sda

Northampton Fire Department

Memorandum
To: From: Date: CC: Re: The Northampton Public Safety Committee Brian P. Duggan, Fire Chief March 29, 2012 D. Narkewicz, D. Nichols Rescission of the EMS Reserved Receipt Account

I am attending a homeland security training program and unable to attend the April 2, 2012 meeting of the Public Safety Committee. Chairman Adams has asked me to provide a memo relative to the rescission of the Emergency Medical Services (EMS) Reserved Receipt Account. Overview: Revenue collected from EMS transport services is paid to the City of Northampton and not the Northampton Fire Department. This revenue is then deposited into the EMS Reserved Receipt Account and available for appropriation by the City Council. As the revenue needs to be in the account prior to appropriation, Deputy Chief Norris appears before the Council requesting several transfers per year. If the order to rescind the EMS Reserved Receipt Account is approved, these funds will then be deposited into the General Fund and be appropriated in anticipation of revenue on an annual basis. This change would take effect concurrent with the start of the Fiscal 2013 budget. Although this would reduce the need for periodic transfers, the costs associated with EMS are volume driven and if both volume and revenue increase and adjustment transfer may be required at the close of the Fiscal Year. As an advocate for both my personnel and the Department, I just like any other Department head in the City would prefer a dedicated revenue stream as it allow the clear ability to project and plan for the shifting needs of the program. This

Page 1

Public Safety Committee

March 29, 2012

question is a reflection of financial management practices and I believe that two key principles are important: 1. The critical aspect of EMS operations is the appropriation provided through the City Council. 2. These funds can only be spent once, during Fiscal 2012 we are expected to collect 1.75 million and expend 1.63 million. On average an additional $150,000 is required for capital expenditures. Based on the skill of Deputy Chief Norris, we have had exceptional success obtaining grants and required no capital appropriation during Fiscal 2012. Communities across the Commonwealth are split as many deposit funds into the General Fund while others use a Reserved Receipt for Appropriation Account for this purpose. Either way, the City Council still needs to appropriate these funds and I need to advocate for the resources necessary to do our job safely and effectively. This translates to the real question not being the structure of the account but the recognition by the Council that failing to appropriate sufficient resources will deteriorate the capabilities of the exceptional system that we have built. Reflections on Northamptons EMS Program
As we developed the EMS system, our collective vision was to create an exceptional program and working with our people we have done just that. The quality of our efforts has been recognized by both the Mayor and our patients. Examples of the unique advanced procedures that we offer are:

Continuous positive airway pressure (CPAP) which reduces the need for more invasive procedures and assists the breathing of people that have fluid in their lungs, this reduces the potential of hospital admission and ultimately reduces the need to place a patient on a ventilator. Cardiac Rhythm transition to Bay State Medical which reduces the time to surgical cardiac intervention. Automated CPR Machines which increases the outcome of our patients as well as safety of our responders. Power Stretchers which reduce injuries and provide the patient with more comfort.

Page 2

Public Safety Committee

March 29, 2012

Personnel that are Inter Facility Transfer Certified. Pediatric Advanced Life Support Training.

In short, the quality of both our service and our staff is exceptional. As an example of our level of service quality, last week a man came into my office to thank my staff for the exceptional job that they did saving his life. Two months ago this man went into cardiac arrest while shoveling snow. During this response, we utilized the automated CPR machine, drug therapy, airway management and defibrillated the patient more than a half dozen times. This is a tangible example of the staff and equipment needed to provide the quality service that we have sought to provide. Concerns from our Personnel This discussion has generated concern among our personnel. Much of this concern stands as a reflection of their buy-in and pride. I am sure that these concerns will be presented to the Public Safety Committee by our staff; some of these concerns are summarized below: The equipment and staffing required providing the quality program we have created could be diluted and the program as well as patient care could suffer. Our personnel feel strongly about this point as they are frustrated with our inability to replace fire apparatus as approved within the capital plan. These funds would not be exclusively available for the use of the Department. Our personnel believe that the creation of this account was a foundational aspect of creating the EMS system.

Page 3