As South County EMS squad asks towns for funds, Great Barrington wary

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GREAT BARRINGTON — A local ambulance squad has sent out a call for financial help to the communities that it serves, but budget-conscious officials in Great Barrington seem reluctant to rush to the rescue.

The Select Board and Finance Committee on Tuesday voted not to recommend that the town approve a $131,000 subsidy for Southern Berkshire Ambulance. The request will be discussed at a budget hearing March 17, when residents will decide whether to send the matter for a vote at the annual town meeting in May.

The ambulance squad is, for the first time, asking the six towns in its coverage area to help shoulder some of its budget amid dwindling insurance reimbursements and other factors. In all, it seeks about 10 percent of its $2.08 million budget.

The request amount represents the nonprofit service's deficit in 2018 from low reimbursement rates for calls in Great Barrington and Housatonic.

Members of both boards grilled William Hathaway, the agency's director, about the nonprofit's financials and paltry fundraising, and asked why it waited so long to deal with annual shortfalls.

Hathaway said the agency has been whipsawed by changes to federal reimbursements and chronically unpredictable revenue projections, given that payment for emergencies is sorted out after the ambulance responds.

The nonprofit was formed in 1968 and was an all-volunteer service until 2014. Now, it is staffed by 15 full-time paramedics and EMTs, with 24 part-time volunteer paramedics and EMTs. Hathaway said the agency responded to 3,304 calls across all its towns last year.

Of these, 947 came from Great Barrington and Housatonic. But, out of the $594 cost per call, the agency received $432 in payment, Hathaway said.

He also said that call volume in Great Barrington is on the rise, particularly since it has a hospital and a high concentration of nursing homes.

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Hathaway said that while the agency could continue without municipal help, it might run the risk of "reducing services."

"We are very proud, and we really do not want to come to the towns," he said, noting that about 80 percent of the agency's calls involve Medicare/Medicaid patients, while reimbursements for Medicare are less than 1 percent of cost, according to a report by the U.S. Government Accountability Office.

"We are in a perfect storm," said Bob Holdsworth, a health care consultant who is helping the agency forge its way into the future.

Nationwide emergency

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That storm mirrors a nationwide emergency for nonprofit ambulance services, which are folding at a swift rate. And the public appears to bristle at this. A National Highway Traffic Safety Administration survey found that 92 percent of those asked think that EMS should be treated as an essential government service.

A local study confirmed that the current model of delivering emergency services is clinging to life. The examination commissioned in 2018 by the Berkshire Regional Planning Commission found that the Berkshires' rural, cash-strapped towns and shrinking volunteerism require a regional approach with a central governance that would integrate emergency medical technicians.

But, it hasn't happened yet. The ambulance squad has a $2.08 million budget to work with this year, and its request to all the towns amounts to about 10 percent of that. The agency is asking Alford for $2,563; Egremont, $14,279; Monterey, $9,885; and Sheffield, $42,000. It is asking for $1,830 from Mount Washington, which has been paying the nonprofit $1,500 per year of its own accord.

Great Barrington's slice is 6.3 percent of the agency's budget, Hathaway said. And this boils down to a $15.15 cost per hour for Great Barrington.

"That's one of the lowest subsidies I've ever seen across the country," Holdsworth said, noting that both state and federal government aren't pitching in the way they used to.

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"They are looking at pushing services back to the local level," he said.

But, town officials, still trying to shave down a proposed operating budget that already is close to a 5 percent increase over last year, and a hefty school assessment, have been closely questioning every request or line-item hike.

But, all agreed that the service is crucial to the area, and they asked that town staff brainstorm with Berkshire Health Systems officials, and do a deep dive into the economics before committing taxpayer money.

"I feel like I don't have the full picture," said Select Board member Leigh Davis. "There might be a more creative way to get out of this hole."

And board member Bill Cooke wondered why Great Barrington should bear the greatest burden of all the towns, when its hospital and nursing homes make it a "profit center" for the agency.

Dennis Hogan, the agency's board chairman and a longtime paramedic, said the nonprofit will continue fundraising amid the crisis, which, he said, is fueled at the federal level.

"The main source of our revenue is being cut and cut," he said.

Heather Bellow can be reached at hbellow@berkshireeagle.com or on Twitter @BE_hbellow and 413-329-6871.


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