Consolidation of Community Ambulance Service

The East Windsor Ambulance Association believes regionalization of EMS services is the future of EMS Connecticut. Combining services or particular functions of EMS provides the efficiencies and cost saving required to compete in todays EMS economy. Small  and medium sized EMS services must be proactive and prevent commercial ambulance services from offering your town government an offer that they will not refuse.

Communities leaders and taxpayers are demanding a high level of EMS service while eliminating their own financial obligation to subsidize it. This can be done because of increased commercial ambulance competition for 911 emergency service. Private for profit companies offer pie in the sky proposals for coverage with no evidence it will hold up their side of the bargain.

Several communities have replaced longstanding community EMS systems in favor of the for profit commercial option. The reason for this actions was their community service could not or would not provide the advanced level of care required of their community. And they would not provide their service without tax revenue. The community ambulance faced commercial ambulance services that put the zero cost bid option in play to force the hands of municipal leaders.

In  addition, this past year, the way PSA assignments of Emergency Medical Services in Connecticut has been changed in a way that will negatively affect most smaller EMS providers. The change to Primary Service Area (PSA) designations, gives a municipality the ability to now reassign the PSA to another service for practically no reason.

To prevent a takeover from aggressive commercial ambulance service actions, your service must provide paramedic level care by your own personnel, you must do it at almost no cost to the taxpayer, and you must provide this service without almost no mutual aid to your community. In East Windsor, we have done that and done it well.

So I have created a sort of simple self-assessment would be to ask yourself 10 simple questions;

1. Is your organization financially sound for the foreseeable future without receiving town funding?

2. If you receive the following from your town government; insurance, worker’s compensation coverage, housing, fuel, fringe benefits, and payroll, could you afford to do it on your own?

3. Do you provide full time employment benefits to the majority of your staff?

4. Are you passing more than 5% of your emergencies to other providers?

5. Are all of your calls that require a paramedic getting one? 

5. Are your patients receiving a paramedic intercept bill? 2 bills? or bundle bill?

6. Are you frequently having to send a paramedic to Basic Life Support calls?

7. Do you consider your response times for all of your calls to be excellent? Less than 10 minutes from the time of the call?

8. Do you have enough staff to cover all of your shifts? 

9. Is all of your equipment state of the art and up to date?

10. Is your service in close proximity to a for profit commercial provider making you vulnerable to a bidding war?

11. If a microscope was placed on your service could you survive the scrutiny with a commercial ambulance company breathing down your neck?

12. Could you survive a competitive bidding process that would have strict response requirements and resource requirements, no municipal funding or supplements, and can you provide a competitive employee package to all employees?

Your effectiveness as a service will be determined by the answers to these questions. These are the questions your municipal leaders will ask. Our service has addressed most of these issues and ensured we are in a the right place.

Our service provides for a non profit alternative with a proven track record of high qualty care, above industry standard response times, and a call pass rate of less than 3%. It is done with all paid in-house employees. we do this without taxpayer funds. They provide us a small facility and pay our utilities.

It has also been demonstrated that many communities will make changes regardless of your community support. The Town of South Windsor has already eliminated their service after many loyal years of service. Glastonbury is on the verge of doing the same.

It my belief that the creation of a larger more efficient non profit regional initiative is what will prevent communities from leaving their community ambulance services behind.

As a combined service we will provide each community a high quality paramedic service without direct tax revenue. The fiscal status of our state and our towns are not likely to improve anytime soon. 

To that end I encourage any forward thinkers in community ambulance services or municipalities to explore the idea of consolidation or contracting with us and contact me to talk it over. Similar non profit services are the best fit but we will explore any possibility. Proximity is irrelevant because much of the savings would occur in the no staff functions such as insurance, maintanence, billing, and the like.

I look forward to hearing from you.

Emergency Medical Service Chief Paramedic Chief Thomas Clynch  

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