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SPENCER — Agreements related to emergency response and Spencer Rescue Squad’s transition to a town department topped the Selectmen’s agenda on June 8.
An intercept agreement, as explained by Fire Chief Robert Parsons, allows Spencer to bill a neighboring town a base fee of $300 for advanced life support (ALS) services. The advantage to this arrangement, he said, is that the other towns like Paxton, the Brookfields, Charlton and Leicester, would then “send us a check right away,” and then they would bill insurance companies for the basic life support portion of services.
Parsons said it is “more of a courtesy,” for North Brookfield, that only has basic life support (BLS), while the other towns, like Spencer, have ALS.
The fire chief said this situation occurs rarely but works out better because it can take up to six months to get reimbursement from insurance companies.
Over the past three years, intercepts have happened 44 times, with 15 occurring last year, Parsons said.
“It seems like an odd arrangement. I don’t like the possibility of not having costs covered,” said Selectman vice chair Jonathan Viner.
Viner and Selectman Jared Grigg said they would prefer the agreement not be for five years, with two or three years seeming more reasonable to them.
Parsons explained he had to drive around to all the towns on June 9 collecting paperwork and having the agreement signed so any changes had to be made immediately.
Selectmen chair Gary Woodbury said the time frame was something they could re-examine “at some point,” in the future.
“The horse is out of the barn. We have to keep this moving forward,” Woodbury said.
Mutual aid pacts approved
The board also approved mutual aid agreements with Brookfield, Charlton, East Brookfield, Leicester, North Brookfield, Paxton, Rutland, Sturbridge and West Brookfield.
In this situation, Parsons said, Spencer would bill out costs 100% and vice versa for the cooperating towns.
In the past, Parsons said, problems arose because Spencer Rescue Squad had a subscription service (whereby users paid an annual fee and received free ambulance rides). Towns like West Brookfield and Leicester did not honor the subscriptions, which were a “bone of contention, but that’s over now,” Parsons added. (As a town department, emergency medical services cannot have subscriptions).
Transport protocols explained
The board also talked about the fact that there is a protocol in place for where patients are transported by ambulance. Parsons noted it depended on the severity or nature of the condition but was limited to Harrington Hospital, St. Vincent’s and UMass Memorial (Belmont Street) and UMass Medical Center (Lake Avenue North).
For example, Level 1 traumas and heart-related matters are handled at UMass Medical Center, while OB/GYN matters go to Memorial and knee injuries to Harrington.
Parsons noted Medicare/Medicaid rates are dictated by the state and Spencer has rates (like Spencer Rescue Squad established) that encompass ancillary items used in ALS like monitors, IVs and medications.
The fire chief also said the department is exploring establishing a “non-transport,” fee to cover costs when an individual “abuses the system.” This abuse would be a person calling EMS repeatedly for a medical concern and then refusing to be transported by ambulance when personnel respond.
He said (non-transport) situations like assisting with falls in the home would not be charged a fee because they are “legitimate calls.”
Employee issues discussed
Additional topics covered by Selectmen concerned the Spencer Rescue Squad employees and their transition to town employee status as of July 1.
Town Administrator Jeff Bridges said that at the time the hand off from the Rescue Squad took place, the nonprofit said they hoped the town would let the employees keep the amount of vacation time they earned.
Bridges said the budget had $100,000 for overtime and $50,000 for per diem time and things like vacation and sick time and training were factored into their estimates. However, he said the town had a maximum of four weeks of vacation time set by bylaw and questioned how employees who were getting five weeks (with the Rescue Squad) could accrue more under the current system.
Selectman Chris Woodbury asked what would happen if one of the former Rescue Squad employees started on July 1 with the town and quit after a few months, saying, “I want my five weeks’ vacation.”
Bridges said he would come to the June 29 meeting with some possible language requiring a specific amount of service before having vacation time awarded.
All time off must receive the fire chief’s approval.
Another personnel matter involved the difficulty the department is having filling one career paramedic position. Parsons said he is hearing from possible candidates that they do not want to work in Spencer without a public safety classification.
Gary Woodbury questioned why the issue was brought up again because the previous Board of Selectmen (before the most recent election) voted unanimously on the classification and said they would re-visit the matter in a year when actual numbers are known.
Parsons noted he wanted the board to be aware of the difficulties he is having in hiring someone. A “Group 4” offering allows the employee to retire earlier at a higher rate.
Bridges added that a pension assessment for EMS will take place in two years after an actuary does an evaluation. (He said the issue is what the town’s contribution to the employee’s pension will be).
The administrator said the town would be learning more about what would make the positions more attractive over time.
Parsons explained the department is slated to have 12 employees. To date, five have moved over from the Spencer Rescue Squad. A sixth person who was coming decided to work in New Hampshire instead, where the pay is better.
Other people are in the process of lining up jobs in other fire departments, Parsons said. The vacant positions are for EMTs and paramedics.
