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Fire Department-Based Ambulance

August 27, 2007

Paul Cohen, Town Manager

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AcknowledgementThank You to:

- Fire Chief Jack Parow

- Police Chief Jim Murphy

- Finance Director Kerry Speidel

- Assistant to the Town Manager Kellie Hebert

For Their Contributions in Analyzing theAlternatives for Ambulance Transportation

Services.

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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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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 Medical ResponseFire 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 Trinity’s Main Headquarters at Drum Hill.

Greater Lowell Emergency Medical ServiceProvides Paramedic Service

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Fire-Based Ambulance

Two Transport Ambulances –  One At

Center Station & Other At West Fire Station

Hire Five Additional Firefighter/EMTs

New Fire Captain Oversees Operations

Transport Patients to Hospital

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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 AreTwo Transports Within 90 Minutes

Average of 3/Month Are Three TransportsWithin 90 Minutes.

Fire Department Responds to All MedicalCalls

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Mutual AidEstablish Mutual Aid Agreements withWestford, Tewksbury, Billerica, & Carlisle.

Seek to Establish Mutual Aid Agreementswith Private Ambulance Providers.

Chelmsford Would Respond to Mutual AidRequests 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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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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Finances

Switch to Attached Financial Spreadsheets

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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 with 12 Firefighter/EMTMinimum 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 $250,000 in net revenuefrom ambulance operations.

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QuestionWhy doesn’t 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. It’s uncertain what this

nation’s 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 Workers’Compensation 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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Question

How 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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Question

Could 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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Closing Thought“Finally, we believe that the most important element of emergency 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