BRATTLEBORO — Approaching its 60th anniversary, Rescue Inc. - Windham County's largest and longest-serving ambulance provider - is marking an exceptionally healthy year.
The private nonprofit that serves 14 communities has opened Vermont's first training academy for emergency medical services, signed pioneering support contracts with the town's main health care facilities - Brattleboro Memorial Hospital and the Brattleboro Retreat - and is set to distribute fall COVID-19 and flu vaccines to the uninsured for the state Department of Health.
"The regional model on display at Rescue Inc. could be Vermont's best chance at ensuring there's always an ambulance around when you need one," Seven Days summed up in a March cover story about EMS challenges statewide.
Seemingly the only ones who disagree: municipal leaders in the provider's home base of Brattleboro.
They've spent the past year pursuing a potentially costlier plan to trade Rescue's 130 regional employees and 11 ambulances for their 24-member fire department - a majority of whom lack EMS experience, records show - and three yet-to-be-obtained vehicles.
Back in February 2022, then–Town Manager Yoshi Manale was just weeks on the job when, behind closed doors, he reopened Brattleboro's nearly six-decade contract with Rescue.
He asked the agency to drop its $285,600 annual fee and work for free, then a month later falsely stated that Rescue had pulled out of negotiations, spurring him to suggest a municipal takeover he said would reap a "$500,000 to $700,000 net gain in revenue."
None of Manale's claims have proven true (a town-commissioned feasibility study found a municipal takeover would cost more), and he went on to abruptly resign eight weeks later.
But local leaders - who haven't shared any of the background facts and figures - have yet to give up on the proposal, even after residents at this year's March Town Meeting adopted a nonbinding resolution advocating a "transparent" decision-making process.
New requirements for EMS proposals
Rescue nonetheless is set to file paperwork this week seeking its old job back.
"We're time-tested and proven," Chief of Operations Drew Hazelton told the public at an Aug. 26 open house. "We have a depth of resources like nobody else."
A standing-room-only crowd at Rescue headquarters greeted the news with applause. But the provider is anything but sure that municipal leaders will agree.
The town Selectboard, for example, issued a call for EMS proposals on July 27 and gave parties a month to submit bids. Three weeks later, on Aug. 18, board members regrouped behind closed doors and, on Aug. 22, amended the EMS application to add new requirements just seven days before an Aug. 29 filing deadline.
In the past, Rescue paid the town about $8 per call processed by Brattleboro's dispatch system, records show. Under the Aug. 22 addendum, municipal leaders said providers should anticipate that figure increasing nearly four times to $36.37 per call - adding more than $100,000 to any bid.
Likewise, the town never required Rescue in the past to obtain the financial guarantee of a performance bond but is calling for one now - upping costs even more.
Finally, the Aug. 22 addendum requires outside bidders to share a "complete billing rate fee schedule," even though municipal leaders acknowledge they won't be providing the public with the same data for the current interim model.
Rescue isn't contesting the request for its billing rates. Such information could shed light on a larger out-of-state bidder such as American Medical Response, which obtained its current contract for nearby Greenfield, Massachusetts, by promising not to bill the municipality but instead to charge residents through their medical coverage.
But Rescue is questioning the other last-minute changes, as well as the fact that outsiders are required to offer proprietary information the town has yet to generate for a prospective takeover.
"It's easy to play poker," Hazelton said, "when you get to see your opponent's cards."
In response, municipal leaders say the new requirements are simply part of a "competitive public procurement process."
"The Selectboard has not yet determined its dispatch fee, and this is subject to negotiations with private companies who submit a proposal," Town Manager John Potter said.
"My experience with essential and critical contracts for municipalities, like EMS, is that a performance bond is a necessity. Without such protection, the public entity is exposed to the whims of an irresponsible private contractor and oftentimes left with little or no leverage," he added.
Potter said his office would prepare a "framework" to compare a municipal takeover with an outside provider in an "apples-to-apples" way.
But third parties who must offer specifics aren't convinced, especially when the town is relying on self-generated takeover estimates that don't match its commissioned feasibility study or figures provided to VTDigger by the state's seven largest combined municipal fire-EMS stations.
"Typical Vermont politics," Clement Roger, director of operations for Amcare Ambulance Services of St. Albans, said about the Brattleboro situation. "An argument over personalities more so than dollars and cents."
Amcare had considered bidding on the contract, Roger said. Then it calculated the costs and found annual expenses could run as high as $2 million while insurance reimbursement could reap as little as half that.
Roger, a 33-year EMS veteran, joins a growing list of experts statewide who question how Brattleboro - with little advanced experience or equipment and an annual fire department turnover rate of 66% - can set up an efficient system amid growing financial and staffing problems everywhere else.
In contrast, the Amcare operations director said Rescue had a well-established base of equipment and employees (its annual turnover rate is 5%) that, used regionally, cut costs for all communities involved.
His conclusion: "The town of Brattleboro would be crazy not to go with Rescue."
He's not alone in his assessment. To offer their own information, municipal leaders have launched their own webpage on the issue. In the public feedback section, only one resident - the spouse of a fire department administrator - has called for a municipal takeover. In comparison, more than 30 residents have submitted letters in support of Rescue.
Wrote Sandra Pinger, a bookkeeper: "If your goal is to raise taxes and cause havoc with the residents in the town of Brattleboro by choosing to go local instead of with another provider, then you are on the right track. If you are truly interested in serving our community with the best cost-effective option, then the answer is Rescue."
And Heidi Fischer, an emergency department nurse: "I have been watching and living the mess the selectboard and former town manager have made of emergency care in Brattleboro. I implore the selectboard, please, for the good of Brattleboro residents' health and well being, do what is right and best for each and every one of us. Find a way to restore the relationship with Rescue."
Such talk permeated Rescue's weekend open house, during which supporters distributed cards asking residents to communicate their concerns before the Selectboard holds a public forum scheduled for Tuesday, Sept. 12 and votes on a plan Tuesday, Sept. 19.
"Why is the town not disclosing its costs if it's requiring that of other people?" resident Robert Oeser asked when given the microphone. "I'm not a mathematician, but this doesn't make any sense. How do we get back to something that resembles sanity?"
This News item by Kevin O'Connor originally appeared in VtDigger and was republished in The Commons with permission.