Cottage Grove's city council voted unanimously to stop providing emergency medical services to neighboring Newport and St. Paul Park, ending years of the city absorbing the financial gap between what ambulance calls cost and what insurance actually pays. If the state signs off, M Health Fairview EMS will take over coverage for both cities on September 1.
The vote follows months of tension over who should pay for ambulance runs outside Cottage Grove's own borders. As reported by the Pioneer Press, Cottage Grove Mayor Myron Bailey had asked Newport, St. Paul Park and Grey Cloud Island Township to contribute toward EMS costs, with Newport asked for $49,064, St. Paul Park for $51,734, and Grey Cloud Island Township for $7,000 in 2025. Bailey called the shift to Fairview Cottage Grove's best long-term sustainable solution, and pointed to budget issues and rising healthcare costs as problems communities across the country are facing.
Cottage Grove will continue providing EMS to Grey Cloud Island Township, which agreed to contribute toward costs, according to the Pioneer Press report. The council cited rising healthcare costs and increased demand as communities have grown as reasons behind the change, and noted that Cottage Grove had considered handing the territory to another provider if the other cities would not contribute.
Why the Numbers Stopped Adding Up
The math behind Cottage Grove's decision has been public for months. Mayor Bailey said in November 2025 that an average EMS call costs the city roughly $2,800 to run, while Medicare and Medicaid reimburse only about $537, according to the Cottage Grove Journal. That gap left Cottage Grove taxpayers covering the shortfall not just for their own residents but for calls in Newport, St. Paul Park and Grey Cloud Island Township as well.
The problem is not unique to Cottage Grove. A 2024 report by the Minnesota Emergency Medical Services Task Force found that seven of the state's eight EMS regions lost a combined $66 million in 2022 when comparing operational costs to insurance revenues, and 30% of local EMS directors doubted their systems could meet community needs within five years, per the Minnesota Legislative Coordinating Commission. Governor Tim Walz signed a $30 million emergency EMS aid package in May 2024, sending $24 million in direct relief to strained ambulance providers and $6 million toward a rural “Sprint Medic” pilot, though local EMS leaders warned it fell far short of the estimated $120 million needed statewide, according to the Hastings Journal.
What Comes Next for Newport and St. Paul Park
Both cities say they saw this coming. St. Paul Park Mayor Keith Franke said in 2025 that his city was sympathetic to Cottage Grove's concerns, noting that Cottage Grove originally initiated coverage for St. Paul Park, per the Pioneer Press. Newport Mayor Laurie Elliott called the situation complex and nuanced, and Newport has said management and operation of EMS falls under Cottage Grove's direction and authority.
Under Minnesota law, a Primary Service Area determines which provider serves each community, and any modification requires approval from the state's Office of Emergency Medical Services. That agency was created under 2024 legislation, HF 4738, to replace the former Emergency Medical Services Regulatory Board effective January 1, 2025, following a state audit that flagged regulatory oversight weaknesses, according to the Minnesota Legislative Reference Library. Newport's city government has said it anticipates the change will be approved, and the Minnesota OEMS typically approves such modification requests within about 10 days of a request, per the City of Newport.
Fairview Steps In, Cottage Grove Stays on Backup
Fairview EMS, subject to state approval, would provide both Basic Life Support and Advanced Life Support coverage for Newport and St. Paul Park, operating from a station roughly the same distance from Newport as Cottage Grove's own station while keeping standby ambulances deployed throughout its metro service area. M Health Fairview is part of one of the region's largest healthcare systems, and city officials have said its ambulance service is expected to deliver response times comparable to or better than what residents currently experience.
Even with Fairview taking over as primary provider, Cottage Grove Fire and EMS will keep responding to critical calls in Newport and St. Paul Park under existing regional mutual aid agreements, according to the City of Cottage Grove. St. Paul Park has been preparing for months for the possibility that Cottage Grove would discontinue service: some of its police officers already hold EMT certification, and city fire and police responders are expected to undergo further EMT training and switch to Fairview for medical director guidance and protocol this year. St. Paul Park has also made its buildings available to Fairview EMS staff for rest breaks and report writing, and officials describe the city as having a robust plan for engaging with its new primary provider.
A Broader Pattern of Regional Cooperation
The EMS split is not severing ties between the cities entirely. In August 2026, Newport announced a separate infrastructure project connecting its water supply with Cottage Grove's system to receive PFAS-filtered water funded through the 3M settlement, according to a Newport City Council Facebook post — a sign that the two communities continue to collaborate on shared services even as their ambulance arrangement comes to an end. Cottage Grove Fire and EMS remains a familiar presence on regional roads; the department was among those dispatched to a fatal Highway 61 crash near St. Paul Park earlier this year, underscoring how closely the two cities' emergency response systems remain intertwined even as their formal EMS contract ends.
