BERLIN — The Berlin City Council spent a significant part of Monday’s work session discussing issues relating to the fire department going out on emergency medical service calls.
The issue had been raised during the council’s previous meeting on July 6 by Council Member Lucie Remillard, who asked why the fire department was assisting with so many calls.
Fire Chief James Watkins said that when Butler Medical Transport took over Berlin Emergency Medical Service, he sat down with the new management to develop a better working relationship between the fire department and EMS.
Watkins said when he first came to the fire department in October 2019, he noticed there was some hesitancy in the two departments about working together. He mentioned that one of the questions by Butler’s Senior Operations Manager Scott Lees during those discussions was why the fire department did not go out on medical calls with EMS.
Watkins said throughout the country, most municipal fire departments that work with private EMS agencies will do first response to provide manpower, backup and a driver if needed.
He said that Lees was used to Conway Fire Department going on every medical call. But Watkins said he didn’t feel that the Berlin Fire Department needed to go on every call so the two groups came up with a compromise arrangement under which both departments would go on more serious calls. That decision, he said, would be based on 911 determinants labeled as “charlie, delta and echo.”
Watkins said in reviewing codes, he had to understand how the codes were being used to determine whether the fire department was providing patient care at the scene or simply waiting for an ambulance to arrive.
In that respect, he said he has instituted a quality assurance program regarding the various call-out codes to review every run to try to fix the codes that would require the fire department to be called out.
During Monday’s meeting, Remillard asked how it is determined which calls the fire department will go out on.
Watkins said it was dependent on 911 and the information they received for the initial call.
Remillard asked whether or not it was standard for the fire department to always send two trucks to an EMS call, noting that residents have been asking questions regarding the need to always have two trucks on the call.
Watkins told the council that sending two trucks is how the department operated historically and is due in part to manpower and equipment issues.
Watkins said that he is working to standardize the equipment on all of the department’s fire trucks. He said originally Fire Engine 1, the ladder truck and Fire Engine 4 all had EMS jump bags on them, but only Engine 1 had an airway kit. To rectify that issue, Watkins purchased an airway kit for both of the other units as well as suction units for each vehicle.
“Our goal is it doesn’t matter what truck, we want to have the same equipment,” he said.
Watkins said that hypothetically the department has its paramedic assigned to the ladder truck and two people assigned to Engine 1, adding that they would bring both trucks in case the department receives a fire call when they are out on an EMS call. He said for an EMS call, the department needs to send at least two people, meaning they would either have to put the paramedic on Engine 1, which would put three people on Engine 1 if it responded to a scene, thus requiring someone to go back to the department to get the ladder truck if a fire call came at the same time, or put two people on the ladder truck, leaving only one at the station to bring the engine to a fire call if necessary.
Watkins also said that all of the necessary equipment for responding to an EMS call is on the ladder truck as that truck has more space available for the storage of necessary equipment.
Council Member Diana Berthiaume said his concern was not so much the fact two vehicles were going out to calls, but more the budgetary issues of sending out fire trucks to EMS calls. She said the city already provides a subsidy to Berlin EMS and that the city is providing an additional subsidy to the EMS company by using city staff. She said that both the city’s police and fire departments have increased their volume with respect to assisting EMS.
Watkins said that in projecting out the numbers for 2021, the fire department’s incident numbers will average out, he said that while the number of EMS calls is up, the department’s fire numbers, especially those relating to building fires are down. Watkins later said that the department is paying the firefighters to respond to any activity and that he doesn’t believe there is much cost difference to the department in going to EMS calls, with the possible exception of slightly higher costs for diesel fuel.
“I don’t believe there is much of a difference,” he said.
Council member Roland Theberge asked whether it might be more cost efficient to put EMS under the control of the fire department, but Watkins said that couldn’t be done as the department does not have an ambulance and is currently only doing basic life support work in their EMS assists.
Theberge then asked whether or not the city receives any compensation for the fire department responding to EMS calls and Watkins responded that the only way they could be paid is if they actually transport patients to the hospital.
In response to a comment from Council Member Mark Eastman, Watkins said that the city does not have a typical rescue truck like many departments have and that the ladder truck effectively acts as the rescue truck, since the vehicle was purchased in 1996.