PROVINCETOWN — The select board and other town officials are now backing Fire Chief Michael Trovato’s call to create a full-time emergency medical services department with 16 new staffers.
This means the end of the 85-year partnership among Provincetown, Truro, and the nonprofit Lower Cape Ambulance Association (LCAA). Trovato has been seeking this change since 2018, but it took a report from consultant Tom Impey of Capital Strategic Solutions to tip the balance.
“It is not rocket science,” Trovato told the Independent. “I have been telling them this for years, but if they hear it from someone they hired from over the bridge, then they will listen.”
Provincetown pays LCAA nearly $1 million a year for backup ambulance services. In addition, LCAA collects the fees for every ride to Cape Cod Hospital. Leaving the LCAA would thus bring $1.2 million a year into the Provincetown Fire Dept. accounts, Deputy Fire Chief Jimmy Roderick told the select board on April 25.
That is nearly enough to pay 16 new emergency medical technicians (EMTs) and paramedics, which would cost $1.4 million, Roderick said.
Those16 EMTs and paramedics would mean there could be a crew of four in the station 24 hours a day. That is the theoretical staffing level now during the summer, when “summer standby” crews and the LCAA are fully staffed. But the part-time and per-diem jobs offered by Provincetown and LCAA are not attracting enough employees, Trovato said, to keep staffing where it needs to be.
And that is hurting emergency services. The town’s service zone plan, filed with the Mass. Office of Emergency Medical Services, calls for response times in Provincetown and Truro of nine minutes 90 percent of the time, according to Trovato.
“We rarely meet those standards,” Trovato wrote in his report to the select board.
For decades, Truro and Provincetown found it efficient to pay LCAA to provide a stable of medics who have other jobs but could fill shifts that provide backup coverage. But the labor pool has shifted, and on-call medics are few and far between. Now, even the smallest towns must hire full-time rescue crews because there are so few on-call backups living nearby. Paramedics are in high demand Cape-wide; this has hurt LCAA’s ability to keep a full roster, Trovato said.
The LCAA medics have other jobs they must go to. The department cannot make them stay if someone calls in sick.
In recent years, Truro, Provincetown, and LCAA have all been understaffed. Wellfleet and Eastham have been taking up the slack through mutual aid, Trovato said.
The LCAA crews often use town-owned ambulances. So, while the nonprofit keeps the fees paid by insurance, the town must maintain the ambulances, the study noted.
During budgeting discussions early in 2022, Trovato asked Town Manager Alex Morse to increase his budget so he could hire four new medics, but the request was turned down pending the results of consultant Impey’s work.
“The board is motivated to support the fire dept.,” said the select board’s John Golden on April 25.
“There is nothing I would not do to make this fire dept. whole and happy,” added board member Bobby Anthony, “because if it’s whole and happy that means the town of Provincetown is well protected.”
The study recommended phasing out LCAA in two years. In the meantime, the fire dept. has applied for a federal Staffing for Adequate Fire and Emergency Response grant. If the town gets it — awards are announced in the fall — the feds would pay for all 16 new staffers for three years, totaling $4 million, Roderick said.
After that, though, the town would have to pay the medics — that is, if they can be found. Trovato said he has eight people working part-time as “summer standby,” or who are just on call. If he can offer them full-time work, that would stop them from taking a job at another department.
Trovato would like to keep an on-call crew of firefighters even as he scales up to a salaried medical service. This is because isolated and densely packed Provincetown needs bodies fast in a fire. The current number of call firefighters is 45, he said.
Another study presented on April 25 recommended that Provincetown construct a fire substation for $18.9 million. While Trovato liked the idea, the select board did not comment. Morse said staffing and a new substation would be considered together in future planning.