ALS


ambulance

Yesterday afternoon from 6-7 PM before the regular meeting of the Board of Selectmen there was a well attended session that was billed as a working meeting of the Board of Selectmen with Chief Kingsbury and Lieutenant Bennotti of the Medfield Fire Department to discuss the possible solutions for the town to the provision of Advanced Life Support (ALS) services to town residents. The MFD currently only provides intermediate basic life support (EMT) ambulance services to residents, and only one of the current seven full time firefighters is a paramedic.

One firefighter recently resigned, and will be replaced with a paramedic, however, until the whole service is staffed with paramedics, the two paramedics will not be able to provide paramedic services.

The ALS session was not covered by Medfield.TV – I do not know why not, as I was not involved in making that decision.  Personally, I would have put it on TV.

Basically the Chief and the Lieutenant

  • expect that the MFD will have increasing problems in the future staffing a call department,
  • expect the current towns providing the ALS intercept services (Westwood, Walpole, and Norfolk) as tiring of doing so if we are not making efforts to solve our situation,
  • see no likely chance of doing a regional ALS with other towns (Dover and Sherborn are the logical ones),
  • generally see no interest in current EMT’s becoming paramedics,
  • see the cost of using a private ALS provider as similar to the cost to expand the MFD (they have been quoted $600,000 per year, plus $250 per run by private providers), and
  • therefore that the best solution is for the town to hire eight new full time firefighter/paramedics at a cost of about $650,000 per year, plus start up costs.

Whether to hire the paramedics will be a decision for residents to make at at the annual town meeting (ATM).

Below are the Chief’s cost projections:

* lIJ) RAIF'f * ALS Paramedic Budget Proposal (Estimated) Based on hiring 8 Firefighter Paramedics (Step 4) 2184 hrs (42per wk x 52) x $25.62 = $55,954 per $55,954 x 8 = $447,632 Additional annual personnel costs: Medic Stipend - $6000 x 8 = $48,000 Vacation - 96hrs x 8 x $38.50 = $29,568 Sick Time- 72hrs x 8 x $38.50 = $22,176 Holidays -11x8 x 10.5 x $26.62 = $23,673 Personal Time-31.5hrs x 8 x $38.50 = $9702 Clothing - $600 x 8 = $4800 Cleaning - $3 00 x 8 = $2400 Town share health care - $50,000 Town share Medicare - $6500 Annual Estimated costs - $644,451 One time startup costs: Protective Clothing- 8 x $3200 = $25,600 Uniforms: - 8 x $600 - $4800 Medical Equip - $60,000 Estimated startup costs - $90,400 Year one estimate - $734,851 Annual Medical Control Fee $10,000 - Revolving Acct (pay $5000 now)

I suggest that these figures do not reflect the true cost to the town of the additional employees, as these estimates do not include the present value of the future retirement benefits the town will ultimately have to pay.  Those retirement benefits (i.e. pension and health care) are called Other Post Employment Benefits (OPEB).  To truly tell us the cost, the estimates should include the present value of the actuarial costs we incur each year to pay future retirement benefits to such employees.

The town was only recently required to figure out the value of its OPEB liability. Currently the unfunded actuarial cost for the town’s OPEB is over $40m. OPEB costs currently cost the town about $1.5m. per year, and the town only just recently (a couple of years ago) started to budget $400,000 a year to pay into a trust fund to partially cover the future OPEB as they come due.  Therefore the town is still adding over $1m. a year to its OPEB liability, which is basically pushing off current town costs to be paid by future residents.

OPEB benefits to retired former town employees were until relatively recently not funded at all while those retirees were working, and even now the town is not fully funding its future OPEB liability.  As we add new town employees, we may want to include the OPEB liabilities in our cost estimates.

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4 responses to “ALS

  1. thank you for this.

    Like

  2. Stephen Callahan

    Pete, Thanks very much for this update. I have a question. You mention “generally see no interest in current EMT’s becoming paramedics,
    see the cost of using a private ALS provider as similar to the cost to expand the MFD (they have been quoted $600,000 per year, plus $250 per run by private providers), and therefore that the best solution is for the town to hire eight new full time firefighter/paramedics at a cost of about $650,000 per year, plus start up costs.” What happens to current EMT’s if they have no interest in becoming paramedics? Do they get terminated? If so, is there a cost to terminating? Is cost analysis above for eight paramedics incremental to existing cost of EMT’s? Is there a savings if EMT’s get terminated and if so how factored into analysis? Best, Steve Callahan

    Like

  3. Selectman Osler "Pete" Peterson

    There are no terminations planned. The Chief’s plan is to add 8 new paramedics to the existing 7 EMT’s so that we will have a total of 16 full-time firefighters (after we replace the recent retirement). So the town will move from the current two firefighters per shift to four per shift, of which two will always be paramedics. We were told that one current firefighter is interested in becoming a paramedic – the rest will continue as firefighter/EMT’s. This discussion has only just begun, as in addition to the Board of Selectmen it has to get vetted by the Warrant Committee and voted at the annual town meeting (ATM) to happen.

    Like

  4. Stephen Callahan

    Thank you. You make an excellent point on retirement (pension and health) benefits.

    Like

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