The Jaffrey-Rindge Memorial Ambulance is anticipating greatly increasing the request for town support from both Jaffrey and Rindge this year to more than 2 1/2 times the current request.

During a meeting with the Rindge Select Board on Monday, JRMA Chief Bill Johnson spoke with the board, as well as Jaffrey Town Manager Jon Frederick and fire chiefs from both towns, about the 2025 budget request. In 2024, both towns contributed $93,000, split evenly between them, to the ambulance’s overall budget. The anticipated request for 2025 is $250,000, with each town paying half.

Johnson acknowledged the jump.

“It is a sizable increase as opposed to what has been paid in the last few years,” Johnson said.

Johnson said the increase was “multifactoral”, and included a major wage adjustment that took place this year, reimbursement rates from insurance companies dropping and capital expenses related to both equipment and the ambulance bay infrastructure.

JRMA is an independent non-profit that services both towns, and is housed in a building owned by the Town of Jaffrey, but is not owned by either town.

Pay increases and staffing shortages

“Staffing is a massive, massive problem. It’s not just us – this is a national problem,” Johnson said. “It is very difficult to find qualified staff and staff that is going to fit your culture and your ideals. This is a hard job to get into and a hard position to have any longevity.”

Johnson said that currently, the ambulance operates with per diem staff, with himself as the only full-time employee at 32 hours per week. The department has two ambulances. One is staffed from 6 a.m. to 6 p.m. seven days a week with two personnel, and the second is staffed by on-call workers. Overnight, staff for one ambulance is kept on call.

In an effort to attract new employees and improve retention, Johnson said the ambulance has adjusted its pay rates, increasing starting EMT pay from $16 per hour to $20 per hour, advanced EMTs from $17.50 per hour to $22 per hour and paramedics from $23 per hour to $27 per hour. Johnson said this put Jaffrey-Rindge Memorial more in line or slightly above surrounding communities, and that the pay increases were the bulk of the extra funding needed for the coming year.

Overall, the expected payroll budget, including pay, stipend pay and FICA, was $410,000 this year, with an anticipated $591,541 budget for 2025.

Calls for service and insurance payments

The JRMA has responded to 1,199 calls since January. Of those calls, 769, or about 64%, were in Jaffrey, and 419, or 34% were in Rindge, while 11 calls were responses to other towns, including Peterborough and New Ipswich.

Johnson said that split is about in line with the previous year’s service. In 2023, the ambulance responded to 1,381 calls in total, with 887 in Jaffrey, 483 in Rindge and 11 in other towns.

Based on the current average number of calls per year, Johnson said the ambulance needs to make about $527 per call in order to make its budget. He said that insurance reimbursements vary based on the carrier, and some of the expected reimbursements have decreased. What insurance does not pay is charged to the individual, and the town does employ a collection service to try to recoup late or unpaid bills.

“We can increase the rates [for service] but should insurance not pay, it places the burden on the individual,” Johnson said.

The ambulance does not charge patients when they respond to a scene but the person refuses treatment or transportation. Johnson said that is not the case in all states or services, but said he was not in favor of changing that practice for JRMA.

Infrastructure and equipment

Johnson said he would like to move to a model that fully staffs at least one ambulance at all times, but the current ambulance barn is not rated for occupancy. He said he is exploring some options, including upgrading the building with fire suppression or other improvements, or housing workers overnight at Camp Monadnock – about a four minute ride from the ambulance bay – for a nightly fee.

Johnson said in addition to needed improvements to the building, equipment has grown increasingly expensive, and the ambulance service is limited in the type of ambulance it can purchase due to the size of the ambulance bay. The JRMA recently purchased a new ambulance, which was delivered earlier this month, for $305,350. The funds for the ambulance came from the JRMA’s capital reserve.

Johnson said the purchase of the ambulance has put the capital reserve in the mid-$200,000 range, noting that if there is an immediate need to replace the 2017 ambulance, JRMA would not have the funds to replace it without a loan. He said the ambulance would be using excess funds to build back the capital reserve.

The ambulance also purchased a new power stretcher for the ambulance, at a cost for $34,683 for the stretcher and a maintenance contract, which will be paid for in five annual installments.

Ashley Saari can be reached at 603-924-7172, Ext. 244, or asaari@ledgertranscript.com. She’s on X @AshleySaariMLT.