EMS ORGANIZATONAL ANALYSIS FOR THE SOUTHERN BERKSHIRE REGION Official Report prepared by: Hanifen & Associates, LLC in Partnership with Kramer & Associates and Meyers EM K&A EMS ORGANIZATIONAL ANALYSIS FOR SOUTHERN BERKSHIRE REGION Project Team Leader: Project Team Associates: Randall W. Hanifen, Ph.D. William M. Kramer, Ph.D. Patrick Meyers, B.S. Table of Contents I. FOREWORD...............................................................................4 II. EXECUTIVE SUMMARY ........................................................9 III. HISTORICAL PERSPECTIVE ..............................................14 IV. COMMUNITY RISK ASSESSMENT ....................................17 V. BALANCING ALL EMERGENCY SERVICES ...................29 VI. RESPONSE DATA ...................................................................32 VII. EMS STATION LOCATIONS….……………..……………..37 VIII FIRE STATION LOCATIONS ...............................................39 IX. REPLACING FIRE & EMS STATIONS ...............................41 X. REGIONAL APPARATUS ....................................................43 XI. COMMUNICATIONS AND DISPATCH ..............................54 XII. MUTUAL AND AUTOMATIC AID ........................................60 XIII. HEALTHCARE REFORM/TECHNOLOGY ........................62 XIV. REDUCED TURNAROUND TIMES ......................................67 XV. MOBILE INTEGRATED HEALTHCARE............................74 XVI. RELEVANT NATIONAL STANDARDS ...............................79 XVII. ENSURING ADEQUATE RESOURCES ......................... 84 2 Table of Contents Continued XVIII. NATIONAL STAFFING TRENDS .......................................86 XIX. STRATEGIC & BUSINESS PLAN .....................................91 XX. CONCLUSION ......................................................................149 XXI. APPENDIX 1: RESUMES ....................................................150 XXII. APPENDIX 2: DEMOGRAPHICS ......................................154 XXIII. APPENDIX 3: MEDICARE ................................................177 XXIV. APPENDIX 4: REDUCING TIMES ..................................179 XXV. APPENDIX 5: VOLUNTEER SHORTAGE .....................184 XXVI. APPENDIX 6: FIRE BOARD .............................................185 XXVII. APPENDIX 7: NEW AMBULANCE COST .....................188 XXVIII. APPENDIX 8: LATEST TECHNOLOGY .......................192 XXIX. APPENDIX 9: REFRENCES .............................................193 3 FOREWORD During the winter of 2019 Randall Hanifen of the Consulting firm, Hanifen and Associates, LLC, led a team of consultants in conducting a study regarding the EMS and fire department operations in Southern Berkshire, MA, delivering service from numerous stations, funded in numerous ways and operating under various organizational structures. Active partners in the study were William Kramer of the firm Kramer and Associates and Patrick Meyers of Meyers Emergency Management. (Resumes of consulting team members are found in Appendix 1.) The consultants performed an analysis to determine the capability of numerous EMS organizations within Southern Berkshire County to answer EMS calls and utilize partnering agencies for first response for emergency medical calls, both now and into the future. In addition, it was quickly recognized by the consultants that the primarily volunteer fire service was losing volunteers and having difficulties attracting new volunteers. Staffing, organizational structuring, EMS and fire station conditions and locations, and similar factors were studied in detail. The suitability of the current organizational structuring of the region was examined to determine a course forward. A complete analysis is a complex undertaking where a change in one factor has a ripple effect changing all others. For example, the types of emergency medical emergency response vehicles determine the size needs of a given station. The age and condition of an existing station determines whether it is viable or needs replacing. If it needs replacing, then maybe the property can be sold, and a replacement facility can be relocated to a more advantageous location. If there are savings in the costs of stations and new apparatus, does this allow paid staffing? The consultants have balanced all of these factors in presenting a blueprint for the future in Southern Berkshire. The Southern Berkshire Regional Emergency Planning Committee deserves credit for seeking a neutral opinion regarding the EMS Operations since this service is among the most vital and expensive of governmental services. Lengthy interviews with a wide cross section of stakeholders indicated that there are differing opinions regarding the state of EMS response in the Southern Berkshire region. In discussions with governmental leaders, EMS officials, fire officials, and ordinary citizens, however, the consultants found appreciation for the EMS and fire organizations providing the service within the region. Officers and members of the EMS and fire organizations, as well as governmental leaders and elected officials all participated actively in meetings with the consultants, consistently displaying a progressive spirit that can only be beneficial to the residents and corporate citizens of the Southern Berkshire region. A consultant is usually no more intelligent than the client that he or she is serving but can bring objectivity and non-bias to a jurisdiction that can be quite valuable. It is hoped that this study will provide information that can be used by regional officials to create an EMS transport and first response service commensurate with increasing demands, and quality service which residents and businesses of the area deserve. While the area is unique in many 4 of its remote areas, the citizens still expect EMS care and fire suppression when they summon the service. Increasingly scarce tax dollars mean that there is a genuine community value in any efficiency that can be gained in EMS and fire department operations. In volunteer departments, like many in Southern Berkshire, the lion's share of a budget will not have to go to staffing. Hence, as the progression of the need for service intersects with the decreased numbers and time availability of volunteers. Planning for salaries is imperative. Special thanks to Heather Barbieri for facilitating the visits and coordinating the logistics of the consultant’s visits. Thanks to the Southern Berkshire Regional Emergency Planning Committee for their interaction and providing feedback and history as we worked to develop the data and plans within. Thanks to the town selectboard members, town administrators, fire chiefs, and EMS Directors, and rank and file of the fire and EMS organizations, all of whom cooperated fully to make sure that the study was comprehensive, and momentum was maintained. Thanks also to the Massachusetts State personnel, who were helpful in providing meaningful information throughout the study. On many occasions we had both formal and impromptu meetings and discussions with these individuals as well as personnel throughout the rank structure in the EMS and fire organizations. We gained much insight into the heart and spirit of South Berkshire’s future at these meetings. Southern Berkshire Regional Emergency Planning Committee First Last Name Name Organization Title Augusti Bruce MEMA Program Coordinator Backhaus Gareth Monterey Police Chief/EMD Barbieri Heather Fairview Hospital EMD Berkel Stephen Alford Fire Department Beinvenue Gail MDPH RHC Buell David MA State Police Lieutenant Burger Charles Great Barrington Fire Chief Burrows John Sandisfield EMD Coburn Katie GB Healthcare Administrator Curtin James Tyringham EMD Hamill Daniel Otis Interim Police Chief Harner Charles Fairview Hospital Director of General Serv. New New Malrboroughugh Harvey Ed Malrboroughugh EMD Hathaway William SBVASS Director Lanza-Weil Carmela MRC Volunteer Coordinator New Litchfield Bobby Malrboroughugh Assistant EMD Marsden Chris Stockbridge EMD McGurn George Egremont Selectboard Muir Scott Stockbridge Fire Captain/EMT Munson Eric Sheffield Police Chief/EMD Oggiani Lou West Stockbridge EMD Parsons Stacy COAD Chair New Shalaby Michelle Malrboroughugh Selectboard Chair Smith Jayne BRPC/BPHA Senior Health Inspector Walsh William Great Barrington Police Chief/EMD Whiting Charles Otis Police Officer Wood Rene Sheffield Selectboard 5 Special recognition to Smitty Pignatelli for his attainment of funding and support of the project. During the Consultant’s interview with Smitty, he demonstrated great support and care for the communities served with a forward-thinking outlook on shared services. This type of passion and collaboration is what is needed to improve the delivery of government services in any area. The Town’s Selectboard members in the region have a reputation of being pro-active and to their credit supported this forward approach in mapping out the direction needed for its fire and EMS services. Town Selectmen Members Alford Peggy Rae Hendon-Wilson Charles Ketchen Peter Puciloski Egremont Bruce Turner, Chair George McGurn, Vice Chair Mary Brazie Great Barrington Stephen Bannon Chair Edward Abrahams Vice-Chair Daniel Bailly Bill Cooke Kate F. Burke Mt Washington Brian Tobin, Acting Town Police Chief Jim Lovejoy Gail Garrett Monterey Carol Edelman-Chair Kenneth Basler Donald Coburn New Malrboroughugh Tara B. White Michele Shalaby Chair Nathaniel Yohalem 6 Otis Donald Hawley Chair Gary Thomas William Hiller Sandisfield Mark Newman Chair Brian O'Rourke George Riley Sheffield David