1. Article 12 Ambulance Enterprise Fund MOTION (majority vote) Move that the Town appropriate $1,326,707 for the purpose of operating the ambulance service, and to raise such amount, $625,879 be raised from department receipts, $577,280 be transferred from retained earnings and $123,548 be transferred from general revenues.

2. Acton’s Current Medical Response Emergencies requiring ALSEmergencies requiring BLS 1 ambulance and 1 engine dispatched to every medical call BLS care started while waiting for subcontracted ALS intercept unit Patient transported to hospital under ALS care in Acton’s ambulance ALS Average Response Time 00:08:08 1 ambulance and 1 engine dispatched to every medical call Patient transported to hospital under BLS care BLS Average Response Time 00:04:45

3. ALS vs. BLS Calls

4. Differences between BLS and ALS BLS (EMT-Basic)ALS (EMT-Paramedic) CPR Artificial ventilations Oxygen administration Basic airway management Spinal immobilization Vital signs Bandaging/splinting Obstetrics Blood Glucose monitoring Albuterol Treatments Can provide all BLS skills plus: EKG monitoring Manual defibrillation Advanced airway management External transcutaneous pacing Fluid therapy Needle chest decompression Administration of critical care medications

5. Different Levels of Training EMT-Basic: certified healthcare professionals who are trained to provide basic-level life support to persons who are hurt or injured EMT-Paramedic: certified healthcare professionals who provide the most extensive pre-hospital advanced life support and carry additional specialized certifications: Advanced Cardiac Life Support Pediatric Advanced Life Support Neonatal Resuscitation Program Pre-Hospital Trauma Life Support Critical Care Paramedic

6. Current ALS Service Area Coverage area: 127.4 mi 2 2 ALS Intercept Units shared among entire service area (24/7) Population total: 85,919 Response time: 00:08:08

7. Proposed ALS Service Area Coverage area: 20.3 mi 2 2 ALS Transport Units dedicated to Acton (24/7) Population total: 21,584 Response time: 00:04:45

8. Why is this important for Acton? Provide faster pre-hospital care for Acton residents Provide higher quality of service for Acton residents Improve patient outcomes Higher availability to advanced life-support Revenue neutral

9. Projected Revenue SourceProjected Revenue Basic Life Support Revenue$550,000 Advanced Life Support Projected Revenue$298,790 Total Projected Revenue$848,790 Reference MMA Feasibility Study

10. Estimated Expenses ItemCost Paramedic School for 4 Students$137,000 Initial Equipment and Supplies$70,000 Restocking Supplies$20,000 Total Expected Costs$227,000 ALS revenue will help offset start-up costs

11. 5-Year Plan $1.1M fund balance 6/30/13 Utilize $150K subsidy for FY16-19 Begin ALS implementation FY16 Accommodates capital and start up costs Projected fund balance of $700K on 6/30/19 ALS Program is self-sustaining Conservative Revenue Projections

12. Article 12 Ambulance Enterprise Fund MOTION (majority vote) Move that the Town appropriate $1,326,707 for the purpose of operating the ambulance service, and to raise such amount, $625,879 be raised from department receipts, $577,280 be transferred from retained earnings and $123,548 be transferred from general revenues.

13. Detailed 5-Year Projection Starting FY14 balance: $1,091,998 FY14FY15FY16FY17FY18FY19 Estimated Revenue Current BLS $550,000 Increment. ALS $298,790 Subsidy $200,000$150,000 Income Totals$750,000$700,000$998,790 Estimated Costs FY Oper. Budget $756,512$779,207$802,584$826,661$851,461$877,005 Capital - Ambulance $260,000$275,000 Capital Admin. Veh. $60,000 Incremental ALS costs Supplies $0$20,000 Paramedic start-up $0$70,000$0 Paramedic school $0$137,280$0 Total Costs $756,512$1,326,487$882,584$846,661$871,461$1,172,005 Estimated FY Draw $(6,512)$(626,487)$116,206$152,129$127,329$(173,215) Ending Fund Balance $1,085,486$458,999$575,205$727,334$854,663$681,448