LITTLETON — Following discussions in February, the Littleton Select Board agreed to a 90-day Emergency Medical Services ambulance service contract extension with Franconia on Monday.
In addition to voting 3-0 for the extension, the Littleton board voted 3-0 to form a task force with members of both towns to work on what could be a longer-term solution with Franconia and to report back within 60 days so the towns will have 30 days if an issue arises with the 90-day extension.
“The bigger picture is people need care,” said Carrie Gendreau, the Littleton Select Board vice-chair. “We can talk dollars all day long, but a life is more important. By extending at least three months, that gives us a little bit more time. A lot of towns are going this route, more regionalization.”
“Hopefully, this is something to be built upon that benefits the whole area,” said Franconia Selectman Dan Walker.
“It could be a pilot project,” said Interim Franconia Town Administrator Sharon Penney.
The extension comes after Franconia, in January, disbanded its Life Squad because of no more members and Littleton Fire Rescue, also in January and after experiencing higher than anticipated call volume in Franconia that sometimes left no LFR personnel in Littleton when responses were needed, initially opted to not renew a contract with Franconia from 2022 that was set to expire on March 31.
In the following weeks, Littleton developed an agreement that could work.
The contract extension increases the $300 per call Franconia pays Littleton to $500.
It also provides a stipend to be paid by Franconia so firefighters can have station coverage and maintain staffing in Littleton.
The stipend is $100 for a single role (certified firefighter or licensed EMS provider) or $200 for a dual role (certified firefighter and licensed EMS provider), which will be paid above hourly pay and that LFR Chief Chad Miller said will help offset the cost to people’s time.
The extension also has Franconia paying up to $5,000 for placing Franconia Ambulance 1 back in service as a transport ambulance under LFR (to provide a backup in addition to LFR’s two ambulances) and provides additional money for LFR operations.
The 90-day extension might be scalable as long as LFR can staff calls for service, said Miller.
“The 90 days gives us time to see if Littleton or somebody else will be providing that service,” he said. “It is a big ask for us to go a long time with our staffing … We came to an agreement to try this, but it doesn’t buy a lot of time. What it needs is more employees, and more employees bring cost.”
Monthly reviews will be conducted to see if the contract extension isn’t placing an undue burden on LFR members.
“The framework is there budgetarily,” said Miller. “Staffing is going to be the big question.”
“One of the things I don’t want to do is burn out our guys,” said Littleton Select Board Chairman Roger Emerson, an advocate of seeing what kind of state assistance might be available for communities facing EMS challenges.
Walker agreed and said burnout helps no one.
During Franconia’s town meeting vote on Tuesday, residents passed Article 9, which authorizes $160,275 for the ambulance contract with Littleton for the 90 days from April 1 through June 30.
They also passed Article 10, which authorizes $325,890 for the purpose of securing the ambulance service from July 1 to Dec. 31.
A petitioned article in Franconia that sought $375,000 to hire full-time professional EMS and fire coverage in a combined department was tabled.
With Articles 9 and 10 on the warrant, the Franconia Select Board had not supported the petitioned article.
Walker said previously that the problem isn’t money but a shortage of qualified first responders.
Monday’s meeting in Littleton also included Franconia Select Board member Jill Brewer, several Franconia residents, several local fire chiefs, Littleton firefighter/EMTs, Littleton budget committee members John Goodrich and Steve Kelley, state Reps. Dave Rochefort, R-Littleton, Linda Massimilla, and District 2 Executive Councilor Cinde Warmington.
Walker said Cannon Mountain and the private Lafayette Center nursing home make up a good chunk of calls in Franconia, and his town needs to reach out to the state-owned mountain and the nursing home to see if they can provide any resources or reimbursements for first responder services.
Another challenge arises when surrounding towns offer better pay, which draws first responders there, said Penney.
“The problem is cannibalizing from other towns,” she said. “People are being recruited away. That undermines everyone in the neighborhood.”
As for reimbursement, Warmington said she has already been contacted by other communities facing similar concerns regarding the inadequacy of the reimbursement for EMS services.
Warmington said she has contacted state Sen. Suzanne Prentiss, D-West Lebanon, who has a background in EMS, and is meeting with Justin Cutting, director of the state fire academy, for their thoughts on how small towns with EMS challenges can be helped.
In addition, she said she has reached out to Medicaid representatives and those on the commercial side bout possible increases in reimbursements.
“I had a reach-out with New Hampshire Fish and Game and the Division of Natural and Cultural Resources to see if there’s any opportunity there for any funding to come from fees on [the Cannon Mountain] side,” said Warmington. “The state has property and sometimes that places an additional burden on communities.”
As for buying time, some good news is that LFR has been working on a federal SAFER grant that pays 100 percent the first year for staffing and would cover nearly $600,000 to hire one firefighter/EMT per shift, said Miller.
“That gives us some time to work through some of the finer details and also helps to spread some of the cost Franconia incurred up front over multiple years so it doesn’t hit all at once,” he said.
Goodrich said he wanted to plant a few thoughts for the discussion.
“I think this is an opening to do regionalization and I see it as entirely necessary,” he said. “Recruiting and finding the right people is exceptionally difficult … Maybe plant a seed with our state educational systems on how to train people to do this. We are obviously into a professional EMS group. We were before. I think the other issue at the state level is we have difficulty in accepting volunteers. And I think there needs to be room for both.”
Regulations that are imposed make it difficult to recruit volunteers and therefore offset costs that towns are bound to incur with regionalization, said Goodrich.
“I think there is a clear role for volunteerism that is being ignored,” he said. “I think somehow the state has to help make that doable … We are bound to incur very significant and steep costs if we don’t do something differently.”
Littleton Town Manager Jim Gleason said the majority of today’s calls are medical calls that require EMTs and paramedics with qualifications and experience.
“It’s not what EMS was 20 years ago,” said Miller. “I think that has a lot of effect on volunteerism as well.”
Rochefort asked members of the two towns if they have any legislative requests and if they are facing any administrative rules that are acting as barriers or hurdles to EMS entry.
In addition, the New Hampshire House of Representatives passed a recreational marijuana bill that, if made law, would collect tax revenue and make money available for municipalities for first responders and additional monies for communities that allow sales within their community, he said.
Retired Littleton firefighter Ray Bowler said the talk about regionalization needs to be spread out to towns beyond Littleton and Franconia.
Sugar Hill Fire Chief Allan Clark, president of the Twin State Fire Mutual Aid Association, agreed and said there is a problem in the state and it’s being recognized.
Today, EMS makes up about 80 percent of calls a fire department receives, said Clark.
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