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Money Issue Stalls Progress on Better EMS, Borough Relationship

An oversight committee looking into Naugatuck Ambulance has been making strides, but officials say an issue over payments has given them pause.

 

Naugatuck Ambulance Inc. continues to operate without a contract with the borough as a newly formed oversight committee reviews its performance.

Both sides say they have made strides in opening lines of communication en route to a better working relationship. But a recent flap over payments made by the borough to the ambulance company seems to have put a hitch in progress.

Although the joint boards of mayor and burgesses and finance decided last year not to pay Naugatuck Ambulance, the borough still handed the group $75,000 in checks this year. The borough is now seeking to get back that money, which it says was paid in error, and has vowed not to make any further payments.

The fact that a financial issue is halting progress between both sides is no surprise: the original concerns about Naugatuck Ambulance among borough officials revolve around money. Naugatuck officials say that because they had paid for the services of EMS, they should have some knowledge of the group’s financials to see how much money the organization is bringing in. Naugatuck Ambulance, under the direction of President Larry Santoro, has not done that, borough leaders say.

That was one of the major reasons the borough formed an EMS oversight committee last year. And it's why borough officials chose to seek bids from other ambulance providers. When the bids were opened in May, it was revealed that Campion of Waterbury was the lowest bidder, asking for $96,000 annually. Naugatuck Ambulance’s bid was $296,000.

But local officials have not acted upon the bids. Therefore, Naugatuck Ambulance still provides EMS services in the borough. The main reason the bid has not been acted upon is because Naugatuck Ambulance still holds the primary service area responder designation given by the state. That means the association must provide services to Naugatuck regardless of whether it is operating with a contract or being paid by Naugatuck.

It also means it is very difficult for Naugatuck to bring in another company to replace the organization as long as it is doing it’s job and wants to continue as the EMS provider. 

Santoro says there is no reason to bring in another organization. He says there is no question his organization provides remarkable care to the community.

Naugatuck Ambulance's Take on the Situation

Santoro, who has been involved in Naugatuck Ambulance for 46 years, said he believes the oversight committee is overall a good thing because it will educate the borough’s administration on the operation of EMS in general, and Naugatuck Ambulance in particular. 

“They will find that there is multiple oversight already in EMS,” he said. “We have federal regulations we have to abide by. We have state regulations we have to abide by. We have sponsored hospital regulations we have to abide by. We are inspected every two years by the office of EMS and DMV…Our employees have to be re-certified every two years. There is not another emergency organization in town that has to do that.”

Santoro says Naugatuck Ambulance, the second busiest emergency response unit in Naugatuck, besides the police department, has response times that are better than the national average for ambulance associations. He also said that based on letters they receive from patients and families, he believes the organization provides “exemplary service.”

“Look at towns around us. How many others have staffed two ambulances a day for like 19 hours a day?” he asked rhetorically. “That’s not to disparage the volunteers around us because they do a great job. …When we were Naugatuck Volunteer back in 1999, we realized we had some staffing problems. In a two-week time period between when we went from volunteer to paid, we went from 56 open shifts (a month) to zero.”

He also says his organization does a lot for the borough that officials may not realize including providing extra shifts during storms, on the Fourth of July and during the Memorial Day parade.

“We also take care of all the medical waste for all the agencies in town,” he said. “This is stuff that costs us money and has not been in any of the past contracts. This is just Naugatuck Ambulance providing a high quality of care to the citizens of Naugatuck.”

He said that in his 46 years, only one official complaint has been filed with the Department of Public Health against Naugatuck Ambulance; the organization was found to be not at fault, he said.

“I’d say that’s pretty good,” he said. "...We've been providing a high level of care, and we will continue to do so for a very long time."

And the Naugatuck EMS oversight committee has started asking residents to provide feedback about Naugatuck Ambulance’s care. In the past month, there has been one complaint filed, but further investigation revealed the complaint was about another ambulance provider, not Naugatuck Ambulance.

The Borough's View 

Deputy Mayor Tamath Rossi, chairwoman of the EMS Oversight Committee, said the group was formed “under the direct advice and counsel of the Department of Public Health, Office of Emergency Medical Service.”

“There have been many other communities that have the same type of oversight committees, which have been created in order to create a collaborative and cooperative relationship between the provider and the community and to assure the highest level of service is being provided to the community,” she said.

She says the borough simply wants to fully analyze its EMS service.

She too believes the conversation between both sides has improved to a degree, but the latest issue over payments is discouraging, she said.

Latest Money Issue 

Santoro says he was within his rights to continue to seek payment from the borough. He points to email correspondence between his attorney, Dominick Thomas of Derby, and an attorney, Alicia K. Perillo, who works for the borough’s contracted law firm, Fitzpatrick, Mariano and Santos. 

In that email correspondence from June, Perillo asks if Naugatuck Ambulance will continue to provide services even if there is not a contract in place.

The response from Thomas was: “Naugatuck Ambulance will continue to provide EMS services without the contract renewal under the terms and conditions of the existing agreement until this matter is resolved. In other words, there will be no renewal of the agreement for a period of time, but the service and billing will continue as in the existing agreement.”

Perillo confirms in a later email that she understands. 

Santoro said the discussion about billing is proof that Naugatuck EMS was prepared to ask for money from the borough, which set aside $100,000 for EMS services but didn’t intend to pay Naugatuck Ambulance.

Rossi says the borough’s understanding is that the "billing" in question refers to billing patients and their insurance companies for services rendered, not the borough. She said she believes Naugatuck Ambulance knew the borough didn't plan to pay the organization but submitted requests for payment anyway. Rossi says the borough's payroll department has now been made aware of the situation and will not make any further payments to Naugatuck Ambulance. 

Mayor Bob Mezzo said he would not discuss the billing scenario because it could potentially be a legal matter for the borough in the future.

“That is one of the many issues we will be discussing about EMS in the near future,” he said. 

What Happens to the Ambulance Building in 2013? 

Another issue that could throw a monkey wrench into the debate over how EMS service is provided in Naugatuck revolves around the Naugatuck Ambulance headquarters on Rubber Avenue.

There is a reversion clause in the deed for that building that says it goes back to the borough on Sept. 12, 2013.

Rossi said the borough is reviewing its options for that building and is attempting to work out an arrangement with Santoro to have Naugatuck officials inspect the building. So far, she said, she hasn't had a response from Santoro on that issue.

Santoro told Patch he has no idea what will happen with the building after September.

“I know I have some legal opinions about what could happen in our favor, but we’ll have to wait until then,” he said.

Andrew Santamauro January 12, 2013 at 12:55 PM
Having dealt with contracts dealing with services, I'm having a hard time reconciling the fact the Naugatuck Ambulance submitted a bit for 296,000.00 per year while Campion Ambulance submitted a bid for 96,000.00 per year. That is a very big discrepancy. So Campion will provide the same, or even better service for 200K less? Every contract I dealt with I knew that the company providing the service was out to make a profit. So the bid was not low enough that it would cut into their bottom line. So I have to ask, is Campion underpaying their paramedics? Will Campion operate at a fiscal loss so that they can keep the town's business? Or, are they a nonprofit? I find it odd that Campion can staff two ambulances, pay salaries and basically provide the same if not better service as Naugatuck Ambulance for 200K less. Who is getting the shaft...The employees? The town? The company?
SocKet rocket January 12, 2013 at 02:28 PM
I work in commercial EMS Answers to your questions: 1: Worst service for 200k less 2: Yes they underpay there medics compared to the rest of the State. But they do pay on par with what other services pay medics in this geographical area. 3: Yes they will operate at a loss to keep the towns business. Commercial EMS doesn't make money off 911 calls, they barely even break even if they do. They make all there money off non emergency ambulance transfers. I guarantee you Campion has its eyes on money that can be made doing non emergency transfers from the nursing homes in town. 4: they are a private commercial service. Meaning they are for profit. All they care about is $$$$. 5: the people of the town will get shafted. The town will save money. Campion will make money in the end. The employees have jobs in this economy but they are shafted to an extent. Naugy ambulance employees will get shafted but I'm sure can find work for the big commercial EMS services. 6: what if we had commercial police force provided by a for profit company. It amazes me why there aren't more municipal EMS services in this state. I know why... Because there aren't many profits to be made responding to people's 911 calls. But still it's disappointing to see we pay for a municipal fire dept. but can't have a municipal Ems dept. there are way more sick people then fires in town.
Rocky Vitale January 12, 2013 at 07:46 PM
Having worked on an EMS service fr 32 years, I concur with Socket and question the EMS committees knowledge and experience in this area to come to a conclusion without extensive legal work. The Borough will have to pay dispatching fees in any event. Since it's clear Naugy ambulance will not have to give up it's PSA. The State Health Dept regulates exclusive service areas for ambulance providers, sets maximum rates that providers are allowed to charge; and determines the need for licensing and certification. Since the PSA can't be taken away, the Borough should bargain in good faith with Naugy ambulance and, in my opinion, should have carried out the existing contract until a new one was in place. They hold the PSA plain and simple. To see that payments were made when they shouldn't have been, calls into question the oversight of our finance area.
Lynn January 13, 2013 at 01:30 AM
I agree Rocky, "to see that payments were made when they shouldn't have been, calls into question the oversight of our finance area"!!! What is going on??
Vox Populi January 13, 2013 at 04:09 AM
If Naugatuck provided the service in the period in question and they were billing at the rate budgeted, Campion's rate, what is the problem with paying them for the service provided? It is not like we are going to pay that money to Campion, because of the PSA issue. Therefore the town is paying for the service from Naugy Ambulance at the rate bid by Campion for the service provided. Where exactly is the impropriety inferred in the two comments above?

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