BRATTLEBORO — Brattleboro's municipal government and the town's nearly 60-year nonprofit emergency medical service provider are on course to part ways because of an escalating contract dispute.
Newly hired Town Manager Yoshi Manale announced on April 11 that Rescue Inc. would stop responding to Brattleboro calls as of July 1, leading his office to draft a transition plan to hire a private ambulance company until the local fire department can secure enough employees and equipment to take over.
“After a careful internal analysis,” Manale said in a news release, “I felt that not only can [the Brattleboro Fire Department] provide a high level of service after a year of transition, but it also makes financial sense.”
But shortly after the town issued the press release, Rescue Inc. Chief of Operations Drew Hazelton shared a letter he sent Manale revealing a rift between municipal leaders and the EMS provider, which covers more than a dozen communities in southern Vermont and neighboring New Hampshire.
Before former Town Manager Peter Elwell's recent retirement, Rescue believed it was set to continue serving the town as outlined at the provider's 2021 annual meeting.
“The system is working,” Elwell said publicly at the September session aired and archived on Brattleboro Community TV.
But Hazelton received a different response after the new town manager began this January.
“You stated that you were only willing to allow Rescue to continue providing service to the town without paying for those services at all, and that any shortfall should be shifted to the other communities that we serve,” Hazelton wrote Manale.
Rescue's chief of operations said he was told that Brattleboro, which currently pays the provider $285,000 a year, subsidizes the surrounding area by dispatching its firefighters to mutual aid calls.
“The fact that the fire department responds to other towns in our county is irrelevant to the fundamental issue here - paying for services the town receives,” Hazelton wrote Manale.
The town, in response, released a follow-up letter to Rescue from Manale and newly elected Selectboard Chair Ian Goodnow contesting those claims.
“At no time has the town of Brattleboro suggested we were ending the contract,” they wrote. “In fact, we have only asked Rescue Inc. to provide the town with justification for its assessment of $285,000 a year.”
The town estimates the provider annually reaps about $865,000 in public and private insurance reimbursement from Brattleboro residents, adding up to a yearly local haul of $1.15 million.
“We inquired why Rescue Inc.'s calls for service fees are amongst the highest in the state,” the letter continued. “The Selectboard and town manager's responsibility is to ensure that Brattleboro residents have the best services at the most reasonable cost.”
What's the plan?
Under the transition plan set to start in 2{1/2} months, Brattleboro would sign a one-year agreement with Golden Cross Ambulance of Claremont, N.H., to house and staff two vehicles at Central Fire Station on Elliot Street.
Former Selectboard chair and current member Tim Wessel told The Commons that Golden Cross “is willing to offer their services for one quarter of what Rescue is.”
The municipality then would work to obtain a pair of its own ambulances and enough employees and equipment to operate them.
“This municipal fire/EMS model is the most efficient and effective standard practice for the rapid delivery of medical care,” the town said in the April 11 news release. “It is currently being utilized in a highly successful manner by five of the six Vermont municipalities larger than Brattleboro,” which is the state's seventh most populous community.
Manale used Rescue's 2019 IRS filing to estimate the municipality could receive a $500,000 to $700,000 net gain in revenue annually through EMS insurance reimbursement.
“We plan to propose that this additional revenue be invested in quality-of-life improvements for the people of Brattleboro,” the town manager said.
But the plan doesn't detail the so-far-unpublicized costs of obtaining ambulances, additional employees, and equipment and of related tasks ranging from dispatch to billing, all which must be approved at a Town Meeting.
It also doesn't address a statewide shortage of crisis responders.
For example, the town of Williston, in Chittenden County, made national news last fall when local firefighters responding to an EMS request couldn't find on-call replacements, leaving their station empty for almost an hour.
“The call people just aren't there,” Brattleboro Fire Chief Leonard Howard told VTDigger at the time.
The Brattleboro Fire Department currently responds to about 1,400 EMS calls a year - at least half of the community's total count in 2021. The department says its staff provides medical care at the following training levels: Paramedic, Advanced Emergency Medical Technician (AEMT), and Emergency Medical Technician (EMT).
Current staffing includes two paramedics, six AEMTs, and 18 EMTs. Seven members of the department will complete an AEMT class in July.
Howard has been on record the last few years suggesting that Brattleboro Fire Department would like the town to purchase an ambulance and take on all EMS calls.
A difference in approach
In his letter to the town, Hazelton opposed any fire department plans to boost its EMS numbers because of “years of poor patient turnover, gender discrimination, verbal abuse and general lack of cooperation by certain members.”
“It is my opinion that [fire department personnel] lack the necessary oversight to provide clinically appropriate care to the citizens of Brattleboro,” Hazelton wrote. “The change would also likely cause unnecessary transport delays and an overall reduction in the entire system's performance.”
Municipal leaders refuted the accusations.
“After an extensive internal investigation by our Human Resources department, we found this to be without merit,” Manale and Goodnow wrote in their letter to Hazelton.
They also called it a “conflict of interest” for Hazelton - who chairs the Vermont EMS District 13 board - to offer an official opinion about fire department plans that take the place of Rescue.
The town is set to host three public forums on the issue, but many on social media aren't waiting to comment.
They're also questioning why municipal leaders spent the last Selectboard meeting debating whether to allow the town's Harris Hill Ski Jump to display a sign year-round, only to announce the news about Rescue in a news release.
“Is it not astounding that there was more discussion about a ski jump sign than about this?” wrote one Facebook user.
“How will this affect the Brattleboro tax rate to pay for increased staffing, vehicles, maintenance, supplies, training?” posted a second.
“It's a vital resource that cannot be replicated at the snap of a finger or even a year,” added a third. “And, unfortunately, any fallout will be at the expense of community members.”
Hazelton said Rescue Inc. charges the town of Brattleboro $24 per person for services. That rate hasn't changed in recent years.
“$24 per person is a reasonable fee, and no one has ever told me otherwise,” Hazelton said. “That's what allows the town to have 24-hour-a-day EMS coverage.”
Hazelton says he is concerned for both the town and his staff. “It's an unfortunate decision. The staff is crushed,” he said.
Rescue Inc. provides other services to the town, including COVID-19 vaccinations through its mobile clinics funded by grants. The nonprofit also provides coverage for all town activities - including fire scenes and parades, like the Fourth of July parade, and the former Strolling of the Heifers - and provides mass casualty support in the event of catastrophes.
The organization also has a volunteer technical support team for mountain and water rescue. And Hazelton told The Commons that Rescue Inc. is written into all protocols involving the local schools for coverage for accidents, active shooters, and hazardous material accidents.
It is not unusual for us to run five calls simultaneously,” said Hazelton. “This town has a lot of needs, and we've been quietly attending to those needs for almost 60 years.”
“If people want us back, the public needs to contact their elected officials to let them know what they want,” he said.