybe we can get something done.
“So, I will end with this…I understand that each Mayor is looking out for their own citizens. I get that. Do I want to end our amazing EMS service to our neighboring communities? No. Of course not. I eat or attend events in each of my neighboring communities. I want the best ALS service there if I ever need them, no matter if I am in Cottage Grove, or one of our surrounding communities.
“But we cannot continue to move forward in the current process and not have support from our neighboring communities to cover some of cost of services provided in their communities. How we get there will depend on which direction they/we want to go.
(Short term and long term)
“I am open to dialogue and discussions. Let’s see where this goes.”