Speakers labeled via automated voice-based diarization + AI name-matching against the city's official roster. Automated transcription can still mis-hear a name during fast speech (e.g. a rapid roll-call vote) -- clear near-misses are auto-corrected, but this is not manually verified line-by-line. Treat names as a strong best guess, not an official record.
[0:00] Jonathan: I have a minor question before we get the real meeting started on that. So you won't like it if we send up remedial people. I have one.
[0:25] Frank: We're live. We're live. Live. Good afternoon. October 8th meeting of the Fire and Rescue Planning Committee. I usually try to start with do we have any questions on the minutes from the last meeting? The only comment I have on it is on the last page under trail mapping, somehow I was given at least partial credit on that and I would like to take my name off of that. It was solely town staff, at best I encouraged them to do it. So if you want to strike with the help of Chief Wallace and give the credit where the credit is due, I would be grateful. And if there's nothing else, I would move we accept the minutes from the last meeting. Second. All in favor? Any opposed? All right, so going down the list, I love these minutes because it gives us a place to start and make sure we catch everything while we're at. So the facilitator conversation so I guess that's where we're at just pass it out thank you I sent my only thoughts on it we're looking
[2:06] Christie Woodard: For input and feedback we drafted something for the committee to react to so we're definitely open to hearing from you I
[2:19] Jonathan: Feel I would be remiss if I didn't at least I think the scope of work for what it's trying to do I don't have any real objections to the problem is that the situation right now is we're working on a process and not an end point and to me this is really getting someone to say okay how do we get to the point of being able to do the municipal fire department whereas what's really on the table right now is how do we go from where we are through the set of stages I could give examples but instead of Stages to the pinpoint where that really is going to be the only option left open to us it's not in my mind an option we're headed to on purpose right the current system needs to be extended as long as we can because it's very cost-effective. So I think the scope of work really needs to work on the stops on the train track, right, that have to sort of be gated before you get to what you're asking for here.
[3:34] Frank: So you're asking for, like, waypoints or?
[3:38] Jonathan: Yeah, so I mean, I can do examples in my head And the problem with doing examples is I'm just making them up, right? They're not studied examples, right? But you know, like, with the next stop we're making is, we're trying to get to 7 by 24 because we think it's required. You know, and then you can go down the path where you need more required, or you can tackle the issue, you know, a medical is doing quite well right now in terms of the department's providing it using the system we have, the merged system we have right now. But if things start to go the other way, then what do you got to do? Well, you got the station bill. You're going to put an ambulance there and run with an ambulance instead of the fly car. You're going to staff it with another person. So the ambulance comes with two people, just like every other ambulance arriving in a municipal-type setting anywhere in the country. And then, you know, presumably, you know, you have some kind of call system to deal with the fact that we occasionally have two calls. So you've got to have a second ambulance there. And then when that part of the system starts to wear down and doesn't work really well, then you're going to have to staff a second, come up with a way to have staff a second system. And, you know, like the end point on this would be like everybody else in the planet. You've got a crew of four and two ambulances. So, you know, it's like how do you go from here to here? And with the stops on the way, and you know, how many stops do you really need, and what are the checkpoints, and in my mind an obligation we have to try and extend the current system as long as we can. That's an example, I'm not saying that's a good example, I'm just saying it's an example I just made up, I [Speaker D (unidentified): really] We're talking about working on a scope of work here.
[5:45] Speaker D (unidentified): I really want to do what you guys want me to do, or we want to do what you guys want, but you just said, I still don't know what it is. You want the system to last as long as it can, and I think we would all agree we all want that. I'm not sure how to write that down and to get in a consultant to how do we say that. I don't, I don't, I don't, I get lost in what we all want. Ben said we should be able to get through this process and, I'm not trying to, six to eight, ten months or whatever it was, under a year, I'm not sure what the process is to get us there. I, 'm struggling to be able to write a scope of work if I'm not sure exactly where we're trying to get the work to lead us.
[6:31] Chair: Chair, I think you've done that, Frank, because as you read through here, what we're attempting to do is to evaluate those steps as and I agree you know with Jonathan where this part of this scope of work is to have a I assume this is going out as an
[6:49] Christie Woodard: RFP so I you know I agree completely this part of this process is to look
[7:05] Chair: look at where we are, as Jonathan points out, what are the options available to us to expand as required by either lack of volunteers or by the change in the demand for services. And we have to evaluate each one of those options and look at it in terms of, are we ready to move there? Are the individuals, groups ready to move there? What's it going to cost? I mean, are we going to have the support of the community to move there? I mean, we can want to go there, but we still got to have support from the community. And to get that support, we've got to demonstrate that we need to make that step. So I think you've done it with your scope here. And I agree Ben had some language in the email about creating conversations with stakeholders and so forth, and that's what we did for the paramedic program
[8:14] Frank: that's what we did in the original 2008 study, right? Yeah, so an interview all of
[8:17] Chair: us, I entirely support that as well. Yeah, so I think you're okay. I don't think you need to be specific with this. I think we're looking at a broader picture of what our options are, and then making decisions later on, as Jonathan was saying, when do you make those moves? It's not a wholesale go from A to B. There's going to be some.
[8:42] Christie Woodard: CHRISTIE WOODARD- I did want to point out, Frank is budgeting for the 24-7, two firefighters on. So this is a proposal to add money to the 2027 budget to bring in a consultant slash facilitator to work through this process or, you know, lay it out for us.
[9:01] Frank: Which will actually, that study will only begin to start at the same time the new staff is actually already coming online. So I don't know if we need to study that at this point.
[9:10] Christie Woodard: No, but, I mean, it will get picked up.
[9:12] Jonathan: But, I mean, given the budget cycle we have, to be clear, new money starts at the earliest in April.
[9:20] Chair: Yeah. And we don't know, I mean.
[9:22] Jonathan: I mean, I don't know if this, you know, once you get bids and you have an idea what the money is, as you know, then it may be inside the window of other available funds as you look at 2026, whatever. But that's not something I have visibility into.
[9:41] Chair: CHRIS RODGERS, JR.: Well, we know the last study cost $30,000. So the likelihood it's going to cost less than that, I think, is pretty slim.
[9:49] Frank: CHRIS RODGERS, JR.: Is that what it is? I mean, it was $30,000. I don't remember.
[9:53] Christie Woodard: CHRISTIE WOODSON, JR.: I can't remember if it was $20,000 or $30,000, but yeah.
[9:55] Chair: CHRIS RODGERS, JR.: It was right near $30,000. 30. So you're looking, I think we got a grant for that one actually, but you're looking at the ballpark number in there. But until you have an opportunity to talk to some people, I don't know how you're going to arrive at that number unless you investigate it with some, with some consultants.
[10:19] Jonathan: I guess back to your question, Frank. In my mind of stepping through the mental gymnastics of this, I start with what does the end look like, where are we now, and what are the boxes we're going through to get there. And I don't think you have to be, you know, I don't think you have a lot of choices available to you on the end, okay. Just because the size of our community, the number of calls, you're just not going to end up staffing 14 full-time people to have a crew. You're going to have to have a system of call support, trucks, whatever. So I think you can draw that picture and say this is what it's going to have to look like at the end. And here's, here we are now, and okay, how many, how many places along the way is it really required to, you know, conceptualize, right, what the next step is, and some of them are constraints, okay. We're, we're just again reluctant, since we're broadcasting the meeting, to throw out ideas that people will think like I've thought these ideas through and that's what we should do. I'm just trying to use examples of, you know, constraints that we have that if you want to fix them, it takes some time to fix them. So if you ultimately conclude that the size of the central building we got is insufficient for the program that you need to run then you got to do something about the third bay that or the fourth bay or whatever to fix it and there's a runway to do that so you know i think you could look at the things and say okay for the time you decide that 's a fact you know how fast could you do that right well we're gonna have this building in 2028
[12:21] Frank: Well, so on that, I think it's more on staffing. I think, personally, that gets me thinking about, are we gonna ask them to put together, or help us put together, a plan that says this is conceptually where our five-year window, and it may be that the end of the five-year window we haven't completed stuff, or are we asking them to come up with a plan that's a 10-year window, or what we're doing it? I'm, I'm happy with this, with that one minor thing that I sent out in the email, but I think one of the things We learned from the feedback we got from Kennebunkport was that each of the separate fire companies kind of did their own thing that was, that made sense for them. Some of them the property became municipal property, some of them they maintained it, they all still have their own identities though they're part of, I mean, the municipal fire department now. They have called firefighters, maybe that's where we end up, but to me that can open my eyes up, it doesn't have to be all or
[13:29] Jonathan: not. I mean, and that didn't see, I don't know if anyone interpreted anything I set up to this point of all or not, that is incorrect, I
[13:40] Speaker D (unidentified): don't, I did, I certainly didn't, I
[13:47] Mary Ann Borgeson: I think, you know, including the stakeholders, and I also added to include the board members, because, you know, we're, we're going to be supplying people as like we do now, we'll be doing that in the future, so I think they need to be involved as well. The board members are stakeholders, specifically, yeah, I just want to make sure, yeah, in all three departments, of course, it's
[14:15] Frank: my recollection, when the original study was done, they talked to the boards, they talked to the responders, they did all of those interviews, and that's, and that thing started out with a very narrow, that work scope was to determine whether or not the original proposal, but the town should start buying the fire trucks made sense or not, and then when they got done they came back to the town with a very broad report that covered a lot more than that, so which I think, I my recollection was I was surprised the amount of information we got back from them in that report, based on what the original ask was for. So, I mean, the reality is, under this scope of work, when they interview you or me or you or any of us here, we could say, I think it's very important that you help us create a roadmap that says in six months we're going to do this, or when this event happens, we're going to do this. And then they would take that into account when they help build this final report.
[15:17] Chair: There's gonna be events that are gonna have to occur to trigger these changes. As we've already learned from the paramedic program, the municipal program, we can't always. That is not a finite amount of time. With the volunteer forces, it's up and down. We have one year, one department's strong, the other one's not, and then it keeps bouncing around. I think it's very hard to tie a timeline to something unless we can. It may require us to do an evaluation as a committee every year and see where are we. And then with that evaluation of our resources, make recommendations to the Board of Selectmen on where we think the next step needs to be.
[16:05] Frank: DAVID BURRAGE.: And on the EMS side of it, at any given moment in time for the last 15 years, I can point to a period of time. I cannot point to any period of time where you couldn't say one of the departments were struggling.
[16:16] Mary Ann Borgeson: MARY ANN BORGESON- Yeah, you're right.
[16:18] Jonathan: But I guess maybe I didn't say it well. I'm not thinking in my head that we say on January 1st, 2030, then this event has happened and we're going to do X, Y, and Z. I think the, I like to call them the failure modes, but that's probably not the right way because it doesn't fail hard. It fails soft. So we know, you know, you picked ambulance services, right? At some point, the struggle is going to become so severe that we're going to have to react with a change in the way we do it. And we should have in our heads and on paper and sort of planned out, we don't know when the struggle is going to get severe enough that it's a service disruption risk. But at that point, what are we going to do? Now, I can outline myself what I think I would do, which kind of more or less maps what I said earlier on the, you know, whatever. But, you know, we can cover up those gaps, and we have covered them up for a reasonable period of time, you know, of transition. But you can't do it long term. So I don't think of this as a timeline-driven thing, but more of an event-driven kind of thing. Like, as I said, you know, we clearly run. We have a stool with three legs and if you lose a leg, it's not gonna work and we should have done enough work To say okay when we lose we lose a leg Okay, you know, this is this is our response plan
[17:53] Mary Ann Borgeson: Yeah, it's a business continuity plan to me. It's like a
New Business
[17:56] Jonathan: new business same words different basically
[18:03] Chair: Form of town meeting government doesn't necessarily lend itself to immediate changes, right? You know, we have certain dates in June or March that we meet as a group of citizens to make decisions in short of a real huge emergency, calling an emergency town meeting.
[18:24] Frank: Which is relatively rare. I don't recall a lot of those, but one of the times we did it was to extend MC2 to 24-hour coverage. You know, I've been overnight, I've been a handful of them, so.
[18:36] Jonathan: Well, they're not completely rare.
[18:38] Chair: But we understand that some of that political process does take time. Sure.
[18:45] Frank: So I want to suggest maybe a little bit more proactive than reactive. Because I think what we've done in the past has been primarily reactive. I think we need to be proactive. This is what we're talking about is proactive. I'm talking about a proactive plan. So do we start transitioning before we hit this soft failure or whatever kind of failure you're talking about? Shouldn't we start that transition before that happens? And what are the steps in the transition? So I'm more interested in the transition plan. What is the transition to rather than saying we're going to wait until we have a soft failure or some sort of failure before we implement it? Because as you were just saying a minute ago, right, it takes months to fund something in response to a failure.
[19:37] Jonathan: I'm just going to, you know, kind of jump in here. The responses cost can be quite low. I'm just going to do what I did before. And, again, I don't know how to say this enough, right? I'm not suggesting this is the plan. I'm just telling you, in my mind, this is what I would do, right? Right. So if we have a meltdown in the ambulance system, what are we going to do? It's going to be and we have the central building built. What are we going to do? We're going to put two ambulances in the building and we're going to add one person on top of the MC2 to run. And we're going to have some form of backup call system. That's what we're going to do. And that doesn't take very long to implement. We already own the ambulances. We already have the MC2 contract. So we got a we got a, you know, a paramedic coming in a rig. And we already have, no matter which system melded down, we already have a pretty substantial pool of EMTs and drivers that can be converted from they run to, you know, the building where the ambulance is now until they head to a different building. I just don't see any big.
[20:48] Frank: The licensing is a challenge. That's not something that's going to happen real quick.
[20:53] Jonathan: I mean I don't, you can speak to that, and that's part of what I'm suggesting you work through. And as part of the process is, okay, what are the gates that I got to do when I reach this point? So I know what they are so I can work on ways to reduce the penalty for, you know, not having to meet it. In part of it is the
[21:16] Chair: organizational culture. I mean, we got a quarter our own organizations and ask these folks, what is your vision and what is it, what do you believe is where we're headed and when do we need to be there? It's, you know, it's not as simple as just moving. We've got to be satisfied that the group we have is on board with those type of decisions. So there's going to be a period of time where we have to, you know, approach these people and demonstrate, if you will, based on some evidence, that moving in any direction is in the best interest of the community, not necessarily the department. Sometimes you got to bite your lip and you've got to move to where it's what's best for the community as a whole. I think the parameter program is an example of that and municipal programs an example there where we made steps to be what is best for the community as a whole. And I'm, I'm hoping we continue to use that as our basis of why we're making these changes, not maybe what's good for an individual organization. We exist for a purpose. Without the purpose, we have no point in existing. All right, any other comment or feedback on? I'm good.
[22:43] Mary Ann Borgeson: Are we going to ask about what it takes to be a municipal department? Are you guys interested in any of that? Because we will have to have, if we move to a municipal format, we'd have to know all those steps, change in regulation, that's right in there. Yeah, that reads
[23:02] Jonathan: like the key item, that looks like the key deliverable of the whole project.
[23:06] Mary Ann Borgeson: That's what I want to make sure. Yeah, okay, all right, I didn't see it specifically in there, okay. I
[23:21] Frank: was impressed to find out that company still in business after 18 years that's something yeah it was it was that 's very uncommon for a company like that still be in the same form it was in 18 years later so well quick whip out the
[23:37] Jonathan: original report, send them some feedback on their work. We
[23:44] Frank: have to add an initial on the end of the name, right? International public comment today. The folks want to, anybody want to share anything on this particular topic?
[23:59] Jonathan: It's probably live, so.
[24:00] Mary Ann Borgeson: Yeah, I think it is.
[24:01] Kathy Hurst: Kathy Hurst. I don't see, when I think of a municipal set of operation, I think of central government, but there are hybrids. It's not specified in here that you'll consider a hybrid or composite system where you have the volunteer and the municipal, but I think that's could be a winner for this town. Yeah, I think I
[24:35] Jonathan: think the last sentence is an attempt, I mean, I didn't drive this, but I think the last sentence, Kathy, is an attempt to try and drive that recommendation, emphasized unified, in which the three independent retain their entity for certain purposes
[24:47] Kathy Hurst: which I really think a compositor hybrid system looking at, and we have some locally that you can look at, and I'm sure these consultants will be
[25:06] Christie Woodard: completely familiar with that too. Yeah, it does say the work shall consider models under which the three departments may continue in some form as independent entities or become part of a municipal system. Yeah, that's great.
[25:20] Kathy Hurst: I think there's room there, I think there's room.
[25:23] Speaker D (unidentified): We certainly, we're gonna need them.
[25:25] Jonathan: You can't, in the vision that we have, you cannot operate the system without the three departments being functioning, okay? You just cannot. You can reduce the scope of what they're doing, but you cannot eliminate it.
[25:39] Speaker D (unidentified): I don't know if you can reduce the scope.
[25:40] Jonathan: There's no possible way. [Frank: Not well.] Yeah, it's just, there's no, I'll rephrase my comment. There's no practical way. Everything is possible if you have enough time.
[26:00] Frank: Anybody else want to speak to it? No? Okay. All right. I appreciate the work on that. Yeah.
[26:11] Jonathan: Sorry, I don't want to just end on that. So presumably you guys are going to turn this into an RFP that we could then issue, and given the timeline of the...
[26:20] Christie Woodard: It's interesting, because we don't typically issue an RFP until we have the funds for it. So we've got to think a little bit about that process piece. But what we might do is send this to the company and say, could you give us an estimation here?
[26:35] Jonathan: I mean, there are lots of bidding processes where we don't yet send them an RFP. You send them, you know, we're interested in an expression of interest. Chris, can you give us an estimate of cost for this particular project? Do you provide any guidance on how you would change it or amend it so that it would work better for the process? So I think you could do some work that basically ends up with the net point of finding out who's interested, what their issues are, and what a cost might be. Go ahead.
[27:07] Kathy Hurst: I'd be careful about referring to the fabulous 2008 report, but it could be helpful in saying these are the sections that we might want to update. You know, let's not go over the whole thing. That's not needed, but these are some sections, some data that need to be updated in those fabulous diagrams and graphics.
[27:33] Mary Ann Borgeson: Yeah, yep, I agree.
[27:43] Frank: All right, let's see, 2-4, I think we covered 2-4 already, 2-5, is there anything to report on 2-5? We're pretty well all set on that, right? The budget planning and staffing, there's no update on that, right?
[28:07] Christie Woodard: We have a draft budget, we can bring it to you next meeting. All right.
[28:14] Frank: EMS licensing and equipment updates. The jump bag on Rescue 3 is now the same exact same bag as on Rescue 5. And Rescue 7 has the same bag, but I don't think it's got the same stuff in it yet. But we'll deal with that next year, maybe. And we've been told that the state does not want to downgrade our permit until they go through the re-licensing process, which happens the end of November. So the application process is open again, even though we've already submitted it, we've already done the public notice in the paper and all of that. They're basically telling us they're gonna pretend like our original application didn't happen, and we've gotta submit a new application, which would take effect on December 1st.
[29:07] Jonathan: Does that have a required public notice period, since it's a downgrade?
[29:11] Frank: According to Scott, we do not believe we are going to need to republish the notice again, because we've already gone through it. It was already approved by main EMS, the notification was published, it was already approved by them. So unless they come back to us and say we do over, we're believing we're all set.
[29:31] Jonathan: Have there been any subsequent changes on the DEA side about the required activities? [Frank: Required activities?] There was some push going on to get the DEA to revise the underlying rule making that they made to try and solve this problem.
[29:58] Frank: As far as I know, DEA has not published or not announced any intention to change anything. In fact, the DEA, the local DEA agent for our region has basically been quoted as saying that nothing in their rule required Maine Health, Northern Lights, or the other hospital associations in Maine to stop providing us the meds to start with. So as far as the DEA is concerned, they're not the reason this is happening. And as far as MaineHealth and Northern Lights is concerned, DEA is the reason why this is happening. But MaineHealth has been telling us now for over six years that this was their intent to do this. So some of us believe that it was the excuse or the trigger that they were going to use for an excuse. And ultimately, at some point, I firmly believe that they are going to stop supporting EMS agencies as far as supplies, linens, things of that nature. Will stop at some point because it's a cost center for them. So they continue this, they continue to support a bill
[31:09] Jonathan: they'll find a way to bill
[31:13] Frank: yeah at one time they did try to bill for the meds to the patient but then they found out and this was years ago they found out they couldn't do that if it was provided by the ems service even though it was a hospital's meds they couldn't do it so that's when I think main health started on the push towards not wanting to provide us with the meds any longer because they couldn't recover their costs so but that being said main health has been super helpful as far as training and education goes and things of that nature. They've stepped up to the plate in that area in ways that they have never done before. So I don't want to say that they're not helpful to EMS, just in this particular area. Let's see, was there any, that was all we had on the agenda list that we were caring over. Was there any new business that the committee wants to address today? Okay, any new business on the part of town staff? Okay, have folks had a chance to say what they would like to say today? Please step up to the microphone
[32:39] Sean Hall: Sean Hall, or as Island, I'm speaking to you today as a firefighter, an EMS provider in town. I appreciate the committee. Let me speak before you on the 10th of September. A representative of Barb's own act fire and rescue had the same opportunity I have today to speak before the committee, and there was some discussion of changing the response model of town firefighters on medical calls. Historically, we've been told that we can respond as town firefighters to delta and echo level calls in town and for those folks that are unfamiliar with the dispatch designation codes they have an alphabetical designation ABCD or E or using the phonetic alphabet you know alpha through echo with alpha being the least serious echo being the most serious alpha and Bravo or BLS level or basic life support level calls while Charlie through echo our ALS level calls and require that higher level of care one definition I found states that an echo level call indicates that the patient is critical, excuse me, or in catastrophic condition and requires instantaneous emergency response. A delta level call was defined as indicating that the patient is unstable or potentially unstable and that their condition could deteriorate rapidly, desensitizing immediate intervention. The representative from Harpswell Neck when he met with the committee was clear that he was seeking a response change from the town staff solely with respect to delta-level calls. He did not feel that the data or facts that he presented necessitated a response from us and commented that we didn't add any value responding to those calls. So he referenced 42 delta and echo-level calls between January 1st and August 31st of this year and stated that the vast majority of those calls were shortness of breath calls or loss of consciousness calls and they were not MI or cardiac arrest calls, as if to indicate that additional medical response from an engine company would not lend any value, as the term he used, to their side of town with us responding. I wanted to refute that a little bit. I also during his testimony came up with some issues I want to come with some solutions for and potential suggestions for improvement to the response models that we have in town today, but I do want to address the notion that delta level calls don't necessitate a more robust response and also to kind of refute the notion that the dispatch determinant codes of alpha, bravo, charlie, Delta and ECHO are always accurately assigned, and I think he brought that up stating that perhaps, you know, Deltas were over assigned, but I have some instances here I'd like to talk about where dispatch determinant code did not really paint a clear picture, and also I've got four instances in that same date range of January 1 through August 31st for which the town staff did respond with an engine and were able to add some value. So if you'll bear with me, I'm just gonna go over those calls. On 14 January, town firefighters staffed the first apparatus on scene for a motor vehicle crash and joined a single OBIFD EMT who had responded direct to scene in resuscitation efforts for a pedestrian victim of that crash. They did so prior to the arrival of the MC2 paramedic and the OB-IFD ambulance. The on-duty town staff that day was comprised of one firefighter paramedic and one CPR certified firefighter. Despite the best efforts of all involved, this patient's injuries were incompatible with life and resulted in a fatality. So that particular code to which the town firefighters arrived before any other apparatus or advanced level responders was given a dispatch determinant code of Bravo, not Delta or Echo. On 6 March of this year, town firefighters staffed the first apparatus on scene for a vehicle fire on Harpswell Neck. The duty crew of two initiated fire suppression measures until it was brought to the crew's attention that a burn victim with critical injuries was present, at which point one of the town firefighters, licensed at the paramedic level,, initiated patient care, communicated the patient's condition with the inbound MC2 paramedic over the radio, and ultimately served as a second paramedic during the transport of the critical patient to Midcoast Hospital. They were later transported to Maine Med, and they did so once Arpsil-Nax ambulance arrived and was able to commit to that transport. That call was given a dispatch determinant code of Delta. On 20th July this year, town firefighters licensed at the paramedic and advanced EMT level run an electrical hazard call on West Cundys Point when an OB ifd medical call came in for an allergic reaction with difficulty breathing. So again, difficulty breathing and loss of consciousness calls that the representative said that didn't really necessitate a more robust response. So this difficulty breathing call was due to an allergic reaction. Chief Wallace was on scene at the electrical hazard and asked the duty crew to respond to the medical call as MC2 was on an alpha level back pain call with Harpswell Neck Fire and Rescue and MC1 was responding from some distance away. The duty crew responded with Engine 3 to Bailey Island where Rescue 3 was already on scene and EMTs had administered one dose of epinephrine to the patient who remained symptomatic. The duty crew obtained IV access on the patient for the administration of IV diphenhydramine prior to MC1's arrival on scene and then aided in the transport of the patient to the hospital. Chief Wallace was also there as an advanced provider. This call was given a dispatch determinant code of Charlie. So again, not a Delta or an echo call, but certainly a critical call. On the 10th of August, town firefighters licensed at the paramedic and advanced EMT levels responded from the Orr's Island station to a cardiac arrest call in Harpswell Neck's response area. Both of the duty crew were advanced cardiac life support certified, and both had run countless cardiac arrest codes. The MC2 paramedic was out of town and attached to a call with Orr's in Bailey Island, and MC1 was responding from Woolwich. Despite previous assertions to the contrary, the duty crew arrived on scene prior to MC1 and MC2, but due to circumstances on scene, were unable to immediately initiate advanced life support measures. This emergency also resulted in a fatality. This call was given a dispatch determinant code of Delta. So please note that all of these emergencies I listed were either potentially life-threatening or resulted in the actual loss of life and then not one of them was assigned a dispatch determinant code of echo. I also like to point out that those calls wish the town firefighter on all calls they arrived before mc2 and mc1 paramedics and on the two calls where the volunteer ambulances made it to the scene prior to the duty crew that the responding town firefighters held the highest EMS life since levels on scene as advanced EMT and or paramedic so I think there is some utility with the town staff responding on Delta level calls and I know the committee discussed I know chief Wallace had sent out some qualifiers to go along with that with respect to provider discretion acting with due regard for the public while we're on the road and also paying attention to what our index of suspicion is to how useful town firefighters can be. But I think for an individual from one department to make recommendations based on their experiences or their 42 calls that changes response profile file for the entire community, I don't know that serves the entire community well to not have paid staff who are dual certified and in a station and able to respond immediately, to not have them roll on these calls and to be turned around if they're, it's determined that they're not needed. So currently, with respect to the license levels of the dual certified town staff we have three advanced EMTs and one paramedic so there was some discussion from the representative of Harpswell neck that unless people are showing up with a higher license level that they 're not going to add any utility to the calls so given the way our staffing structure is the likelihood that we're going to have advanced level providers responding with an engine if we're permitted to is pretty high I think it's in the best interest of the patients and the town at large that we continue to respond with Delta and echo level calls with the understanding that we can be turned around the harpsil neck representative you know was very clear that he was talking just about Harpswell neck response area so I asked the my fellow EMS providers at Orson Bailey Island and Cundys Harbor fire department the individual text message I made sort of a informal survey the question I asked them is would you like to have town staff respond on Delta and echo level medical calls on an engine, with the understanding you could turn them around if not needed. Of the 22 EMS providers to whom I asked this question, I received 18 responses, which is pretty good for surveys. We didn't have such good luck with some of our surveys.
[43:34] Mary Ann Borgeson: We never get them back.
[43:36] Sean Hall: I received 18 responses, and 16 of the respondents were in favor of town firefighters responding to medical calls that were classified as Delta or Echo, which seems to support that adage, when you need them it's better to be looking at them than looking for them. So again, I'm just essentially petitioning this committee that when we look at our response posture, that we consider the town staff not only an asset with respect to fire but also to EMS calls, and I think it's in the best interest of the population at large and certainly those patients that we endeavor to serve and turn around their circumstances, that we roll with Delta and Echo level calls. Any thoughts on that? I've got a few other points I wanna make.
[44:28] Frank: Why don't you finish up what you have to say? Okay.
[44:32] Sean Hall: So there was also some discussion on the 10th of September meeting with respect to response times based on where the town staff is stationed and whether or not the response times added any impediment or conversely any efficacy with the town staff responding one of the members of this committee stated during that if you're responding from oars island station your 20-minute response just isn't effective i thought well let me take a look i'm going to get in my car and measure out the distances and track some times traveling at the speed limit or not exceeding it by any more than five miles per hour I came up with the following distances and times between the stations so from the Orr's Island station to the Cundies Harbor station is 11 miles and took 15 minutes 36 seconds the Orr's Island station to the Harpswell Neck station is 10 miles and took 15 minutes 20 seconds door to door and from harpswell next station to the kundi's harbor station is 15 miles and took 21 minutes 57 seconds so obviously these times are going to be affected by traffic volume, environmental conditions, whether or not we're responding with lights and sirens, and some things like that, but we're looking at traveling at distance at the speed limit, pretty much those kind of response times. So I believe a duty crew with an engine can make it station to station more rapidly than that. So I think there is some efficacy in having them respond on calls. I think they can get there in a timely manner, particularly when we take into account that the duty crew is at a station with apparatus and ready to respond, as opposed to the volunteers, and not to diminish their efforts at all, this just the nature of things, they're responding from their home or wherever they are going to a station, getting apparatus, enrolling on these calls, so those response times could certainly be extended in that case. So I also wanted to talk about another issue that came up during that meeting. That was the disposition of the MC2 paramedics fly car and the Lucas machines availability based on where that fly car and where the paramedic are in town. I believe the committee had already discussed that, but it was suggested that the paramedic who was out was on a basic level call and was unavailable. As the committee is aware, the MC2 medic rides transport on all of our rescue calls regardless of patient acuity level, and if the MC2 fly car is at Maine Medical Center in Portland so is the Lucas device should it be needed on another cardiac arrest call or in town or particularly on Harpswell next since they don't have a Lucas on their ambulance that puts our ALS resources that were contracted for out of town the current coverage model that requires MC to ride transport on each call regardless of patient acuity has some other downsides one of them is we you get some skills attenuation with your EMTs they're not working up to their license levels necessarily they become paramedic dependent it's nice to have that safety net of having an ALS provider there particularly for our new EMTs but I would suspect that probably 90 percent of our EMTs have never even called into the hospital when they're inbound with the patient so I would like to suggest a few changes and I'll get to those toward the end here I just wanted to so you know I understand that as providers in town we all have different perspectives those are based on our experience level the calls we've been to how long we've been doing it and there are a lot of factors that play into our perception so I don't wish to diminish the perception of the representative from harps will neck fire and rescue I'm just suggesting that their outlook on our response posture is not necessarily one that works for the entire town it's common practice around the country as has been mentioned today in the committee for an ambulance to roll with a fire engine on delta and echo level calls it's a model that Brunswick uses Bath will either roll with two ambulances on high acuity delta and echo level public calls or an ambulance and a fire engine. On the 26th of September, there was a call in Cundys Harbor where the paramedic got on scene, decided he needed additional resources besides the Cundys Harbor ambulance, and he got on the radio to dispatch and said, send me an engine company. Well, it was at night, so we didn't have an engine company, but we mustered a response anyway,, but I think that kind of illustrates how common it is for an engine to roll with an ambulance that we have a career guy from Brunswick asking for an engine company on that. So some of the recommendations, suggestions that I have for the committee based on sort of my observations and experience in town, but also in response to the testimony that was offered at the 10th September meeting, there is a perception in town that there's animosity between the different departments, and you know, the perception can be reality, and I just want to encourage all of the providers in town to understand that we're here to serve all the members of our community, that there's really no place for personal agendas, territorial divisiveness, or this side versus that side mentality. We've tried to build bridges and work across lines, but there are cultural differences in town. Second recommendation, which I think I've covered, is that the town firefighters be permitted to permitted to automatically roll while exercising due regard for public safety and provider discretion on Delta and echo level calls if Harpsville neck doesn't want us there for Delta's I've said please let us roll for Cundey's Harbor Orson and Bailey Island this has been covered as well but you know my third recommendation would be that all of the three ambulances in town are or equipped with a Lucas device for those instances when the MTC-2 fly car is out of town or adequate manpower for high quality CPR is lacking. And you discussed the in-bags, that was gonna be another one of my suggestions that the ambulances and their first in-bags are standardized with respect to equipment organization to facilitate greater efficiency for the medics or others who are working across agencies,, but it sounds like that is in the works. My fifth recommendation is that the MC2 contract be revisited and potentially revised to facilitate our contract paramedics in town to stay in town if there's a BLS-level call that can be handled by the licensed EMTs at the volunteer level. we don't need to be taking our ALS resources out of town for basic level calls and then waiting on MC one to respond and I would strengthen that by saying if MC two is out of town and we have an advanced providers staffing an engine that they could essentially make the patient contact and advise whether or not, you know, next level care from MC1 is necessary. Doing so would also help to strengthen the volunteer EMT skills, reduce paramedic dependence, and also would serve to reduce the burden of providing a second driver for the fly car on those basic level calls. So I've not looked at the MC2 contract, but I know I've been on a number of basic level calls for which we essentially just drove the person in a position of comfort, and having that paramedic resource on the ambulance when we weren't performing any interventions did not make sense. It took them out of town and out of their response area. Another issue, again, I'm wondering with recent change in status, there are three Cundys Harbor firefighters who previously did interior firefighting that have now kind of stepped away from being interior firefighters. So I think, Chief, I don't know what you're up to now with the number of interior folks,, but like a lot of us, we're kind of, we're always looking for more, but I know the same was true at Harpswell Neck when this program started, and that was sort of the impetus to put the town staff at Harpswell Neck, but I'm looking at travel times and response speed of town staff, and I'm wondering if Cundies Harbor doesn't need to have us a little closer. So I think that having town staff in the farther western regions provide some response time disadvantages to the residents of Great Island and Cundy's Harbor, with the Oars Island station being equidistant and the staffing challenges, you know, facing Cundy's Harbor now with respect to interior people, as Chief Mercier said with respect to the paramedic program, you know, we've got to look at, I think, what is best for the entire community, not just with what we're trying to do with the changing of services in town, but also with where the existing services are stationed, and that is about all I have. So yeah, I basically, I want to do what's right for the people in town, the patients in the town. I've done more CPR in this town, I've lost count of how many times I've done CPR or how many times I've gone to my friends and neighbors while they're having their worst day, or gone to that address and been able to do nothing more than then comfort the family members over the loss of their loved ones. So I just think that we get a little in the weeds with egos and territoriality and lose sight of the fact why we're here and how we can do that better and more efficiently and effectively to serve the community that we're here to serve and that I'm blessed to live in, so. All right, that's all I have.
[57:15] Frank: All right, it's four o'clock. What I'd suggest we do is we can add that to the agenda for the next meeting, if we want to have a.
[57:25] Chair: Are we not gonna have an opportunity to respond, or?
[57:29] Frank: If you'd like an opportunity to respond, please go ahead. Well, thank you. I was just trying to keep it to the hour.
[57:35] Chair: That's all. Well, I appreciate that. But, you know, in responding to some of those remarks, back when the paramedic program was initiated, they did not respond to all calls. They responded to the scene, determined what the level of care was needed, and if it didn't approach advanced care they did not go that was the policy that began from the very beginning of the program and the intent was clearly what you described was to provide that paramedic availability to the whole community mm-hmm my understanding is the director of the program made the decision that they were going to respond on all calls in the ambulance. And I was told to just, I was not told this by the director, let me make that clear. I was told that the justification for that was that they had been basic global calls that they had not responded with the ambulance. where those calls deteriorated unexpectedly to a Delta or Echo call. So now the person is being transported to the hospital with only an EMT or AMT on board. That's the justification that I was told is why they moved away from that policy of not doing that to the current policy to answer that question to answer your question of Central Station of Wars Island I felt I dealt with this quite a while ago it is not a central station it is not a central location for the west side of Harpswell the Harpswell was Island station in the example I use is 10 miles from my residence. The expectation as a citizen of this community to expect my truck responding to my home is coming from 10 miles away. When I have a station a mile from my house that isn't staffed is unacceptable. That's the reason you're at Harpsineck Station and that's the reason you're gonna remain there.
[1:00:18] Sean Hall: okay I in logging those miles I went door-to-door with the assumption that anything south of the existing stations would be staffed by volunteers I understand that proximity to your home is important to you chief but I feel that the proximity of paid staff from the folks of Great Island and Cundee's Harbor with Oars Island being equidistant is just as important I don't
[1:00:49] Chair: disagree that Cundys Harbor is being disadvantaged while you're responding from the Oars Island station I don't disagree with that at all but that does not justify moving from the Hopsnack station and given the West Hopsal citizens less coverage just to ensure another group is greater coverage I don't know what the answer to that is, short of moving something closer to the central location they were proposing for the central station. But the answer is not to respond from the O'Zallon station. I assure you that is not the correct answer.
[1:01:30] Sean Hall: I would argue that the mileage and the time distances suggest otherwise. With respect, Chief.
[1:01:42] Chair: As you pointed out earlier, a lot of this is based on experience, and I have considerable experience on responding at the Harpsineck location and the Harpsineck calls. And I can assure you, in spite of your 15 minutes and 30 seconds, that is not necessarily a true representation of the actual arrival of equipment from the West Island Station. Particularly, I can point out on fire calls as well on rescue calls. So there is a turnout time that still occurs at your station before you get dressed, get in that truck and go out the door. You're not sitting in that truck on the apron leaving. So you have to add additional time to that turnout time for the total response time. So it is not 15 minutes and 30 seconds. It's some amount greater than that.
[1:02:36] Sean Hall: No, you're absolutely correct. And I did address that in stating that we have people at a station and you're not waiting on volunteers to respond to a station and then respond with apparatus. All right, I'm not sure
[1:02:55] Frank: that going back and forth. All right, I'll see you this weekend, but I want to
[1:03:08] Jonathan: somewhat close on that. In the intermediate back bound, there is no plan to change that situation, and I can say I think from my point of point we're not going to change that situation in the near term. That in my opinion again, and I'll put it on the table when we get there, when we get to 7 by 24, we need to discuss the situation again because the circumstances have changed. So I think I think we can just park that one until we start discussing how we're going to staff seven by 24. And there it raises its ugly head because, in effect, the 24 part of the staffing at the moment before we have the central station literally has to happen at OBI.
[1:03:54] Sean Hall: Correct. All right. Appreciate the opportunity to appear before you. All right.
[1:04:02] Frank: All right, I guess for purposes of the next meeting, we can have a conversation about, we were asked to talk about the MC2 contract, MC1 calls and Delta calls. I don't have a problem.
[1:04:20] Jonathan: Well, I just, I happen to know something about this, so let me explain. This is a policy decision and not a contract decision. No, it's a policy decision and not a contract I have asked for and I should hopefully have because part of this issue that came up before I'm hoping to have the MC2 MC1 concurrence timing issue with real facts by the time we meet again because I think that you seriously don't want to discuss about the problem until you understand I understand what the problem is. It doesn't rear its head very often is my personal opinion about the situation, but I'm going to back up my personal opinion with, okay, this is how many times it happens where this change, if we made it, would make a difference. So I hope I should have that by the name.
[1:05:26] Chair: Anything else? That was enough? Sorry. I'll go on there again. If it wasn't because Alan wished to respond on Delta calls, I'm certainly not going to sit here and say I'm opposed to it. If that's a change that wants to be made, that those groups want to continue that, I'm fine with that.
[1:06:02] Jonathan: I thought we had left. Let me just make sure. Yeah. Right. I understand that. But the way I understood it we had left it with the last set of changes is that for sure on Echo level calls it's rolling and on Delta level calls it was going to be circumstance specific and a decision would be made whether they went circumstance specific include such items as is everybody else out of town you know as a as an example which we face sometimes well we left Delta
[1:06:33] Frank: Delta with everything that wasn't Echo, we said provider discretion.
[1:06:40] Jonathan: That's correct. So it's not going. Frank, you can decide to go. I presume Sean is suggesting we go back to the policy of automatic dispatch on Delta-level calls.
[1:06:53] Frank: Because, I mean, one of the calls you mentioned was a Bravo-level call. That didn't get you any closer. The fact you were there was because you were dispatched as a fire engine, not because it was an EMS call. Yeah. so there 's always regardless of where we wind up there's always going to be an alpha level call that came in as i mean i'm going to say always but there are going to be the alpha level calls that come in that having town staff there to help carry the patient or to provide advanced life support right are going to be useful but i don't think we're going to get to the point where we're going to sound the town staff automatically an awful level calls so i think that's why we worked real hard at coming to provide a discretion as far as if you're on duty on Engine 3 and you hear a call down the street and it comes in as a Bravo-level call and it sounds like there's something more to it than a Bravo-level call, nobody on the scene, regardless of where they show up, should be giving you guys flack when you show up because you took the initiative on behalf of the public to make sure that things had their best outcome. come so I mean I think that's kind of what we wound up but we can certainly revisit it again I think you know again it's quarter past four so no I think it
[1:08:09] Jonathan: goes back on the agenda for next week and we'll reset Reese in my mind reset and make sure we are happy with where we are and the written policy that we have that's really what we put on the agenda
[1:08:21] Frank: agenda right if I have no objection if you want to invite David Hudson to come to the next meeting I don't see any reason why it's a public meeting anyway so there's no reason why
[1:08:34] Jonathan: he couldn't that's adding a different topic item so the first topic I think you don't need Dave Hudson for it's like one of the town staff going to roll on you know what EMD code the second one, I think we should have a committee discussion about, which I said before, which is if you want to change this, then you've got to invite Dave Hudson. I personally, contrary to Sean, I personally am not in favor of changing it, but that's neat.
[1:09:02] Frank: Are you talking about MC2 transporting with every single patient?
[1:09:06] Jonathan: Having discretion, right now MC2's policy is they're transporting with the patient. It has a certain consequence. So you change the policy, you get a different consequence. they're both trade-offs on the situation. There's there's merits to both sides of this situation.
[1:09:38] Chair: And I understand why they changed it. They effectively get burned twice on serious calls and I know how we should have been there but as you know you can't always predict those things. That's why I think Ben's point is, and I agree with it wholeheartedly, is we have to keep this whole thing open. This is, there's a discretion that has to be available to everybody to make an evaluation based on your skill, experience, in training, and we can't, we don't want to take that element away from anyone because that's what makes us more effective in responding efficiently and successfully these patients. We don't want to take that away.
[1:10:26] Sean Hall: I'm
[1:10:38] Jonathan: not sure if that comment was on the topic at hand. Right, we were talking about the MC to MC one thing, and you, I think you went back to the deck of Delta echo situation. We
[1:11:00] Kathy Hurst: haven't adjourned yet, so I'm just thinking about post-event, you do have a debrief, and would these things kind of come up and add to the intelligence and understanding? [Sean Hall: With all calls.] Not with all calls?
[1:11:20] Sean Hall: I would like to see more of them.
[1:11:24] Kathy Hurst: Sounds like maybe that would be a good idea, yeah.
[1:11:27] Frank: The post-debrief tend to take.
[1:11:29] Jonathan: Part of that is that what we're really talking about, the system doesn't support very well. When the EMD is assigned on the call, all this judgment stuff of adding more resources, the call deteriorates, whatever, doesn't cycle back into the call. It went out the way it went out from EMD. I mean, it's just, it never gets, I mean, it can, but it never gets updated.
[1:11:58] Frank: I have seen them update the determinant code on Rayleon. Very, rare. That's how I found out they actually will do it, but it doesn't happen. It's very rare.
[1:12:06] Jonathan: It's very rare.
[1:12:07] Chair: It's not going to be downgraded. Yeah. Yeah. They don't come back and say, oh- Yeah.
[1:12:11] Jonathan: But the one you want is an upgrade. Wait a minute.
[1:12:12] Chair: The person is really okay. Yeah. It doesn't- Yeah. They never tell you that. They never downgrade from the initial- They never tell you this. Which is their responsibility.
[1:12:19] Frank: And the question about the debrief, though. When we talk about... So there's a number of different kinds of debrief, right? So- I know. We usually refer to debriefs as something that would happen after a traumatic call. Traumatic as in- Oh, really? responders saw something and so we bring in somebody to help them talk through what they witnessed, right, we tend not to call those debriefs anymore. There's another, I can't remember what the
[1:12:44] Chair: pc name for it is now. There's an after action report that you can have that evaluates how well
[1:12:50] Kathy Hurst: any call goes. No, I'm talking about a post event process. Yeah, so and we tend to do those after
[1:12:58] Frank: A very large scale event, so we, I think the last one we did was the fire down on Huev. We did one after that, it was a significant event, everybody in town was there, and there were, there was at least one hiccup. And so based on that we had an after accident review, we invited everybody in, we had a conversation about what happened, what can we do to try to identify the weak spots and do some training on it and fix a problem. We do not do that level of after action analysis on routine calls. Now I'll tell you right now, Mr. Hall, if he's on a medical call and something happened that was unique, I guarantee you when he gets back to the station with it, with the crew on that ambulance call, he's, he's going to have a conversation real quick with him and say, are you okay, all right, let's talk about what happened, and we'll do that at a much smaller level.
[1:13:53] Kathy Hurst: I mean, if you want a form designed to capture anything, let me know. But I'm just thinking about the process, my middle name.
[1:14:08] Frank: All right. Are we set?
[1:14:12] Jonathan: If we're set. All right.
[1:14:15] Frank: Will we adjourn? Yes.
[1:14:17] Mary Ann Borgeson: And see you in two weeks. See you in two weeks.