Slower Ambulance Daytime Responses Concern Selectman, Health Director

By John Voket

A plan to compensate local emergency medical technicians (EMTs) to cover critically short weekday shifts, thought to be dead on arrival, may get resuscitated if Newtown’s first responders can negotiate to bring in an emergency services staffing agency to employ the volunteers. Slower response times during typical workday hours (Monday through Friday between 8 am and 5 pm) have caused the first selectman, who holds statutory authority over local ambulance service, to press for a solution.

While the daytime shortage of volunteers for ambulance or fire response is not unique to Newtown, a recent trend in lengthening response times, and a growing dependence on mutual aid responders from neighboring communities during the weekday hours, has First Selectman Herb Rosenthal calling for alternatives to be implemented. By town charter, Mr Rosenthal is the ex officio commander of the town’s volunteer ambulance company that is staffed by trained members of the Newtown Ambulance Corps, but whose finances are controlled by the Newtown Volunteer Ambulance Association, a public nonprofit corporation with nearly $1 million in assets.

According to leaders of the ambulance corps, the association recently requested a plan be put in place that would secure weekday paid personnel, compensating any volunteers who would commit to a weekday shift at $15 per hour. Ambulance Corps Chief Ken Appeley told The Bee that a pilot program was all but in place, with day shifts to be covered by local EMTs who know the streets and traffic patterns best.

But within a week of the new program launching, the association abruptly reversed its decision to fund the paid schedules. During a November 9 ambulance association meeting, the association’s longest tenured board member, Malcolm McLachlan, said, “It was not legal according to labor law.

“A top labor lawyer in Boston gave us opinions [on the plan] and said the fines would put us out of business,” Mr McLachlan said.

But Joel Guarcia, director of the Connecticut Office of Emergency Medical Services (CT-OEMS), said the corps was on the right track in proposing their own members receive the first opportunities to staff paid shifts. He said many Connecticut communities are relying on one of several emergency service staffing companies to employ local EMTs as contractors, then providing them with paid shifts in their own communities on a priority basis, and based on the availability of local responders to staff those local shifts.

“You always want home grown people to be covering ambulance shifts,” Mr Guarcia said. “I’ve found these emergency service staffing agencies try to draw folks from their general service area.”

Mr Guarcia empathized with town leaders who are hard-pressed to ensure every call for help is answered expediently, and by certified professionals who hopefully have some working knowledge of the local street grid.

“Communities are increasingly being forced to look at staffing patterns without doing a disservice to residents or their loyal volunteers,” he said. “The best-case scenario would be to have people who are familiar with the towns and roadways, but also a financially viable alternative.”

Vincent Wheeler, operator of VINTECH Management Services, LLC, the state’s oldest established emergency services staffing firm, said Mr Rosenthal or the association could negotiate a contract to employ Newtown emergency service personnel as the primary day shift paid staff on the Newtown ambulance. A contract of that nature, he estimated, would begin at about $16-an-hour, just $1 more than the association proposed paying volunteers directly.

“The federal Fair Labor Standards Act prohibits any person to work and volunteer for the same company,” Mr Wheeler told The Bee. “But if you live in Newtown, and there is an open day shift in Newtown, I can send you there to work.”

He said the nature of his business requires him to staff all his contracts, so on the occasion a Newtown EMT is available and all local shifts are full, that person may be offered a shift or be expected to staff a shift in a neighboring community. By the same token, if there are no Newtown EMTs available to staff the Newtown weekday shift, Mr Wheeler might bring in an EMT to cover that shift who knows the town, but resides in a neighboring community.

“Local people accessing priority scheduling can be accommodated in Newtown,” he said.

Although she has no direct, day-to-day authority over ambulance services, Newtown Health Director Donna Culbert said she would be equally concerned about response times if EMTs unfamiliar with the town were posted at the ambulance garage during the busy daytime periods.

“The system they have isn’t working out [based on current response times],” she said. “But if we have to go with a paid shift, it would be better to use local folks who know the community and the people. Local EMTs know how the best ways to get around town in the event of an emergency.”

The first selectman said, up to now, he has permitted the association and the corps to continue working through the challenges of staffing the day shifts. But in the face of significantly increasing daytime call volume, and shortages of ready volunteers to answer the calls, he is prepared to step in if the situation is not rectified soon.

“The town has been well-served by the ambulance association, as well as the many dedicated corps volunteers. My hope is the two groups work out these issues so the people of Newtown can continue to benefit from our local basic life support services,” Mr Rosenthal said. “But I’m becoming more concerned with the issue of covering all the weekday ambulance calls.”

Overextended During   The Day

The first selectman said the limited number of corps volunteers available during the day are becoming overextended, in part, because of the escalating number of calls to the town’s elderly housing locations, local nursing and assisted living centers, and the Garner Correctional facility. Mr Rosenthal said he was upset to hear about the issue from a newspaper reporter, instead of learning about the level of disconnect from an association volunteer or member of the corps.

“As the person by statute who holds the authority over local emergency services, it is disconcerting that neither the corps nor the association has brought their issues to my attention,” he said. And while Mr Rosenthal has not chosen to step in and hire a paid service to cover the weekday shifts, he understands that the time to solve short staffing issues is imminent.

According to an email received from Laurie Veillette, a corps member seeking a seat on the association’s board, the association called a meeting for November 18 to discuss the staffing issues with members of the corps’ e-board. Mary Neilson, a member of that ambulance corps leadership board, crafted a proposal on paid day shift staffing for the association, before the fiduciary’s members reversed their decision on the plan.

Because of the association’s corporate status, its meetings are closed to the public and press, as well as members of the volunteer corps, unless they are specifically invited to attend. Ms Neilson was expected to present finding from her study at the November 18 association meeting.

In a copy of the study obtained by The Bee, it is reported that the corps is fully cognizant of the issues of short staffing. The report states: “Newtown Ambulance [Corps] has a current call volume of 1,900 per year, and provides mutual aid to Bethel, Stony Hill, Monroe, and Southbury. In response to changing times constraints such as personal, business and cost of living Newtown ambulance’s membership has declined in proportion to its call volume. As a result, Newtown Ambulance has on occasion had difficulty providing coverage to the town and its residents, which, in turn has placed constraints on our mutual aid towns [that] are also stretched beyond their means. Due to these factors Newtown Ambulance Corps has needed to look into other avenues of providing coverage to their residents.”

Rising Costs

Newtown currently pays about $150,000 annually to Danbury-based BSI Inc — the for-profit arm of Danbury Health Systems, which owns Danbury Hospital and runs the ambulance company for the city and other contracting communities — to share 24-hour paramedic service with Bethel and Redding. Up to now, the Newtown Volunteer Ambulance Association has not billed or charged for its services, but its leadership recently suggested the town might have to contribute if a pay-by-the-day shift is put in place.

The sole taxpayers’ contribution to the association is a bi-annual $50,000 allocation to help pay for new ambulances, which typically have a three- to four-year optimum lifespan as primary responding vehicles before they are relegated to backup status. But former association president Stephen Savarese said recently that if the town was forced to staff the ambulance company full-time, it could cost more than $500,000 annually.

“We have looked at the potential yearly costs to the town, and learned that it would cost a half-million dollars or more to fill that zero line item in the town ambulance budget,” he said.

Ultimately, emergency service professionals from the state OEMS director, to the first selectman, to Chief Appeley and many others on the local corps all agree that the best solution would be to find a way to staff the town ambulance service with local EMTs. Nobody wants the town contracting for a service whose members are unfamiliar with the town’s geography.

“We’ve got a family atmosphere here among our volunteers,” Mr Appeley said. “The corps would rather find a way to start hiring our own folks for the day shifts than put taxpayers in a position where they would have to pay an outside company. That would be the last option.”