Andover Townsman, Andover, MA

April 4, 2013

Hard to justify scrapping current ambulance service

The Andover Townsman

---- — At a time when there is increasing pressure on every public dollar, it is hard to justify a community’s abandoning an effective, efficient regional service and striking out on its own.

Fire Chief Michael Mansfield wants to upgrade the town’s ambulance services from basic life support to advanced life support, in the process dropping an advanced life support ambulance service provided by Lawrence General Hospital. Selectmen Monday were right to suggest Mansfield should work with the hospital rather than look to create a new taxpayer-funded service.

Emergency medical technicians are trained to provide basic life savings care and transport patients to the hospital as quickly as possible. But when a patient is suffering a more serious medical crisis, he or she needs the services of paramedics, who are trained to provide a higher level of care than EMTs. A paramedic is able to administer intravenous fluids and medications, insert breathing tubes, read electrocardiograms and provide other such advanced treatments.

In a presentation to selectmen, Mansfield has said having its own advanced life support ambulance service would allow Andover to cut response times by 20 to 25 percent over ALS crews dispatched from Lawrence General.

Mansfield asked selectmen to fund the first-year start-up cost of just under $146,000. Mansfield said the cost would increase slightly year by year, but the revenue generated by the service each year through 2017 would cover the full cost of the program.

The ALS service provided by Lawrence General comes at no cost to the community, and their greater number of patient interactions leads to great experience and better outcomes for patients, hospital representatives countered.

If public safety officials in town have concerns with LGH’s handling of town cases it should work with the hospital to improve the service. The hospital is planning a multi-million-dollar medical center on Route 133 in Andover and is trying to entice residents to return to using LGH rather than travelling to Boston for non-emergency medical needs. LGH has every reason to listen and respond to any legitimate concerns town safety officials may have about all its services.

But we are not aware of any great volume of complaints from Andover or anywhere else about the quality of Lawrence General’s ALS service. The service has a track record of exceptional clinical results, performing successful intubations 98 percent of the time, compared to a national average of less than 80 percent. The LGH crews arrived on the scene in Andover in an average of less than 8.5 minutes.

It seems to us that starting a new ambulance service at a time when health-care reimbursements to providers are being ratcheted down by national legislation is an unnecessary risk for taxpayers, particularly when a no-cost regional service already serves the community well.

It’s worth reconsidering when people should be tried as adults

The state legislature’s joint Judiciary Committee has two bills before it that would raise from 17 to 18 the age where young offenders could be prosecuted as adults.

While no one wants to be seen as being “soft” on crime, a persuasive argument can be made that treating 17-year-olds as full-grown adult criminals leaves them vulnerable to abuse and more likely to re-offend.

Rep. Brad Hill, who sponsors one of the bills, has cited a Northeastern University study that showed youth placed in the adult system are 34 percent more likely to be re-arrested for a violent offense than those placed in the juvenile system.

“The juvenile system is designed to get at the root causes of delinquency,” Hill argues. “Risks such as gang influence, family problems and school issues often contribute to delinquent behavior. These youth-specific issues are recognized more quickly and addressed more skillfully in the juvenile justice system.

It should be noted that we’re not talking about major crimes here. Local district attorneys would still be able to seek adult charges in serious crimes, especially those involving violence. And youthful offenders would still answer for their transgressions; they would just do it in a more appropriate setting.

In Massachusetts, all 17-year-olds accused of crimes are prosecuted as adults (meaning no one is required to contact their parents when they are arrested) and can be sent to adult jails and prisons, often putting them at high risk of sexual assault and suicide. District attorneys do, however, have the option to charge first-time offenders between 17 and 21 as “youthful offenders,” keeping them out of the adult detention system. To its credit, the Essex County district attorney’s office makes liberal use of the first-time offender program.

It’s worth noting that 38 states and the U.S. Supreme Court consider 18 to be the proper age of adult criminal responsibility. It’s time for Massachusetts to give the issue a long look.