In regionalization, Northern Berkshire seeks more efficient, and increasingly attractive, EMS model
NORTH ADAMS — With necessity being the mother of invention, the regionalization of emergency responder agencies has begun in the Northern Berkshires.
Heading into the third month of the merger of Village Ambulance in Williamstown with the North Adams Ambulance Service, officials say the task of melding procedures and communications continues apace.
While the national average response time is more than 8 minutes and the average response time in rural America is roughly 15 minutes, the North Adams service has an average response time of 5 minutes and 37 seconds. About 45 percent of their calls have a response time of less than five minutes, while 32 percent of the time they reach the victim in less than eight minutes. Their longest response times, more than 30 minutes, occur only in 1.2 percent of the calls.
After about a year of study and preparation, the merger of the two professional first responder agencies became official Jan. 1. Village Ambulance had been suffering financially because of changes in medical care reimbursements and a lack of payment from some patients, and had been on a path to insolvency.
A committee comprising town, college, fire department and ambulance officials decided the best option to save the service was to merge with North Adams Ambulance, which is on much stronger financial footing.
Village and North Adams Ambulance Service are professional agencies.The relative difference in household income between Williamstown and North Adams explains the difference in financial challenges — Williamstown has few residents who qualify for government reimbursements of their ambulance fees, so when their insurance deductible doesn't cover it, some can't afford, or decline, to pay the fee.
The merger leaves North Adams Ambulance as the only ambulance service covering all of the towns in Berkshire County that border Vermont, and more.
They already covered North Adams, Clarksburg, Florida, Monroe, Rowe and Readsboro, Vt. After adding the Village Ambulance coverage area of Williamstown, New Ashford and Hancock, the coverage area went from 169 to 265 square miles.
And they have mutual aid agreements, in which they send a unit when that town's service is otherwise occupied, with Adams; Pownal, Vt.; Whitingham, Vt.; Stephentown, N.Y., and Berlin, N.Y. They also handle patient transfers to Springfield, Albany, Southern Vermont Medical Center and Berkshire Medical Center. North Adams Ambulance contracted with Rowe in Franklin County after a volunteer ambulance outfit in Charlemont couldn't muster a crew and respond to calls in less than 50 minutes. North Adams Ambulance can get there in about 30 minutes.
And getting to Readsboro, Vt., is also a long haul.
"We have been using North Adams Ambulance Service for over six years now and they have been great," said Bartholomew Howes, assistant chief with the Readsboro Fire Department. "The department has a first responder service to get on scene quickly and provide basic life support skill until NAAS arrives and can provide paramedic level services to the patient. While NAAS is not a local service to us in Readsboro as they are based in North Adams, they have always been very quick to respond — with the average response time being about 18 to 20 minutes."
Howes said North Adams Ambulance goes further than just responding to emergency medical calls.
"They have a 'rehab trailer' with food and drinks to provide to personnel during extended calls along with the ability to heat and cool personnel down depending on the weather condition," he said. "This trailer comes to every structure fire, search and rescue and is available anytime upon request. The level of service they provide to us is second to none."
When the merger became official, North Adams Ambulance absorbed Village Ambulance's assets allowing their fleet to grow from five ambulances to nine, and added the former Village Ambulance station location on Water Street in Williamstown.
The Village Ambulance chair car medical transport service, which provides medical transportation for college students and others in need of a ride to medical appointments, was also part of the merger.
Logistically, having a station in Williamstown helps with their ability to respond to calls more quickly in both coverage areas, said John Meaney, general manager of North Adams Ambulance. He said two ambulances are stationed at the Williamstown location. If one goes out on a call, another rolls in to cover.
But the devil in this deal is in the details — administratively, there is a raft of chores to complete including unifying procedures, passcodes, ambulance equipment inventories, telephone systems, narcotics controls and communications procedures. Spending accounts and other accounts also need to be unified. Outstanding Village Ambulance vehicle loans had to be transferred.
"It took a lot of work," said Win Stuebner, a doctor and former chairman of the Village Ambulance board of directors and current member of the board of the new ambulance service. "There were at least two months of due diligence. Then we had to sprint."
Robert Moulton, chairman of the North Adams Ambulance Service board of directors, said the transition went better than expected.
"I think it is going to work out great," he said. "I think it will be great for both communities. It just shows what can happen when two partners have the same goal."
Jason Hoch, Williamstown town manager, said that, at this point, the merger seems like a natural fit.
"A logical, methodical process led us to this point," he said. "And it has turned out to be the most logical solution for us and for North Adams."
Most of the crew members from Village Ambulance have been brought on board the new agency and have completed their orientation. North Adams Ambulance took on 27 employees as a result of the merger with Village: eight EMTs, six paramedics, 11 chairvan drivers and two office personnel.
Now, North Adams Ambulance employs 87 people — 25 full-time and 62 part-time. Of those, 28 are paramedics, six are Advanced EMTs, 38 are EMTs, 11 are chairvan drivers and four are office staff.
Still to be done is the hiring of eight to 10 more part-time EMTs to fill out the roster.
Awaiting attention on the back burner, until the higher priority items are attended to, is the re-branding of the new service.
Meaney said there will be a new name, new uniforms and patches, new signs and new vehicle labeling. The name change has to be registered with state officials and several other entities such as banks and granting agencies.
"We wanted to make sure the higher-priority operational issues were resolved before getting into the rebranding," Meaney said. "We're hoping by June to have everything said and done."
The cost of the rebranding, as well as others costs incurred by the merger, is being covered by a contribution from Williams College and Williamstown of up to $200,000. Meanwhile, the service responded to 892 calls In January. The average for North Adams Ambulance has been about 500 in a month. At the time of the merger, Village Ambulance was averaging around 333 per month.In January, the first month of the merger, the newly combined ambulance service responded to 892 calls.
"It has been super busy," Stuebner said.
He said the newly united crew is feeling good about the operation.
"I think morale is very high," Stuebner said. "They've worked together before, but everyone was a little bit nervous about how this was going to go. But I can't imagine a scenario that could have worked out better."
While there are other Berkshire County ambulance services contemplating regionalization, this merger may be the first of several.
"The need for regionalization is underscored by the trend of increasing calls for service," Meaney said. "There needs to be more communication and more cooperation between agencies. At the end of the day, it's about the patient — getting help to their door as quickly as possible."
Scott Stafford can be reached at email@example.com or 413-629-4517.
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