Brattleboro forum will discuss EMS options

Selectboard plans to make a final decision on future of fire-based EMS on Sept. 19 after months of study

BRATTLEBORO — As the Selectboard continues to unpack and scrutinize the myriad details involved in deciding upon a new emergency services (EMS) delivery plan, the next big date is Aug. 29.

That's when requests for proposals (RFPs) from potential interested third-party providers are due.

"We have been moving through a process over many months," said board Chair Ian Goodnow during a fire/EMS transition update at the Aug. 15 board meeting.

"I see the discussion tonight as an opportunity for us to set the table and make sure everybody's on the same page for what's going to be happening in the next 35 days," he said.

Revenue and cost information pertaining to a fully municipal EMS alternative has been publicly shared over the past several board meetings.

Town Manager John Potter went on to note that the town continues to maintain and update the project website and to post and answer public commentary.

Those with questions or comments can continue to weigh in via email to [email protected].

Currently, town staff members are preparing a "framework," said Potter, so that board members and the public will be able to compare a municipal scenario with third-party possibilities in an "apples-to-apples" way "that's consistent."

The framework will also include "the intangibles" that the community and Selectboard may want to think about - for example, customer satisfaction, procurement overhead, town/staff integration, and billing rate policy.

A factor in the comparison will be the town's ability to maintain a fire-EMS "effective response force," which the board has discussed several times.

The town needs adequate numbers of firefighters to safely respond to a large fire event but must balance that need with what resources are needed for emergency response and what taxpayers can afford.

Board member Franz Reichsman said the effective response force "really means having enough firefighters to put out a fire even if they're doing something else at a given moment" and effectively managing "what they are doing when they're not putting out a fire."

Key dates coming up

Some important milestones in the project are coming soon:

• Saturday, Aug. 26: RFPs are due, and proposals from potential providers, if received, will be made public.

• Tuesday, Sept. 5: That information will be shared at the Selectboard meeting, where it will be discussed.

• Tuesday, Sept. 12: A public forum is tentatively set for 6 p.m. at Brooks Memorial Library to review in detail any viable EMS alternatives, compare them, and ask for public input.

• Tuesday, Sept. 19: The Selectboard will meet and, if the current timeline has held up, make a decision regarding the future of EMS services in town.

Earlier in the spring, the town decided on the parallel tracks of investigating the pros and cons of an EMS service provider versus a municipal EMS service by Sept. 19.

The plan allows the preferred model to be selected in time to incorporate the fiscal impact into the fiscal year 2025 General Fund budget. It would also allow a chosen provider, if that is the board's decision, time to prepare for a July 1, 2024 start date.

Reichsman also noted that while he has heard from many residents, he finds the "exact scope of the decision" is still "not completely clear in people's minds."

"We don't even yet know exactly what our choices will be," he said.

"Please understand we're not just looking at making isolated decisions about EMS, we're integrating that with what our effective response force for firefighting has to be as well, and all those numbers change depending on which assumptions you make at any given time under any given service model," he said.

Although assured the town has spoken to outside officials, resident Kate O'Connor spoke, advocating for outside presenters to be invited to speak to help clarify what's going on in the "bigger context" of EMS, "instead of us all spitballing."

She noted issues around EMS are a big topic of discussion and involve two pathways: municipal and regional.

Rescue will apply; AmCare will not

Two responses to a June 1 request for information (RFI) were returned to the town. The purpose of the RFI was to begin to identify EMS providers that may be interested in serving Brattleboro.

The RFI was given to a list of 82 EMS providers along with notification to the state heath/EMS departments in Vermont, New Hampshire, Massachusetts, and New York. Notice was sent to a variety of EMS trade journals, posted on the town website, and published as a public notice in the newspaper of record.

The Commons learned independently that the two firms responding to the RFI were Rescue Inc. and AmCare Medical Systems, Inc., of St. Albans, which is part of AmCare WLRC Medical, a regional East Coast organization.

This week, Rescue Inc. Chief of Operations Drew Hazelton told The Commons that Rescue is moving forward with the next step.

"We will be submitting a proposal," he said.

The town broke ties with Rescue Inc. in 2022 after many years of service, but Hazelton expressed optimism for a new, future relationship.

"There were certainly challenges with the relationship prior to Brattleboro's sudden departure from Rescue Inc. and, although we haven't had any conversations about that as of now, I believe we can get those challenges resolved going forward," Hazelton said.

"I think the key pieces of the proposal are that Rescue has a history of providing extremely high quality of EMS to the region," he said, describing the nonprofit's model as "time-tested and proven."

"We continue to serve the citizens in Brattleboro through other programs we run, and we think it's important to at least give the Selectboard the opportunity to look at the services we provide and give the citizens of Brattleboro the ability to benefit from the services we provide," Hazelton said.

Rescue will host a public open house on Saturday, Aug. 26, from 4 to 6 p.m., which will conclude with an informational meeting for officials to answer questions. That portion of the open house will be recorded and available to the public through Brattleboro Community Television after the meeting.

On the other hand, AmCare Medical Systems Director of Operations Clement Roger said his company will not be replying to the RFP because he doesn't feel AmCare can come close to matching whatever cost Rescue might determine.

"From what we're seeing in Brattleboro and in our research, it looks like Brattleboro is looking for the best deal for them, and there's no way we can come anywhere near what Rescue Inc. came in at," Roger said this week.

"For us to come there and purchase a building, new ambulances, and the reimbursement rates being as they are in Vermont, it would probably cost anywhere from [$750,000] to $1 million, and we know they don't want to pay that much," he added.

"My payroll here in St. Albans is about $1.6 million a year and that's for three, 24-hour-a-day crews," Roger continued. "To properly cover the volume in Brattleboro, we'd have to have two, so […] you can sum it up: It would cost too much."

Saying AmCare wouldn't be able to compete with any potential cost projection from Rescue Inc. is still a bit of a guess, as Hazelton clarified.

"We have not done projections for this proposal yet," Hazelton said when asked.

He went on to explain that at the time Brattleboro left Rescue, it was considered a "member town" for EMS coverage with Rescue. That meant all costs and revenues for 15 towns, including Brattleboro, were aggregated and shared.

"We've never separated the cost or revenue of one individual town, and that's an exercise we'll have to do now to provide that information to the town," Hazelton said.

"We paid for dispatching services in Brattleboro, so we charged about $280,000 annually," he said. "We paid them back just over $50,000 in a dispatch assessment annually."

Hazelton said the actual cost to the taxpayers in Brattleboro - prior to the town leaving - was about $230,000.

This News item by Virginia Ray was written for The Commons.

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