BRATTLEBORO — Out of the gate at the Sept. 12 public forum at Brooks Memorial Library, Assistant Town Manager Patrick Moreland surprised some by recommending the Selectboard choose a fire-based EMS service for the town - a move supported by the 10 other town staff members present, each speaking in favor of it.
"I believe we have a fantastic opportunity in the municipal model," Moreland said.
He continued to note that after reviewing the Request for Proposal (RFP) responses from American Medical Response (AMR) of Springfield, Massachusetts, and locally based Rescue, Inc., plus follow-up discussion, he thinks the only viable options are the municipal model (fire-based EMS) and Rescue.
He called AMR "not the right model for Brattleboro," saying the town needs three available ambulances while that company's proposal includes just one.
In Moreland's estimation, there is "very little comparison" in the two choices he says are the only workable ones, and he said it "comes down to good patient care, sound finances, a unified approach to public safety, and accountability to the public."
Moreland advocated for the municipal plan under consideration by the Selectboard, admitting there will be "significant new costs" but that reimbursement revenue would "more than compensate."
He estimated savings of $150,000 with the fire-based municipal model in its first year, should the board go in that direction.
"We're clearly looking at a model that does not add new costs to the general fund," he said, adding "at worst" it would have a "neutral" impact.
The municipal plan is based on using American Rescue Plan Act (ARPA) money to fund "unavoidable and not inexpensive start-up costs" for a town-run emergency service.
Moreland said that he and other staff members support using the ARPA money.
"I don't see this as a waste of found money," he said, calling it an "opportunity […] for this one-time expense. In my mind, this is exactly the right thing to do."
Supporters in general cited public oversight to delivery of essential services as a duty of town government and accountability to the public as pluses for town-run EMS. The phrase "our town, our people, our responsibility" was repeated several times by staff members.
The meeting
The library was full at the start of the meeting, set for 90 minutes but lasting almost three hours.
"I know we will all be well-behaved this evening," said Town Manager John Potter at the start. "We're tackling what is an emotional issue for some people […] we want to be understanding […] give others the benefit of the doubt that they are acting in the best interest of the town and not their own self-interest.
"No decisions are being made tonight so the stakes are low," he said, calling it "a time to be curious, for learning [and] for understanding why people are thinking the way they do."
Potter said the aim of the meeting was not to take a "deep dive into comparing alternatives."
"We assume most of you have been following along," he said, adding that a summary of those alternatives was handed out.
"We want to try to get beyond the emotional level and try to get to what you think is best for Brattleboro […] and why," Potter said.
He said, too, that public comment will be accepted at the board's Sept. 19 meeting, when board members are still set to make a decision about what the future of EMS here will look like.
Potter encouraged anyone with a different recommendation to speak directly with Selectboard members in the next week. Contact information is on the town website (brattleboro.org), as are all pertinent reports and memos.
Resident Judy Davidson and others weren't thrilled with the format that allowed for statements by so many staff members, who took about an hour of the hearing.
"A process with 11 people is not a public process. We do not need it and it was really disappointing," she said, to a smattering of applause.
As many others did, she added that she cast no aspersion on either Rescue or Brattleboro Fire Department personnel, but she did not support spending ARPA money.
Supporting Rescue
Resident John Kennedy, noting he has attended all meetings on the EMS issue for the past 14 months, said, "The fire-based EMS is the best for the town of Brattleboro."
Kennedy also took issue with the Brattleboro Reformer, VTDigger, and The Commons, saying all the local news sources let the community down by not reporting the truth of the town/Rescue break-up, which he characterized as essentially due to Rescue's refusal to renew the contract.
In fact, in his March 2022 letter to the board, Rescue Chief of Operations Drew Hazelton offered to meet with the board and offered a date by which he needed to hear from them. He also said Rescue couldn't work free of charge for the town.
At the time, board member Ian Goodnow replied to Hazelton, saying the town wanted to know the justification for the rate Rescue had proposed and said Rescue had denied the town's request to see the provider's financials.
What does seem agreed by both sides is that following Hazelton's accusations of "poor patient turn over, gender discrimination, verbal abuse and general lack of cooperation," several incidents were jointly investigated by both town and Rescue human resources (HR) staff members and were found to be without merit by town HR - and not refuted by Rescue's HR folks.
The investigations led to interorganizational controls, including a Universal Incident Feedback form and scheduled meetings between line staff from the two organizations.
Potter told The Commons before the meeting, when asked about this, that "with implementation of consistent tracking and use of this Universal Incident Feedback Form, several subsequent situations were documented and investigated at which Rescue itself concluded their staff had been on scenes putting their own safety and the safety of patients and BFD staff at risk."
"The pattern of denial, baseless accusations, and harmful public statements towards BFD staff was, I believe, as evidenced by this letter, a serious concern in 2022," said Potter, who was hired after the decision.
"Despite that history, however, the town has always had an open mind through the RFP process to see signs from Rescue of a positive renewal to the relationship," he said.
'It's about the financial impact'
Rescue supporters spoke of the company's 56-year history of service to the town and better uses of ARPA money, some also noting personal stories of lifesaving experiences from the provider.
Resident Kate O'Connor, who has been closely following the financial impacts of all proposed models under consideration, said for her it's not about "whether the fire department's good or Rescue's good; they're both good."
"To me, it's about the financial impact it's going to have on our town," she said, adding there's "no money made from EMS in this town."
"The revenues don't match the expenses and they're never going to," she said, noting someone has to make up the difference.
Plus, she said, she's heard "over and over" that expenses will go up. O'Connor pointed out that costs for a municipal system in just year one for additional work needed amount to $950,000.
Noting "giant question marks," O'Connor added that a statewide workforce shortage for EMS personnel and supply chain issues for delivery of ambulances (which the town would have to buy to run its own system) are real concerns.
"It's nothing personal for me," she said. "It's 'Can we in this town afford to do this?'"
At the end of the public commentary, Hazelton spoke briefly.
"We want to make sure you know we are ready to serve, we want to take care of the people of Brattleboro […] we are also more than willing to work out whatever problems exist."
Closing the meeting, Potter said, "I saw a lot of wheels turning, and I really appreciate that. […] Go in peace, and we will see you around."
This News item by Virginia Ray was written for The Commons.