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Northfield EMS seeks upgrades to service

NORTHFIELD — The town’s Emergency Medical Services Department is exploring several ways to improve its service.

A move to paramedic-level service, the purchase of a used ambulance and supplementing on-call staff with part-time positions are all options.

Emergency Medical Services Chief Mark Fortier said the self-funding department can do all of the above without affecting taxes.

Paramedic-level service is the industry standard in emergency medical care, said Fortier. He said all it will take to upgrade Northfield’s service to paramedic level is a letter of support from the Selectboard and passing an inspection from the state Office of Emergency Medical Services.

Many of the emergency medical technicians who work for the on-call service are licensed to give paramedic-level treatment — but not in Northfield’s ambulance.

“Northfield EMS is unique, in that we are staffed by fully trained paramedics, but can only operate at the (advanced life support) intermediate level,” Fortier told the Selectboard. “It’s frustrating, having the training and not being able to use it.”

In addition to being Northfield’s EMS chief, Fortier works as a paramedic for the Orange Fire Department. When he’s in Orange’s ambulance, he can administer life-saving drugs and perform other procedures that he can’t when he’s working for Northfield.

Whether or not the Selectboard supports it, the level of service Northfield EMS provides is going to change.

The ALS-intermediate classification will soon cease to be an option, as the state is adopting national standards for emergency medical services.

When that happens, Northfield EMS will either have to take a step backward, to basic life support-level service, or one of two steps forward.

If the town’s ambulance service is to move forward, it will either have to move to a paramedic level service, or the “advanced EMT” level, which sits between the paramedic level service and outgoing ALS-intermediate level.

Both the current ALS-intermediate level and advanced EMT level do not allow EMTs to perform some of the life-saving procedures that paramedics can.

Instead, they must wait for a paramedic-level ambulance to arrive and take over treatment and transportation, even though the EMT onboard Northfield’s ambulance may be trained to administer the more advanced measures.

In emergencies, minutes count, and a paramedic-level ambulance can take much longer to respond to town than Northfield EMS. In addition to losing that crucial time, Northfield EMS loses money when another agency has to respond for an “intercept.”

Until a renegotiated intercept contract with Baystate Health Ambulance was signed by the Selectboard Tuesday, each intercept cost Northfield EMS a base fee of $350. Fortier was able to get the base rate lowered to $300.

“Last (fiscal) year alone, the enterprise fund paid $21,825 to other paramedic services to provide care that our own staff is trained to provide,” wrote Fortier. After the base fees, specific fees for treatment and medication are added.

The EMS department budget comes out of an “enterprise fund” rather than taxation. The department bills patients for services rendered, and deposits payments into the fund. Fortier said the department has been running in the black, and accumulated about $45,000 in excess revenue in the three years it’s been self-funded, $12,000 in the past year alone.

Fortier would like to use some of that money to buy a second ambulance so the service can cover simultaneous calls.

New, outfitted rigs can go for about $150,000, according to Deputy Chief Randy Wheelock. He and Fortier are looking into a high-mileage used ambulance for $25,000.

“It will fulfill our short-term needs,” Fortier told the board. It could make a second ambulance cheaper in the long run, too.

“It’s a high-mileage chassis with a good body,” Fortier explained. “We could put that body onto a new chassis later.”

The ambulance body is a major part of the purchase price for vehicles like the $150,000 ambulance for which Northfield EMS was denied a grant.

For example, Ford Motor Co. lists its heavy-duty 2013 F-550 cab and chassis (without a truck bed or box) for a suggested retail price of $42,325, and less expensive lighter-duty chassis are used in some ambulances.

Unlike Northfield’s van-style ambulance, truck-style vehicles are modular. The body and cab can be removed from the frame and replaced, or transferred to another chassis.

Fortier said an additional ambulance will end up saving money in the long run, by allowing the department to respond to more billable calls.

“It would help us cover our ever-increasing call volume,” wrote Fortier. “In the month of May alone, we experienced three simultaneous calls (within our town), in which we had enough personnel to staff the calls,” but only one ambulance.

Other times, however, there is a shortage of available EMTs. Fortier offered a fix for that, as well.

He asked the Selectboard to support part-time workers for up to 30 hours each week, without benefits.

For most calls, he said, the department is able to muster at least one on-call EMT to respond. However, to transport a patient, the ambulance needs to have a second EMT on board, due to EMS regulations.

Part-timers could be scheduled to work when on-call EMTs are less available, he said. They would also be able to provide elder care and conduct home visits, and help with administrative work while they’re not on a call.

Fortier said all of the above can be supported by his department’s earned revenue, at no additional cost to taxpayers.

Though a second ambulance and part-time personnel would use the department’s non-tax revenue, the proposals would need to be approved by voters at an annual or special town meeting. The move to paramedic-level service, however, only needs a letter of support from the Selectboard.

Selectboard Chairman John “Jack” Spanbauer said he’d like to see some projections of revenue and expenses before supporting any of the proposals.

“I’d like to see the numbers crunched,” he said. “I’m interested in the idea. I’m not convinced yet, but I could be.”

David Rainville can be reached at:
drainville@recorder.com
or 413-772-0261, ext. 279

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