Mutual aid EMS calls from Naugatuck ‘too much’ for area providers

By Elio Gugliotti, Editor

NAUGATUCK — Four area EMS providers have stopped responding to non-life threatening mutual aid calls in the borough, citing a “failing system” at Naugatuck Ambulance Inc. that led to an unsustainable level of mutual aid requests.

Officials from Beacon Hose Co. No. 1, Middlebury Fire Department, Oxford Ambulance Association and Seymour Ambulance Association — volunteer companies — decided in early July to stop responding to Priority 2 mutual aid EMS calls in Naugatuck.

Priority 2 calls involve cases that are not considered life threatening. The decision could lead to delayed responses for such calls.

“All of the area EMS agencies with whom I have met regarding this matter hold our reciprocal mutual aid agreements in very high regard. … The Borough of Naugatuck has benefited from the mutual aid system well past its intended design. The use of mutual aid should not take the place of adequate staffing of your service,” Beacon Hose Chief Brian DeGeorge wrote in a July 6 letter addressed to Mayor N. Warren “Pete” Hess that was also sent to Naugatuck Ambulance President Larry Santoro and local officials.

The borough does not operate Naugatuck Ambulance. Naugatuck Ambulance is a private nonprofit that holds the primary service area responder designation for Naugatuck. PSARs are overseen by the state Department of Public Health and grant exclusive rights to the holder to provide emergency medical service in a given area.

Santoro declined to comment.

The four departments are still responding to mutual aid calls for life-threatening situations.

“We (Beacon Hose) can’t stop doing Priority 1 calls,” said DeGeorge in an interview, noting he couldn’t sleep at night knowing there’s an ambulance sitting in the firehouse in Beacon Falls if someone was in serious trouble.

American Medical Response and Trinity Health of New England EMS, both based in Waterbury, and the Bethany Fire Department, a volunteer company, are still responding to priority 1 and 2 requests in Naugatuck.

DeGeorge said his department doesn’t mind helping, but the number of mutual requests from Naugatuck was beyond what the system is designed for.

“It’s just too much,” he said.

From Dec. 13, 2020, through June 12, 2021, Naugatuck Ambulance received 2,340 EMS calls, according to figures provided by the borough. Out of those calls, 815, or nearly 35%, were passed off to area agencies for mutual aid.

AMR and Trinity Health responded to 311 and 284 mutual aid calls, respectively, in Naugatuck during that time. Beacon Hose responded to 146 of those calls. The next highest was Middlebury, which responded to 38 calls.

Christopher Boyle, a spokesman for DPH, said the standard for passing EMS calls off for mutual aid can vary depending on situations occurring.

“A mutual agreement is a voluntary contract that services sign to help each other cover their service area,” Boyle said. “Unless a complaint or bad outcome highlighted an issue there has been no set standard of how many calls may be passed to mutual aid.”

Beacon Hose, Middlebury, Oxford and Seymour ambulance services are staffed mainly by volunteers.

Beacon Hose, for example, has two ambulances and two full-time, paid EMT positions. The two positions are filled by one full-time employee and rotating part-time EMTs. The paid EMTs cover the day shift during the week, but after about 5 p.m. on-call volunteers, who receive a small stipend per call, respond to medical emergencies.

DeGeorge said the high level of mutual aid calls taxed the department and its daytime staff. He added the crews covering at night and the weekends are volunteering their time to help their town and have other jobs.

“When we’re doing our own thing, our world is in perfect order,” he said. “When we go to Naugatuck four times during the day, the rest of our stuff doesn’t get done. It’s OK when it’s an every-once-in-a-while thing, but it was starting to get to be every day.”

He said if both of Beacon Hose’s ambulances respond to calls in Naugatuck at the same time, which has happened, it causes a domino effect and leaves the department reliant on mutual aid from other towns for coverage.

The issue has been simmering for some time. In December and January, representatives of local EMS agencies, borough officials and Santoro met to discuss the matter. The meetings, DeGeorge’s letter states, were to help Naugatuck Ambulance leadership address “their failing system” and provide fair warning that the level of mutual aid was not sustainable long term.

Bethany Fire Department officials were also part of the discussions but decided to continue responding to Priority 2 calls, despite concerns.

The letter states Naugatuck Ambulance added additional staff after the meetings, but it wasn’t enough to manage the call volume. The total number of EMS calls in Naugatuck has increased in recent years. There were 4,666 calls in 2018. That climbed to 5,920 in 2020, according to borough figures.

DeGeorge said the department couldn’t sustain the level of mutual aid anymore without any changes in sight.

“When we have no stop point, we had to do something,” he said.

Financial issues were cited during the meetings for Naugatuck Ambulance’s “staffing delinquencies” and “frequent breakdowns” of the department’s ambulances, the letter states.

Tax returns for the 2020 tax year show Naugatuck Ambulance had $1,207,678 in total expenses and brought in $1,053,315 in revenue, for a loss of $154,363.

Hess said borough officials are “keenly aware of the problem” and have developed a short-term and long-term plan to address it. He declined to provide details on the plans.

“Rest assured that we will take all appropriate action to protect everyone,” he said. “We have spoken to Naugatuck Ambulance and we are ready to immediately take over operations if necessary. Our plan will provide better service for borough residents and also provide coverage for our mutual aid partners. Our team is prepared to do whatever it takes to provide first-class service.”

The Board of Mayor and Burgesses discussed emergency services during a special meeting July 19 but took no action.

The borough simply can’t take over EMS operations since Naugatuck Ambulance holds the PSAR. The state must change the designation. Municipalities can request a change by claiming a performance crisis or unsatisfactory performance of an agency. Municipalities can also submit alternative plans to change the designation.

Borough officials and Naugatuck Ambulance have been at odds over the agency’s performance before. Ten years ago, officials looked into replacing Naugatuck Ambulance over a change in paramedic services and other concerns. Officials sought bids for EMS providers, but couldn’t hire another agency since Naugatuck Ambulance holds the PSAR.

Borough officials, with the help of the local state delegation, pushed for changes in the state law. In 2014, the General Assembly passed a bill that requires municipalities to coordinate with ambulance providers whenever they update their emergency medical services plans. The measure also provided for removal of providers who fail to give quality patient care.

Doyle said DPH hasn’t received any complaints about Naugatuck Ambulance and there aren’t any active investigations of the agency.

Naugatuck Ambulance’s license expires in March 2022. In 2017, Naugatuck Ambulance was fined $1,000 as part of a consent order for failing to maintain a run report on an advanced life support call in April 2014, according to state records.