The Carlisle Mosquito Online

Friday, November 6, 2009

Option for town’s Advanced Life Support services takes shape

Fire Chief Dave Flannery presented more detail on plans for Carlisle’s Advanced Life Support (ALS) services at the Board of Selectmen’s meeting on October 27. As of September 2010, Emerson Hospital will no longer provide ALS services.

Local emergency medical technicians (EMTs) respond on emergency calls within a few minutes and provide immediate care. ALS paramedics are part of the regular hospital staff and can respond with special equipment within 13 to 15 minutes. ALS is specialized response for life-threatening emergencies such as heart attacks.

Carlisle residents comprise a small percentage of users of the regional service. In 2008 there were 2,200 ALS calls with only 1.8% originating in Carlisle.

Flannery said that three options were originally considered for the 13 towns currently served by Emerson ALS (see “Change is coming to town’s Advanced Life Support services,” Mosquito, October 2): a regional system including Emerson Hospital and the towns; a new system run by the towns without Emerson; or a new system with member town governance but a private contractor providing services.

A fourth option, for Carlisle to provide its own ALS services was not considered viable. Flannery said that costs of start-up, personnel training and maintenance would be prohibitively expensive for Carlisle. Carlisle is a member of the Central Middlesex Emergency Rescue Authority (CMERA) and a subgroup of that organization is recommending a “hybrid” model of the options considered. In this model there would be a regional ALS system governed by the CMERA-participating communities with a third party subcontracted for management and for providing ALS service.

There would be two ALS teams in contrast with the present one vehicle available through Emerson Hospital. And the teams would be “dynamically deployed” throughout the area. Their home base would vary throughout the participating communities depending on volume. There would be centralized billing for both Basic And Advanced Life Support and maintenance of electronic records.

For this model to work the rate structure will have to change. At this time Carlisle charges the Medicare rate plus 32% – $684 for an ALS transport. With the possible new rate structure the charge would be the Medicare rate plus 200% – $1,552 for an ALS transport.

Flannery said that rather than committing to an “all-in” position, several communities, including Carlisle, are proposing a “pay as we go” option. He will keep the selectmen apprised of CMERA’s deliberations. ∆

© 2009 The Carlisle Mosquito