Union Ambulance Committee Backs Re-Chassis of Rescue 1

[0:00] Becky Mountland: It's going to start right after I'm coughing. When [0:04] Ruth Wall: do I smell cinnamon rolls? Dunno. You smell cinnamon rolls? Yeah. There's the light, see? There we go. That's the magic word, cinnamon rolls. Alright. [0:14] Jesse Thompson: For the record, if everyone could just go around and say your name and the town you represent. [0:20] Tom Jardine: Tom Jardine, Union. [0:22] Kevin Callahan: Kevin Callahan, Appleton. [0:24] Ruth Wall: Ruth Wall, Appleton. [0:26] Kate Grinnell: Kate Grinnell, Washington. [0:27] Becky Mountland: Becky Mountland, Union. [0:28] Jesse Thompson: And I am Jesse Thompson. I live in the town of Union and I am the fire rescue chief for the department or whatever. I've been along a few days. So first thing is, Todd wanted me to kind of re-go over the re-chassis of Rescue 1 we talked about and that's kind of where we wanted to go. wanted to still kind of confirm that you wanted to confirm numbers and stuff like that and what I got is it's still going to be $250,000 potentially probably more now because as this was quoted earlier in the year and as we know everything's gone up yeah and it's about a six month time frame from the time they start to the time they're done the lead time is still up in the air so that's the time leading up to when it gets done and that could be a few months before they get it in it all depends on who's in front of us is the is [1:26] Tom Jardine: the price subject to change you know it's in it's in the queue once we say we're going to do [1:32] Jesse Thompson: this the price is locked in right so tell that 's a good thing it's not going to change in the middle of it and it's the same way when you're buying any brand new apparatus to once you say once you commit you get the price and you sign on the other one they have to [1:48] Ruth Wall: give it to you for that amount can you still use rescue one right now oh [1:52] Jesse Thompson: yes okay we're using it and we're alternating the truck so this month rescue two is primary and then rescue one is secondary and then we do that to try to spread out the mileage so we're not beating one truck to death we can say wear and tear are they both diesel they're both diesel both have deaf we've been fortunate with the deaf system so Todd looking for I think [2:21] Becky Mountland: formal saying yes we'd like to go forward with that all right probably I [2:27] Jesse Thompson: think we didn't actually take a vote we just discussed it I think that was [2:37] Tom Jardine: within this group's scope of authority to so or we make a recommendation make [2:43] Jesse Thompson: the recommendation so [2:46] Ruth Wall: well what if what if we don't recommend it [2:57] Jesse Thompson: something else do we want to do we want to not recommend every chassis do we want to buy a brand new rescue 2 instead [3:03] Becky Mountland: I guess so. Let's break it down, I guess. Two, these are the choices we can rechassis R1, we can buy one, try to find a used one out there, or we can buy a brand new. Those are the pretty much the [3:16] Jesse Thompson: choices, right? I would say very hard to find a used rescue. I took me, took me a while to find the rescue [3:22] Speaker G (unidentified): two that I found, so that one's pretty much out the window. It's not out the window, but it, the pickings [3:30] Jesse Thompson: are getting slim, right? And finding something decent. My recollection from the last meeting was [3:34] Tom Jardine: that one of the considerations in purchasing rescue one was the ability to re-body in the [3:39] Jesse Thompson: future. Yes, that's right. That's that's the whole point. If you were to say buy a new rescue one, I would completely shut that down because the whole point that we, that I sold it on was that it can be and it would be re-chassis until it could no longer be re-chassis. Okay, so we've been laying the trail this way for a while. Yes, and the idea is that in the near future rescue 2 will have to be replaced and the idea is we basically take the specs from rescue 1, throw it on the table, say build me the same truck and that the same thing will happen is that it will be re-chassis until it can no longer be re-chassied. So, and when they do it, like I said, they completely take it off the current, you know, Dodge chassis that it's on there. They completely strip all the paint, all the wiring, everything, and they redo it. Wow. So, and there's various stages to that. They can literally just take it off and throw it on a new chassis and roll it out the door without touching it at all. I don't think that's a good practice because them stripping the paint and everything, to see areas that may be do [4:50] Ruth Wall: you ever have leaks in the roof of the box the [4:55] Jesse Thompson: truck is very solid among [5:00] Tom Jardine: the folks here is anyone object to the rebody of rescue one? So can I entertain a motion to make a recommendation that we proceed with recommendation of rebodying rescue one? Second, you proceed. Second. [5:19] Jesse Thompson: So is that what you need? I believe so. If not I'll come back to you. Okay. We don't have to wait till the next meeting. I think we can probably shoot it through email if we need to. The one thing that Todd wants me to really bring up is multi-year contracts, and because we really want to kind of lock things in, and that way it's fair to the town union, and it's fair to Washington and Appleton, and I guess what he's looking for is what would, and this gets into a little hard for Appleton, but I'm kind of looking at you, Katie, and I'm sorry, what would you like to see? Do you want to see a three-year contract, a five-year contract? Do you want to see, you know, I don't, and I hesitate to say necessarily a percentage cap. How's that like, we guarantee we won't go above this unless there's some, you know, [6:21] Kate Grinnell: extraordinary circumstances? Yeah, Washington does a lot of three-year contracts, so obviously we have in-house public works like you do, but our mowing, our cemeteries are, we do hire out just because it's of the configuration. We hire out plowing of the town office and fire station complex, and all of that's on a three-year contract. So I think, you know, we're, Washington's very familiar with, you know, three-year contracts. We would possibly be open to five-year, but I say, I would say for right now a three-year is a good starting point. You know, our, I don't think our budget committee is going to balk at anything like that, especially if there's, like you said, a potential for a cap of it won't increase more than X percentage. I do know that I've had a lot of questions, and I keep telling them, we're just, you know, this is still in, still in beginning talks. Things are getting hammered out. Nothing is finalized yet, but a lot of questions about, okay, if we start, if the three towns start putting into capital for whether it's rechasing or getting a new rescue, to who owns it, and you know, how does that do, choose, do Washington and Appleton also have a percentage ownership of this? If and when the town sells it, do we get a percentage back, kind of thing? So there's some questions about that, but I think as far as the annual contract goes, I think a three-year contract would certainly be something that the town of Washington would be able to entertain. [8:21] Tom Jardine: I see those two distinct issues. One is the continuous sharing mechanism for three years or five years, and then the second one is a conversation about setting up a reserve. Yeah. [8:32] Kate Grinnell: Creating a reserve amongst the three communities, and I think, I think you're right, I think they are two separate issues. They just did, it may have been originally two separate conversations. When I came on this board, it was kind of a conversation that was, both conversations were happening at the same time. So when I went back to Washington, both of those were part of the conversation. And I think, you know. [9:00] Jesse Thompson: I think they're separate, but they're together at the same time. Because the contract kind of lays that all out. And it's kind of, and I hesitate to say anything, but it, you know, however,, because I am not the contract person, so don't take it from me, like, you can look at it two ways. Like, yes, the Towns of Washington should, you know, get something back. Or, like, hey, this is part of the usage fees because, you know, it's getting used to cover those towns. And once again, those are things that need to be figured out by someone who's higher than me. Not you, yeah, but those are things that Todd wants me to find out of like what would you like to see, what are some questions. I think if you and Todd could [9:47] Kate Grinnell: possibly come to us, certainly come to a select board meeting in Washington, that would be fantastic. If you would also be willing to do a, no, yeah, not really an official public hearing, but a Q&A where we could, you know, post it ahead of time, that hey, this is what's, you know, this is what's going on, and if you want to have questions, if you have concerns and want to make your voice heard, this is the arena to do it. And I've got a gavel, I'm happy to hit people over the head to get him to shut up, right. I'm on video, I have a gavel, and I will have to gavel them [10:30] Becky Mountland: down. I've gone through that in my head too, like, because I thought how does the legality of it all work, because I've thought about it, yeah, like, and I 'm [10:43] Kate Grinnell: sure there's, I'm sure, I mean, we are certainly not the only multi-town [10:49] Speaker G (unidentified): ambulance service. No, we're not, and so the other thing that I've been doing is [10:54] Jesse Thompson: I've been getting contracts from other towns and seeing what they have, and it seems like a lot of towns currently run the way we do for that, it's a single year contract, it automatically renews unless someone says something or there's something question, but I think a lot of, a lot of departments, and I know this throughout, are looking for the multi-year contract because it's more stability and be like, hey, you know, here's some give-and-take, you know, we [11:25] Speaker G (unidentified): Will not exceed this percentage well and I can, you know, also say from my point of [11:32] Kate Grinnell: View if we sign a multi-year contract with you, I don't have to think about it every year, I don't have to answer questions every year. Robin slumber fire where multiple pieces of equipment across multiple towns are lost, you know [11:47] Speaker G (unidentified): We won't see a 50 increase in year three, right? Have you guys heard anything? So Todd and I went to [11:55] Jesse Thompson: An Appleton board meeting, Washington has already started doing which is putting money aside. Have you heard anything back from them about any of that? Not [12:09] Speaker G (unidentified): Officially, okay, I haven't asked either. [12:11] Kevin Callahan: I mean, I know there's some ideas, yep, you know, we've got, because we 've got some other things [12:17] Jesse Thompson: Going on, fire apparatus, yes, yeah, no, I think I know there's a lot of things going on, it yeah, that was just one of the things that Todd wanted and I think we're gonna, I think the idea is like if that's kind of what we, if that's what the answer was, then we're going to work on following up and like we'll work on coming to Washington since that's what you're requesting and stuff like that. Has Todd put numbers to a proposed reserve scenario? I don't have an answer for that, but that kind of goes into the next, the next one a little bit. We're working on pulling all that [12:54] Tom Jardine: Together. Okay, before we leave, I'm a relatively new member of this body. I've not seen the actual [13:00] Speaker G (unidentified): Contract, right, yeah, I think the only reason I've seen it is because of my [13:10] Becky Mountland: Select board, I just wrote down what is it, the contract that was several [13:16] Ruth Wall: Months ago in price, because gas is now twice at what it used to be, diesel I [13:28] Jesse Thompson: Mean, I think I have an old one from, or is that a request I should, it's one for Todd, okay, I'll just reach out to Todd, but it sounds like the entire board wants it, so yeah, can we just reach out [13:46] Kate Grinnell: As a board, yeah, just if he could forward every, just the mailing list, the one, the one I mean [13:53] Jesse Thompson: It literally is and I'll just kind of just, this is the one for Washington and I'm not gonna read into it, but it just basically listens out what the service are provided, payment of said services which includes a month and basically, you know, hey if you, they don't want to renew the contract, this is when they need to end it, how long the agreement is and then the cancellation of it, so does it [14:17] Tom Jardine: Have the method for allocation of costs? It doesn't look good, it does [14:28] Jesse Thompson: Not, such, oh it just has such assessment to be determined on a yearly basis, yeah, so the answer is no, it's a very generic [14:38] Kate Grinnell: Yeah, I think when we get it just has the number that I'm assuming you and Todd have, you know, figured out of this is what the it costs to run the ambulance, the rescue service, and therefore, yeah, you know, unions percentage is this for this year, Washington's percentage is this, Appleton's percentage is this. Here you go, Washington, here's your bill, but you population base, correct? Yes, population. [15:04] Jesse Thompson: Base, okay, so the way the way it works is we take anticipated revenue, so another and I generically, I want to make sure that's said generically, let's just say we, let's just say it cost, you know, five hundred thousand to run the inbound service, we bring in a hundred and fifty from billing, we take a hundred and fifty off the top, that leaves us what, three hundred and fifty thousand that the towns must raise. We take that number, we put it in a formula that's based on population, unions, Union pays more. Because it has a higher population, and then it goes down from there. And that's how we figure it out. And then, but it's based on what our operation cost is. So then if the next year we go up to 550,000, we take whatever the anticipated revenue is minus it, and then obviously it goes up from there. [15:59] Ruth Wall: So I just want to understand, can you be in a three-year contract locked in and the price goes up and you wish you weren't in the three-year contract? There I'm sure there are times, but. [16:13] Jesse Thompson: Typically that's why there's a there's a key, typically what you'll say is you won't exceed x amount of percentage, you know, you won't see an increase like we won't be like, hey, we're going to do, you know, you know, a five year, we're going to plan on five percent every, once again, our betrayal numbers, I just want to make sure no one's, hate, you know, hanging me on it, but like say, hey, we're going to do five percent for the next three years, so five percent every year, and then say, hey, by the way, yeah, no. We're changing it to 37 or, you know, 50 and I. [16:48] Tom Jardine: Anticipate that if we, if we go down the road of a multi-year agreement to sharing these costs, that'll probably one element of that contract would likely be right for the community to terminate with a sufficiently long notice period, yeah. [17:04] Jesse Thompson: Yeah. And I think that was another piece that Todd wanted to build in is, you know, kind of cancellation and stuff like that. Like, you're going to, you know, because we planned on, you know, like, being together for three years. Like, and you're like, well, you're year one into it. Now you want to go with X, Y, Z. Like, there's got to be some skin in the game, so to speak. [17:25] Tom Jardine: And how many years are we, have we been operating under this annual thing? [17:29] Jesse Thompson: Forever. Probably as long as I've been alive, to be honest. Really? I have one in here that I found from 96, and I'm pretty sure they go further back than that. Among these three communities? [17:40] Ruth Wall: Yes. Okay. Yup. And Hope was in it at one point, too? Yes. [17:46] Tom Jardine: So do you need something from this body as to proceeding with a multi-year agreement? [17:52] Jesse Thompson: No, we're working towards it, but I think it was more just trying to get ideas, especially from Appleton and Washington. Washington what they would like to see in a multi-year contract what you know kind of what scares them you know and what you know what are they okay with you know kind of like hey we'd like to have some kind of percentage cap because that makes it easier for budgeting like if you can say hey you know on a worst case scenario we're going to add 10 percent for the next year for the you know every year you know they can plan that out or you know like hey we prefer a three-year contract over a five-year because we're already used to three [18:30] Speaker G (unidentified): years it's it's not it's not long but it's long enough yeah it gives you some [18:36] Kate Grinnell: stability on knowing that hey yes we're gonna have all three communities in this but then also gives each community the option of you know okay yeah no this really isn't working for us anymore okay it's not another decade till we can get [18:52] Becky Mountland: out of this is it a both or both or nothing or can well hypothetically not going to happen Washington say yes I'd love a three-year and Appleton be like nope we just want to stick [19:03] Jesse Thompson: with the one year it could happen but it that makes it really hard yeah so typically like it what we'd like to do is that's why I try to find that happy medium for everyone [19:15] Kevin Callahan: One, you know, so a couple of maybe very detaily details to not discuss but just throw out there. One is, you know, what kind of, if we go to a multi-year with a cap and there's another curveball like the DEA thing where, oh, now you guys have to figure out how do you do controlled narcotic storage and nobody planned for that. I mean, that was not a small ticket item for any of the providers. You know, how did we negotiate those kinds of things? Because we, you know, three years, a lot of things can happen. I think that's where you have [19:53] Jesse Thompson: that clause in there and I think I mentioned it is like pending, you know, like discussion of pending anything critically. I don't know how the wording would go, okay, to put a clause in parties of good faith would enter into conversation. Yeah, you know, like that was something that was, no one, they say we saw her come in but we didn't and but like it was an unplanned event. Yeah, but so yeah, cool, so that's one thing. The [20:23] Kevin Callahan: other thing is insurance. You know, we learned losing a truck and getting a fire truck that burned at Robins, we were given 120,000 for that truck. The one that we've applied for grant for is 1.2 million. I think maybe 1 million, I can't remember [20:47] Kate Grinnell: exactly. I'm guessing that's probably not a bells and whistles truck. That's not [20:51] Kevin Callahan: the one that we are under contract in Camden to replace our 35 year old engine is 1.2. It's just the going rate. Yeah, you know, for a cab over with a good crew, you know, just all of the stuff that we need for rural firefighting. Anyway, the insurance plans, you know, when Owls had rolled their tanker a few years ago, they had insurance coverage that gave them replacement, so they're able to get a new truck. I know that's a lot more expensive, but again, I don't know where that lands and if that's something that the towns can, I know that ask about or dictate or say we [21:28] Kate Grinnell: want. I know that MMA, I'm assuming your insurance is through MMA for the vehicles and my [21:36] Speaker G (unidentified): understanding is what we have is replacement cost. So and Washington has replacement costs, but they [21:43] Kate Grinnell: are no longer doing replacement costs on vehicles older than 20 years and I don't know how that affects if you get something re-chassied? [21:54] Jesse Thompson: Technically, if it gets re-chassied, it's a new vehicle. It's a new vehicle? Okay. Because the chassis, it goes by the year of the chassis. Okay. Awesome. [22:01] Becky Mountland: Perfect. Love that. So just to make sure I understand, you want to make sure that unions keeps a certain type of coverage on the vehicle that you're? [22:10] Ruth Wall: Yes. Okay, I just want to make sure. [22:11] Kevin Callahan: So if the ambulances get wrecked, if an ambulance gets wrecked, there's an insurance policy in place that will replace that vehicle at current rate. [22:20] Becky Mountland: Yeah, I think it makes total sense. I just want to make sure. It's been a long day. [22:25] Jesse Thompson: no because we when we burned up a fire truck here because it destroyed itself because it had motor problems the motor blew up we got replacement costs unfortunately the replacement cost because it was a homemade truck was not as good as the great thing is that we got our brand new we got our I say I'm not our brand new but our new tanker out there pretty much covered we just happened to be lucky the way everything fell together yeah I'm don't mind me I'm okay it's the rest of the world that so Which kind of brings me to the next thing is, once again, how would we bring up, so basically end of year money carry forward. And so what we're looking to do is if for whatever reason we have money, because we have a good year for building, I know that sounds kind of horrible, but I mean, like, here's the thing, we project we're gonna bring in this amount of money, you know, two hundred fifty thousand dollars. Hey, we brought in three hundred thousand. What are we going to do? [23:38] Speaker G (unidentified): With that money, pizza party. Okay, sorry, that's, that's, that's kind of the. [23:46] Kate Grinnell: Typical Washington town office joke. Oh, we have extra money, let's order pizza. But typically it. [23:52] Jesse Thompson: Would be good to put it in a reserve account, go into, i.e., you know, equipment slash vehicle reserve. So that way also if we have a year where, hey, all of a sudden for whatever reason something happens, we can make up the shortfall if there's ever a short year or shortfall where, hey, the DEA is coming up with a new rule, we have reserves to pull from. And then that way we're not having to ask the towns for surprise money. Yep, we have reserves. I mean, we already do that anyway, but it's the idea is like. Kind of want to put it together in writing and like, this is our plan that is going into a reserve account. Is that an issue because the billing lags somewhat? Okay, when I, because. [24:42] Tom Jardine: Because otherwise, you're taking, as you described earlier, you're taking the billing off the top and then allocating the remaining expenses. [24:48] Jesse Thompson: Yeah, and once again, the billing off the top is, it's a projection of what we earned. So usually it's what we earned over the last three years average. I see. It's not an accident. Yeah. This is like, hey, we think we can bring in this amount of money. Because this has been the average over the last three years that we've been having. So, which that changes when we do more calls. that are let me rephrase it we do more billable calls you can bring in more revenue in theory so it was this a question whether you establish a reserve or take dividends so to speak to the communities I think it's kind of that because I know I think what Jay has done in the past is that I know a couple of years when we had a good year we gave a reduction to the towns and so I think the idea is that we don't don't do that anymore we just like hey this is good you're we're going to dump it in a reserve account so that way whatever happens if we have a bad year we don't have to go to the towns be like but sir I'd like some more you know and but once again then we then we have talks about why did that happen but like we have that safety buffer that way we don't have to be like hey so guess what we're 100 000 short we need to have we need to figure out how we're going to do this because if you look down south I think York ambulance they were like 500 000 short and that's a private entity that's not municipal so we're trying to prevent that from happening but that's why we stay on top of the billing and all [26:31] Ruth Wall: that stuff is reimbursement from Medicare Main Care adequate oh it never has been [26:41] Jesse Thompson: Main Care is definitely a lot better than the federal Medicare rate but it 's still it's still short Main Care pays about 200 percent of what the federal Medicare rate pays so and federal Medicare pays about 80% of what it costs to go on a call on a good day. [27:07] Tom Jardine: Do you have what you need from us to respond to Todd? Yeah I think you guys [27:12] Jesse Thompson: are kind of in favor of like hey we'll work on building a the money that we kind of have left over will go into a reserve account. Is that a decision, isn't that kind of a select board decision? it is but the slug board really depends on what you're what you're saying okay [27:29] Becky Mountland: so we only are recommending everything we do is right recommendation so as [27:34] Kate Grinnell: Someone who also writes a town budget in my free time, I like the idea of having the reserve fund. I just want to make sure that it remains an option of once the reserve fund gets to a certain amount, whether it's a hundred thousand, two hundred and fifty thousand, or hey, we've had a we've had a surplus for five years, you know, and it doesn't have to be a set thing, but that at some point we can look at it and say hey, we've got a decent reserve fund, we've got some excess this year, let's use that to offset each town's right after assessment, that's the word I'm looking for, once there's a once there's a healthy reserve hit a certain dollar point, yeah, and like I said, it doesn't necessarily have to be a certain dollar amount or you know just, but that remains an option on the table does [28:43] Speaker G (unidentified): that need to be motioned or is it faster Jesse I'm slow look [28:54] Ruth Wall: the [28:56] Jesse Thompson: The fact that I'm writing it down instead of like, oh, I'll remember it, is a huge accomplishment for me. [29:01] Becky Mountland: And it's actually multiple figures, too. [29:05] Kevin Callahan: Was there ever any movement on changes in law or regulation around being able to bill for non-transporting calls? [29:16] Jesse Thompson: So, a lot of that gets into some... [29:19] Kevin Callahan: And if it's a big topic, let's not go there. I just was kind of curious since we're talking about billing and revenues. Nope. [29:25] Jesse Thompson: So, the long and short is the service can do whatever it wants to do. We typically, for no transports, typically if we go and give a med or something like that for your diabetics, as you know, we can start IVs and give sugar through the vein and all that. We attempt to bill, it's not a lot, but we just try to recover what we use for supplies. When someone's in cardiac arrest and we try to go and save them, we can technically bill for that. And maybe I'm wrong in thinking this, I have a hard time sitting there asking because we could technically bill insurance. Medicare will pay us a little bit of money. But like, hey, sorry, your loved one passed away, but can we have their insurance card? That does not feel right on the inside. It also doesn't feel right to send them a bill and have them call and be like, why am I getting this? We typically try not to do that. But like for car accidents and we go and do an assessment, car insurance will pay for that. So we build the car insurance, that's why we get a lot of that from the deputies when we're there, because we can bill for that. So it's it's not much, but the idea is like at least it's paying for some fuel and a little bit of the time. So what you described, not billing, is that customary, not billing for services, someone who passes, some services do some services is dealt. So it all depends on what the appetite is. I mean, we most certainly can. I just personally have not done it. What's the frequency of that? We probably run half a dozen cardiac arrests a year. So I just once I have a hard time sitting there and say, I'm sorry that your significant other has passed away, but can I have you, can I have their insurance card? I realize you have [31:11] Tom Jardine: personal feelings, but I guess that's why I asked what's customary. Well, what are [31:16] Jesse Thompson: the most communities do? I think most communities kind of do what we do is we just don't, they just, we're going, we're going to answer the call, we're going to [31:26] Ruth Wall: do what we need to do, and then that is a lot of materials and stuff when you're [31:32] Jesse Thompson: running a whole code, that's there is a lot of materials. But if we transport to the hospital, we can get the insurance information from the hospital, and then [31:40] Speaker G (unidentified): totally different, right? These are no transport, because I'll do whatever [31:51] Jesse Thompson: anyone else does. I'll do what this group suggests to do, but just remember when they come up with the pitchforks, we're all gonna be up in line together, so I [32:00] Becky Mountland: will not be by myself. So what about mr. Jones who because I've seen it on the scanner page all the time fell down, needs to help up, we don't ever bill for those, correct? [32:15] Jesse Thompson: We do not. There are other departments that have done that in the past, and that gets into a whole issue is then you're just sitting on uncollected debt because mr jones does can't afford it. But I mean, and we used to do this at the department that I my full-time department that I work at, and we end up stopping the practice because we just, if they were counting as an uncollected debt and it was just, you know, even though it was just a hundred [32:42] Kate Grinnell: dollars, but it sits on your books, and you've got, and you've got to be clicking every month that [32:47] Speaker G (unidentified): it's correct. Yeah, and your auditors hate you at the end of the year. Yes, so we just do it as in [32:53] Jesse Thompson: and for me, mr jones who fell down and needs help getting up and just needs to be dusted off, [32:59] Speaker G (unidentified): sort of speak, it's good community service. Oh no, i totally agree, i was just thinking, yeah, but [33:06] Tom Jardine: Good community service will add up. Yeah, you don't want to be enabling someone to stay, someone remaining in a home that maybe they shouldn't be, and we have to be in an [33:18] Jesse Thompson: assisted care facility rather than, and we and we have, we have mechanisms for that. So basically we kind of, and this is standard throughout, is basically like if we go there, be like hey how you doing, get them up, like all right, like well I'm fine, you can leave now, like all right, no I need to see you get up and move around. I need to be able to see that you can make it to the kitchen and you can go to the bathroom. Those are the two biggest things, that way you can get something to eat and drink and take care of bodily functions. If you can't do that, hey, we need to have a realistic talk, okay. And then we and we sit there and we do that, and then if they're still fighting us, we can make a phone call to the hospital and say hey I'm here with Mr. Jones, he cannot walk from one thing, you know, from the living room ten feet to the kitchen or five feet to the bathroom. He, you know, when we paint that picture for the doctor and they can be like nope bring them in, and they doctor can have [34:13] Ruth Wall: us bring the patient in automatic, and sometimes you need law enforcement to [34:16] Jesse Thompson: help you do, sometimes you law enforcement to help you out with that because they're very adamant that they're not gonna go and they're fine. That's true. So and sometimes and sometimes they're like hey I'm willing to go but I don't want to go with you. Well who can we call that and we'll help you get into their car, we'll do that too. A lot of a lot of different facets to all of it, and that's that's the [34:39] Ruth Wall: kind that takes a lot of time, and it seems like you ought to be paid, but it does, but once again [34:47] Kevin Callahan: it's trying to do what's right for the communities. Yeah well and it's and it's also I mean we have the rescues are staffed, you know, so you're burning some fuel to go to somebody's house. Yeah but it's not, yeah it's not an additional, it's not an additional expense because the payroll is already being, you're already paying [35:09] Ruth Wall: it. I would think when people are saying what about all this cost, that this kind of scenario is really important to mention the times that you don't transfer it and you don't get paid, but you spent half an hour assessing the person or making sure they eat their peanut butter sandwich so they don't, you know, there's so many times when we spend, yep, and it's capital and it should, it should get paid for by it, by the rate of the calls where you do get reimbursed if [35:48] Jesse Thompson: we could recruit more money yeah it would certainly help but it is what it is unfortunately i hate saying that but any other discussion on the carry forward the last thing i have on here and once again is kind of we would like to know kind of what the town will really i mean obviously you want us to be a 911 transporting service but is there anything else that we can do within that wheelhouse that the towns would like to see from us i mean we, you probably don't know, but we go out and we maintain all the AEDs. The AED in there got taken care of. We're working on that. We take care of all the AEDs in the schools and in the libraries and on the first new fire apparatus in all three towns. That's built into the budget, and it's something that we've done for years. A couple years ago, we updated all of them. We got a grant from Stephen and Tabitha King. We were able to update them because they hadn't been updated since I think in 2008, 2007, 2008. So just like anything, everything has a shelf life, so we decided it was time to update them, but that's a huge cost. So we applied for the grant and we got the grant along with our second Lucas device. But it's kind of, you know, and I've said it before, we're experimenting very cautiously with the community paramedicine. And we've had some patients they want, I think there's a couple that are on that we may be getting potential again. There's one lady where somewhere that needs, you know, IV fluids every so often, and so I think the good thing is Maine legislation has put it into law and I believe it takes place January 1st, but we can start billing MaineCare for those calls if that MaineCare, so we can start recovering some money, and my plan is when we start doing that and I haven't really talked to Todd about it so Todd if you're listening I'm sorry you can take me out back and deal with me later but would be basically to take that money and set it aside for the community paramedicine program that way it's designed for that once again we're doing it with a staff that we have them already on duty we're not changing any anything the way we do they go and do it when they're here so they're already being paid so and the idea is eventually that maybe we can kind of do the same thing we can set money aside and Eventually we'll be paying for itself without any extra incur, incurring costs on the tax. So we're, let's say we're trying it out. I have one person, will this is the, my CP person. So and we only, we can only have, I think seven patients max. We said, we set that limit on ourselves just because we weren't sure how many would want it or how much need, and that way we can control. So we actually got one, we the Rockland District Nursing called us and asked us if we could help them out with a patient and we're like, yeah sure, you know, where do they live? Oh, they live in Rockland. Like, no, sorry, no. If they live in Washington, Appleton or Union, absolutely. So, but they're finding about it. And so, but if there was something else that the towns saw that we could help out. Right now, I have people who are on the rescue who are cross trained. And basically when they go to fires, you know this Kevin, if there's no one, as I say, and dead or dying in the front lawn. They go and they start helping the firefighter operations. They'll pull hand lines, they'll pull, they'll throw ladders, they'll do all that stuff to help the fire departments out. Because all the departments are struggling for people. [40:00] Kevin Callahan: Well the rescue gets there before the fire apparatus typically too. [40:04] Jesse Thompson: And so the ones who are trained, they'll give a scene size up so that way if they can, you know, the chief or whoever the officer for that community is that's going can make better decisions. That's something that we've been working towards. Just like anything else, there are some days where I don't have anyone who's quote-unquote cross-range, but my EMS people are at least getting comfortable with doing scene size-ups, which is basically coming across the radio saying what they're seeing. Like, hey, I've got a two-story house and I got fire in the attic or on the second story. That tells a lot. Like, hey, I probably need more help. Or hey we're on scene with nothing showing like all right hey we're going to continue and you know have all my units continue in emergency but you can have mutual aid come in non-emergency so those are those are some things that we've worked on improved become more valuable to the community [41:09] Ruth Wall: I'm not really sure and I probably should know this, are you staffing for both [41:14] Jesse Thompson: ambulances in base? No just one, we're just doing the one and then it's it's paid on call for the second one. Okay so and I think here today we just we just gave a call away [41:27] Speaker G (unidentified): Today so we're up to five. You were, I think you were, oh no sorry, I was [41:34] Kate Grinnell: thinking missed calls. Yeah that's right. Yeah so I think at the end of August you were at four six [41:44] Speaker G (unidentified): six so seven. Yeah so that one last year's it is like [41:51] Jesse Thompson: like and but that seven we missed and two and two of those were because the second one of the trucks was broken down. Can't control it, wear and tear, it just happens. But so even then we're still higher than what we were for all of last year. But means we're also getting the truck, we're getting that second truck out more too. We're having more calls than that second truck is getting out. We have a good quarter of people who are willing to come in and staff it and also the [42:21] Speaker G (unidentified): number of calls is higher this year, so significantly higher. And you know I'd like to say like hey [42:28] Jesse Thompson: look we can prove that it's the fairgrounds that caused you know the huge increase. No there was barely any calls down there, barely any calls. So it's just calls in the area. I think populations yeah are growing and whether we realize it or not I can't tell you. I'm in terms of driving you know my ride normally consists of just going the 17 corridor but when I'm in the rescue or something along that lines and I'm going down like I'm seeing like there's a new house going in there. When did that house go in? Yeah it's just it's not stopping. So that which is going to put a demand on services as well. Yeah but then once again hopefully with the demand we're [43:12] Speaker G (unidentified): recouping the amount of money that we should. I think you guys, I've been in three times four [43:19] Becky Mountland: times in nine months say we weren't able to man a second rig. I think that's incredible. Yeah that's a volunteer fire like ambulance crew. I think that's really, I'm glad you think that but [43:31] Jesse Thompson: that in my own internal irks me a little bit. That's just because I have pride yes and so I want to make sure that once again very prideful of and I get it probably can be a sin but I want to make sure that we're doing what's right for the community. But as a community member I want you to [43:48] Kate Grinnell: tell your career that I am impressed. Yeah with those numbers. Not to bring up specific incidents but yesterday the thing at Jackson's Corner Store yesterday morning did you send both ambulances to that? Yep so that's and that was they were not far apart no so [44:07] Jesse Thompson: That's that's what we're trying to do again. Hey, we're going to a car accident, I want both trucks to go because you can have multiple patients, and if worse comes to worse and they're like nope, we don't need the other truck, turns around and comes back, and it's ready for the other call that may happen. [44:28] Kate Grinnell: Nine something in the morning, it was it was on the scanner page on Facebook. I know we heard we heard the cop go by, and my husband's like check the scanner page what happened, and then we heard the ambulance, and I'm like oh there's Union, and then like I swear it was less than five minutes. [44:49] Speaker G (unidentified): Later, second one, I'm like oh Union got the second bus out. Yeah, we're really trying to work on that. [44:55] Jesse Thompson: I was so I know there's some people who had have had concerns, Appleton Karen, she's one of the select board members, Karen actually went to school with her son, it used to be Karen Lewis but it's not, Karen Luke's hasn't been that way for years, but still she was asking the same question, and I said we try to put both trucks because anything like that there's potential of having multiple patients, and especially in car accident with two cars, you don't want to transport patients from car A and car B. Together, that's that's very bad, I think a bad plan, I mean. [45:32] Kate Grinnell: Sometimes it's a bad plan to transport the ones from the same car together, it absolutely can be. [45:38] Jesse Thompson: So they have to understand like they're asking questions that I may not have. Oh yeah, because the problem is when we when we fully switch over, we had to buy the first rounds of our controlled substances because we didn't have any of that in stock, then we had to buy, and then we started buying the other stuff that we have to have as well because it's starting to expire, so. [45:58] Becky Mountland: I just want to make sure that they understood like that number and where the like how long. [46:02] Jesse Thompson: That actually was. Yeah, it's it should start leveling out now. We were very lucky is that we already had stock on hand, so we so that's a huge thing, we already had stock on hand. On top of, I found when we when this was all happening, Main General, because we used to keep a Main General box just for the controlled substances, basically said hey you need to fill these forms out, but don't bring the boxes back, they're yours now with everything in them, so it added to our supply and our reserve, so it helps. us out so hopefully that you know Stacy is making a new line item within the budget. It will it will for me it will show zero because we didn't put any money into it. All the money that's coming for medications coming out of my supply line, but we're probably going to end up making a whole new line item for that just so when you see it for the budget, like I don't want you to be [46:59] Speaker G (unidentified): shocked. Yeah, definitely should have its own line item. Yeah, so but I'm keeping [47:06] Jesse Thompson: track of it outside, so I'm gauging where we're gonna land. Yeah, it [47:11] Kate Grinnell: wasn't something you knew ahead of time, so there wasn't a line item for it. You got to pay for it out of something, so that makes sense that it's right now it's coming out of your supplies line [47:19] Jesse Thompson: item, but once again we are doing our due diligence and we're watching it very carefully. We're being careful, we're not buying, I don't want to say we ever bought things that we don't need, but sometimes we were, we would keep extra things on hand. So things that don't, that doesn't expire, we will buy those because I don't worry about them expire, but everything on an ambulance expires, so we're just trying to do our due diligence and keep quantities that we need to keep so we're not over stocking stuff. So but everything is live, our door locks are in, our med vault is in, and everything is for operational wise is operating perfect. Everyone is, it's definitely going to seem like this is going to be an easier, sucks that we have to pay for it, but it's definitely a lot better because then we're not having to wait on nurses at [48:13] Speaker G (unidentified): the hospitals to give us our new boxes. So that improves your turnaround time to get back to station? Yes, we don't have to sit there and wait. Okay. [48:22] Jesse Thompson: There is a little bit of a benefit. [48:29] Kevin Callahan: Can you let me know if and when you go back up to Appleton Selectport? I'd just like to hear the conversation. No, absolutely. [48:39] Jesse Thompson: So I think what we're going to do is because Appleton technically you every time can have Union has one more representative, but like you're supposed to have an alternate, and I think we're gonna ask that one of the select board members be an alternate because it's great to have like Katie here who can voice the select board because she's part of them, you know, be good to have someone from the select board of Appleton here as well because then they can say you know along with you, but say hey You're on, you're on track, or hey, you know, kind of give some more guidance. It's a little easier for the union peeps because, you know, I've got Todd and have more of a direct [49:22] Kevin Callahan: read is Karen's last name Reed. Okay, thank you. It took a [49:25] Becky Mountland: few minutes, it does usually find it. Can you let us all know what day you're going to go to that [49:31] Jesse Thompson: go to the different stock board meetings? Yep, and I think it would be absolutely fine. I don't think any town would have a problem with any of the ambulance advisory board members coming [49:41] Becky Mountland: me I just like to sit there so I know what's said. Yeah, and I'm nosy, let's be honest. I want to see [49:48] Kate Grinnell: how other select boards are in their meetings. Gives you that reason. A lot of them we meet every week, that's a lot, but also, but also we don't really, but also on average we're out of there in 15 minutes, so you know three board member, right, we're a three member board and our payroll is weekly, so at a minimum we'd have to be meeting to sign [50:18] Speaker G (unidentified): warrants anyways, so is there any other questions for me about anything dealing [50:25] Jesse Thompson: with and with the ambulance? Well the problem is with November then we know November last week, yeah, the night is gonna be a problem because planning [50:36] Becky Mountland: board, yeah I'll chase once that and I'm not looking at the calendar yet, so I [50:41] Speaker G (unidentified): didn't know, I still have to save to my phone. I'd say if the 10th works for [50:48] Kevin Callahan: room, don't talk about that. I should be able to get here unless we have some [50:52] Jesse Thompson: crazy call like right again, that's exactly what will happen. Yeah, you [50:58] Kate Grinnell: just, you'd actually just jinxed yourself for the next three months, [51:03] Jesse Thompson: trust me, I've done that. I planned things very close to the end of shift and [51:08] Tom Jardine: okay, Thursday December 10th at 6 30 pm, I started out [51:21] Becky Mountland: December and [51:24] Jesse Thompson: yes I will keep everyone posted about when we're, when we meet with the boards and everything like that. My plan is I will have an estimate for the mold boom by then for Washington, so I try to, I know [51:43] Kate Grinnell: I know we're paying because we're, we're, yeah, you're a calendar year compared to [51:49] Jesse Thompson: a fiscal year, but you and I know we did it the one year to pay us with to do it the same time as a school district, is that yep, we don't have a problem doing [51:59] Speaker G (unidentified): the vote then, but you just need to have a idea, it's, it's nice for the Budget [52:05] Kate Grinnell: Committee to have just a rough idea as we're going through our budget process of, okay, we're looking at the ambulance going up 7% this year versus we're looking at the ambulance going up 17% this year, okay, where do we really, do we really need to put XYZ in the municipal budget or come out wait another year? We, I will say Washington does have an open, we've got one open spot still, and I may try to tap someone from the budget committee for our alternate, okay, yep, unless you, unless you have any suggestions of someone in washington you would like me to drag onto the board [52:50] Jesse Thompson: no i it's whoever you think and i but that's kind of why i wanted someone from appleton in washington whether it be budget committee or select preferably select board because it gives me that insight that i that i need to be like yeah and it's nothing against the two of you but yeah I get it 's difficult sometimes so