Towns seek ‘Plan B’ for Charlemont ambulance

Thursday, January 19, 2017

CHARLEMONT — Worried that the volunteer ambulance shared by Hawley and Charlemont won’t meet state criteria in time for its license renewal this spring, town officials are looking at ways to keep the 70-year-old volunteer service alive — at least until legislative bills filed on behalf of the towns go through the state Legislature and are acted upon.

Selectmen’s Chairwoman Beth Bandy called a meeting this week to work out a plan for providing ambulance service for roughly 1,500 people in Charlemont and Hawley — plus for visitors to ski areas, whitewater rafting businesses, bike parks and zip lines. She is concerned that the Charlemont Ambulance Service won’t get another waiver that allows the ambulance to respond with only one Emergency Medical Technician (EMT) and a driver — because state law now requires ambulance services to respond with at least two EMTs for all calls.

She said the state ambulance regulatory program field supervisor has indicated the service will not get an extension of a waiver to respond to calls with only one EMT. She said the state Department of Public Health has concerns that it’s unsafe to have just one EMT and a first responder answer calls.

“Their concern is of making this look too permanent,” Bandy explained.

She said the Selectboard is drafting a request for proposals, for EMTs to staff the ambulance on a 24 hour, seven-days-a-week basis.

“What are we obligated to do,” asked Hawley Selectmen’s Chairman John Sears.

“Nothing,” Bandy replied. She said the towns are not required to provide ambulance services. “We’re not required to respond,” she said. “If we don’t find a way to pay for an ambulance, then we wouldn’t have it. Not having (an ambulance) is an option from the state. We’re not going to be penalized. But, on the other hand, we need one for the townspeople. It would create a political problem, but also a health care problem,” she said.

Last year, the town filed two bills that were enacted by the state Legislature. The first bill would have amended the requirement to send two EMTs out on each ambulance call to one EMT for volunteer ambulance services for populations of 3,000 or less. The bill would have helped towns the size of Charlemont, that have difficulty finding enough EMTs who are able to respond during weekdays, when many work out of town. The bill was held up on the last day of the legislative session, because of concerns raised by Department of Public Health lawyers, according to former Sen. Ben Downing’s office.

Another bill, to levy a 3 percent recreation tax on commercial outdoor activities, including ski passes, whitewater rafting, zip lines and other venues died in a Senate committee after questions were raised by the state Department of Revenue.

Both bills are to be resubmitted, possibly with revisions, this month. But even if they are eventually approved, they may not be acted upon in time for the ambulance service’s license renewal this May.

The recreation tax, which has been supported by the town’s outdoor adventure businesses, was to be used to improve the ambulance service and hire EMTs.

Hawley town officials suggested asking the outdoor recreation businesses to donate the equivalent of a 3 percent tax for the ambulance — possibly as a “payment in lieu of taxes” arrangement. But Charlemont Selectman Sarah Reynolds, an employee of the Berkshire East mountain resort, pointed out that the proposed recreation tax was to have been added to customer’s ticket prices, not to be paid from regular business revenues.

When asked how much it would cost to operate an ambulance service round-the-clock, ambulance director Dana Johnson said the minimum cost would be around $450,000 for an EMT-run service and about $750,000 for a service with paramedics available.

Johnson said he didn’t believe the state would take away the license. He said the ambulance service didn’t have a waiver, but a letter stating the service could use a first-responder to drive the ambulance, as long as there is one EMT.

Bandy believed the letter was for temporary permission, but said she would ask for something in writing from the state ambulance regulatory supervisor.

“In four months, we may not have an ambulance service,” she repeated. “It’s irresponsible of us to come up to spring without a Plan B in place.”

Charlemont Finance Committee Chairwoman Amy Wales said the revenues that come into the ambulance service from insurance coverage are less than what it costs to have the service. Wales said the ambulance service brought in about $94,000 in fiscal year 2012, when the ambulance served four towns, including Heath and Rowe. In 2014, she said, the revenue was about $67,000.

Town officials estimate the cost to add a 40 hour per week EMT would be at least $50,000 per year.

One idea was to temporarily hire a full-time EMT to be available on weekdays, when the volunteer EMTs are more likely to be working out-of-town. Then volunteers would be covering calls at night.

Some thought hiring an EMT who could also work as a town employee, for instance, in the Highway Department, might be more sensible, because the employee could work for the town when there were no ambulance calls. Another idea was to hire EMTs that may work for the recreation businesses that use the ambulance.

Having an EMT available 24/7 would be hard, because the fire station where the ambulance is housed doesn’t have overnight facilities. The bathroom is insufficient, and there is no room for a building expansion.

“A Plan B is good, but on the other hand, it could be a shovel you’re digging your own grave with,” said Hawley Selectman Hussain Hamdan. He said the cost of hiring a full-time EMT might not sound like a big cost to state officials in Boston, and they might accept the interim solution instead of the legislative changes the towns are supporting.

The ambulance issue will be brought up at the next Small Towns Summit on Thursday because it’s an issue that other small towns are struggling with. The meeting takes place at 7 p.m. in the Hawlemont Regional School, 10 School St.

According to Bandy, newly elected state Sen. Adam Hinds is to file the EMT legislation for the town, while state Rep. Paul Mark is to refile the town’s recreation tax proposal, which was approved by townspeople last year at annual town meeting.

Another suggestion was to contact Lt. Gov. Karyn Polito, who has been to western Franklin County several times and who may be more familiar with some of the issues here.

In 2014, the Charlemont Ambulance Service was shared by four towns, including Rowe and Heath, but it came close to losing its license because there were not enough EMTs available to respond to calls.

In May 2015, the town filed an action plan to reorganize the ambulance services.

Marguerite Willis pointed out that the volunteer ambulance service was started by townspeople in the 1940s. She said the town should find out who makes the decision to grant the ambulance service licenses in the state and talk to them directly.

When someone asked what the towns would do without an ambulance service, Willis remarked: “People are resourceful. They’ll know to call someone and say, ‘Take me to the hospital.’ We’ve always taken care of our own.”