Lanesborough Seeks Advice on Ambulance Service
LANESBOROUGH, Mass. — The Select Board queried emergency medical service officials on Monday about the challenges for the town ambulance and what could happen if it upgraded its services — or shuttered.
In March, town officials and residents questioned the need for 24/7 service and when EMS Director Jen Weber presented her budget.
Berkshire Health Systems EMS Coordinator Crystal VanDeusen accompanied Weber to help answer the board's questions. One of the main talking points was the difference between Advanced Life Support (ALS) and Basic Life Support (BLS) and the cost.
Currently, Lanesborough service is BLS and officials were told switching to ALS it would be expensive.
"An ALS service, just to outfit an ambulance alone, would be between [$800,000] and $900,000 an additional amount of about $150,000 would be equipment. So that point you're looking at, you know, over a million right there," VanDeusen said.
"That does not include staffing that ambulance. Currently, paramedics start somewhere between $30 and $35 an hour, depending on where you go. And honestly, being where Lanesborough is situated in the community, and having such a strong BLS service, it doesn't really financially make sense to go an ALS route, given that you have Northern Berkshire, obviously, to the north and County and Action in Pittsfield, and having short transport times."
However, she said, there's a high enough call volume that staffing 24/7 makes sense, adding recently there had been some "pretty high acuity calls" but the service was able to get here quickly and save the patient. Wait times are critical for patients where having a fast response from BLS is better than having to wait longer for ALS.
"In terms of patient care, BLS is going to do everything that ALS would start with, the basics and bread and butter of EMS is ABC — airway, breathing and circulation — and that's really what BLS services hone in on so everything that would accompany ALS, BLS could do for the patient immediately," she said. "Those are what's going to save somebody's life."
In response to questions about the status of EMS in North and Central Berkshire, VanDeusen said the closure of Adams Ambulance more than two years ago put a strain on the system. Northern Berkshire EMS had to hire additional staff to cover Adams and Cheshire "and still today, their struggle is to provide as immediate care what Adams Ambulance would have provided, and losing the service would be detrimental to the area."
"Jen can share how many times she's gone mutual aid to Pittsfield, but I've reached out to Lenox Ambulance, and in just the last year, they've gone 35 times mutual aid to Pittsfield, and that's a pretty staggering number for a service who now has two ambulances and is very busy, taking them out of service from their area is crucial," she said.
Weber said Lanesborough has provided mutual aid to Pittsfield some 60 times last year, with the occasional mutual aid from Pittsfield but most of those calls are because they need a second ambulance on scene. The town's service helps to cover a certain portion of Pittsfield and each of the towns were given a "slice" of the city to help cover if needed.
"So the section that Lanesborough covers is a very typically higher acuity, higher call volume than the other sectors," she said. "So we see almost double what Lenox and Dalton see. We have Hillcrest Commons. We have a lower income area around Wahconah Street that uses the ambulance significantly. So we're about double what they're doing last year, though, just for Pittsfield, we were 60, so right on, right on tap with what Lenox is saying."
Select Board member Jason Breault suggested the town should be investing in its ambulance service, saying taking another service out of the mix would not be a good situation.
"I think just people need to realize this the state of what we are dealing with right now," he said. "There's a reason why I know this stuff. I used to be the dispatch supervisor at the Berkshire RECC [Regional Emergency Communications Center], and on a daily basis, we were dealing with calling for mutual aid for Pittsfield. ...
"I don't think it's that hard to try to keep something in place, you know? I think it's harder once we lose it to try to bring it back. And that's my personal opinion."
In terms of salaries and 24/7 coverage, VanDeusen said she thought most if not all services with full-time emergency medical technicians had 24-hours shifts with starting pay of $25-$26 an hour. This allows EMTs to work more than one job and is considered a draw for staffing.
"We have talked a lot about scaling that back, at least from the hospital perspective, what that might mean, and there's been a lot of naysayers that they would end up having to leave and go to different services out of our area because of that change," she said.
Select Board member Michael Murphy said its challenging to balance what the town can afford and how much the aging population is relying on EMS.
"We're finding that in a lot of our towns, baby boomers are coming of that age where not everything's going right anymore, and we have less younger families who are in this area, lots of second homeowners who are coming here to retire and so, yeah, it's been a challenge," VanDeusen said.
Weber also said other municipalities like Egremont, Great Barrington and Monterey are investing in their own ambulance service because the private services they pay for are not enough to help cover.
She said, in response to questions, that regionalization conversations need to happen but she wasn't comfortable broaching them until the service was 24/7.
"There have been a lot of conversations that are happening about this, but I'm uncomfortable offering 16 hours a day to a town, especially if we're going to ask them for some kind of compensation for that," she said. "Once we can really put something into play, and you can show other towns that it's successful, I foresee it getting bigger and making more sense, and maybe that becomes the standard for Berkshire County."
Weber said the goal was "just want the patients to get the ambulance the quickest. It doesn't matter what it says on the side [of the truck]. ... I'm happy that somebody who's calling for help is getting an ambulance. To me, it is not important where it originates from, or who, who the person is calling. And I think that's regionalization, that's the whole structure."
She also pointed out the EMS hosts free classes on cardiopulmonary resuscitation, "stop the bleed," and certifies police officers, making it easier to work together on calls.
The meeting started with a letter from one of the EMTs that strongly supported Weber for her many of skills and generosities. While only that letter was read by Chair Deborah Maynard, she said there were a lot of other letters to the board that were both for and against Weber and Lanesborough Ambulance.
Tags: ambulance service, EMS,
