Amb-07 Presentation 1unit Sept 6 2007

8/6/2019 Amb-07 Presentation 1unit Sept 6 2007

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Goals

High-Quality Pre-Hospital Emergency

Medical Care

Public Safety: Have All Five Fire Stations

Open to Provide Effective Response Time

for Fire and Medical Emergencies.


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Whats Changed From the Initial

Proposal?

Fire Department operates one primary

response ambulance.

A private ambulance contractor, responds at

all emergency medical calls by bringing an

ambulance into town to provide secondaryemergency response ambulances.


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Advantages Over Initial ProposalEssentially replicates the current delivery methodof emergency ambulance service. A primaryresponse ambulance continues to be located in thetown center. An additional ambulance is stationedin town each time an emergency medical call isdispatched.

Firefighter/EMTs at the West Fire Station wouldnot be operating an ambulance and transportingpatients out of town. This would increase fire andemergency medical capability and response time.


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How Do the Finances Change?A private ambulance provider would respond to

approximately 30 calls per month. This equates to

292 transports per year.

The Towns projected net revenue by operating

one primary emergency response ambulance

would be $218,000. The two ambulance model

forecast $285,000 from ambulance operations.


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Why Consider This?

Currently Closing A Fire Station Daily Due

to Budgetary Constraints

Five-Year Financial Forecast Projects

Mounting Budgetary Deficits

Contract with Trinity Expires on 12/31/07

All Aspects of Town Operations Being

Reviewed For Effectiveness.


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Ambulance Call Volume

Calendar 2006: 2,648 Medical Calls

Average of 7.25/day

2,145 Medical Transports (81% of calls)

Average of 6/day


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Current Emergency Medical

Response

Fire Department Responds to All Calls

54 of 56 of Firefighters are EMTs

Trinity EMS Staffs an Ambulance 24/7 inChelmsford Center at No Cost to the Town.Trinity Transports Patients to the Hospital & BillsPatients for Ambulance Transportation Services.Secondary Response Ambulances Are Available

from Trinitys Main Headquarters at Drum Hill.

Greater Lowell Emergency Medical ServiceProvides Paramedic Service


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Fire-Based Ambulance

Fire Department Staffs an Ambulance at the

Center Fire Station.

Secondary Response Ambulances are

Provided at No Cost to the Town by a

Private Ambulance Provider,.

Hire Five Additional Firefighter/EMTs.New Fire Captain Oversees Operations.


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Fire Dept. Staffing LevelsCurrent Staffing Level: 13 Assigned perShift with Minimum of 9.

Daily Closing of Either East, South, or WestFire Station.

Proposed Staffing Level: 14 Assigned perShift, with Minimum of 12.

All Five Fire Stations Open.


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Simultaneous Ambulance Transports

Calendar 2006: Average of 23/Month Are TwoTransports Within 90 Minutes

Average of 3/Month Are Three Transports Within90 Minutes.

Fire Department Responds to All Medical Calls

A Private Ambulance Contractor Responds Whenthe Towns Ambulance is Not Available.


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Mutual AidEstablish Mutual Aid Agreements with Westford,

Tewksbury, Billerica, & Carlisle.

Seek to Establish Mutual Aid Agreements with

Additional Private Ambulance Providers.

Chelmsford Would Respond to Mutual Aid

Requests From Other Communities.


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Enhanced Public SafetyAll Five Fire Stations Open Provides FasterResponse Time for Fire and Medical Emergencies.

Firefighters/EMTs Assigned Per Shift Increasesfrom 13 to 14 and the Minimum Per ShiftIncreases from 9 to 12.

Weekday Compliment of 19 Uniformed Personnelif All Positions are Filled.


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Finances

Switch to Attached Financial Spreadsheets


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Question

Did Trinity EMS, the Towns Current

Private Ambulance Service Provider, Have

An Opportunity to Partner with the Town?

Yes, discussions took place with Trinity EMS

officials on August 9, August 21, August22, and August 23. Trinity EMS declined.


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QuestionCan This Be Done with Only Five Additional

Firefighter/EMTs?

Yes, because the additional staffing levels provide

the necessary personnel to staff the ambulance.

Comparable towns such as Tewksbury & North

Andover operate two ambulances with 12Firefighter/EMT Minimum Staffing Levels.


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Question

What is the cost to increase the minimum

staffing to 12 personnel?

This cost is exceeds $100,000. Funding for

the additional staffing levels would come

from the projected $218,000 in net revenuefrom ambulance operations.


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Other Mass. Cities & Towns

69%, which is 242 out of 351,

Massachusetts Cities & Towns Provide a

Town-Based Ambulance Service.

Adjoining Communities of Tewksbury,

Billerica (Separate Dept.), Westford, &Carlisle Provide Fire-Based Ambulance.


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QuestionWhy Doesnt The Town Award an AmbulanceContract to the Highest Bidder?

Town Counsel has advised that the anti-kickbackprovisions of the US Social Security Act prohibitthe solicitation or receipt of, or the offering orpayment of, compensation (or remuneration as

the statute calls it) in exchange for referrals forservices for which payment may be made, inwhole or in part, under a Federal health careprogram such as Medicare or Medicaid.


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QuestionWhy doesnt the Town consolidate thenumber of fire stations?

A recently completed analysis performed bythe MMA Consulting Group concludes thatthe Town needs to maintain its five firestations to provide an effective responsetime for fire and medical emergencies.


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QuestionWhat about the cost for pension and retired health

insurance for the five new Firefighter/EMTs?

The contribution levels of newly hired employees

into the pension system essentially covers their

future pension costs. As for retired health

insurance costs, these costs would not be incurredfor about 30 years. Its uncertain what this

nations health care system will be at that time.


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Question

What About the Additional Liability?

The Town already responds to all medical

emergency calls and has liability insurance

coverage. There is no additional premium

if the Town were to provide ambulancetransportation service.


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QuestionWould there be additional WorkersCompensation insurance costs?

Police and Firefighters are not covered underWorkers Compensation insurance, but are coveredby MGL Chapter 41, Section 111F which provides

for no loss of pay if injured on duty. The Townhas an insurance policy for injured on dutymedical costs and lost time. The Town alreadyresponds to medical emergency calls.


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QuestionHow will ambulance billing take place?

The Town would contract with a vendor that

is experienced in municipal ambulance

billing services. The fee is estimated to be

4% of funds collected and is included in thisanalysis.


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QuestionCould a Fire-Based Ambulance Service be

Operational By January 1?

Yes, the Town could purchase a new

ambulance off the State bid list and receive

the vehicle within a few weeks. ExistingFirefighters are already trained as EMTs.


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QuestionWill a private ambulance contractor provide

coverage for Town events such as

Chelmsford High School football gamesand the 4th of July parade at no cost to the

Town?

Yes.


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Closing ThoughtFinally, we believe that the most important element ofemergency rescue is a well-trained and professional FirstResponse team. The Town should never lose sight of the

fact that it is the immediate response of our EMT-trainedfirefighters, police officers and ambulance personnel inthose first few minutes of an emergency medical situationwhich can literally determine life or death. During thehighly publicized and politicized course of our study, this

has remained the central focus of our committee.

Ambulance Study Committee Final Report June 26, 1995

Documents

Amb-07 Presentation 1unit Sept 6 2007