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EMS plan moves forward for Deerfield, Whately, Sunderland

— A fully staffed ambulance located in South Deerfield that will be available around the clock every day of the week is the likely future of emergency medical service in southern Franklin County.

The Regional EMS Committee, made up of emergency management and fire officials from Deerfield, Whately and Sunderland, recommended an integrated municipal regional ambulance service for the three towns.

This service would include one fully staffed, 24-hour, seven days per week first response paramedic ambulance. Based on response time analysis, this regional system would likely be located at the South Deerfield Fire District.

The three towns have anticipated the committee’s recommendation since they hired consultant Bruce Baxter of Bruce Baxter and Associates, a firm based in Haverhill, to come up with options for the towns to quicken response time and provide better service to patients. The study is paid for by a $15,000 grant from the Franklin County Regional Council of Governments.

Each community owns and operates its own community-based ambulance service. According to a Nov. 7 report by the committee, a regional service would minimally staff a first call-first response Class 1 paramedic ambulance 24/7. Simultaneous or second calls would be managed by on-call personnel in the ready reserve ambulance, which are fully stocked and capable of being placed in service with a one-minute notice.

The primary response ambulance would be the current Deerfield ambulance. Either the Sunderland or Whately ambulance would be the ready reserve ambulance to be replaced by 2016.

The system would be governed by a regional oversight board comprised of seven members, including each town’s EMS director and each town administrator.

It would cost the three towns an additional $200,000 for this service. The towns currently pay $600,000.

The proposal addresses several issues. It provides a consistent higher level of service, reduces reliance on mutual aid ambulances by providing a 24/7 staffing model and provides quicker response times. All current full-time and on-call staff would be eligible to participate in the new service as well.

The proposed service area encompasses 68.84 square miles. Collectively, there are 10,184 residents living in 4,421 housing units in that area. During the work week, the population swells by an additional 5,000.

The three towns hope to implement a shared service during this budget year. Before that happens though, the towns plan to review actual budget numbers and hold public hearings. The next meeting is scheduled for Dec. 10 at 7 p.m. The location is to be determined.

All three fire chief and EMS directors — Gary Stone of Whately, Matt Russo of Deerfield and Robert Ahern of Sunderland — insisted the need for a change and endorsed a regional service.

“One thing we can’t afford to do is ... to do nothing. The system we have now is on the verge of failing,” Ahern said.

The system is failing for several reasons, Baxter said. Although each of the towns has the most cost-effective approach to delivering emergency care today, the challenge is it’s a model better suited for 1965 or 1982 and not 2012, he said.

Issues challenging the existing on-call systems are a diminishing labor pool as people work two to three jobs outside of their local communities, a changing society that places less emphasis on volunteer work, and increasing regulations in health care.

One of the problems is there is no ready reserve ambulance capacity in any community. If any ambulance is out of service for maintenance, EMS personnel have to wait at the scene until a mutual aid ambulance arrives.

According to Baxter, the EMS service chiefs report that 20 percent of all 911 requests are transported by mutual aid ambulance services due to the lack of personnel.

The response times — the time elapsed from the moment the 911 call is received to the time a staffed ambulance arrives at the scene — are also sobering.

In Deerfield, it takes an ambulance 26 minutes in 87 percent of all responses to arrive on scene. In Sunderland, it takes 18 minutes in 91 percent of all responses. In Whately, it takes 19 minutes in 91 percent of all responses. In comparison, it takes 15 minutes and 59 seconds in 90 percent of all responses or 12 minutes and 59 seconds in 85 percent of responses in similar communities.

This is based on fractile time, which measures the real amount of time necessary for an ambulance to arrive on scene. The figures were calculated by the Franklin County Regional Council of Governments with data provided by Shelburne Control, which dispatches the three EMS departments.

According to Baxter, a fully staffed ambulance covering the three towns located at the South Deerfield Fire District would minimally result in a 30 percent consistent improvement in ambulance response time based on similar rural areas. Alternatively, the Sunderland Fire Department would provide a consistent 27 percent improvement in response time. This means an ambulance could be on scene within 15 minutes or less if changes are implemented.

There were three other options presented by the committee, but none were put on the table.

One option was a do-nothing approach. It would have maintained the current systems.

The second option is to develop a regional municipal paramedic intercept-support service. The committee said this did not fix enough problems. There would be no additional crew to staff a new ambulance and it would cost $500,000 a year on top of the $600,000 the towns are already spending.

Option three requires one town, most likely Deerfield, to be the primary provider for all communities and leaves the current services in place in the remaining towns. This would keep current staff and eliminate concerns associated with access to different towns. The problem is one community is burdened with more financial responsibility.

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