The Interior Alaska community of Delta Junction is getting its ambulance service back, after the area’s only private ambulance company ended its contract with the city earlier this year.
The Delta Junction City Council decided on March 28 that it would partner with a nonprofit organization to fund emergency medical services on about 260 miles of Interior Alaska roads. But Councilmember Pete Halgren said the city will have to dip into its savings to make it work.
“The city has the money to be able to do one year, but we don't have the money to make it sustainable,” he said. “That's the problem.”
The city used emergency pandemic relief funds to pay for ambulance services for the last two years. But the city’s ambulance contractor, Delta Medical Transport, walked away in January when the relief funds dried up.
Now that Delta Junction has found a temporary way forward, the company is back at the table — but the city’s funding model is a bit different this time around.
The next year of service will cost about $1.3 million, and any deductions from a patient’s insurer don’t count towards that total. The nonprofit organization Rural Alaska Emergency Services, which was established in 2023 to raise funds for emergency services in Delta Junction and other Alaska communities, will put up $180,000 towards that amount and try to raise even more money from community members. Delta Junction will also apply for grants from the state’s Department of Health to pay for the service.
The worst case scenario, according to Halgren, is if the city has to foot the entire bill.
“The city of Delta Junction cannot afford a million-dollar-a-year project,” he said. “We try to live like a family — namely, spend less than you take in. We overestimate our expenses, we underestimate our income, and generally, it's worked out.”
For now, it’s good news for Delta Junction. But several months of heated dialogue between Delta Junction residents and officials over proposed solutions highlight the unique challenges of operating emergency medical services in remote parts of the country.
A 2019 National Rural Health Association study points to a multi-pronged problem: \nural areas across the country mostly fund emergency medical services through a hodgepodge of grants, local tax dollars, and community fundraising — think golf tournaments and bake sales. That patchwork of funding doesn’t usually provide a revenue stream that can reliably maintain equipment, software or people. Most rural emergency medical services also depend on volunteers, which can be hard to recruit and retain.
Like Delta Junction, there’s a cluster of communities in Southcentral that works with a nonprofit to keep up emergency services. Matthew Lorenz heads Copper River EMS, which serves people living in the Copper River Basin. They also survive off grants and community donations, and they’re pretty much all-volunteer.
But with no municipal support, Lorenz said it can be a stretch.
“We know we have to be independent, and so we have to live within our means,” Lorenz said. “There's no tax base or anything like that that we can fall back on and say, ‘We want to expand our services,’ or, ‘We need more money from you.’”
Lorenz said they run three aging ambulances over 400 miles of roads, which are often poorly maintained and icy. So, in order to keep people on the fringes of their coverage area safe when help is so far away, they push basic first aid classes.
Leaning on donations might not be the perfect answer, but in Delta Junction, several residents told the City Council that they’re satisfied with the solution. But Halgren, the Delta Junction councilmember, said the city is heading into uncharted waters.
“Hopefully, at the end of the year, we’ll be able to say we’ve come up with the funding,” he said. “But it’s not just going to take people digging into their own pockets. I don’t mean to be mean about it, but it’s time to put our money where our mouth is.”
