Worcester, Mass., has signed a five-year contract with UMass Memorial Medical Center under which the hospital system will continue to provide ambulance service for city residents and UMass Memorial will reimburse the city $1 million to upgrade its dispatching operations and hire more dispatchers.
Also, the city will allow UMass Memorial ambulances to return to neighborhood fire stations for the first time in about five years, a change that hospital and city officials said will improve emergency response times and that The Research Bureau has been calling for.
The move, however, runs counter to the efforts of fire officials in recent years to assume more emergency medical responsibilities as the number of structure fires has gone down.
City Manager Michael V. O Brien said he plans to station UMass Memorial ambulances staffed with paramedics at the Park Avenue and Burncoat Street fire stations, although that will require backup trucks now garaged at the stations to be moved.
That complicated piece of logistics will probably have to wait until the new Franklin Street fire station opens sometime next year at the site of the warehouse blaze that killed six city firefighters in 1999, Mr. O Brien said.
Hospital officials, meanwhile, said they will spend several million dollars over the life of the contract to improve UMass Memorial s emergency capabilities, including new radio technology that will be integrated with the city dispatch system, and to buy new ambulances.
"This is for the health and safety of our citizens," the city manager said. "We can improve first response and improve medical call taking and dispatching."
Fire Chief Gerard A. Dio said that while he can live with the terms of the new contract, he would prefer that the Fire Department provide all emergency medical response and transport services, as many other communities do.
While The Research Bureau has said it would be too expensive, and difficult for the city to bill customers, the chief said the Fire Department could handle billing just as well as the hospital, which, he noted, makes more money by expanding its ambulance service.
But because the prospect of a city-run ambulance system appears unlikely, Chief Dio said he has been pushing, without success, to buy several ambulances for the Fire Department to supplement UMass Memorial s fleet of about a dozen ambulances.
The chief maintained that fire companies can respond quicker to medical emergencies because they are already dispersed around the city in 11 stations.
A Research Bureau report from October showed that firefighters - who are trained in basic life support, as opposed to advanced life support like UMass Memorial paramedics - had an average response time last year for medical incidents of 4 minutes, 3 seconds. Hospital-based paramedics had a response time of 5 minutes, 57 seconds.
That is too slow, the chief said.
"I don t like waiting," he said. "If you need medical help, would you want to wait?"
In the meantime, Chief Dio said he hopes to accommodate the city manager s plan to free up fire station space and house the ambulances, but that he can not promise it will happen.
The new pact takes effect tomorrow and follows a previous five-year contract. The hospital system has provided ambulance service to residents, at no charge to the city, since 1991.
City Councilor-at-Large Joseph M. Petty, chairman of the council s Public Safety Committee, which is slated to review the contract, called it "very good news for the city."
John G. O Brien, the hospital s president and chief executive officer, said the changes in the contract will further reduce ambulance response times that he said are already fast.
"Seconds mean life and death for people," said Mr. O Brien, who is not related to the city manager.
The hospital chief acknowledged that the agreement is a boon to the hospital system, which he said has been growing at a fast clip and has rebounded well from its financial and hospital management problems of a few years ago.
He also noted that the emergency medical response relationship with the city is part of a series of community initiatives that UMass Memorial has undertaken with the city, including youth, public health and housing programs.
"It is good for the community and it is very, very good for UMass Memorial Medical Center," he said.
The hospital president also argued that the ambulances take advantage of UMass Memorial s array of emergency services, including helicopter, new $126 million emergency room, and Level 1 trauma surgery specialties.
"The heart of it all is the medical center, and the heart of that is trauma," he said.
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