The town is still on-track to conduct a long-planned study to assess new operating models for the Madison Ambulance Association (MAA) this year, according to First Selectman Peggy Lyons, as the association continues to struggle with employee retention and revenue.

The study will likely begin in the next couple weeks, Lyons said, with an aim to have an “independent view” of how to move forward by the time budget discussions begin to ramp up.

For at least three years, various town officials have promised to look into possible changes as to how MAA operates. MAA is partly funded by the town but is also supported by donations, and billing for a narrow array of services.

Consistently, the MAA has needed to ask for special appropriations or dip into its rainy day fund in order to remain operational. The town initially denied a request for a $253,000 budget increase this winter, but changed course and granted it after the onset of the pandemic in March.

At a recent Board of Selectmen (BOS) meeting, Selectmen Bruce Wilson said the MAA continues to struggle. He said that three times in the last month, the MAA has had to take vehicles off the road due to lack of staffing, and has had to ask people to work overtime on a regular basis.

The $253,000 was intended to mostly fund benefits for MAA employees and family members as well as some pay increases, MAA President Sam DeBurra said back in January. That money was made available to the MAA on July 1, and Lyons said she expected employees also to be granted raises on that date.

The issues with the current operating model have been well documented, and discussed several times in recent years without much changing. State law prevents the association from billing patients if they are not transported to a hospital, and patients using Medicare or Medicaid—a significant portion of Madison’s population—can only be billed at a rate much lower than state guidelines.

This means the association has to write off a large amount of its billable services—more than $700,000 in 2018, Bernier told The Source last year.

Retention has also been a big issue, with MAA reporting losing staff to employers that pay better. MAA Director Chris Bernier said in January they had seen five or six employees take jobs in other towns during 2019.

Originally, Lyons said she had intended to fold the ambulance study into a broader re-examination of all of the town’s emergency services. Conversations with consultants made it clear that would be a much longer process, she told The Source.

A study of just the MAA can likely be completed in time for the town to begin discussing any changes as far as operational model or funding for the next fiscal year, according to Lyons.

Efforts to contact Bernier were not successful by press time.