Ambulance Coverage

1. Ambulance Coverage Town of Westhampton, Ma December 17, 2012

2. Overview Current Contract Town of Westhampton signed agreement with Northampton- 5 yr. contract 2010-2015 Provided for ALS response and transport Allowed for our personnel to join Northampton personnel in all continuing education training and refresher training free of charge

3. Financial Provisions of Contract FY 2011- $10,800 FY 2012- $12,600 FY 2013- $14,400 FY 2014- $16,200 FY 2015- $18,000 Total over 5 years- $72,000 Remaining Amount- $34,200

4. Potential Options Easthampton Fire Hilltown Ambulance Highland Ambulance Alert Ambulance Pioneer Valley Ambulace Westhampton Fire/EMS Combination of above resources

5. Easthampton Fire Paramedic level Service Limited Staffing Current City Leadership-history of terminating contract due to expense

6. Hilltown Ambulance Regionalized service Paramedic level Service 8hrs/day Longer response times Unknown response capabilities after midnight Limited resources

7. Highland Ambulance Regionalized service Paramedic level service 0800-midnight On call personnel after midnight Long response times/winter time, etc. Limited resources

8. Pioneer Valley EMS Sister company of MedStar Ambulance Base in Northampton 4 ambulances Paramedic level response capabilities Ability to provide additional resources if needed

9. Westhampton Fire/EMS Option Westhampton Fire Department members provide service Work in conjunction with another ambulance partner Basic Level response capabilities

10. Ambulance Committee Recommendation • Westhampton Fire Based Ambulance transport service-Basic level • Hours of Operation for transports- 4PM-Midnight / 7 days / week • Midnight-4PM- Transport services provided by Pioneer Valley Ambulance Service • Westhampton EMT’s continue to respond to every call regardless of hour

11. Call History-Trends Total Call Volume- Fiscal Year FY 10- 67 FY 11-64 FY 12- 82 Calls between 4PM-Midnight FY 10- 22 or 33% FY 11- 26 or 41% FY 12- 41 or 50%

12. Start Up Costs Ambulance- $3,000 funded from Firefighters Association-Easthampton Ambulance AmB Pro License- ePCR reporting- $2,995 start up cost License fee- $600/year Food & Drug license- $300 Additional Insurance- $1,200 Stretcher & Stair Chair- to be funded by grant funds Prelimary start up costs to Town-$5,095

13. Funding For Start Up Costs Utilize $15,000 of funds contractually committed for FY 14 ambulance contract Funds to initially be drawn from free cash

14. Revenue Projections 10 ALS calls @ $1,000/call= $10,000 5 BLS calls @ $800/call= $4,000 Total billed= $14,000 Total collected- $10,500 (75% collection)

15. On-going cost/year • EMS Billing- 4% collected revenue ($420/yr. based on revenue collections of $10,500) • Supplies- $1,000 • Fuel- $250 (15 calls @ $15/call) • Vehicle repairs & maintenance-$1,000 • Personnel- $1,200 ($40/call/person). This would take effect July 1, 2014. • ALS intercept fee- $2,750 (based on 10 ALS intercepts /yr.) • Annual insurance increase- $1,200 • Ambu Pro- $600 beginning in FY 15 • Training/recertification- $1,500 • Total costs- $9,920

16. Operations (4PM-Midnight) • Westhampton Ambulance primary transports unit • Primary ALS intercept comes from Pioneer Valley Ambulance • If Westhampton unable to staff ambulance, Pioneer Valley Ambulance becomes primary transport unit

17. Operations Cont. • ALS calls (4PM-Midnight) • All calls will be emergency medical dispatched (EMD’d) by Northampton Control • During this time frame, if determined by Northampton Control Dispatchers that it is an ALS level call, they will automatically and immediately call for an ALS intercept • ALS intercept service will meet up with our personnel and supply advanced life support equipment and supplies while Westhampton transports patient and assists with patient care

18. Operations Cont. • Midnight – 4PM • Pioneer Valley Ambulance- Primary ambulance transport service • If Pioneer Valley Ambulance unavailable to respond, next ambulance service on mutual aid matrix will be called • Westhampton EMT’s toned and will respond as we do today • Provide initial stabilization and treatment and transfer care over to transport ambulance service

19. Benefits • Provides increased level of service to community • Decrease transport times from time of incident to arrival of patient at a health care facility • Provides for improved continuity of care • Allows us to take care of our own • Provides for motivation and recruitment of additional personnel • Enable personnel to increase skill level • Eliminates community from continually being a bargaining piece for other services • Eliminates current retain fees from other services that will continually go up each year • Will provide revenue stream to help offset costs for providing expected services to the community

20. Action Items • Personnel begin orientation at Cooley Dickinson Hospital Emergency Room (minimum 4 hours / person)- January 2013 • Personnel begin ride time with ambulance services to get ride time experience (minimum 5 calls each)- January 2013 • Development policies & procedures- January 2013 • Procurement ambulance, stretcher, stair chair- April 2013 • Development affiliation agreement CDH-April 2013 • Development of provider agreement with Pioneer Valley Ambulance- April 2013

21. Action Items Cont. • Apply for license- April 2013 • Establish mutual aid and intercept agreements- April 2013 • Internal training- Review State OEMS protocols, Ambu Pro training, report writing documentation, stretcher operations, radio reports, etc.---Ongoing • Establish a EMS reserve receipt account for ambulance revenues to be later utilized for EMS operations • Update insurance coverage on vehicles • Implementation- July 1, 2013

22. Proponents of this System Every Westhampton EMT Dr. Raymond Conway-Medical Director, Cooley Dickinson Hospital Pioneer Valley Ambulance- met with management staff numerous times and personnel have already come out to Westhampton Northampton Control- Tom Dunphy, Director