Merrimack County commissioners float county-wide emergency medical service
Published: 10-29-2024 9:39 AM
Modified: 10-29-2024 3:12 PM |
Facing a request to contribute funding to a non-profit emergency medical services provider that responds to calls at the Merrimack County nursing home and jail, County Commissioner Chair Tara Reardon raised the prospect of launching a county-wide EMS service instead.
The idea arose during a meeting on Monday between the non-profit Penacook Rescue Squad and representatives from Boscawen and Canterbury, two of the three towns Penacook Rescue services.
Prompted by mounting call volume, Boscawen and Canterbury requested the meeting because about one-third of the calls Penacook Rescue handles come from the county nursing home and jail, which are located in Boscawen.
While a significant portion of those calls lead to reimbursement via Medicare or Medicaid, the county currently does not pitch in money of its own, while Boscawen, Canterbury, and the third town in the compact – Salisbury – do.
“The goal is to separate this so that it falls on everybody who has residents within the [nursing] home or within the jail, not just the small town of Boscawen,” said Matthew Burdick, a Boscawen Select Board member. “There are people from all over the county that are housed there, and yet we’re the ones that are taking the brunt of it.”
But the three members of Board of Commissioners – Reardon, Stuart Trachy, and David Lovlien Jr. – were noncommittal on whether they would chip in.
“We’ve got some information that I want to read more closely, and then we’ll see if there’s more research we want to do,” Reardon said.
The county-based EMS service that Reardon raised as an alternative is a common model in other states, but not in New Hampshire, which prizes local control.
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In 2022, Cheshire County became the first county to transition to that model, but the roll-out has been plagued by accusations the county is undercutting local fire departments unfairly, reporting by InDepthNH found.
The transition to county-based EMS services in Cheshire County is “a train wreck right now,” Penacook Rescue Chief Shawn Brechtel said following Monday’s meeting.
Boscawen Select Board Chair Lorrie Carey chalked up consideration of a county-wide EMS system as a negotiation tactic, but she said there could theoretically be some financial benefit to further regionalization of EMS services in the area.
“In New Hampshire, we’re extremely local control-motivated, however, we’re getting to a point where we have to look at the impact on the taxpayers,” Carey said. “I certainly would advocate for more partnerships and more cooperation between the county and smaller towns.”
Boscawen, Canterbury, and Salisbury currently split Penacook Rescue’s operating costs, while billing from ambulance transports primarily gets allocated to capital expenses, such as purchasing new equipment.
This year, the three towns paid a total of $539,000, but costs are increasing. Brechtel estimated that the non-profit’s payroll could land at around $750,000 this year.
The towns did not ask for a specific contribution from the county, but last year about 29% of the 1,056 calls Penacook Rescue handled were to the county nursing home or jail. Costs are currently split between the three towns by population rather than call volume.
Penacook Rescue’s model is unusual in Merrimack County. Of the county’s 27 municipalities, just over half currently rely on their own fire department to provide EMS services. Of the remainder, five pay for services from another town, four rely on a hospital ambulance company, and four – the three Penacook Rescue towns and Northfield – use an inter-town agency, according to information provided by the New Hampshire Department of Safety.
But as the population in the state ages and as costs go up, towns are increasingly re-examining the most cost-effective way to provide quality service to their residents.
“We’re just struggling – all the small towns are struggling – to provide the staff and then not to tax our taxpayers out of their homes,” Carey said.
If Merrimack County were to secure an alternative for its county facilities other than chipping in for the costs of Penacook Rescue or establishing a county-wide service, it would be a major blow to Penacook Rescue’s billing revenue.
“That is a steady stream of funding for us, so it would be significant,” Brechtel said. “We would be able to exist, but we would certainly have to adjust our capital improvement [plans] quite substantially.”
In the face of regional challenges, Carey advocated for collaboration rather than competition.
“If instead of working against each other, we work together, we end up with a better product in the end,” she said.