holyoke firefighters ambulance proposal 2014
DESCRIPTION
A proposal from the Holyoke Firefighters, I.A.F.F. Local 1693 covering the benefits, costs and equipment needed to establish the EMD, a backup BLS transporting ambulance and the ultimate long term goal is to provide the primary BLS transporting ambulance within the HFD.TRANSCRIPT
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PDF Documents
Holyoke Firefighters
I.A.F.F. Local 1693
January 2014
Proposal for the EMD &
BLS Ambulance Service
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INTRODUCTION
The Holyoke Firefighters I.A.F.F. Local 1693 is proposing to provide the citizens of
Holyoke with a full service, pre-hospital emergency medical care system. Local
1693 plans to do this with a three phase plan. The Crawl phase consists of
obtaining and operating the Emergency Medical Dispatch (EMD) within Holyoke
Fire Department (HFD). Phase 2, the Walk phase, consists of operating a backup
transporting Basic Life Support (BLS) ambulance within the department. Finally,
the Run phase is that HFD will operate the primary BLS transporting ambulance
for the City of Holyoke. This plan will include the provision of rapid response,
treatment, and transport; for the purpose of improving the quality of community
based patient care. Through employee teamwork and a distinctive command
structure, this proposed Fire Department based system will deliver the optimum
level of EMS response and patient care, including transport.
Scope of the Proposal
This proposal will cover the benefits, costs and equipment needed to establish the
EMD, a backup BLS transporting ambulance and the ultimate long term goal is to
provide the primary BLS transporting ambulance within the HFD.
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Phase 1 Crawl (Immediate)
Emergency Medical Dispatch (EMD) refers to a system that enhances services provided
by Public Safety Answering Point (emergency) call takers, such as municipal emergency
services dispatchers. It does so by allowing the call taker to quickly narrow down the
caller's type of medical or trauma situation, so as to better dispatch emergency services,
and provide quality instruction to the caller before help arrives.
Based on specific question-and-answer logic trees ("systematized interrogation"), the
dispatcher is able to determine a problem type and priority for the call, and use that
information to:
provide systematized Pre-Arrival Instructions, including o Dispatch Life Support (DLS), which gives phone instruction to aid the
patient until help arrives o provide other information to the caller
activate appropriate protocols o dispatch the appropriate resources o dispatch using the appropriate modes (emergency mode or normal
driving) o activation of secondary protocols, such as notifications
What are the benefits?
Control of assets whether private or public Dispatching of the appropriate resources according to the emergency Better accountability Better response times Better familiarity with the geographic layout of the City of Holyoke Financial compensation for dispatching outside resources. Eligible for limited secondary Public Safety Answering Point (PSAP) Grant Funds
What do we have now?
Fully operational emergency dispatch center providing service 24 hours a day throughout the year
Alarm room currently has 8 EMD certified dispatchers Fully equipped for interagency communications
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What do we need?
Contract between the City of Holyoke and an EMS ambulance service Equipment, including software & hardware, provided by a contracted EMS
service to dispatch and track their units Establish an EMS enterprise fund Hire additional EMD dispatchers Agreement with Holyoke Firefighters I.A.F.F. 1693
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Phase 2 Walk (Short term)
Backup BLS ambulance is the level of medical care which is used for victims of life-threatening illnesses or injuries until they can be given full medical care at a hospital. BLS is generally used in the pre-hospital setting,
What are the benefits of a backup BLS ambulance?
Community based service
Decreased response times
Promotes continuity of care for the patient
Reduces the need for out of city resources
Provides experience & training with the goal of becoming the primary BLS
ambulance Service for the City of Holyoke
Grant possibilities
What do we have now?
HFD currently has 65 EMT Basics, 3 EMT Intermediates, 4 EMT Paramedics
2 Class 5 ambulance licenses
Holyoke Firefighters are long term career minded workers dedicated to the City
of Holyoke
Holyoke Firefighters know about the needs in their communityand are highly experienced emergency medical care providers
Currently respond on average to over 4000 EMS calls a year and receive No
Revenue for the service
EMS provider agreement with Medical Control
What do we need?
Two fully equipped ambulances
o Purchased or Leased
o New, Used or Refurbished
Billing company with guaranteed recovery
Change Class 5 license to a Class 1 License
Establish an EMS Enterprise Fund
Have Medical Control agreement updated
Agreement with the Holyoke Firefighters I.A.F.F. Local 1693
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What are the numbers?
Private Insurance will be billed at approximately $697.93. This is the average billing rate
for fire department ambulances in the surrounding area. See attached ambulance fee
schedule for reference.
*Medicaid / Masshealth reimbursement rates are the lowest reimbursement rate paid
by all insurance providers. Refer to 114.3 CMR 27.03, code A0429
**Based on Holyoke Medical Center EMS Run Data, 2012
Estimated % of
Reimbursements Paid by Medicaid / Masshealth*
BLS Emergent Rate of
$236.27 x 500** Estimated Back Up Transports
100% $118,135
75% $88,601
50% $59,068
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What are the start up costs?
Two ambulances - $130,000 - $300,000
o Ambulance cost variables
Type I, Type II or Type III
New, Used or Refurbished
Purchased or Leased
Engine / Fuel Type
Equipment & Supplies - $45,000 - $75,000
o OEMS required equipment & supplies
o Electronic Patient Care Reporting (EPCR) Hardware & Software
Training - $10,000 - $15,000
o Estimated 40 hour ride time per Firefighter/EMT
o Overtime cost for Field Training Officers (FTO)
License & Agreements - $800 +
o Class I ambulance fee -$800
o Medical Control Agreement - Unknown
What are the operational costs?*
Routine Maintenance - $1575
Oxygen Cylinder Refills - $250
Ambulance Supplies - $4050
Fuel - $2900
CMED Charges - $1790
EPCR Maintenance Fees - $4500
Billing Company - $4200
BLS Ambulance License and Inspection Fees - $800
Total - $20,065
*Based on Holyoke FD & Chicopee FD current EMS operational costs.
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What is the potential revenue?
BLS Emergent Rate of
$236.27 x 500 estimated back up transports
% reimbursed
Revenue minus
estimated operational cost of $20,065
100% / $118,135
$98,070
75% / $88,601
$68,536
50% / $59,068
$39,003
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Phase 3 Run (Long term)
What are the Primary BLS ambulance benefits?
Holyoke Firefighter/EMTs are all trained responders, prepared to handle any
situation that may arise at a scene including patient care and transport
Treatment and transportation by Holyoke Firefighter/EMTs is seamless &
promotes continuity of community based care for the patient
Effective & efficient pre-hospital emergency response
Revenue generation
Reduces the need for out of city resources
Increased grant possibilities
What do we have now?
HFD currently has 65 EMT Basics, 3 EMT Intermediates, 4 EMT Paramedics
2 Class 5 ambulance licenses
Holyoke Firefighters are long-term career minded workers dedicated to the City
of Holyoke
Holyoke Firefighters know about the needs in their community and are highly experienced emergency medical care providers
EMS provider agreement with Medical Control
What do we need?
An additional fully equipped ambulance to allow for two Primary BLS ambulances
City of Holyoke agreement declaring HFD will be the primary emergency
ambulance service
Have Medical Control agreement updated
Obtain agreements for ALS intercept services
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What are the numbers?
Holyoke Medical Center EMS Run Data
Medicaid / Masshealth Reimbursement
for the year 2012
Total EMS patients
transported
2010
2011
2012
2013 (As of Sept.)
6448 6706 6570 5014
Estimated % of
reimbursements paid by Medicaid / Masshealth
BLS Emergent Rate of
$236.27 x 6570 transports
100% $1,552,293.90
75% $1,164,220.43
50% $776,146.95
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What are the start up costs? Most costs associated with the Primary BLS service would be already covered in the start up costs of the Backup service. One additional ambulance with equipment would be needed. Full staffing would be needed to run a Primary BLS transporting service. There would be the option of paying for salaries with the revenue generated from the ambulance service. What are the operational costs?*
Routine Maintenance - $20,700
Oxygen Cylinder Refills - $3000
Ambulance Supplies - $50,000
Fuel - $37,500
CMED Charges - $23,500
EPCR Maintenance Fees - $4500
Billing Company - $85,000
BLS Ambulance License and Inspection Fees - $1200
Total - $225,400
*Based on Holyoke FD & Chicopee FD current EMS operational costs.
What is the potential revenue?
BLS Emergent Rate of $236.27 x 6570 estimated transports % reimbursed
Revenue minus
estimated operational cost of
$225,400
100% / $1,552,293.90
$1,326,893.90
75% / $1,164,220.42
$938,820.42
50% / $776,146.95
$550,746.95
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Conclusion
The men and women of the Holyoke Firefighters I.A.F.F. Local 1693 have been
preserving life and property since 1851. This mission is accomplished through fire
prevention, public education, firefighter safety, fire rescue operations, emergency
medical services, technical rescue operations and disaster management.
The vision for this service is one of growth and adaptation, necessary to maintain
and enhance the quality and level of community based services delivered to the
citizens of Holyoke. This continual improvement will facilitate safe, efficient and
effective emergency response and patient care; leading to positive outcomes for
those requiring emergency medical services in the city of Holyoke.