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The Fire Department made a presentation to the Board of Selectmen on Tuesday.

Lanesborough Ambulance Presents Options For Stability

By Andy McKeeveriBerkshires Staff
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Firefighter PJ Pannesco outlined ways the Ambulance Squad can improve.
LANESBOROUGH, Mass. — The Ambulance Squad has turned its call response around in the last three months and is looking to improve even more.
The squad is run through the Fire Department and, on Tuesday, fire and ambulance officials met with the Board of Selectmen to discuss its long-term stability.
The ambulance service has been going through a difficult financial time and the Selectmen has proposed to shut it down and instead contract with County Ambulance, which agreed to become the primary at no charge to the town.
The Fire Department, however, wants to keep providing the ambulance service and has made a conscious effort to boost its income. And, members have proposed four ideas to help stabilize the service into the future. 
"We want to take care of the people in town. It is my mom, my aunt, my uncle, my friends, people we care about and we want to take care of them," Deputy Chief Butch Garrity said.
Garrity led a presentation on how the operation is currently working. A call comes into dispatch and call type is determined. That determination is whether it is an immediate emergency and requires an advanced life support response. If so, ALS is provided by County Ambulance now and is dispatched immediately alongside Lanesborough. County takes the transport in that case.
If the call is determined to need basic life support, Lanesborough is toned out and can handle the call on its own. Three minutes later if nobody from Lanesborough has called in to respond, another set of tones goes out. Two minutes after that, a final set of tones goes out and County is dispatched.
"If it is basic life support then we just get dispatched. If it is advanced, we both get dispatched," Garrity said. "The most you would have to wait for a backup ambulance to get dispatched would be five minutes."
But, he added, "it is not on the baby not breathing call, it is not on that spectrum. It is on the other end" in which the five-minute wait occurs.
The problem facing the ambulance service, however, is that in recent years there haven't been enough volunteers to respond to BLS calls and more and more of those transports are going to County. There are 13 emergency medical technicians on the department but only about half are active and the volunteers often have jobs or other obligations to attend to at a given time.
The lack of revenue from the calls is coupled with growing costs to run the service. Patients are not paying bills, leaving an estimated $50,000 hole in the enterprise fund. For the last couple years, the ambulance service has had to dip into its reserves just to cover operations and has not been able to save for a new ambulance.
The squad will have to replace its ambulance in a couple years, at an estimated cost of $225,000. It currently only has $50,000 toward that purchase.
Firefighter PJ Pannesco said when the enterprise fund was created in 1990, the intent was solely to bring the insurance payments and patient billing into the account and save for new ambulances. But a handful of years ago, that was changed and more and more operational bills began to come out of the enterprise fund instead of the Fire Department's budget.
"We've also taken on everything from repairs, routine service, license, fees, two salaries, equipment, medical supplies, EMT classes, EMT recertification costs, EMT license renewal costs, EMT stipends," Pannesco said.
Selectmen Chairman John Goerlach said he didn't realize all of those additional costs were coming from the enterprise fund and not another budget line.
Pannesco called what has happened to the service the "perfect storm" leading to recent financial troubles. The uncollected bills piled up during the economic downturn while the price of supplies and licenses continued to grow.
But he believes the tide is changing internally. The squad has taken the lack of responses seriously. In November, there were 24 service calls and the town handled 11. Of the 24 calls in December, the town handled 18. And so far in January, it has handled seven of nine.
In those three months, the department says it is now handling more than 60 percent of the calls. That is a drastic change from the number Selectman Henry "Hank" Sayers has been hearing about the months and years prior. Sayers said Lanesborough had been only answering 25 percent of the calls.
"You can't ask another ambulance service do 75 percent of your work," Sayers said.
The Selectmen came up with a solution to avoid the eventual need for taxpayers to purchase an ambulance.
The idea from Sayers and Town Manager Paul Sieloff is to park the Lanesborough ambulance, have County take over the transportation, while the department's first responders are still called to the scene to stabilize a patient. It would take the town out of the game of billing, collections, and keeping up with the ambulance purchase and repairs.
But it would also cut off the revenue stream.
"We could get an many EMTs as possible and have the people available to race to somebody's house and provide that aid," Sieloff said.
Deputy EMS Chief JD Hebert countered saying, "everything crucial happens in the back of the truck." Hebert says every business and non-profit goes through ups and downs and this is just one of the downs. He fully expects the service to be able to turn things around.
EMT Daniel Bolognia said the Selectmen's plan would take the squad completely out of the billing and therefore would not receive any income to replace medical supplies. He said in one response, the town could use a $600 epi-pen and then there'd be not money to replace it.

Butch Garrity provided an outline of the current operations.

Pannesco presented a few options to help stabilize the squad:

1) Charge all additional costs such as trainings and licenses to the Fire Department's budget. That would require an increase in that budget line that would be paid by the taxpayers;

2) Recruit more EMTs. The Fire Department didn't take volunteers for just EMS, but it is opening the door to those volunteers now. That also includes sending a seasonal highway worker to training to have him be available during the work day.

3) Reallocate the $10,000 line for firefighter stipends to staff EMTs during the weekends.

4) Request an extension from the state to continue to use the current ambulance instead of buying a new one right away.

"The bottom line is we want to continue to provide medical service, ambulance service to the community," Pannesco said.
Sayers said the only way he'd consider taking the volunteer firefighter stipends away is if every single member of the department agreed.
He also added that the Selectmen have tried to help the squad out. It has asked around in town departments for anyone willing to become EMTs to little avail, finding only the one volunteer in the highway department. That concept was to have town workers available during the day.
Deputy Chief Jeff DeChaine said the department has been recruiting new EMTs and has two in classes now. The department just found out the insurance costs to bring on more and is looking to increase its staffing numbers.
"We made a hell of an effort in the last three months, we have more people coming," DeChaine said. "We are trying to hold up our end of the bargain and get back to where we need to be. I don't see how pulling the plug now and going to something different is going to be better," DeChaine said.
Others questioned how long County would provide the service for free. In the past, private ambulances have charged towns to become the primary and if Lanesborough is shut down, it puts the town in a tough situation when renegotiating the contract. 
"No cost being involved today does not mean no cost further down the road," resident Dominica D'Avella said.
In the midst of all of the talk about money, Town Clerk Ruth Knysh remembered the night her mother had a seizure. Lanesborough was unavailable and County took 45 minutes to get there. Whatever the ultimate decision is, the focus needs to be on patient care, she said, and not on the finances. 
"For me to go through that and then have to hear about it [happening] again, something has to change and I don't know what it is," she said. "Unless you've been there with one of your family members, you don't know how it feels to be waiting."
Pannesco responded by saying that is exactly why it is best to have as many ambulance rigs available as possible.
Another option floated could be the town pursues a waiver from the state from the obligation to have two EMTs respond to every call and instead have just a driver and an EMT. That would allow for more responses as well. Hebert said to do that without approvals would be a violation of the license he has spent years protecting, so not really an option he is looking to entertain.

The long meeting at the Fire Station ended with an agreement that the Ambulance Squad would continue to collect more information and data and return to the board in a month. 

Tags: ambulance service,   EMS,   

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Lanesborough Planning Board Extends Solar Permits

By Jeff SnoonianiBerkshires Correspondent

Representatives of solar developer Engie North America address the Planning Board on Monday night.
LANESBOROUGH, Mass. — Solar power was the topic of the evening at the Planning Board meeting on Monday night as the board extended permits for three large commercial solar operations. 
Engie North America Inc. was seeking an extension to special permits previously issued for projects at 405 South Main St. (Skyline Country Club), 550 North Main St. (Pillar LLC), and land on Partridge Road owned by Petricca Development. The substantial use permit expired on Aug. 20 and the company is seeking an extension to the end of the year. The extension was made necessary by recent snags in obtaining the panels.
"We can get the panels, but in mid-June there was an exemption that was put in on bifacial (two-sided) solar panels to the tariffs that are being imposed on imported solar panels," said Matt Singer, project developer for Engie. "What that did was really turn the solar module market upside down. We were pretty far along with a supplier, ready to finalize a deal, then the market changed overnight and [the supplier] essentially backed out and we had to line up a new supplier. Which we did."
All the sites had minor issues that were addressed by Engie.
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