In an unusual arrangement, the residents of South St. Paul and West St. Paul have two ambulance services at the ready should they need medical help. Sometimes both show up for the same call.

Now, though, HealthEast Medical Transportation has begun to question whether it wants to continue sharing its ambulance territory with the fire department for the two communities.

In a Jan. 29 letter to the cities, HealthEast informed the South Metro Fire Department that it would terminate its contract for community ambulance service at the end of this year. HealthEast has paid the department about $240,000 a year for providing about 35 percent of the ambulance transports in West St. Paul and South St. Paul. Ending the partnership would leave the department with a huge hole in its budget.

"We can provide the highest quality of service in the most cost-effective manner" by providing all the ambulance service itself, the HealthEast letter said. "We believe the community will benefit from this change."

Since then, at the urging of Sen. Jim Metzen, DFL-St. Paul, and others, HealthEast has agreed to discuss the possibilities for the partnership to continue.

"I have taken a huge interest in this," Metzen said. "They [HealthEast] give us $240,000 a year for the two communities. They are pulling that away."

The South Metro Fire Department often arrives at emergencies first, and it could take HealthEast three to five minutes longer to respond, Metzen said. "That could be the difference between life and death," he said.

He is preparing to propose legislation that would remove West and South St. Paul from HealthEast's service area if the talks fail to continue the partnership.

"They are going to see my bills introduced … to put them on notice that I am not quitting," Metzen said.

HealthEast has been concerned that South Metro Fire has not met all billing, documentation and road safety standards, said Laura Olson, director of HealthEast Transportation. "Our concern is really around ensuring that all the standards are met," she said.

"Right now, we are going to continue to talk with them and clarify some expectations. At this point, we want to keep the dialogue open. We want to talk with them about what they are willing to do — if they can meet all the expectations."

HealthEast ambulances serve various Dakota County cities under a license from the Minnesota Emergency Medical Services Regulatory Board.

The license gives HealthEast the authority to discontinue its arrangement with South Metro Fire without approval from the state, but it would have to ensure that ambulance service would continue to the two cities, said Pamela Biladeau, the board's executive director.

Dan Niederkorn, a South St. Paul City Council member and chairman of the South Metro Fire board, said the board hopes the arrangement with HealthEast can continue. "Between the two of us, I think we provide an excellent service for our constituents."

West St. Paul City Council Member David Wright, who represents that city on the fire board, said he expects the issue to take months to resolve.

A Fire Department study presented last year found that though the two communities had saved money by merging their fire department's they still pay more per capita for the service — $102 — than the state average cost of $69.

One reason for the higher cost was full-time paid firefighters. Another was the ambulance service.

After seeing the study late last year, the two City Councils agreed to discuss what, if anything, to do about the higher costs. But the discussion has not happened yet, Niederkorn said.

Not long after HealthEast sent its letter, Fire Chief John Ehret retired, and the department is now in the process of replacing him.