Up-Island boards consider Tri-Town Ambulance change

West Tisbury will bring the formula to its annual town meeting. 

The West Tisbury Public Safety Building houses Up-Island's Tri-Town Ambulance service. — Eunki Seonwoo

Updated 8:44 pm

All three Up-Island select boards met in a joint Zoom meeting to vote on a new cost-sharing formula for the Tri-Town Ambulance service. The final decision on it will be delayed until after the annual West Tisbury town meeting. 

According to Ben Retmier, Tri-Town Ambulance chief, the Tri-Town Ambulance committee was approached by Aquinnah finance committee chair Allen Rugg in February. Rugg was concerned about the budget for the ambulance service and how it was affecting Aquinnah, Retmier said. Rugg asked if the committee would be willing to look over and possibly change the ambulance service’s funding formula, and the committee agreed to look into it, Retmier said.

Retmier and Tri-Town Ambulance administrative assistant Allison Graczykowski worked together to create a formula that was looked upon favorably by the committee, alongside input from the towns’ finance committees. The formula takes into account the call volumes from each town and the fact each town needs an ambulance service. It also looked into the revenue sharing among the three towns. 

Retmier presented the call volumes of the up-Island towns in the fiscal years of 2019–21. In each fiscal year, West Tisbury had the highest percentage of call volumes, while Aquinnah had the lowest. In the fiscal year of 2021, West Tisbury made up 55 percent of the call volumes, Chilmark made up 36 percent, and Aquinnah made up just 9 percent. These call volume ratios also reflect the number of people living in each town. Ultimately, the formula will decrease the payments only for Aquinnah, and create a bit of an increase for West Tisbury and Chilmark to make the pay structure more equitable. If approved, the formula would take effect in 2023. 

Retmier said Tri-Town Ambulance always keeps track of the run numbers, and updates the committee every three months during their meetings. Retmier said going forward, the run numbers would be updated on a yearly basis, so by December the Tri-Town Ambulance would know how many times they were needed per calendar year. 

“Aquinnah uses 9 percent of the service and pays 33 percent of the load, and has done that for a long time,” Rugg said. “Aquinnah uses 9 percent of the service, and rather than paying 33 percent, it will be paying 27 percent. Chilmark would pay 34 percent for 36 percent of the usage. West Tisbury uses 55 percent of the service, and their share would go down to 39 percent. The numbers show this is a compromise to move forward constructively.” 

Tri-Town Ambulance committee chair Warren Doty, a Chilmark select board member, pointed out that for Aquinnah to make a first-class ambulance service with paramedics would be very expensive for such a small town. “We think this is a reasonable proposal,” said Doty. 

West Tisbury select board chair Skipper Manter said that since the formula would increase the financial burdens on the West Tisbury taxpayer, it should be brought before the town’s annual town meeting to gain input from the residents. Manter prefers keeping it at thirds, saying the amount of runs and ambulance reimbursements by insurance policies from West Tisbury are helping to supplement the service for Aquinnah and Chilmark. 

“It’d be more acceptable if there were additional crew or expenses, one way or another,” Manter said about the increase in West Tisbury’s portion. “But that doesn’t seem to be the case here. Whether West Tisbury has 55 percent or 35 percent, the staffing wouldn’t change.”

Retmier said staff was hired depending on the ambulance service’s labor needs, not based on town run ratios. 

West Tisbury finance committee member Cathy Minkiewicz said the Tri-Town Ambulance formula should not be decided just by the select boards. She said not bringing it to the voters during the town meeting would set a precedent for other issues to be decided by select board members, without resident input. 

The Chilmark and Aquinnah select boards unanimously approved the new formula. 

The West Tisbury select board voted 2-1 in favor of moving the issue to the annual town meeting. West Tisbury select board member Kent Healy was the only dissenting vote, saying this was an issue that should be decided by the select boards. 

In other business, the Up-Island select boards unanimously approved a change to the Tri-Town Ambulance memorandum of understanding. Originally, the memorandum’s wording allowed only select board members to be officially a part of the Tri-Town Ambulance committee. The newly approved wording now allows those appointed by an Up-Island select board to be official members of the committee. The vote allows Jim Newman, who is no longer on the Aquinnah select board, to be a member of the ambulance committee.

Aquinnah select board member Juli Vanderhoop was unable to attend the joint meeting.

Call volume ratios during the fiscal years 2019-2021 portion edited for clarity and to correct the spelling of Ben Retmier’s name.