by CHRIS LINDAHL
@cmlindahl
Daily Hampshire Gazette
SOUTHAMPTON — The relaunch of the town’s paramedic-level ambulance service is being pushed back for a second time to Aug. 1 as new staff is hired and planned drug management procedures are put into place.
Those services were temporarily suspended after a May 28 inspection by the state Department of Public Health Office of Emergency Medical Services.
The inspection found expired drugs on each of the Fire Department’s two ambulances, several lapses in drug record-keeping procedures and revealed the extent to which months of personnel problems had affected the department.
The service had been without an ambulance coordinator for three months after Deputy Chief Kyle Miltimore stopped showing up for work in February, Fire Chief John Workman said.
In the meantime, two former Southampton firefighters have criticized Workman, who has been chief since 2013, questioning his qualifications and his ability to run a paramedic-level ambulance.
State, town and Cooley Dickinson Hospital officials had previously agreed to restart paramedic-level services by June 10, which was later pushed back to July 1 as paramedics were retrained and practices overhauled.
The department has an affiliation agreement with CDH to supervise the administering of drugs by paramedics.
Workman met again with DPH officials on Tuesday. Though he was given the OK to restart paramedic-level services immediately, Workman said he will wait until about half-a-dozen new EMTs are hired “rather than try to just rush back in.”
The services will be restored by Aug. 1 at the latest, he added.
“They liked all our policies and our procedures,” Workman said of the meeting. “We are really changing the culture here in the department.”
Details of the department’s struggles are outlined in the DPH’s report of the May 28 inspection obtained by the Gazette.
? The inspection found Ativan, an anti-anxiety drug, on both ambulances that had passed its expiration date two weeks earlier. The drug had been noted as expired in the narcotics log book, “but never reported to management for replacement.”
? Inspectors found the log showed “no accountability” for drug usage. There were instances of usage filed at the CDH pharmacy that were not entered into the Fire Department’s log.
? There were multiple dates in the log with no entries of narcotics being checked.
? Some entries in the log were accompanied by signatures that “could not be verified,” making it unclear who was responsible for conducting the drug audit.
? Inventory checks of non-narcotic medication had not been routinely conducted. The last record of inventory was noted in April.
The report also mentioned the “many personnel problems” that have plagued the department, one of which left it without an Advanced Life Support (paramedic) coordinator for three months during Miltimore’s absence.
After not coming to work since February, Miltimore was granted a three-month leave of absence by the Select Board in May.
Miltimore’s absence left Workman with “no one responsible and qualified to oversee the ambulance operations,” the report reads.
Workman is a basic-level EMT. Paramedics are EMTs who have undergone further training that allows them to administer drugs and perform advanced medical procedures.
The ALS coordinator is charged with ensuring that all necessary drug management protocols are followed.
In Miltimore’s absence, the coordinator’s duties were “intermittently filled and there was no backup in place,” Workman said.
Soon after the state inspection, Workman appointed paramedic David Murrett as ALS coordinator.
Workman noted that the previous system of relying solely on the coordinator for drug management was a “single-point failure.”
He said the department has overhauled its practices so that if one person misses a step in drug management procedures, it will be picked up by another person.
“We have a lot of people doing different parts of the job to ensure all the paperwork is being done correctly,” he told the Gazette Tuesday. “We’re really building a system that’s higher in quality and has more redundancies in place so we never end up in the position we were in before.”
Another new policy is reviewing every dispatched ambulance call “just to see if there’s any points we can learn from,” Workman said. The department had previously reviewed only a percentage of all calls.
The department’s paramedics have already completed the training that was agreed on by Workman, DPH and hospital officials after the May 28 inspection, he added.
Workman said he looked to Northampton fire officials in developing his department’s new standards.
“We’re emulating Northampton’s EMS model,” he said. The department is “benchmarking off of higher standards that we can find.”
Despite these improvements, Workman said he voluntarily chose to hold off on restarting paramedic-level services until new EMTs and paramedics he has hired have completed paperwork with town officials.
That process is done through the Personnel Policy and Procedures Board, which typically meets twice a month, because the town does not have a human resources department.
Two former firefighters have made public their views that Workman is to blame for the Fire Department’s shortcomings.
After serving on the department for nearly 12 years, Wayne Theroux resigned in May as lieutenant, citing concerns with Workman’s management and his basic-level EMT qualifications.
“It had gotten to the point with the chief that the department was going extremely dysfunctional with his command,” Theroux told the Gazette. He added that he believes Workman does not know how to operate a paramedic-level ambulance service.
Theroux’s cousin Mark Theroux, a former Southampton fire lieutenant who resigned in April, spoke out at Town Meeting in May against the need for a second shift at the department.
The second shift would mean that EMTs would cover more calls directly from the fire station, rather than responding from their homes. Residents will decide whether to fund the schedule change by way of a $135,000 Proposition 2½ override at the July 9 special town election
“I would say that with better management, the shifts could be covered at night and it’s just not needed,” Mark Theroux said.
Asked Tuesday about the comments by the Therouxs, Workman chalked it up to bitterness from former employees.
Both Therouxs appeared before the Select Board this month, with Mark Theroux offering comments at two meetings.
On Tuesday night, Mark Theroux questioned the delayed rollout of paramedic-level services and criticized the board’s decision to allow Workman to reside in Easthampton. His original 2013 contract had required him to live in Southampton.
Workman’s contract was modified by a 4-1 vote by the board in June, with Chairwoman Elizabeth Moulton the lone “no” vote.
Chris Lindahl can be reached at [email protected].
