The mayors of Johnston, North Providence and East Providence have had enough. After a meeting with Providence Mayor Angel Taveras and the city’s Public Safety Commissioner Steven Pare, the municipalities have given the capital city a 30-day deadline to lessen the burden that mutual aid has placed on the shoulders of neighboring communities.
“This is no longer mutual aid; it’s automatic aid,” said Johnston Mayor Joseph Polisena at a press conference Tuesday. “The Johnston residents can no longer afford to subsidize the city of Providence.”
Polisena said the municipal leaders called the conference to quell rumors that they would be cutting off mutual aid to Providence. Rather, the solution proposed by Polisena and his colleagues, Mayor Charles Lombardi of North Providence and Mayor Bruce Rogers of East Providence, is that Providence pays $500 for emergency response calls not covered by insurance. This would not include calls to the Fire Departments, as there is a separate protocol in place.
Pare says that isn’t happening.
“That’s not possible because of our fiscal condition in the city of Providence,” he said.
Pare was likewise skeptical that the city could afford to put additional rescues into service – the preferred alternative of Lombardi.
Lombardi got into a sticky situation when one of his fire trucks went out of service, and he admits that he leaned heavily on Providence. They were always responsive, he said, but he also had to find a more permanent solution, which meant purchasing a new ladder truck at significant expense to the town. Providence must also make that difficult choice, he said.
“The best thing that could happen for all of us is that the city places a couple new rescue trucks in service,” he said. “My wish would be that they take care of their problem and we can all live happily ever after.”
Providence has six rescues in service, and fields 32,000 calls annually – approximately 5,000 for each rescue. The cost of a new rescue would exceed $200,000, not to mention additional personnel costs. Pare says that is just not feasible at this time.
“We can’t afford to bring additional rescues into service. We’re feeling the strain because of our fiscal condition in the entire state,” he said.
In 2011, Johnston rescue responded to 473 calls in Providence. With 4,917 calls total made last year, that means roughly 10 percent of rescue calls are going to Providence.
Providence, on the other hand, responded to Johnston only 23 times.
Johnston has three rescues in service. At times, the mayor said two of those vehicles are responding to calls out of town. When the Atwood Avenue station has to respond to the town’s west end, callers could experience a delayed response, as EMS must cover 26 square miles of town.
“I’ve become very concerned with the safety of Johnston residents,” he said, reciting an emergency responder saying, “Minutes mean a lifetime.”
The mutual aid picture being painted in neighboring communities is quite similar. North Providence responded to Providence 553 times in 2011. This year, the calls are trending higher even than that.
“We’re here to help each other, but I feel at times, we’re jeopardizing the service to our community, while at the same time subsidizing the service to Providence,” Lombardi said. “This has become first response; that’s a problem.”
Mayor Rogers called the system “not-so-mutual aid,” and said East Providence especially, as the city is under the “very watchful eye of a state appointed budget commission,” must look at every dollar they spend. East Providence EMS responded to Providence 562 times last year, as opposed to 44 trips from Providence to East Providence.
“The term mutual needs to be defined,” Rogers said.
Putting a price on these calls is difficult, as the costs vary depending on the course of treatment enacted. The average basic life support call is roughly $1,060. A call requiring additional treatment starts at $1,278 and goes up from there. Municipalities incur an additional expense when these calls take place during shift changes, meaning that the town is on the hook for overtime for EMS personnel.
Some of those responses are covered by insurance or Medicare, but in cases when they are not, or when only a portion is covered, the towns are looking to recover the $500 flat fee.
If, for example, a call costs $1,060, and insurance pays $200, Johnston would bill Providence for $300, bringing the reimbursement up to the $500 benchmark.
“It’s a very small, nominal fee,” Polisena said, adding that the municipalities still lose money, even after instituting a reimbursement system.
Polisena estimates half of all calls are not covered by insurance. He believes it costs in excess of $100,000 annually for the town. That money, he added, could be put back into the rescue budget to buy new equipment.
The mayors first met with Pare on May 4, and brought up concerns that Providence was overusing mutual aid. The group met again on May 16, and set the 30-day deadline, which will expire in mid-June.
What will happen after that remains unclear. The mayors said they would re-evaluate at that time, based on the city’s response. Polisena says he already knows what he will do, and though he would not reveal his plan at this time, said it is “in the best interest of the citizens of Johnston.”
The mayors of North and East Providence did not indicate their minds are made up, but all three agreed their decisions would be based on how Providence moves forward.
Pare did acknowledge the city has a problem, but said a solution would likely take longer than a month to put in place.
“We had a discussion about how we can use our existing resources to meet the needs,” he said.
His department estimates that only 80 percent of EMS calls are true emergencies. For example, the city has roughly 12 callers who use rescue services frequently – as much as 100 or more calls each year – for mental health issues. If the city were to take a different approach and connect them with mental health counseling, Pare believes the strain on the system could be reduced. EMS in Providence also responds to calls for backaches, headaches and vomiting.
“You start looking at that amount of calls we’re taking by that small population; something’s wrong. Those aren’t emergencies and we shouldn’t be dedicating our resources to those kind of calls,” Pare said. “We have to look at how we prioritize our calls.”
Regionalization is another long-term solution he envisions.
“To me, we should be regionalizing those services across the county or the state so when there’s an up tick in demand, it’s covered,” he said.
Changing the way Providence Public Safety operates will take time, though, both in training for staff and education for the community.
“It’s going to take longer than 30 days to get relief,” he said.
If any town were to cut back on mutual aid service to Providence, Pare worries there could be a serious public safety issue in the capital.
“It puts our community at risk. It puts lives at risk. You never know when someone needs a rescue or needs a fire engine,” he said. “We rely on one another for public safety. When it comes to emergency, the community doesn’t care; they just want help when there is a true emergency and that’s what we believe in.”