Kennett Township votes to delay decision on single-service EMS provider12/09/2020 10:53AM ● By Richard Gaw
Board calls for collaborative proposal by Longwood and Kennett fire companies by Jan. 20, 2021. If it’s not acceptable, they’ll award exclusive ambulance and EMS provider rights to Longwood, beginning on March 1, 2021
By Richard L. Gaw
At the conclusion of an often heated four-hour discussion between them, the Kennett Township Board of Supervisors voted 2-1 at their Dec. 2 online meeting to delay a proposal that would enter the township into exclusively using the Longwood Fire Company as its single-source emergency medical services (EMS) provider next year.
By a vote of 2-1, the board back-stepped on an original proposal that would make Longwood the exclusive EMS provider to the township beginning on Jan. 1, 2021, and eliminate the EMS services of the Kennett Fire Company to the township.
At 11:10 p.m., board chairman Richard Leff and supervisor Whitney Hoffman voted in favor of extending all EMS services for the township to Longwood beginning on March 1, 2021, and in the interim allow both Longwood and Kennett to submit a collaborative proposal for proving ambulance service to the township by Jan. 20, 2021.
The board would then consider the proposal and reach a decision by Feb. 3, 2021, and if it does not accept the proposal, Longwood would receive the EMS contract. If the board does accept the new proposal, it would then consider a revised motion to authorize an EMS partnership between Longwood and Kennett next year.
Supervisor Scudder Stevens voted against the decision.
Depending on how it is ultimately decided, the way EMS and ambulance services operate in the Kennett community is likely to change dramatically for its residents. The current ambulance and EMS system for the township and Kennett Borough provides its residents with one 24/7 Advanced Life Support ambulance (ALS) from Longwood; one 24/7 Basic Life Support ambulance (BLS) from Kennett; and one Advanced Life Support ambulance (ALS) from Longwood that operates 16 hours a day.
Generally defined, ALS responses are for patients with
serious symptoms such as chest pain, shortness of breath, severe trauma or
seizures; BLS responses treat patients with less serious issues such as slip
and fall injuries, abdominal pain and cuts and lacerations.
At 7:10 p.m., township manager Eden Ratliff introduced a proposal that stemmed from an October 29 presentation he gave to the board that addressed a 2016 study that called for the township to explore the possibility of moving to a one-source provider of EMS and ambulance services – east and west of Bayard Road.
The study, created by experts that were hired by the Regional Fire and EMS Commission, did not recommend that the township choose Longwood as their single-service provider.
In his presentation, Ratliff reviewed the pros and cons of the proposal. On the positive side, he said, moving to a single-source EMS provider would consolidate the twin services of unit-hour utilization transport (UHU) and mobile intensive care units (MICU), and eliminate a duplication of services.
The “cons” of the decision, he said, would very likely cut the number of EMT staff at the Kennett Fire Company, reduce overall EMS coverage [by about 6,000 hours a year] and increase the number of missed calls for service.
Currently, Ratliff said about 4.5 percent of calls to both EMS units are routinely missed – which included 148 missed calls in 2019. By moving to a single provider, he estimated that the percentage would rise about two percent, but would still fall below the 10 percent danger zone for missed calls.
Ratliff also said that the proposal would also stipulate that a Longwood MICU and a chase car - a non-transport vehicle that staffed with paramedics that follows an ambulance - would be stationed at the Kennett Fire Company, which he said would reduce response times for ALS and BLS calls.
The topic of short- and long-term savings to the township was frequently raised during the meeting. Ratliff predicted that while there will be a cost savings of about $250,000 to the Fire and EMS Commission, “The challenge is that we are trying to model for the future, which is really difficult because we are using somewhat old data to try to guess what’s going to happen in the future,” he said. “It’s not going to provide immediate savings to Kennett Township in 2021, whether it’s adopted tonight or effective in three or four months.”
At the conclusion of his presentation, Ratliff said that the single-source provider proposal is “an emotional conversation.”
“This is not fun for anybody, and I can certainly appreciate that,” he said. “In the spirit of regionalism and collectivism and working together, it’s not just about what works in Kennett Township, but it’s also about what’s working in other municipalities who are impacted by this.”
Commenting in favor of the proposal, Leff said that the current two-source provider system is “inefficient,” and is scheduled to result in a 30 percent increase in EMS and ambulance cost to the township beginning next year.
“Given the lack of change over the decades, including an EMS commission of six municipalities not resulting in any meaningful change over three years, I felt the need for Kennett Township to step forward to help make changes to this long-standing system,” Leff said. “Is it the perfect solution? I know it’s an improvement over what we currently have, and if we don’t start moving to one provider – including one that we know – then we will never be able to make any other improvements in the future.
“Do we want to continue to have two ambulances responding to the western part of the township with related inefficiencies, increased costs and subsequent double billing of people in Kennett Township?”
Voices of opposition
Public comments during the meeting – whose attendance was just north of 100 -- ranged from general support of the proposal to scorched-earth opposition. Several of those who rejected the proposal called for the township to “stay put” with its current two-source EMS service.
“I don’t see this as an improvement,” said one township resident. “I think we’re getting a steal for what we’re paying as Kennett Township residents to have this extra coverage. In terms of [ALS response time], our township looks pretty great overall. That’s what drives people here and that’s what helps our property values. In no way do I think cutting 6,000 hours of ambulance coverage -- to save our residents [between] $20,000 to $40,000 optimistically -- is a good idea.”
Another resident expressed concern that streamlining ambulance and EMS service would have an enormous financial impact on the Kennett Fire Company, confine coverage to only two ambulances and lead to delayed response times.
“I am willing to absorb the cost in order to keep Kennett in the mix,” she said.
“How many times in the last month has Kennett covered Longwood?” another resident asked. “As someone who has listened to these calls go out, it’s way more than you are putting out to the public. People will die if you go to two MICUs. Should we pick which of your family members it’s okay to kill off? Why are we not talking about how fractured the relationship will be between the borough and the township and the township if you choose this horrible option?”
The supervisors were asked why the township is considering the possibility of moving to a one-source EMS provider in a year when more than 300 Chester County residents have already died from COVID-19, and early indicators point to a continuing surge of COVID-19 cases during the winter months ahead.
“One of the first questions I asked when I sat down with the fire departments is, ‘What is happening with COVID? Are calls increasing or decreasing?’” Hoffman said. “Calls are actually decreasing. They actually have less call volume this year than they have before.
“We’re going to hammer out what we want to do here, and we’re trying to figure out what’s most efficient and what’s best for the services.”
Supervisor fires back at proposal
The largest – and longest -- voice of opposition to the proposal belonged to Stevens, who delivered a 90-minute, nine-page rebuttal to the single-source EMS proposal. He called it an “ill-conceived action” that would have a severe impact on the Kennett Fire Company, the Regional Fire and EMS Commission, and the safety of township residents.
“The question we here debate is about more than theoretical dollars and cents. It’s about the lives and worth of our neighbors,” Stevens said. He said the decision to choose a single-source EMS provider would lead to three full-time and 12 part-time EMTs being laid off “in the middle of a pandemic, the worst health crisis in the last 100 years. There are human and ethical values and questions here that can’t easily be ignored,” he said.
Referring to the 148 emergency service calls to both EMS units that were not received in 2019, Stevens predicted that the consolidation of service would increase the number of dropped calls to an unhealthy ten percent in as early as two years.
“There is no guarantee that [Ratliff’s] assurance of no degradation of coverage is credible,” Stevens said. “In fact, it is more probable that the increased strain will have dire consequences for the individual and family – of that person waiting for that crucial service.”
Stevens also rejected the proposal’s idea to place a Longwood ambulance and chase car at the Kennett Fire Company, calling it a “slim to none” chance, and will dig a rift into any possible cooperation between the two departments – a partnership that dates back 150 years.
He then disputed Ratliff’s suggestion that changing to one provider would save the Regional Fire and EMS Commission $250,000 and thus trickle down into savings for the township and its residents. Calling Ratliff’s calculations a “red herring,” Stevens said that costs can also remain controlled “in any number of ways, including by keeping a bifurcated serve arrangement, and expanding it to give [the Kennett Fire Company] all of the township’s BLS calls,” he said.
While the proposal is being put forth by the governance of the township, Stevens continued to hammer away at the township manager.
“I wanted to observe that [Ratliff] has given us a simple, binary, black and white choice, [saying that] ‘we can either do this with these consequences, or we can do that, with these consequences,’” Stevens said. “In fact, as with all of life, there are multiple ways to view and solve problems.”
At one point in Stevens’ presentation, Hoffman accused her fellow supervisor of conducting “a character assassination” of Ratliff.
Undaunted, Stevens continued his opposition, forecasting that if the township moves to a single-service provider, that Kennett Borough would withdraw their membership in the Regional Fire and EMS Commission.
“It is an equally strong bet that the Commission would not be able to function without a significantly increased financial demand on the remaining municipalities in the Commission – of which Kennett Township is the largest contributor,” he said. “My very large fear is that the Commission will fold, [which would be] a very sad and problematic event for fire and EMS services in the region.”
Stevens suggested that the township administer a request for proposal in order to see what other EMS providers in the county may be able to offer the township -- a decision, he said, that would generate a significant cost savings when compared to choosing a single-source provider.
He also suggested that the decision be allowed more time, in order to seek other potential solutions and preserve the integrity of the relationship between the two fire companies.
“Since the time frame for Commission funding has already been extended until June 30, 2021, and that is the only entity whose financial circumstances are directly affected, that is the only deadline that makes sense,” he said.
“This whole discussion is built upon an unnecessary and fomented time constraint. We should take the time to find a more realistic solution without burning down the bridges that have been built over 150 years of good and valuable service.”
Stevens is not the only key stakeholder opposed to a possible consolidation of EMS services for the township. In a Dec. 2 letter to the Kennett Square community, Mayor Matt Fetick and Borough Council member Ethan Cramer – both of whom serve on the Regional Fire and EMS Commission – wrote that “in the midst of a pandemic we don’t see the value in terminating three full-time and 12-part time EMTs in order to reallocate those funds to either a different provider or a different level of service.”
In their letter, Fetick and Cramer assured borough residents that there have been no discussions by borough council to eliminate EMS service to the borough from Kennett EMS, which provides the borough with 24/7 1 Basic Life Support Ambulance service. They support a long-term, comprehensive fire and EMS solution for the region.
“Until there is a long-term, comprehensive solution we do not support changing our current delivery methods for fire and EMS,” the letter stated.
In their letter, Fetick and Cramer wrote that if the township ultimately chooses a single-source EMS provider, “we will need to consider if remaining in the Regional Fire and EMS Commission makes sense. And, we will need to evaluate the delivery of Advanced Life Support (ALS) to the borough.”
Continued discussions, and future discussions
After Stevens’ presentation, the supervisors spent the following hour engaged in a back-and-forth discussion that explored options and ratcheted up their differing opinions. Stevens told Leff that the decision to go with a one-source provider would potentially “put the Kennett Fire Company out of business, and then we say in two years that we need to have them back, but they’re not there. The bones are gone. The making of this decision becomes a very important and crucial thing. I am suggesting that you take this a little more slowly.”
“We’re not putting Kennett Fire out of business,” Leff replied. “What we’re doing is centralizing our central EMS service under one provider.”
Later in the meeting, the two waged another disagreement
about the possible increase in missed EMS calls that may occur by using a
single EMS provider.
“We will leave a trail behind us or rack and ruin. Lives and property,” Stevens said.
“And why do you say that?” Leff asked.
“I do not wish to repeat my speech,” Stevens replied.
“We’re still missing calls now, and yes, we may miss more, but maybe with one provider we can figure out ways to miss fewer,” Leff responded. “Right now, with separate providers, who do we turn to in order to make it better? We don’t. We just bleed the system as it is, and that’s my problem.”
“The only way you solve that problem is by putting more vehicles and people on the road, so that you have enough to cover it,” Stevens said.
Leff referred again to the findings of the 2016 study.
“I’ll turn back again to this expert’s recommendation – to designate a single provider for emergency medical services – and for decades, we haven’t done that,” Leff said. “There was another recommendation a couple of years ago, and we stopped it. We made that decision, not the Commission.”
Kennett Fire Company Chief Steve Melton recommended that a representative from both fire companies and one from the township and the borough meet in order to come up with a universal response – and possibly, a compromised solution.
“I believe both organizations at this time want an answer,” Melton said. “It seems like every three years this is something that we have to deal with, so if we can sit down one last time with the EMS and chiefs from both companies and a representative from the township and the borough, maybe we can try to find an answer.”
Longwood Fire Company Chief A.J. McCarthy said that he would be agreeable to further discussions, as long as it is not clouded with incorrect data that has complicated the thorny issue of determining how EMS services will be disseminated to the township.
“The one thing I liked about this conversation the most was that it was factual,” McCarthy said. “There was no emotion in it. So if there is any hope for us to sit down and hash this out, a lot of this misinformation and smear campaigns on social media have to stop. If you truly want to come to something, which is what we have been trying to do, it has to be on a professional level, and to date, it has not been that way.
“I’m optimistic that we can try to talk again, but the big thing is that the data that was requested was for a single-service management system. That was the goal of the Commission – to get to a single source that is going to be able to analyze and get the most efficient use of this dollar. When you have two separate individual non-profit entities that have totally different internal governments, I don’t think anybody is going to mutually say, ‘Let’s do that.’ It’s like merging the borough and the township. It’s not a feasible thing.”
Hoffman agreed to the proposal, providing there are solid deadlines.
“I have patience to work this out this out, but if everybody is not going to work together and we’re not doing anything productive, then on midnight on whatever date we agree to, that’s it,” she said. “We’re taking a vote on something, and I’m done.
“If we can agree to work it out, I am willing to do that, but I want a hard deadline.”
At 11:10 p.m. – after two attempts to finalize the wording of the revised proposal – Leff and Hoffman voted in favor of withdrawing the original motion and pass a new motion that will soon bring Kennett and Longwood to the negotiating table and holds them to a Jan. 20 deadline to submit a new – and potentially mutual -- proposal.
“At least this gives us another month to talk about it among different groups, to try to hash out something that’s better,” Leff said. “Maybe we can. Maybe we can’t. This at least puts a stake in the ground.”
To contact Staff Writer Richard L. Gaw, email [email protected].