Town of Halifax, Vermont

September 26, 2012

Call to Order

This special meeting of the consortium of towns served by Rescue, Inc. began at 6:32 PM at the Marlboro Graduate Center, Brattleboro, VT.  Board members in attendance were Lewis Sumner and Edee Edwards.  Earl Holtz was not present.  Members of the public in attendance included Christina Moore, of Halifax, who is the representative for Halifax on the Rescue, Inc. Board of Directors.  Others who spoke at the meeting included: Tim Johnson, moderator; Darah Kehnemuyi, Chair and President of the Rescue Inc board; and Mark Considine, Chief of Operations of Rescue, Inc; and Dick Clark of the Guilford Selectboard.

Rescue, Inc funding

Darah Kehnemuyi welcomed everyone to the meeting, which is usually held annually.  It was hosted by the Town of Guilford this year.

Mark Considine walked through a slide set addressing the complexities of funding the longest-continually operated Rescue squad in the state of Vermont.  He also noted that this is a paramedic-level service (able to perform invasive life saving practices without direct physician oversight), and that there are many fixed costs of operating “for readiness.”  They have two, 24 x 7 x 365 manned stations which operate to cover greater Brattleboro and the greater Townshend areas.  In the past 3 years, they have served in over 15,000 incidents.

Coming to Vermont is a new single-payor system, and the full implications of that on funding a service like Rescue, Inc, are still largely unknown.  Add to this the possibility that US Congressional budget disputes will lead to automatic cuts of 6-13% of Medicare transports—currently about50% of their patients—and the crystal ball looks even murkier.  Rescue Inc. has laid out plans to try to reduce the risk of cost-shifting back to local governments.

Noted payment type distributions:

Medicare–50%  (65% of costs are recovered by Rescue)

Medicaid—15% of patients (only 35% of costs are recovered by Rescue)

Private insurers—23% of patients

Self-pay—12% of patients

Noted costs:

$536 per call

VLCT had done a study 10-years ago which stated that the fixed cost per year of a 24-hour ambulance service is $350,000.  Therefore, they need at least 600 reimbursed transports to cover this “cost of readiness.”  Many rescue agencies cannot maintain a paramedic-level service, due to the large training requirement for personnel to maintain this certification.

Comparative costs:

$56/ per capita for another agency.

A second agency was looking at $9 increase per capita, with another $7/per capita increase the following year.


Division 1: $21.75 per capita (a 2.5% increase)

Division 2: $26.72 per capita (2% increase)

Essentially, the town of Halifax can expect to see its assessment for the portion of town covered by Rescue, Inc, go up by 2-2.5%.  Currently, this annual amount is $1000, so it will go up approximately $25.  A detailed letter will be sent to each town.

Dick Clark of Guilford asked a question about whether the other First Response services in the area were helping or hindering the picture with Rescue.  Considine replied that Rescue knows they are part of a service system, and yes, these other services are valuable.  Having said that, reimbursement is noted to be provided based on transportation.  That payment model rewards going to the ER, which is an expensive service.

Other Business / Hearing of Visitors

Christina Moore during the ride home also noted additional concerns about proposed or possible changes in the makeup of the Rescue Inc. board.  As they look to fund more from a non-profit perspective, they may shift the make up of the board to decrease town representation and instead have people noted for their fund-raising capabilities.  Given the ongoing challenges with the funding and viability of the Whitingham Ambulance Service, this could leave Halifax without a strong voice in future discussions about ambulance service as a whole.

The meeting adjourned at approximately 8:00 pm.

Respectfully submitted,

Edee Edwards,

Selectboard Vice Chair