Start-up costs of Brattleboro EMS takeover, sold as a money saver, could total $1.9 million

Municipal leaders have revised estimates to launch a town-run ambulance system after dropping a nearly six-decade contract with the private nonprofit Rescue Inc., which most recently charged $285,600 a year.

By Kevin O'Connor

June 21, 2023

https://vtdigger.org/2023/06/21/start-up-costs-of-brattleboro-ems-takeover-sold-as-a-money-saver-could-total-1-9-million/

BRATTLEBORO — Start-up costs for a proposed fire department takeover of local emergency medical services could cost taxpayers nearly seven times as much in the first year than the annual charge of this town’s former EMS provider, Rescue Inc., municipal leaders said Tuesday.

The Brattleboro Selectboard surprised residents in April 2022 when it voted with little notice or public debate to drop its nearly 60-year contract with Rescue, a private nonprofit, as part of a transition plan to study whether the town should pick up ambulance coverage.

Then-Town Manager Octavian “Yoshi” Manale claimed the plan not only would cost less than Rescue’s $285,600 annual fee but also reap a “$500,000 to $700,000 net gain in revenue.”

But that original outlook by Manale — who abruptly resigned eight weeks later — hasn’t proved true in a test run with Golden Cross Ambulance of Claremont, New Hampshire. And a full takeover by the town in 2024 would require start-up costs of between $1.3 million and $1.9 million, municipal leaders told the selectboard Tuesday night.

The revised estimates are nearly eight times more than the start-up figures Manale presented at an April 2022 selectboard meeting during which members voted unanimously to drop the Rescue contract.

In an April 2022 memo, Manale said the town could purchase one “refurbished” ambulance for $110,000, a second “used” ambulance for $55,000, paramedic school enrollment for $36,000, related equipment for $30,000, radios for $15,000 and vehicle lettering for $3,500 — all for a total of $249,500.

“Most start-up costs will come from savings for the town in the new contract,” wrote Manale, projecting his plan would spend less than Rescue, the region’s largest and longest-serving EMS provider.

Instead, the town has spent more on EMS since the change, having drained the last dollars of a projected surplus just weeks after the July 2022 switch, its spending shows.

On Tuesday, municipal leaders presented new start-up estimates that said the fire department would have to hire an EMS supervisor (at $127,056 a year) and six new firefighters (at $88,404 each). Their salaries would total $240,000 during the launch period before becoming an annual projected $657,480 operating expense.

The plan also calls for a $20,000 transition consultant, a $30,000 billing software program and a $250,000 fund to make up for the lag between charging and collecting ambulance fees from insurers.

The fire department would also have to buy three ambulances, with new models currently priced between $200,000 and $400,000 each.

Depending on the vehicles, local leaders estimate start-up spending would total $1.3 million to $1.9 million, which they said could be covered by federal American Rescue Plan Act money or by borrowing funds through bonding.

Residents at Tuesday’s meeting expressed reservations.

“I’m really concerned about the financial impact on the taxpayers of Brattleboro,” said Dick DeGray, a former selectboard member who tends downtown’s flower planters.

Leaders haven’t shared any of the facts or figures that prompted them to approve the change, nor have they yet outlined annual operating expenses past the first year. But an independent feasibility study found that a municipal takeover would increase costs, yet bolster the town’s understaffed system of crisis response.

Specifically, the study said the town could collect an estimated $935,626 in annual insurance payments if it funded enough employees and equipment to respond to all EMS calls, but still would need to pay more than $300,000 a year to cover $1.2 million in expenses — a figure higher than the most recent Rescue contract.

Tuesday’s meeting was the latest in a monthly series launched after this year’s March Town Meeting adopted nonbinding resolutions calling for a “transparent” decision-making process for both ambulance coverage and related ARPA spending.

In response, the municipal government is using the selectboard’s regular meetings to present EMS information and invite public comment. Local leaders are set to discuss operating models on July 25, review all information on Aug. 15 and invite more community input on Sept. 5 and Sept. 12 before voting on an option Sept. 19.