TOWNSHIP OF SALISBURY
LEHIGH COUNTY, PENNSYLVANIA

MINUTES FROM THE BOARD OF COMMISSIONERS
REGULAR MEETING – 7:30 PM
OCTOBER 22, 2009

The Public Meeting of the Salisbury Township Board of Commissioners was held on the above date at the Township Municipal Building located at 2900 South Pike Avenue, Allentown, Lehigh County, Pennsylvania.

Members attending:
Larry Unger, President- Excused-Arrived at 7:50 p.m.
James Brown, Vice-President
Robert Martucci, Jr.
Norma Cusick
Dominic Giles-Excused

Staff attending:
Randy Soriano, Township Manager
Cathy Bonaskiewich, Assistant Township Manager, Finance Director
John Andreas, Director of Public Works
Allen Stiles, Chief of Police
Cynthia Sopka, Director of Planning and Zoning
John Ashley, Township Solicitor
David Tettemer, representative of the Township Engineer.

CALL TO ORDER
Commissioner Brown, Vice President, called the meeting to order at 7:30 P.M.

PLEDGE OF ALLEGIANCE

NOTIFICATION
Mr. Soriano informed the attendees that all sessions of the Salisbury Township Board of Commissioners regular meetings are electronically recorded for the purpose of taking the Minutes.  All public comments on agenda items would be taken at the time of the vote.  All public comments related to non-agenda items will be taken after the agenda has been satisfied.

Mr. Soriano announced that the Township does archive its tapes and are available pursuant the Right-to-Know Law.

Mr. Soriano reminded everyone of the 3-minute rule and asked that everyone should sign in and announce themselves and speak in the microphones.

Mr. Soriano announced that the Board of Commissioner prior to the start of the meeting held an Executive Session in order to discuss a personnel matter.

APPROVAL OF FINANCIAL REPORT AND BILLS PAYABLE
On motion by Commissioner Cusick, seconded by Commissioner Martucci, the Board of Commissioners voted unanimously to accept the Financial Report for the period ending September 30, 2009 and approve the Bills Payable for the period 10/03/2009 through 10/17/2009.

MINUTES
October 8,  2009
Commissioner Brown declared the October 8, 2009 Board of Commissioners Meeting Minutes approved as presented.
 
OLD BUSINESS
Presentation by ESCLV-Operational Assessment Project of the Eastern Salisbury Ambulance Corps.
 
Mr. Soriano introduced Mr. William Cosgrove and Mr. Dennis Farkas of the ESCLV. Both presented the Operational Assessment Project summoned by the Commissioners to formulate recommendations for the Commissioners to use for deciding on a course of action or stay the current course. The Study is reprinted and made part of this record, as follows.

Operational Assessment Project

Of The
Eastern Salisbury Township Ambulance Corps

Prepared for
Salisbury Township Board of Commissioners
October 2009

Dennis P. Farkas and William B. Cosgrove
ESCLV Consultants

Introduction:
Salisbury Township on behalf of the Eastern Salisbury Township Ambulance Corps (ESTAC) engaged the services of the Executive Service Corps of the Lehigh Valley (ESCLV) to assist in reviewing the operational status of ESTAC rendering emergency services in the eastern portion of Salisbury Township, PA.  In addition ESCLV was to assist in determining the feasibility of operational continuance of (ESTAC) and what alternatives may exist to provide ongoing emergency medical services to the citizens of Salisbury Township.

Approach:
In providing information and perspective for this study the consultants felt it important to not only identify the current situation and some of the key precipitating factors contributing to it, but to also look at a broader overview of EMS services and the potential impact that future legislation may have on it.

Since Cetronia Ambulance has a current agreement with Salisbury Township to supply services to the west end of the township and St Luke’s Ambulance has entered into a temporary agreement to supply EMS services in the eastern half of the township we included an overview of their operations as a potential long term option. Upper Saucon EMS was another long term option that was also investigated.

In preparing this report staff and volunteers from the following organizations were interviewed:

Salisbury Township
Eastern Salisbury Ambulance Corps
Eastern Salisbury Fire Ambulance and Rescue
Lehigh County Communications/ 911
First States
Eastern Pennsylvania EMS Council
Cetronia Ambulance
St. Luke’s Emergency and Transport Services
Upper Saucon Ambulance Corps

Background:
Salisbury Township covers 11.3 sq miles, has over 5,200 households and approximately 13,500 residents.  Its geography is unique in the state in that its borders are non continuous, separated by the city of Allentown.  The western side of the township is serviced for EMS services by Cetronia ambulance and the Emmaus Ambulance Corps, while the eastern half received their EMS services from the Eastern Salisbury Ambulance Corps, a part of the East Salisbury Township Fire, Ambulance & Rescue Company. 

The Eastern Salisbury Township Fire, Ambulance & Rescue Company (ESTFARC) was comprised of three components; EMS which supplied the emergency medical services,   Fire having both the fire and fire police responsibilities, and the Auxiliary.  It was governed by a management team represented by a; President, Vice President, Treasurer, Secretary, Fire Chief, Deputy  Fire Chief, two assistant  Fire Chiefs, a Fire Police Captain, and the EMS Chief.

Prior to the announcement of closure, the EMS operation consisted of two full time employees, five part time individuals and ten active volunteers.  Both the EMS Chief and the assistant EMS Chief were volunteers. Two basic life support equipped vehicles are housed at 1000 E Emmaus Av, Allentown, a facility owned by Salisbury Township and leased to the Eastern Salisbury Township Fire, Ambulance & Rescue Company.  All assets are owned by the parent company. 

On May 4, 2009 the Eastern Salisbury Township Fire Ambulance & rescue Company presented Salisbury Township correspondence indicating that they were ceasing EMS operations effective June 30, 2009.  Reasons given were “lack of EMS volunteerism” and “income not covering expenses”.  Operations actually ceased on August 12th, 2009.

Observations:
In 2008 the Eastern Salisbury Fire, Ambulance, and Rescue Company reported a Performa loss of over $51,000 for the EMS services.  In our interviews it was indicated that a major factor in ceasing operations was the belief of similar losses would continue in 2009, dwindling a reserve of over $250,000 built up by ESTFARC.  In examining data from the year 2008 we identified some events worthy of noting:

• A new EMS Chief was elected in 2008 replacing the prior Chief who served in that capacity for over ten years.
• No EMS operating plan or budget was identified for 2008.
• An EMS incentive system was put in place with a payout of close to $20,000.
• EMS operations implemented 24/7 coverage for a six week period.
• An interim Township manager was in place for approximately three months of 2008.
• The long standing EMS billing company was changed to First States in the fourth quarter. This was seen a benefit as First States was more progressive in helping ESTFARC seek optimal reimbursements.
• Medicare payments from October thru December were not realized in 2008.
• Transfer of funds for facility charges in 2008 was $20,000 higher than in 2007.
• Wages and incentives increased over 46% over 2007 levels.
• Billings in 2008 remained in the same range as in 2006 and 2007.
• New Township manager in place September 26, 2008.
• The Township commissioners approved a “ $30,000 subsidy for Eastern Salisbury Ambulance, contingent upon their providing the Township Manager access to financial records to monitor the performance of the squad and disbursement of the funds” in late December.

2009 Observations:

• EMS Chief who had served in that capacity for 10 years prior to 2008 is elected to and agrees to serve again as Chief in January.
• Incentive program is revised reducing expenditures by almost half.
• Benefits were eliminated.
• Non Medicare/Medicaid billing rates were increased effective June 1st by $175 for BLS services and $150 for ALS services.
• Through the end of May of 2009 approximately 121 calls were billed at the lower rate.
• The EMS Chief believes that she and her team did not have ample opportunity to address the issues facing the Eastern Salisbury EMS operation.
• Relations between the Fire Department and the Eastern Salisbury EMS leadership/organization became severely strained.

In reviewing unaudited financials since 2006 for the EMS operations, a total operating net loss of $13,633 is reported for that period.  This number includes a special onetime donation made in 2006 of over $30,000.  It was identified that a $51,381 loss was incurred in 2008, however, based on the observations above with the anomalies that occurred in 2008 coupled with the corrections made in 2009, it would not be expected  that this level of loss would continue. 

From a staffing perspective, issues were identified by all parties interviewed in securing volunteers needed to cover their non-standard operational hours (evenings and weekends). Only Eastern Salisbury Township EMS paid staff members were operating from 6 AM until 6 PM with a mixture of paid and volunteer staff on other shifts.  It should be noted that securing volunteers is not an issue unique to Eastern Salisbury Township EMS. With current billable call volumes ranging in the 350 to 450 call range, supplementing the volunteers with additional paid staff would deteriorate the financials further.  The EMS chief believed that given more time this issue could have been satisfactorily addressed.

Feasibility of Reconstituting the ESEMS Unit:
With the strained relationships currently existing between the ESTEMS and the Eastern Salisbury Township Fire, Ambulance & Rescue Company, any reconstitution would require the creation of a separate 501c3 organization with a defined structure, strategy, budget, and operating plan.  While the current EMS Chief and Assistant EMS Chief are highly dedicated and knowledgeable regarding EMS operations, additional skills are required on the administrative end.

According to the Eastern Pennsylvania Emergency Medical Services Council the benchmark number of calls an ambulance service needs to maintain and staff one Basic Life Support ambulance is 1200 calls per annum. From data obtained from the Lehigh County Communications 911 Center total calls for Call Box #68 (Salisbury Township) for the years 2006 were 1078; 2007 were 1197; and 2008 were 1250. Calls responded to by Eastern Salisbury Ambulance alone were 472 calls in 2006 (or 44% of the total); were 564 calls in 2007 (47% of the total) and were 546 calls in 2008 (44% of the total). The remainder of the calls were responded to by Cetronia, Emmaus, Upper Saucon and St. Luke’s. Eastern Salisbury Ambulance Corps does not have the capability to develop nor sustain on its own an acceptable call volume sufficient to sustain itself financially without extensive volunteer involvement.

Another more intractable factor is the geographic makeup of Salisbury Township. The call volumes indicated above included ALL of Salisbury Township. Divided as the township is by the City of Allentown it is impractical for an ambulance corps located in Eastern Salisbury to cover the entire township and comply with accepted response rates.

Additionally, the new legislation signed into law by the Governor this last August, and scheduled to be implemented over the next two to three years expanding the requirements for EMS services in the state, needs to be considered as being a foundation for the new unit.  Particularly the 24/7 operating requirement being phased in for BLS units will add the need for an additional ten to twelve volunteers as estimated by the current leadership team, bringing the total volunteers to a twenty to twenty-two person level. Given the current opportunity in securing volunteers we believe this new requirement could prove to be problematic for the organization.    
As a result, we believe that the best course for Salisbury Township would be to pursue a relationship with an already established, financially secure, ambulance corps in providing EMS services for their residents.

Alternatives:
In considering options available in providing EMS services for Salisbury Township, we reviewed three potential organizations that are highlighted below:

St. Luke’s Emergency Transport Services – St Luke’s ETS is a non-profit subsidiary of St. Luke’s Hospital & Health Network providing emergency medical services and non emergency transport services for Upper Bucks County and Lehigh County.  It is managed by an Executive Director and has a staff of 80 paid employees.  St Luke’s has two facility locations, one in Quakertown and the other in Fountain Hill. It currently operates 10 ambulances and 3 special service para-transit units and experiences more than 13,000 (emergency and non-emergency) calls per year. St. Luke’s provides for both Basic Life Support (BLS) and Advanced Life Support (ALS) capabilities.

Cetronia Ambulance Corps – Cetronia is a large non-profit corporation providing emergency medical services and non-emergency transport services on a regional basis.  It is managed by a CEO reporting to a board of directors and has on staff 141 paid employees and 15 active volunteers.  Cetronia has seven facility locations and utilizes a “staging” model (staffed ambulances parked in peak volume locations) to be able to respond to a call in the shortest time possible.  It currently operates 19 ambulances and 12 wheelchair accessible transport (ambulette) vehicles and experiences approximately 38,000 (emergency and non-emergency calls a year. Cetronia provides for both Basic Life Support (BLS) and Advanced Life Support (ALS) capabilities.

Upper Saucon Ambulance Corps –Upper Saucon Ambulance is a non-profit corporation providing emergency medical services to Upper Saucon Township residents. It is managed by an Executive Director and has a staff of 23 paid employees and a few volunteers. Upper Saucon Ambulance Corps has one location located in Upper Saucon Township.  It currently operates 3 ambulances and experiences 1200 (emergency and non- emergency) calls a year.  Upper Saucon Ambulance Corps currently provides for Basic Life Support (BLS) capabilities. They would consider implementing an Advanced Life Support Capability (ALS) if supplying EMS services to the Eastern Salisbury Township area. Additionally, Upper Saucon Ambulance has shown a strong interest in absorbing into their organization the volunteers that ran the Eastern Salisbury Ambulance Corps.

Summary:
Both St. Luke and Cetronia are capable of providing both BLS and ALS services to the Eastern portion of Salisbury Township.  Each has also indicated the willingness to explore housing a unit for some portion of the day at the current Emmaus Avenue location.  In order to accomplish this, St. Luke’s would need to secure approval from the Borough of Fountain Hill. 

Both organizations have also expressed a willingness to explore adding some of the Eastern Salisbury Ambulance Corps personnel as volunteers to supplement their existing operations. These individuals would need to be qualified to the appropriate standards of each respective organization. Neither operation expressed an interest in purchasing the current ambulances owned by the fire company. 

Upper Saucon represents a third option, however, initially they would be providing only BLS services. Yet, they would discuss taking on the volunteers that had served ESTAC and looking at utilizing the existing ESTAC equipment. Furthermore, taking on Eastern Salisbury Township coverage would accelerate Upper Saucon’s transition to an ALS service.

It is the considered opinion of the consultants that the Commissioners of Salisbury Township in their deliberations on this issue of emergency medical services coverage take the long view. Acquisition and delivery of emergency medical services in the future (3-5 years away) appears to be more challenging than it is today.  In the future townships with EMS services whether ALS or BLS will be required to man their services 24/7 and staff will be required to have higher competencies than currently defined. Additionally, recruitment of volunteers is a problem that will only be exacerbated in years to come. Finally, the mood of the State Legislature seems to be likely to hold government administrations more accountable for their emergency medical services.

A brief question and answer period followed.

Commissioner Cusick asked for clarification regarding the statement that St. Luke’s and Cetronia indicated willingness to house a unit for some portion of the day.  Mr. Soriano responded by saying that St. Luke’s and Cetronia were open to discussions of housing one of their ambulances where the Eastern Salisbury’s ambulance used to be.  Mr. Cosgrove explained that they have statistically tracked over a period of time, what times of the day and days of week would be most beneficial to the Township to have an ambulance there.  He also stated that Cetronia has ambulances pre-positioned in the county in order to cover Eastern Salisbury.

Commissioner Brown asked whether the Corp could function with all volunteers.  Mr. Cosgrove replied that the number of calls necessary to sustain one ambulance is 1200.  Eastern Salisbury was responding to around 400-500 calls, but the actual billing was around 350.  Mr. Farkas noted that if the Ambulance Corp was an all volunteer organization, there would be more stability, but they still might not have the call volume to sustain the organization.

Several members of the Board thanked Mr. Cosgrove and Mr. Farkas for a job well done in preparing the report.

Several members of the audience commented that they have questions about the report. Mr. Soriano noted that it would be better to first read the report and then follow up with additional meetings. Mr. Soriano stated that the purpose of the report was to objectively study this issue in order to take away the passionate debate that someone may have towards going one direction or another.  Commissioner Brown noted that the report will be on a future workshop agenda after everyone has had a chance to read and digest it. 

Motion by Commissioner Cusick to accept the report from the ESCLV. Motion seconded by Commissioner Martucci. Motion passed by unanimous vote.

NEW BUSINESS
None

ORDINANCES
None

RESOLUTIONS
None

MOTIONS
Consideration of a Motion to reappoint Mr. Tom Grello to the Building Code Board of Appeals.
Mr. Soriano noted that the BOC had initially re-appointed Mr. Grello to the UCC Board of Appeals Board until September 30, 2009 while awaiting more information on his background. Since then, the Township has also requested other resumes from interested citizens willing to be considered for the appointment. Mr. Soriano noted that to date no one has submitted applications and Mr. Grello has followed up with a letter and resume for the Board’s consideration.

Motion by Commissioner Cusick to re-appoint Mr. Tom Grello to the UCC Board of Appeals Board for completion of his term. Commissioner Brown seconded the motion. Motion was approved unanimously.

Consideration of a Motion to authorize the Township Manager to prepare a Request for Proposal for Engineering and Legal professional services for 2010.
Mr. Soriano noted that at the last work session, Commissioner Cusick brought up the services of the Engineer and Auditor for 2010 when the Board also will hold its formal re-organization and make appointments to fill these positions.  Commissioner Cusick noted that looking at professionals every few years ensures that the Township is not locked into any one person. 

Motion by Commissioner Cusick to authorize the Township Manager to prepare RFP for both the Engineer and Legal services for the Board to consider for appointment in 2010. Commissioner Giles seconded the motion. Motion was approved unanimously.

Consideration of a Motion to approve Center Square Associates Escrow Release # 1 ($151,772.66).
Mr. Tettemer noted that he has reviewed this request and visited the site. He advised the Board that all expenses are legitimate and the Commissioners can release the money.

Ms. Sopka, Director of Planning and Zoning, was asked to review this release and accompanying detail inspection reports from the Township Engineer. She agrees with the Township Engineer that the work was completed.
Commissioner Brown questioned Mr. Tettemer if the neighbor living behind the site has had any comments on the landscaping.  Mr. Tettemer responded by saying that he has not heard any comments, good or bad.  He noted that they had revised the landscaping that was on the plan in order to satisfy the neighbor’s specific comments. 

Motion by Commissioner Cusick to authorize the release of Escrow Payment #1 in the amount of $151,772.66 associated with the Center Square Associates development.  Commissioner Martucci seconded the motion. Motion was approved unanimously.

Consideration of a Motion to approve Southbury Park Escrow Release #11 ($29,003.66).
Mr. Soriano stated that this escrow deals primarily with work associated with storm sewer beddings and erosion controls for the Southbury Park Development.

Mr. Tettemer stated that his office was onsite to inspect the work, which is satisfactory, and the Board can release the money. Ms. Sopka stated that in regards to the erosion and sedimentation controls, the Township Engineer is correct.  They are becoming stabilized, retaining water and the wet lands are re-establishing themselves.  Overall, she is recommending the release.

Motion by Commissioner Cusick to authorize the release of Escrow Payment #11 in the amount of $29,003.66 associated with the Southbury Park development.  Commissioner Brown seconded the motion. Motion was approved unanimously.

Consideration of a Motion to accept the resignation of Fritz Brock from the STEAC.
Commissioner Brown read a letter of resignation from Fritz Brock stating that he had to resign for personal reasons but would still help in the update of the comprehensive plan.

Commissioner Brown noted that he will find a replacement for Mr. Brock’s position as soon as possible, with the approval of the Board.

Motion by Commissioner Cusick to accept the resignation of Fritz Brock.  Commissioner Brown seconded the motion.  Motion was approved unanimously.

PUBLIC COMMENT
Commissioner Martucci thanked the volunteers from the Ambulance Corps. for their dedicated service.

Commissioner Brown thanked the volunteers for their many years of service and commitment to the community, and the Commissioners will need to take a hard look at the study and decide the correct course of action.

OTHER BUSINESS
None

ADJOURNMENT
As no other business was presented, Commissioner Unger adjourned the meeting.  The Commissioners later on reconvened for the monthly Workshop. The time was 8: 10 p.m.