MA mall asked to help pay for ambulance service...

[akflightmedic]

Ok, I found this article very amusing. I will bold what I feel are some key statements and then state my worthless opinion at the end.

Mall Asked to Chip in for Ambulance Service

By May Hickey - March 08, 2008

Lanesborough News

LANESBOROUGH - The Selectmen are hoping the Berkshire Mall will kick in funding for the town's Ambulance Service. The board learned at Monday's meeting that a quarter of the calls so far this year have been to the mall.

The board has been concerned about lack of coverage in town, especially after the closure of American Medical Response, a private ambulance service, last year.

For the past 10 years, the town has maintained an Ambulance Fund with revenue from use of the ambulance and from donations. The monies are used to purchase equipment and supplies for the ambulance service. The town-owned ambulance is usually replaced every three to five years. Replacement at this time yields the best trade-in value, say officials.

The ambulance service has been staffed by volunteer emergency medical technicians. There were two backup ambulance companies: AMR and County Ambulance. But last year AMR went out of business. Also, in the past few years, it has been increasingly difficult to find volunteers for weekday staffing, say ambulance officials. As a result, the availability of ambulance service in Lanesborough has been compromised.

To ease the situation, the Selectmen moved $30,000 from the fund to establish an account to hire daytime, weekday EMTs to staff the ambulance. State regulations require that two certified EMTs staff the ambulance.

Fire Chief Charles Durfee has been tracking ambulance calls since Jan. 1. So far there have been 16 calls; four from the mall. The purpose of tracking is to help establish a budget for the ambulance service. The cost of one ambulance call is about $400.

Payment comes from insurance, Medicare and other sources, but some users ignore billings and pay nothing.

The board has asked the Berkshire Mall to make a contribution since about 25 percent of ambulance calls originate there. Mall manager Joseph Scelsi attended the meeting but did not make any commitment on behalf of the mall management.

Durfee recommended that the board contact state Rep. Denis E. Guyer, D-Dalton, to discuss if some accommodation could be made to ease the requirement of having two EMTs for every ambulance call.

The Selectmen said they want to be certain that ambulance service is always available to Lanesborough residents. They are considering all options to ensure service.

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Wow!!!

They say a quarter, 25% of the calls are coming from the mall!! Holy crap! That is a lot of calls.

Oh wait a minute, it seems since January 1st, there have only been 16 calls total!!!!!

4 of which came from the mall. I found this very laughable that they want money from a business which happened to generate 4 of their 16 calls this year.

Give me a freaking break! I also imagine this to be a very small mall based on the fact we are talking a township, all volunteer service and only 16 calls in the area since Jan 1.

Anyways, if you notice one of the solutions proposed byt eh fire chief is to contact the state rep to see if they can avoid sending 2 EMT BASICS on every call. Instead of providing a paid service, they want to be able to lessen it by sending only an EMT and driver. Wow, what a freaking great idea!!

Also, they are trading in their ambulance every 3-5 years. I do not understand this. Yes, in a busier service this makes since in order to maximize resale profit, but in a service this slow, what are they thinking?

I am sure there is a mechanic on payroll for the town or one in town who would volunteer his services or work for a reduced fee to keep this precious resource up and running...right?

Seriously, there is no reason they could not keep a unit 10 years with the low call volume they are running, unless there are a lot of extra activities not mentioned. You know ,parade after parade, county fair, and joyriding about town probably takes its toll I guess.

[Dustdevil]

ROFL! What a bunch of extortionists. Let's see, our town is poorly managed. What should we do? Should we find some competent management? Nah, we wouldn't want any good ol' boys to get their feelings hurt. Hmmm... maybe we can extort some money out of the evil big businessmen. You remember them. They're the guys who already provide a quarter of the tax revenue received for this entire town. They're the reason that people don't leave this town in droves during the day. It's the only place in this godforsaken shytehole that anybody has any reason to go, and that is causing us to send one-quarter of our ambulance runs to their location. Sure, those people would have gotten sick at home if they weren't at the mall, still resulting in an ambulance run, but that's not the point! The point is, it's easier to put the mall managers on the spot on the front page of the local rag and extort some money out of them than it is to squeeze money out of an individual citizen, so that's our plan, and we're sticking to it!

Ya know, they could get a million dollars out of the mall, and I bet you they would still end up with an incompetent organisation, devoid of a single professional paramedic.

Idiots.

[JPINFV]

Well, to be honest, is there really that much that a CPR trained driver has to offer over a second EMT-B? It's funny because when I worked at a water park, all of the life guards were first aid/CPR/AED certified and trained in oxygen administration. Is there very much more other than that that a Basic can do, but not talk other people through [e.g. log rolling onto a back board]? I'll admit that I never had to work a code there, but I imagine that it wouldn't be too hard to get someone who knew how to do compressions while waiting for EMS based fire suppression to arrive.

[CBEMT]

devoid of a single professional paramedic.

To be fair, if I was a professional paramedic looking for a job, why the eff would I want to work there? Sixteen calls in three months? I didn't get into EMS to keep a recliner warm.

[Just Plain Ruff]

What I found to be most funny is the statement that AMR went out of business.

What really happened was AMR realized it was a losing proposition to pay for a emt and a medic to staff a town that runs less than 60 calls a year if you extrapolate the math.

they shut their station down but didn't go out of business, if they did go out of business my wifes cousin would be calling me to help her get a job at the places I used to work.

Are they gonna go after the nursing home that generates 25% of their call volume which I'm sure that the nursing home does just that maybe even more. In the small town where I used to work population 560(salute) we had 1 nursing home and one psych facility. We ran fully 1/3 of our calls from the nursing home alone. So should we have gone after the nursing home to fund our service. Would have been nice to have a brand new ambulance every 3-5 years.

[Dustdevil]

To be fair, if I was a professional paramedic looking for a job, why the eff would I want to work there? Sixteen calls in three months? I didn't get into EMS to keep a recliner warm.

LOL! True. But rookies aren't who ought to be working in such a low-volume system anyhow. Trust me, there are plenty of guys with five years in a busy urban system that are more than ready for a recliner job like that. I know I was.

Good points, Ruff. I also found that AMR remark funny, and probably intentionally disingenuous. I hadn't thought of the nursing home angle though! I bet you're absolutely right about that. How are they going to justify the disparity in treatment between the NH and the mall? I'm betting they can't.

[Doug]

Ok, everyone, for once I actually have first hand knowledge of whats going on here. I live in the next town over from Lanesboro (local spelling.) And I used to work for the AMR that was mentioned and I currently work for County Ambulance that is also mentioned.

First, Ruff, try not to jump to conclusions. AMR was not located in this town, it was located in Pittsfield MA (pop. @45,000) and along with County was the primary 911 coverage for Pittsfield. In addition to these services we did (and with County we still do) provide ALS intercept and mutual aide services for @2/3 of Berkshire county as well as bordering NY towns. We also do transfers but that's besides the point. There are no NH in Lanesboro so your point there is moot. I will agree however that management at AMR Pittsfield/Western MA ran the place into the ground and ignored warnings of lowering call volumes for us and increased business to our direct competator.

I am willing to bet that that call volume of 16 calls since Jan. 1 they are counting calls which they had no response and County covered the call by provideing mutual aide (I did one call that they toned out 3 times, to the mall of all places, that 1 person of unknown level from LFD showed up in POV) so their claims of 16 may even be exagerated. I would also like to note that the trucks they are buying and tradeing are the diesel guzzleing monstrousities that look like they should be towing a trailer on a cross country haul, god forbid these small towns buy something more reasonable.

Sadly Massachusetts seems to be leading the way in it attempts to lower minimum staffing standards for ambulances. Deerfield MA, has attempted several times to reduce their staffing to 1 emt 1 cpr (no i didn't mean to type CFR i meant CPR) because of claims that they just can't get the crews.

I do find it funny as well that on another post people complain about vollys, yet to paraphrase CBEMT...he wouldn't want to work in such a low call volume area.

AK where did you find the article...there is no Lanesboro Newspaper.

AGAIN NO NURSING HOMES IN LANESBORO.

[Just Plain Ruff]

But Doug, I've worked for AMR in two different areas in missouri. Both areas were good areas.

I know that if an area is not a money maker for AMR then they leave. Simple as that. If theres no money to be made then they get out. You cannot deny that fact.

Plus, if there is money to be made AMR is more than likely one of the first services to jump in and fill the need plus their pockets.

You are right, jumping to conclusions I did but since you know the area I'll bow to your experience. I hope you didn't take offense to those generalities.

[Doug]

I just thought of something...by the standards that LFD is setting, ambulance services should be able to bill more for it's frequent flyers, because they use the ambulance proportionatly more than most people, we have a few that MUST make up 2-3% of our call volume by itself. LOL

Also, if it weren't for the mall these people wouldn't have been in Lanesboro in the first place having whatever emergency they were having, thus reducing the billing by $1600 (4 mall emergencies times $400 apiece)

[medicstudent1256]

Ok first off I live in this county(Berkshire County MA) and I also worked for AMR before they closed our division and laid all of us off and I currently work for County Ambulance both of these services are located (or were located) in Pittsfield the largest city in the county..neither of these services ever staffed the town of Lanesboro it was always under a mutual aide agreements along with several other small communities south of Pittsfield and currently County Ambulance is the only ALS service for these small towns. When AMR closed its doors on Dec31st 2007 there was only 22 employees left myself being one of them...the whole county was scrambling because no one had any idea what in the world was going to happen with the void AMR left Lanesboro at that time decided they needed to have full time day coverage it is a very small town with the mall being a huge part of it just due to lack of residents. There was offers to the ex AMR employees from all over..the paramedics were being seriously bargained with County was the only service that was able to come up with the $$$$ so in turn Lanesboro had to offer $15.00/hr just to get anybody to apply this is for basic level service..I believe they wound up with all ALS providers anyway but it is also just on a temporary basis and it isn't the primary job for anybody thats there some of them also work for County. There is a serious lack of professional EMS providers in this area and the days of the volunteer are over (unless you are dedicated like my partner who volunteers in his hometown...but i personally just don't have the time). I personally believe Lanesboro just plain jumped the gun as far as needing full time crews during the day but like i said the whole county was in a panic from AMR leaving...but the primary point that the article didn't mention was that the mall at one point in time requested/demanded that the ambulance in Lanesboro be on "stand-by" at the mall once to twice a week and for the crews to be in the mall doing B/P's etc for the shoppers...don't you think that if they want that type of dedicated truck and crews that they should be responsible for covering the cost?