BY ANGELO LYNN
BRANDON — After decades of taking care of Brandon-area residents when emergency attention was needed, the Brandon Area Rescue Squad is now appealing to the community for an emergency of its own.
Jordan Stage, BARS chief operations officer, recently reached out to the four towns it principally serves — Brandon, Leicester, Goshen and Sudbury — for additional aid as its traditional revenue sources are not keeping up with the ambulance service’s costs.
“Over the years, Brandon Area Rescue has been able to manage and overcome adversities, but our current predicament is dire,” Stage wrote in Town Meeting Day petitions being circulated in the four towns. “We’ve reached a point where the challenges have become too great, and your support is more crucial now than ever before.”
Stage explained that the emergency medical services BARS provides and the ambulance response units it has to maintain and purchase are just too much to cover in light of a revenue stream that is undercut by payment limits from Medicaid and Medicare as well as payments from private insurers that are spotty, at best.
Our current predicament is dire. We’ve reached a point where the challenges have become too great, and your support is more crucial now than ever before.
– Chief Operations Officer Jordan Stage
Stage explained that for most calls emergency medical service (EMS) organizations cannot control what they will be paid. Reimbursement rates, he said, “are substantially controlled by state and federal government programs like Medicaid and Medicare. A high percentage of our transports involve an older population, and a lower income demographic, most of which are insured by Medicare and Medicaid programs… Medicaid patients cannot be billed for any balance, and Medicare generally allows EMS to bill 20% of the allowed amount.”
Commercial insurers also rarely pay the full amount of any EMS bill, “as most patients have a cost-sharing amount that may go unpaid… And EMS also carries a percentage of patients who are uninsured and those bills are rarely paid, if at all.”
VOLUNTEER SHORTAGES
But not only is the revenue stream undercut by government reimbursement limits, insurance programs and others, but BARS and other EMS providers are also challenged to find enough volunteers to run a 24-7 service.
BARS’s ability to attract an adequate number of volunteers has been greatly diminished by the tight Vermont job market and because it serves a sick and ailing community in the midst of COVID-19 pandemic, Stage said, adding there are several factors complicating the shortage, including more intensive and time-consuming training.
“Aging service members, extensive initial and continuing educational requirements, increased provider responsibility and financial liability, full-time jobs and personal commitments, and members moving on to full-time paid career services are all challenges we have to meet,” Stage said. “But given the lack of volunteers and volunteer availability, we need to offer paid positions to help mitigate staffing disparities, ensure coverage, increase our response times, and allow for community outreach.”
“There is a current national shortage for all pre-hospital emergency medical services,” Stage told The Reporter. “A recent study came out and only 11 states in the county deem EMS an essential service, Vermont not being one of them. Every agency in our district (10) is facing the same issues.”
On top of a declining volunteer labor pool, poor reimbursement and dealing with a pandemic, Stage said the cost of equipment repair, buying new medical equipment and additional training all the time creates a triple-whammy for small services like Brandon Area Rescue.
To that end, Stage is appealing to Brandon, Leicester, Goshen and Sudbury for increased funding in the upcoming fiscal year in the form of a town resolution that requests funding. Petitions are being circulated throughout the four towns to get the allocation request as a vote approved by residents during town meeting.
BARS is seeking a total outlay of $116, 720 from these towns, which represent a total population of 5,836 and encompass a 112-square-mile service area.
Requests are based on a town’s population:
• Brandon $82,580 (population 4,129).
• Goshen $3,440 ((pop. 172).
• Leicester $19,800 (pop. 990).
• Sudbury $10,900 (pop. 545).
Stage said that it the towns support the Brand Area Rescue Squad with the increased appropriation request it will be able to hire two or three paid staffers to assist with emergency calls. It will also enable BARS to keep current medical equipment up to date with the proper preventative maintenance.
TOWN RESOLUTIONS
Erin Kilpeck, president of the BARS board, explained that each town will vote on a resolution to fund the Emergency Medical Service, but first a petition has to be circulated to put that amount in front of the voters.
“If we don’t receive the 100 signatures on the petitions from registered voters of Brandon, we cannot be included on the ballot,” Kilpeck said. “We haven’t changed our allocation in a few years, and this year we are asking for more money than in previous years. If it’s voted no, we will lose our current allocation as well, which means we will not receive any additional funds from the town.”
And if the petition is approved to appear on the Town Meeting Day ballot but it’s rejected at town meeting there would be no local service provided to that area, and needs would have to be met by neighboring EMS organization that have the capacity to take on four more towns. But whether neighboring EMS providers could step in is no sure thing and the time it would take to reach a person in need would be longer, Kilpeck pointed out.
Kilpeck also explained that the cost per capita of the BARS town meeting requests works out to about $20 per year. For Brandon, she said, “based on your home value of $100,000 – $199,999, the yearly increase would be $23.91, which equates to $1.99 a month.”
There are other areas BARS is looking for increased revenue, Stage explained. One source is “long-distance transfers.”
“We have local hospitals who are calling sometimes two-four times a week looking for help with transfers from local hospitals whose primary ambulance agency can not keep up with the demand,” he said.
Another source of revenue is “stand-by events.” There is a readiness cost for an ambulance to be on standby in the event of an emergency at such events as as physical agility testing for the police academy (BARS has assisted at such an event in the past).
With the extra funding in this year’s requests, Kilpeck said, the squad’s hope “is to use this additional money to hire more full-time employees and be able to pursue other avenues of revenue and be more self-sustaining. There are many ideas we’ve had — community events, more classes, more outreach, more recruiting, more trainings — but we don’t have the staff to do it.
“The reality is it’s getting more difficult to find volunteers,” she continued. “We all have full-time jobs, and families, and other obligations and find it harder and harder to add this to our already busy schedules. We also have to account for the additional trainings we need to keep our certification, which takes more time than just signing up for your 24-hour shift a month.”
Stage is the one full-time employee for Brandon Area Rescue and is covering a majority of the shifts and essentially works 24/7 because of the lack of members, Kilpeck said.
“There’s also much more than just ‘running calls,’” she said. “There’s the whole business side that Jordan has to keep up with, like billing, vehicle maintenance, ordering supplies and other tasks to keep the organization running.”
