The Warrant Committee and the Board of Selectmen held a joint 2.5 hour meeting last night with about 25-30 residents to discuss how to best proceed with the advanced life support (ALS) issue at the annual town meeting (ATM). The collective wisdom of the all town officials (all the Warrant Committee and selectmen) was to create an ALS Study Committee to gather all the data, to figure out the best solution, and to report back on how the town should best provide ALS services.
Currently, since the private providers ceased providing our ALS intercept services several months ago on short notice, the town provides paramedic service by means of ALS intercepts with ambulances staffed by paramedics from Westwood, Walpole, and Norfolk via the mutual aid that fire departments render to one another. ALS intercept services are the ALS ambulance from one of the other towns meeting the Medfield ambulance en route and transferring the patient to the ALS ambulance to complete the transfer to the hospital. Medfield then splits the monies from those ALS intercept calls with the other towns. It is expected that mutual aid will continue until the Town of Medfield solves how it will provide ALS on its own.
The Warrant Committee presented the issues as it has determined them, and unanimously recommended the creation of an ALS Study Committee to better define the best solution. The following was the Warrant Committee’s written report:
ALS Options Overview
BoS/WC Joint Working Session, April 10th, 2017
As Is For A Very Limited Period – ATM, 2018
Rely on mutual aid to provide ALS intercept
(while evaluating an optimal long term solution)
Financial: Potential $25K to study committee
Service: Same as we have been receiving for several months
Uncertainty: Not a long term solution
Contract ALS
Hire a service to dedicate ambulance and medics to Medfield
Financial: $600K budget
Service: Equivalent to hiring medics
Uncertainty: Control of resources, Potential sharing of costs & services
Hire ALS
Hire medics and equip current ambulance to accommodate ALS service
Financial: $750K budget (Cost of hiring plus $90K to equip ambulance)
Service: Response time fast (assuming no concurrent calls), utilization low
Uncertainty: # of hires/level of coverage, who hires/trains,
cost may be higher due to estimates for benefits/OPEB
Regionalize ALS
Share resources (either hired or contracted ALS) with other towns locally
Financial: Unknown – but lower than other long term options.
Potentially 1/3 to ½ of cost of other solutions – or profit center)
Service: Response time fast (assuming no concurrent calls), utilization higher
Uncertainty: Partners, cost sharing, location of ambulance
Selectmen Marcucci proposed asking the annual town meeting (ATM) to vote to approve about $650,000 of monies to implement the ALS services, and to just leave the form of the ALS services to be implemented in the discretion of the Board of Selectmen. In that scenario, the Board of Selectmen would first get the ALS study results, and then implement on what is proposed. Selectman Murby seemed to agree with that proposal. I prefer to give the town residents the right and opportunity to vote the ALS monies once the Board of Selectmen determines and presents to the residents what the Board of Selectmen thinks is the best ALS solution. However, if the residents opt to trust the selectmen with the monies now to make the best ALS decision later, I am happy to execute on that trust.
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