Regional Ambulance And Medical Services Adapting To NARH Closure

Mar 31, 2014

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After an up and down week, North Adams Regional Hospital is closed for the time being. Health providers and ambulance services in the region are feeling the impacts.

With the hospital closed, people needing emergency care will have to go to Berkshire Medical Center 22 miles away in Pittsfield or Southwestern Vermont Medical Center 18 miles north in Bennington. North Adams Ambulance Service covers 20,000 people in the Northern Berkshires. Chief John Meaney says the organization has leased another ambulance to add to the four it currently has to help maintain coverage with the increased time it takes to pick up a patient, get to a hospital and be available for another call.

“We had been accustomed to a pretty short turnaround time at North Adams Regional, 20 to 30 minutes on average,” Meaney said. “We’re looking at probably hour and a half to two hours turnaround time.”

Williams College economist Stephen Sheppard has been studying the impact distance between healthcare facilities has on patient outcome.

“Heart disease, heart attacks, strokes…these types of things where critical care and timing of delivery is a really important factor, that’s showing up in the data as being statically significantly related to the spacing between healthcare organizations,” said Sheppard.

In an aging population like the one in Berkshire County, stroke and heart attack related emergencies are becoming increasingly common. Village Ambulance Service is based in Williamstown and serves roughly 15,000 people. Board President Dr. Win Stuebner says the coverage demand fluctuates as the organization becomes the first resort for Williams College students when the campus health center is closed outside of business hours.

“We get called for a wide variety of student problems including trauma, medical problems, etc.,” Stuebner said. “We are their infirmary.”

Located less than a mile from NARH, North Adams Ambulance is still determining the additional toll the closure will have on its 40 workers and equipment, according to Meaney.

“We are looking at increased fuel consumption, we’re looking at increased maintenance and we’re looking at employee turnover based on the increased demands,” Meaney said. “We have some mechanisms in place where we are actually trying to recruit and add some additional staff to help accommodate.”

Meaney says of the 4,900 calls North Adams Ambulance received in 2013, more than 2,200 resulted in people being taken to NARH. Just 18 went to Southwestern Vermont Medical Center. Meaney says there may also be financial impacts because the ambulance service has a base rate and then charges per mile.

“Even though we bill a certain rate we necessarily will not receive that,” Meaney explained. “Medicare typically only reimburses us about 60 percent of what the actual bill is. So we are taking into consideration all of those variables. One of the other pieces of this is we also do non-emergent transfers. We were doing a lot of non-emergent transfers out of North Adams Regional.”

State treasurer and Democratic candidate for governor Steve Grossman was in North Adams Sunday meeting with community members. While his office doesn’t make decisions regarding healthcare, he does control the state’s checkbook.

“As soon as I am given permission or authorization to send money to whatever entity is going to reopen the emergency healthcare facilities or to act in a way that’s going to reestablish high quality healthcare for the people of North County, I will write that check or wire that money,” said Grossman.

Adams Ambulance Service is the remaining organization that covers the Northern Berkshires. Southwestern Vermont Medical Center is also preparing to expand its emergency services in response to the NARH closure.

As for North Adams Regional Hospital, Berkshire Superior Court has approved an order that reversed a temporary order that preventing the closure of emergency services, requested by state Attorney General Martha Coakley, also running for the Democratic gubernatorial nomination. The current order grants Berkshire Medical Center the ability to operate a satellite facility at NARH once it gets a license to do so from the Massachusetts Department of Public Health. In a statement Friday, BMC says the application process has already been initiated and is being expedited, but has no timetable. BMC has extended job offers to NBH employees to work at the satellite facility. Another court hearing is scheduled for Thursday.