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SPENCER – Representatives from Action Ambulance Service Inc. described their plans and pricing for Spencer if they are selected to provide emergency medical services starting in 2026. The interaction occurred at the last Board of Selectmen’s meeting and followed a presentation earlier in December by Cataldo Ambulance, another bidder for the work.
The town is simultaneously weighing an offer to make Spencer Rescue Squad a town department.
Michael Woronka, co-owner, president and CEO, along with members of his team, noted its proposal includes offering a 24/7 advanced level service (ALS) ambulance in the first year for free. A second ALS vehicle, working 12 hours, would amount to $394,459 in the first year, with 3% increases year-over-year for inflation.
He said they could get back to the board with prices for an ALS ambulance with 24/7 services.
A 24-hour basic level service (BLS) ambulance would be $696,806 in the first year, “going down from there for BLS,” according to company representatives.
Selectman Ralph Hicks said he would be inclined to go with 16-hour availability for coverage. He also expressed a preference to have both ambulances offer ALS.
However Woronka replied they do not run eight-hour shifts, but 12-to-24-hour shifts. He said employees, no matter what their experience level, are always looking to pick up extra shifts.
He also said there is no difference in the number of errors that occur with the basic configuration versus advanced. Having two people per vehicle does provide the opportunity for tweaks to be made, such as splitting to two calls if there is a major accident, for example.
Addressing questions about mutual aid, Woronka said the solution is having more trucks housed in the community.
“We would like to make the town more of a hub for us,” Woronka said, noting the arrangement would provide “backfill” into its Brimfield/Holland operation. It would also help them have “backup interfacility transfers” from St. Vincent’s Hospital in Worcester like it has with Brewster Hospital and the Mass General/Brigham Hospital network, he said.
Having a hub in Spencer as a solution is an alternative to “having a lot of dedicated (ambulances) that will not do a lot of calls because you’d be paying for a sense of readiness in the end.”
The ALS and BLS ambulances proposed in their bid would be 100% dedicated to the Spencer system and not pulled for non-emergency transports, he said.
Answering a series of questions from the fire department, Woronka said there would be no extra charges for occurrences like high-risk calls that need EMS standby; transports where the patient needs to be physically restrained; or events like the Spencer Fair. (Woronka said they currently cover the Brimfield Flea Market, another highly attended event).
Having integrated training (which Action provides) with the fire department, is critical, he said, as is the “local knowledge,” personnel can provide.
Woronka said the company would rely on the police and fire chiefs to recommend who to remove/maintain and newer employees shadow more experienced EMS workers to learn from them.
He also said small communities “need a lot of customization and hands-on,” services and good communication with town leaders.
The representatives explained they have their own App; IT infrastructure and GPS system so they can always see where the ambulances are, “where they are heading and what’s going on.”
The CEO said they have experience working with regional dispatch centers (which Spencer is joining); would provide comprehensive data to the town about calls; offers its own training/continuing education programs; and could set up operations quickly “in as little as a couple of weeks,” so is on board with the town’s six-month timeframe.
Regarding several questions about collections and reimbursements, Robert Zwirn, chief financial officer, noted they want patients to reach out to them when they receive bills from insurance.
It is easier to get the insurance company to answer the phone when the customer is participating in the conversation, Zwirn said. Less than 1% of their claims go beyond that stage, he noted.
Action only takes issue when the patient receives a check from the insurance company and spends the money on vacations, house remodels, etc. instead of paying their bill, Zwirn said.
Representatives noted that they would not offer a subscription service the way Spencer Rescue Squad has, because it “becomes a fraud situation,” in the eyes of auditors.
Town Administrator Jeff Bridges said he got a legal opinion that said a subscription system is considered “an anti-kickback issue,” and would not be allowed even if the Spencer Rescue Squad becomes a town department.
“We’re human about it,” Zwirn said about residents not being able to afford large bills and living on fixed incomes. He said they have hardship forms that people can fill out, giving them two years to get their balance down.
Zwirn said they appreciates it when residents work with Action Ambulance to set up a payment plan and follow through with an agreement to do so.
The company representatives were also agreeable to having office hours to handle individual (payment) questions and concerns. “The elderly get confused. They need guidance through the process,” Fire Chief Bob Parsons said.
Having a liaison at the senior center, they called “a brilliant idea and one (we) support.”
Woronka said they are looking at an old bank on West Main Street as possible headquarters. Parsons noted that spot was difficult to get out of (with a lot of accidents there) and recommended Action look at other locations.
One location mentioned was 10 Meadow Road at a former fencing business. The building will be for sale and there are garages there, the Action representatives were told.
Bridges concluded by saying the company was “in the middle of a parallel path…” Selectmen are evaluating their proposal along with Cataldo Ambulance’s and pricing what it would cost to have Spencer Rescue Squad as a town department.
A decision is expected to be made at the end of January, following site visits to the bidders’ locations.
