BRATTLEBORO — Brattleboro’s transition to providing its own emergency services “has gone infinitely better than expected,” said Dr. Johndavid Storn, one of two medical directors for District 13, the catchment area for emergency medical services in Windham County, at Tuesday night’s Select Board meeting.
“That’s not to say that we haven’t had some operational challenges [with] bringing new providers into the town and getting everybody up to speed,” said Storn. “But on the whole, really no major incidents.”
During his last review of “the charts,” he concluded “there’s not been any major medical problems directly related to the rollout of the new EMS system. We continue to work to bring the Brattleboro Fire providers up to speed.”
Storn is a Dartmouth Medical Center emergency department physician who works in the EDs in both Brattleboro Memorial Hospital and Cheshire Medical Center in Keene, N.H.
Storn said it’s “a fairly big shift” switching to town-provided services from Rescue Inc., a $285,600 annual contact, which was Brattleboro’s primary responder for almost 60 years.
One of the biggest challenges for a new service is learning how to work with the hospital “to navigate some of the challenges that we face as a healthcare system,” he said. “But again, I think overall, the rollout has gone really smooth.”
Brattleboro Fire Chief Leonard Howard said the focus of August and September has been training new staff to respond to both fire and EMS calls.
“Both Dr. [James] Suozzi and Dr. Storn continue to actively review our work and calls [for] quality assurance and quality improvement of both random incidents and high level clinical interventions performed on emergency scenes,” said Howard.
Suozzi is the other medical director for District 13.
“BFD members continue to complete their advanced EMT course as well as get ready to take their national AMT course,” added Howard.
Currently, BFD has three firefighters enrolled in a paramedic program, he said.
Since the switchover, said Howard, BFD has responded to 689 total call, with 484 of them being medical emergencies.
The average response time is four minutes and four seconds and the average call time is a little more than 27 minutes.
Storn said even though on average the BFD is responding to 11 calls a day, they aren’t spread out over the day and can happen rather quickly.
He also acknowledged that Mutual Aid and backup resources for EMS calls “have been much more difficult to arrange.”
As a result, Howard asked the board to add $37,500 to the one-year contract, for a total of $112,000, to add a second provider and a third ambulance in Brattleboro.
“As we evaluate these statistics, we have learned that having two ambulances along with a fire engine at Central Station and a staffed engine along with an ambulance at Station 2 is crucial to allow us to meet our requests for service that have been required of us for the first three months,” said Howard.
Kate O’Connor noted that so far, $168,500 has been spent on EMS expenses, but the total is actually $270,000, which is $15,000 less than what the town would have paid Rescue, if you include $52,000 for wage increases for fire personnel and $16,980 for the extra position.
“I think the analysis of how much are we spending relative to Rescue is kind of not essentially important right now,” said Patrick Moreland, interim town manager.
Moreland said the town is currently in a transition phase that may not correlate directly to what will happen when the transition is over. And not having the AP Triton report yet means there is still a lot of uncertainty.
“I don’t know where we’re going to land,” he said.
Board members can debate whether they should have included the wage increase in the EMS transition spending, but “I just don’t find it to be all that important right now,” he said.
“I just want to mention that there were varying reasons to increase the fire department salaries,” said board member Elizabeth McLoughlin, “and it was fire department reasons and EMS reasons and starting salaries and gaining new employees.”
The town would have probably allocated that money anyway, she said.
Select Board Chairman Ian Goodnow pointed out that the town is expending the money by investing in its fire department and its firefighters.
Howard noted that other departments across the country are offering more money to firefighters and EMTs than Brattleboro is.
“These guys can go pretty much anywhere they want and name their price, and they go,” he said. “That’s something we have to address regardless of whether we do EMS or stay fire.”
Howard pointed out that the firefighters and EMTs often do more than respond to a person’s health needs.
“We go to somebody who has fallen and needs help getting up,” he said. “We just don’t go there to pick them up and help them. Sometimes we go there and spend a few minutes with them, help them get things that they may need. Sometimes even make them a sandwich to help them feel like they’re in a good place.”
“Yes, you can clear the call in 27 minutes,” agreed Storn. “But sometimes spending an extra 10 or 15 minutes on scene can actually mean that that patient gets better care or more efficient care.”
“So far,” said board member Daniel Quipp, “I would say this transition seems to be working well and people of Brattleboro are being well served. ... If you look at the call-by-call data, I can’t come up with any other conclusion than this is going as it ought to be going.”
He also noted that “[E]ach one of these lines is a story. And there’s so much in each one of those calls that will never really be adequately addressed by a spreadsheet with data.”
AP Triton will be in town in October, with a representative speaking to the board on Oct. 18 and hosting a public forum on Oct. 19 at 6 p.m. at Central Fire Station on Elliot Street. The public forum will also be broadcast by BCTV.