Chester to expand ambulance service with new full-time hire

By Shawn Cunningham
© 2023 Telegraph Publishing LLC

The Chester Ambulance Service could become a more extensive operation, providing community health services as part of that expansion if Town Manager Julie Hance’s vision comes to fruition. The first step came last Wednesday night when the Chester Select Board approved hiring a second full-time ambulance employee.

“Our ambulance service has arrived,” said Hance noting that through “a lot of work, research and conversations,” the service is at a place to consider what it can do in the future.

Hance said that 68 percent of the calls for ambulance service come during the day, when most people are at work. With many emergency medical technicians working their regular jobs during the day, covering those shifts is challenging. And it is even more so since the Covid exemption has been lifted, and all calls must run with two certified staff members. Ambulance shifts in the evenings and on weekends are easier to cover.

Hance also pointed to the median age for the town, which is 55, and to the large number of elderly residents who require medical services. But, she added, “with the loss of the clinic and what’s going on in the health-care today, medical services are not as readily available as in years past.”  Hance pointed to a 58-page federal report called EMS Agenda 2050,  which looks at a vision for the future of such services. She said the town has had discussions with Springfield Hospital, which oversees the medical operations of the ambulance service, regarding what more the ambulance can do for community health.

“We were looking for the gaps,” Hance said, noting that EMTs recently helped someone who had suffered a head injury to set up a LifeAlert system that the person found difficult. She also pointed to senior citizens with ongoing health issues and need to have blood pressure checks. In the future though, Chester Ambulance envisions making patient interactions with the hospital easier by offering services like blood draws for labs. That could mean that people with limited mobility would not have to trek to Springfield once for the blood draw and again to see a doctor.

Hance said that cancer patients who much go to Dartmouth Hospital for treatment must have labs done before their visit. But the Ellsworth Clinic, on the westside of Main Street, where labs could be done, was closed. “But that’s a service” that an advanced emergency medical technician could do before sending it to Springfield Hospital’s lab. Hance said this would be billable for the ambulance service and would take some of the pressure off the hospital staff.

Board member Peter Hudkins asked if this was not the kind of service that organizations like Visiting Nurse and Hospice for Vermont and New Hampshire provides. Hance said that has been the case, but staff shortages have made such service less available. Board member Lee Gustafson asked why the clinic closed and if there was something that could be done to entice someone to open a clinic. Hance said that was a “numbers thing” and Springfield Hospital would not bring back a clinic.

Ambulance Service Deputy Chief Mike Randzio noted that some of the services that his organization could provide could beneficial to the hospital and the town would be asking it to participate in the cost of the service in Chester. Hance also said that the services could also be extended to Andover.

Currently, according to Hance, the service has one advanced EMT in Jeff Knisely and that Randzio  is working on his advanced certification. In hiring a third AEMT, the town would allow the town to bill a number of the calls at the higher “advanced life support” rate rather than the “basic life support” rate. That would also help to offset the cost of the third AEMT.

Hance also said that the new AEMT would free up time for Randzio to work in his capacity as the town’s Health Officer, which has kept him busy with issues on at homes on Cummings and Potash Brook roads. Randzio would also be more available to give trainings in a number of areas, thus freeing up those costs from the budget.

Hance asked the board to authorize hiring an AEMT in August or September, with the unbudgeted impact limited to around five months. After more discussion, the board voted unanimously to do that.

While the town would be hiring relatively shortly, Randzio said the rest of the public health program would be researched and rolled out over a period of time and with the knowledge of the board.