WinnMed Ambulance Service Reports Record Demand While Aging Fleet Strains Capacity

Act now—your donation to local news ensures a brighter, more informed tomorrow. DECORAH — WinnMed's ambulance service is responding to more calls than ever, logging more than 2,000 runs in the past year and traveling over 91,000 miles, WinnMed Director of Ambulance Steve Vanden Brink told the hospital's Board of Trustees on Wednesday. "When I started, we had about 800 to 900 calls for service in 1991," said Vanden Brink, who has served with the department for 34 years. "This year, we had just over 2,000 calls, transporting 76% of them." The department currently operates with three ambulances and 24 members, including 14 paramedics. Seven are certified critical care paramedics, and two are also registered nurses. Vanden Brink said their advanced training allows them to handle the most complex cases, comparable to flight paramedics. But the rising workload and the aging fleet are significant concerns. A 2023 ambulance, which took nearly two years to arrive, already has about 54,000 miles on it. The oldest vehicle, with close to 200,000 miles, is scheduled to be remounted next spring by Lifeline Emergency Vehicles in Sumner. "It's about $100,000 cheaper to remount than to buy new," Vanden Brink said, noting the department paid $226,000 for the 2023 ambulance. The remount process involves stripping the ambulance box down to bare metal, repairing it, and placing it on a new chassis with a new floor. Demand often outpaces supply. Three to four times a month, all ambulances are out on calls. "If you ask me what keeps me up at night, it's an empty garage," Vanden Brink said. "That means I don't have another ambulance to send to somebody else in need." He recalled a recent day when one ambulance was in La Crosse for a transfer, another was handling a 911 call in northern Decorah, and a third was unavailable after a motor vehicle crash with serious injuries. "There was nobody else," he said. With help from firefighters, Vanden Brink personally retrieved an ambulance to cover the call. Falls among elderly residents are another persistent challenge. "Last year, 281 times we were called out for falls, almost once a day," Vanden Brink said. "Probably 50% of the time, we just help them up, assess them, and leave them at home." Without robust in-home care resources in the county, ambulance crews often step into that gap. The department also leans on cooperation with surrounding services from Cresco, West Union, Postville, Harmony, and other towns. But coverage gaps are growing. "We went down to Castalia, because Postville was unable to find a full crew," he noted. "That's happening more and more." Nationally, rural ambulance services are struggling with staffing and funding shortages. "On average, at least 20 services a year in Iowa downgrade or close," Vanden Brink said. "They may only handle 100 calls a year, but they can't find the volunteers." WinnMed's hospital-based model provides more stability, he said, though resources remain tight. "We have one and a half crews on duty. I'd love to have two, but it's a matter of dollars and cents." The department is also pursuing recognition from the American Heart Association's Mission: Lifeline program, which tracks quality measures such as pre-arrival stroke notifications, cardiac screenings, and administration of aspirin for suspected heart attacks. Vanden Brink said he hopes to achieve Bronze or Silver recognition in 2025. Looking ahead, he sees opportunities in expanded paramedic roles and community partnerships. WinnMed has discussed mobile integrated healthcare and community paramedic programs, which could bridge gaps between emergency care and home health. "Currently, those things are not funded [by the county]," he said. "But hopefully we can work at that." Vanden Brink closed his presentation with a reflection on his decades of service and the team's commitment. "We want to make sure we have people there to respond," he said. "That's what matters." Become a part of the exclusive circle! Subscribe to the newsletter for free and gain access to special offers, bonus content and insider perks.