Politics

Brattleboro’s EMS takeover study, launched for answers, sparks more questions

The ambulance bay at Brattleboro Memorial Hospital. Photo by Kevin O’Connor/VTDigger

BRATTLEBORO — Town-funded consultants and the region’s main emergency medical provider concur on a key finding in a $39,000 review of local ambulance options: All provide quality care.

If only they could agree on everything else.

A new feasibility study by Wyoming’s AP Triton consulting firm concludes that Rescue Inc. — Windham County’s largest and longest-serving ambulance service — is the most economical choice for maintaining current local coverage.

In comparison, a proposed Brattleboro Fire Department takeover of EMS duties would increase costs, but would also bolster the town’s understaffed system of crisis response, the report found.

“I think they’re all going to provide good service,” Rich Buchanan, an AP Triton senior project manager, told VTDigger. “The only caveat to be considered is that the department, strictly for the provision of fire service, does not have enough staffing to meet any national standard. There is a benefit to adding firefighters who can serve dual roles.”

As for the price tag? AP Triton researchers and Rescue cite significantly different totals, leaving taxpayers with their own questions as the town prepares to discuss the issue Feb. 7.

‘A great deal of detail that still has to occur’

The Brattleboro Selectboard surprised residents last spring when it voted with little public notice or debate to drop the town’s nearly 60-year contract with Rescue, a private nonprofit, and hire competitor Golden Cross Ambulance to help the fire department pick up EMS duties.

Local leaders at the time claimed the plan would not only cost less than Rescue’s $285,600 annual fee but also reap an estimated $500,000 to $700,000 in yearly insurance revenue after expenses.

“After a careful internal analysis of the feasibility of the Fire Department taking on EMS, I felt that not only can BFD provide a high level of service after a year of transition, but it also makes financial sense,” said then-Town Manager Octavian “Yoshi” Manale, who abruptly resigned eight weeks later under an agreement that included a $72,515 severance package.

Manale told the press that his experience working for the city government of Trenton, New Jersey, “gave me a perspective that I believe my predecessors did not have.” But his revenue forecast hasn’t panned out, as documented by financial figures six months into a test run, as well as by AP Triton.

According to the feasibility study, if Brattleboro adds enough fire department employees and equipment to cover all EMS calls, it would collect an estimated $935,626 in annual insurance payments but still need to pay more than $300,000 a year beyond that to cover $1.2 million in expenses — a figure higher than the most recent Rescue contract.

The only way the town could save money through an EMS takeover, the report said, is if it cut its current level of service.

But Rescue questions whether AP Triton’s cost projections for any town model capture all required spending, which it believes could leave taxpayers with a bill even higher than projected.

AP Triton’s firefighter salary numbers, for example, are based on a current contract set to expire June 30. The selectboard is proposing a 2023-24 budget with a 4% cost-of-living adjustment and, after that, will enter collective bargaining with workers to determine how much more wages and benefits will rise July 1.

Rescue, which regularly replaces its 11 ambulances and equipment, also wonders why AP Triton’s town takeover estimates don’t spell out such expenses as training, certification, inspections, equipment from stretchers to disposable supplies, and an annual state provider tax payment of about $30,000.

“I know our numbers are accurate because we just cost this out to put another ambulance on the road,” Drew Hazelton, Rescue’s chief of operations, said at a recent public meeting. “It’s very expensive equipment and has a very short life.”

In response, AP Triton said it stood by its financial figures — yet added the numbers were estimates aimed at helping the town pick an option and then piece together a more specific budget.

“We have a reasonable idea — enough to start making a discussion on the cost of running a system,” Buchanan told VTDigger. “There’s going to be a great deal of detail that still has to occur.”

‘An analysis based on what was available’

The selectboard approved the EMS change long before requesting, let alone receiving, the feasibility study.

When board members approved the transition plan last April, they voiced concerns about Rescue’s costs as well as what they called an “incendiary” tone of a March 25 letter from the provider seeking an update.

“It’s our job to negotiate contracts that are best for the town,” Selectboard Chair Ian Goodnow said at the time.

Added fellow member Elizabeth McLoughlin: “We’re the town and we can hire contractor A or contractor B. Contractor A sent us a nasty letter, so we go with contractor B.”

But since dropping Rescue in July, Brattleboro has spent enough on unanticipated expenses to eat up the promised savings. Local leaders who focused on finances in the spring pivoted over the summer to professing the need to consider greater municipal control.

“It was never all about the money,” board member Tim Wessel said once the switch drained the expected surplus last September — four months after he deemed the supposed cost-cutting move “a good path, but I am perfectly willing to eat those words if it turns out this is not.”

The selectboard has moved on to focus on the feasibility study’s assertion that average response times by the fire department are five minutes faster than those by Rescue. But the latter agency questions the accuracy of AP Triton’s figures, which it didn’t provide.

Rescue, presenting its own numbers at a recent public meeting, calculated its average response time is only 71 seconds behind the fire department.

In reply, AP Triton said it stood by its findings — yet cautioned they weren’t foolproof because Rescue didn’t participate in the study.

“I would have been able to do more accurate analysis had they been forthcoming and given us their data,” Buchanan told VTDigger. “They simply did not. Therefore, we had to make an analysis based on what was available to us.”

AP Triton questioned why Rescue was withholding information. Rescue, for its part, said it had lost trust with local leaders after the town severed their six-decade working relationship yet tried to blame the agency — starting with an April 11 municipal memo the town later acknowledged was “flawed” because of “inartful drafting.”

(The “flawed” admission came when local leaders, calling for Rescue to be “transparent,” denied a series of VTDigger public records requests for any and all paperwork behind their EMS decision.)

Rescue added it wasn’t questioning the AP Triton study in an effort to return Brattleboro to its fold. The agency has filled the town void by signing contracts with the Vermont Department of Health and the community’s two largest medical facilities, Brattleboro Memorial Hospital and the Brattleboro Retreat. It’s also busy running its new Vermont EMS Academy, where students include Brattleboro firefighters.

AP Triton is scheduled to answer questions at a Brattleboro Selectboard meeting on Feb. 7. The session is expected to draw interest from both taxpayers and the town’s citizen Finance Committee, which is generating its own list of inquiries.

The consulting firm said the high level of local debate and division is unusual.

“Most communities lean toward wanting to have public service,” Buchanan told VTDigger. “In contrast, Rescue Inc. has been providing good care and they’ve been around a very long time, so I think there’s more of an affinity for the organization. That means you have more options. But you’re just getting started here. The community has a lot of things to figure out over the next year.”

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Kevin O'Connor

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