Emergency Medical Technicians (EMTs) respond when there is an accident or an emergency medical need on Martha’s Vineyard. A vital part of the Island’s health care system, they often make the difference between life and death.
EMTs are trained to deliver trauma care and are versed in the basic care of all injuries and diseases. They are taught the skills they need to drive and serve in the patient compartment of an ambulance, and they learn how to use medical equipment such as automatic defibrillators.
This Saturday, Dec. 1, Island EMT supervisors hope to attract new members to the ranks. An open house from 9 am to 12 noon at the new Tisbury Emergency Services Facility on Spring Street across from the Tisbury School will introduce the service to interested people and provide information on what it takes to become an EMT.
“We need new volunteer EMTs every year,” said Jeffrey Pratt, president of the Martha’s Vineyard Association of EMTs, whose main role is recruiting and training new EMTs. Mr. Pratt will retire in January as the Tisbury Ambulance Coordinator, but he will continue to work part-time as a paramedic and intends to do more teaching.
Asked why one would want to become an EMT, Mr. Pratt said, “The motivation varies from person to person. Most of the time it’s from a commitment to their community.”
He said that most people take the training because they want to work on an ambulance. Some take the training for the education because they are responsible for others, a family member or involved as a coach or as a member of another community organization where they might be responsible for providing care for someone in an emergency. He pointed out that EMT training can be an entry level door to other health care professions.
“It takes a real commitment, but a quality person who wants to stick it out for 5 or 10 years can have a singular impact,” Mr. Pratt said. “Being a volunteer EMT is an incredibly rewarding experience.”
The only requirements are a high school diploma, a driver’s license, and passing a background check. EMT training covers a wide range of health and medical information.
The classes start in January and run through April. The first class is an orientation and can be taken before signing up for the program. A volunteer can become a basic EMT in six months, by June, according to Mr. Pratt. There are three and a half months of classroom work, two days a week, Friday nights, and all day Saturday and a month for practical study for the two-part exam, a practical exam taken here on the Island with the class and a written exam taken off Island. The classes average 12 students. Mr. Pratt said he would like to have 15 to 20 in each class.
Tuition for the class is $1,200. Included in this price are all books, a lab kit containing a blood pressure cuff, stethoscope, and more. Sponsorships are offered through the Island ambulance services that will pay the tuition in exchange for a commitment to that service, typically four shifts a month for a year.
Six months more study, testing, and practical experience are required to become an intermediate level EMT and an additional year of work and study to earn a paramedic license.
Volunteer basic EMTs work alongside and assist paramedics. They earn a stipend per shift that varies from town to town. Tisbury EMTs earn $70 per shift. Tri-town pays $75 per day shift and $100 for a night shift. Shifts are from 6 am to 8 pm and from 8 pm to 6 am, seven days a week.
Volunteers are expected to work at least one shift a week. Some work more and some less. “What the services are looking for is regularity over a long period of time,” Mr. Pratt said.
Generally, volunteers check in at the beginning of a shift and then must stay within their town, while on call. Some choose to stay at the ambulance station during shifts.
There are an average of 25 to 30 volunteer EMTs in each of the four Island squads.
There are four ambulance squads on the Vineyard. The towns of Tisbury and Edgartown each field two ambulances. Tri-town, which covers West Tisbury, Chilmark, and Aquinnah, staffs 3 ambulances. Oak Bluffs, which takes responsibility for inter-facility transport, including off-Island transportation, has four ambulances. The squads provide mutual aid, working together across town boundaries when needed.
Three of the four Island ambulance services average between 600 to 700 calls a year each, according to Mr. Pratt.
John Rose, chief of the Oak Bluffs ambulance service, said that Oak Bluffs had 1,654 calls in 2011. The larger number is mostly the result of the inter-facility transfers that Oak Bluffs makes, he said.
The ambulance services are paid for with a combination of town funds, payments from medical insurers, and from patients. The amounts and percentages vary from town to town. Every Island town budgets money to pay for some of the ambulance services.
The accounting methods used to track the income and costs of ambulance services differ from town to town. And the towns pay for equipment and expenses in different ways and at differing times. For example, the Tri-town service budgets money to be set aside every year for capital costs. Most of the other towns budget those expenses only when needed so their budgets are subject to greater changes from year to year.
According to town accountant Suzanne Kennedy, the Tisbury fiscal year (FY) 2012 revenues from insurance and patients for ambulance services was $199,406.97, or 50 percent of expenditures ($398,021.09), which included $54,802 to refurbish an ambulance and purchase defibrillators. The town’s portion was 50 percent, about $200,000. The Tisbury FY 2013 ambulance budget is $334.587. Ms. Kennedy said that the town actually funds the entire ambulance budget with the revenues going into the town’s coffers.
Oak Bluffs town administrator Robert Whritenour pointed out that due to the economy of scale Oak Bluffs has to cover a much smaller percentage of their ambulance service budget. The number of inter-facility transfers results in a larger number of calls that generates more income relative to the cost of the service.
According to an exhaustive report on the Oak Bluffs EMS presented to the Oak Bluffs selectmen in the spring of this year by the town ad-hoc Community Development Committee, the total annual cost for the Oak Bluffs EMS program was approximately $1.5 million for FY 2011. Reimbursements from government and private sector insurers as well as patients provided $1.158 million in revenue, 77 percent of the total. The town paid the balance, $342,000. Some of these funds were used to pay for ambulance, police, and fire department vehicles and equipment as well, the report said.
The Tri-town Ambulance Service’s income to expenses ratio is affected negatively by the economy of scale. They have minimum staffing and equipment requirements like the other services, but they make fewer billable calls.
According to Emily Day, the Chilmark town accountant who keeps the Tri-town books, the total budget for Tri-town Ambulance for FY 2013 is $646,077. The total ambulance receipts for calendar year 2011 were $160,903, about 20 percent of the expenses. Per the Tri-town agreement, 80 percent of those receipts, $130,322, was applied to the Tri-town budget, the remaining 20 percent going to equipment and maintenance costs, leaving $516,655 to be paid by the three towns. $172,218 was assessed to each town.
Edgartown ambulance expenses for FY 2012 were $597,956 according to Edgartown town accountant Kimberly Kane. There were $200,589 in ambulance revenues or 34 percent of the expenses. The town paid the 66 percent difference or $397,367.
For more information, check www.mvaemt.org.