Borough awards EMS pact

Size, commitment to volunteers said to be key

By: Kip Berman
   HIGHTSTOWN — Goliath bested David — or, in this case, St. Francis.
   But it wasn’t just a matter of size, rather a giant health-care consortium’s plans for the community that swayed the borough to award a $139,000 emergency medical services contract to the Monmouth Ocean Hospital Service Corp. (MONOC).
   "Money was not the main issue. It was an issue of MONOC being bigger and more well-equipped," said Borough Councilman Larry Quattrone, who headed up the committee that recommended choosing MONOC.
   At a special session Dec. 29, council voted 5-0 (Councilman Ron Sackowitz was absent) to approve a resolution awarding the contract to MONOC. This despite St. Francis EMS having served the borough for the past year, most of the time for free.
   St. Francis’ bid of $139,700 was $700 higher than MONOC’s. But because the contract was for a professional service, it was exempt from state competitive bidding laws and the borough was not compelled to select the low bidder. Instead, the resources of MONOC — the nonprofit consortium of 19 acute care hospitals has 111 licensed ambulances and 850 staff members — and their plan to train and incorporate local first aid volunteers to reduce the cost to the borough of having to pay professionals, apparently proved decisive.
   Though St. Francis and MONOC offered free training for volunteers, MONOC had an advantage in its commitment to integrate local volunteers into their units, according to local squad volunteer and EMS advisory committee member Curtis Crowell.
   "MONOC went out of their way to accommodate the Hightstown First Aid Squad to meaningfully augment their staffing costs … and their proposal reflected the concerns of our volunteers."
   Mr. Crowell added, "Volunteers will be able to whittle away at the contract costs, especially on evenings and weekends."
   Jeff Behm, MONOC’s vice president of operations, explained that MONOC is required by law to have two emergency medical technicians in each ambulance. But when local first-aid volunteers are certified as EMTs and are scheduled in the ambulance, MONOC will reconcile what they didn’t spend on its own EMTs and bill the borough accordingly.
   Mayor Bob Patten said MONOC is the largest EMS provider in New Jersey and, as it is already serving East Windsor, Plainsboro and Princeton, MONOC would be readily available to provide assistance in the case of a large-scale medical crisis. St. Francis, by comparison, is a relatively new provider of EMS.
   Considering that choosing either provider would have required a dramatic increase in spending — the borough provides $25,000 annually to the volunteer squad) – the mayor said he sees long-term cost-effectiveness in choosing MONOC. If local volunteers prove capable of replacing MONOC EMTs, the borough may not have to pay the entire $139,000.
   "If our volunteers are trained and can do the job, MONOC won’t charge us," the mayor said in reference to the proposed integration.
   Councilman Quattrone said last week that the new EMS expenditure would not have an effect on the annual contribution to the local squad but Mayor Patten indicated that decision has not been made.
   The mayor would not speculate how the new EMS contract might affect local taxes but noted that EMS is a necessary service. Even in the best-case scenario, Mr. Crowell said he believes that outsourcing EMS, at least during daytime hours, is here to stay, given the prevalence of two working parents in a household.
   However, Mr. Crowell is optimistic that the free training MONOC will provide to volunteers will decrease the expense to the borough in the future. And, as Mr. Behm explained, due to Medicare billing practices, it is actually in MONOC’s financial interest to utilize the local first-aid squad, as the local volunteers provide a free service.
   Faced with unacceptable response times due to a dearth of volunteers, the borough began outsourcing EMS service in January 2005. St. Francis EMS, another nonprofit company, agreed to provide around-the-clock basic life support services virtually free of charge.
   But according to St. Francis’ EMT director, Kevin Wallis, due to the low volume of calls, the provider lost well over $100,000 serving the borough. He has previously stated that it cost at least $300,000 to provide around-the-clock ambulance service for a year, and due to Hightstown’s low volume of calls, St. Francis was only able to recoup only about $50,000 in billable ambulance costs.
   In November, St. Francis notified the borough that it could no longer work for free. The Borough Council responded by paying the company $17,000 to finish out the year.
   Upon learning last week of the imminent decision to hire MONOC, Mr. Wallis said he felt St. Francis had been treated unfairly by the borough.
   MONOC, which operates on a $67 million budget and responded to 100,000 calls last year, began serving Hightstown at 12:01 a.m. Tuesday, according to Mr. Behm.