This commentary is by David Petrie, a resident of Brattleboro who has worked in the communications field for over 25 years, although he is retiring this year to take on new professional challenges.
The Town of Brattleboro/Rescue Inc. contract dispute has led me to comment on social media more than I have in years. While many reading my comments may think I’m all for the town of Brattleboro taking over the EMS service for the town, I don’t think either side has provided enough information for anyone to know what is best for our community.
I was first lured into the story by the notion that the town would sever ties with a longstanding service provider. Comments could be sorted into two buckets: “How could Brattleboro think this is a good idea?” and “It’s about time.” I wasn’t ready to commit to either side, but I was interested in seeing how things played out.
Rescue Chief of Operations Drew Hazelton’s March 25 letter to the town, published in Kevin O’Connor’s April 12 story, hooked me completely. I’m a communications professional with years of experience crafting institutional messaging. Hazelton’s letter expressed an anger often unseen in messaging coming from an organization, because that anger is often removed through multiple drafts — and for good reason.
At the end of his letter, Hazelton draws a line — we’re not going to provide service unless Brattleboro comes back to the table for more discussions. Brattleboro said, “It’s been nice doing business with you.” This is an understandable response considering the tone of the letter, and a response that will likely have a devastating effect on Rescue Inc., its employees, and the surrounding communities.
Hazelton’s letter should have cut the accusations and replaced them with sound business reasons regarding why Brattleboro doesn’t want to get into the EMS business. Like the fact that while Brattleboro is currently providing 25% of Rescue’s budget, Brattleboro accounts for 35% of the permanent residents the organization serves, which likely points to a cost savings tied to Rescue’s ability to operate at a larger scale.
That population statistic took me about 15 minutes to figure out, using combined census figures for all the member towns. It’s such a strong figure that it should likely be repeated in all of Rescue’s annual reports for the town instead of the vague platitudes that Rescue serves up as an annual report for Town Meeting Day.
There are many, many other facts that we need to have to decide whether this change will be good for Brattleboro, and the town is failing here as well.
A quick internet search turns up a 2015 article on the National Volunteer Fire Council site about the factors that towns need to consider before providing ambulance service. The article provides a great outline for creating a business plan. What are the call volumes, the number of calls where transport isn’t accepted (can’t be billed), or the number of uninsured (can’t pay) or Medicaid (low pay) patients or Medicare or private insurance patients (high pay)?
How many employees will need to be added, both to provide the service and for administrative tasks like billing private insurance, the government, and/or private individuals and chasing down bad debt?
These are all factors a bank would consider in determining risk, and without them the request for funding would likely be declined. The town doesn’t even mention these factors in its plan, nor does Rescue anywhere in its reports or communications.
At the end of all the posts and comments I’m only pretty sure of two things: Perhaps Brattleboro’s town manager, selectboard chair, and Rescue Inc.’s chief of operations shouldn’t be left in a room alone because it appears anger played a big role here. And the selectboard should reject the contract to change service providers due to lack of information from both sides.
From a business perspective, the internet again shows that ambulance services — even the huge for-profit ones — work on tight margins. The writer of the 2015 article tells us his Massachusetts town loses significant money every year on its ambulance service. Could Brattleboro see the same fate? There’s a lot of work that needs to be done to convince me this will be a boon and won’t be a bust.
Perhaps a mediator needs to get the sides working together, and fast. Hazelton did leave the door open to negotiations in his March 25 letter. In the meantime, the town can do the difficult work assessing whether Brattleboro should start an ambulance service and prove out the true costs and potential profits — work that will likely take months, not weeks. We can decide that next year.
And going forward, Rescue’s board can help the organization’s leadership learn how to best communicate the benefits that are provided to each member town and why transparency can help build customer loyalty. So hopefully we don’t end up in this debacle next year.
