BOARDMAN — On Monday, township trustees approved a new contract for ambulance service, although they were critical of the terms. Now the provider of those services says they disagree with Boardman’s characterization of the agreement.

“That contract had been agreed to 30 days prior to the (trustees) meeting,” said Attorney Brian Ridder, who represents Lane LifeTrans, the ambulance company that provides most of the emergency service for Boardman. “We had no need to be there. We were a bit taken aback that there were critical comments made about a contract that had already been agreed to.”

During the meeting, Boardman Township Trustee Tom Costello and fire Chief Mark Pitzer expressed concerns about changes to the contract.

Costello and Pitzer have said they only agreed to the contract because the township does not have another option.

Speaking of EMT Ambulance, which has the contract for service within Youngstown city limits, Costello said he has “very strong feelings to not deal with the other ambulance company in our area.”

On Friday, Pitzer said EMT charges Youngstown, whereas Boardman does not pay a fee to Lane, and he said EMT regularly sends ambulances that are not staffed with paramedics.

The issue of paramedics — who are trained and licensed to provide a higher degree of emergency medical care than an EMT or advanced EMT — is one of the points of contention between Boardman and Lane in the new contract.

Pitzer said Lane has changed the terms of the agreement so that first-response vehicles may show up without a paramedic on board.

The first item in the 2022 contract notes that Lane will provide “two 24-hour paramedic ALS (Advanced Life Support) ambulances” for the township, whereas the new contract removes the word “paramedic” from the description.

Lane’s Assistant Chief Shane Haddle said that does not mean a paramedic will not be on scene.

“The paramedic may not be on that ambulance, but we do send a supervisor in a marked SUV to the call,” he said. “So the EMT can initiate care and the paramedic will take over.”

Haddle said that in many cases, when the fire department responds to the scene, there is a paramedic driving the fire vehicle, who can provide ALS care until Lane’s supervisor arrives. “There’s no delay in advanced care,” he said.

But Pitzer disputes that.

“That does not mean that the supervisor will be there,” he said. “This has already happened. We have had our guys ride to the hospital because their supervisor was not there.”

Timing is another concern Boardman officials have.

The 2022 contract states that Lane “shall respond within six minutes to 70% of emergency calls and within eight minutes or less to 85% of emergency calls.” The 2025 contract states that Lane shall respond within eight minutes or less to 85% of emergency calls.”

The new contract also specifies that Lane will not be held in violation of that term if traffic, weather or availability inhibit their response — a stipulation not included in the 2025 contract.

According to the statistics that Lane provided — the same information they provide monthly and annually to Boardman — in 2022, Lane responded to 6,036 calls in the township; to 6,332 in 2023; and 20 6,447 last year.

Haddle said Lane’s first-call response time was under 6 minutes on 56% of calls and their average call time was 6:11. He said they were under eight minutes 78% of the time.

Pitzer said that still puts Lane in violation of the agreed upon standards.

As for paramedic staffing, Lane Chief of Operations Tom Lambert said that in 2024, 53% of calls (about 3,417 calls) in Boardman did not require any advanced life support measures, meaning an EMT was sufficient to respond to the incident. He said 45% (2,901 calls) required the care of an advanced EMT, and only 1.2 percent (77 calls needed a paramedic).

Pitzer still takes issue with the numbers.

“They can’t guarantee paramedics, and they can’t meet the metrics set in the last contract, so they went to a flat eight minutes,” he said. Pitzer said the two minutes makes a difference.

“For someone who is unresponsive, not breathing, that two minutes is important. If they’re having a heart attack, it’s important. For a trauma patient, for cardiac arrest — chances of survival diminish 10% for every minute.

Haddle said there are times when other calls interrupt a supervisor on the way, but only when it is a more severe case.

“Our dispatchers are EMD (emergency medical dispatch) trained, so if the paramedic is en route to one call and another call comes in of higher priority, like a cardiac arrest, we have a computer program that determines priority and we will reroute, so that there is no lag in care.”

Pitzer said that leaves his staff to make the decisions at the scene.

“If there’s a patient that we know is critical, we are not waiting for a supervisor to show up,” he said. “On some calls it’s load and go. We need to get them loaded and get them to the hospital because that’s where they need to be.”

President and CEO Joe Lane and his staff said they want a good relationship with Boardman and they do everything in their power to provide the best service possible.

“We can get very deep into the township at certain times,” Lane said. “There’s the two units, and then we might send another, and the township has Medic 71 (the fire department’s ambulance), and we get to seven or eight vehicles deep. The idea is to do the best we can with what we have. When we get deep is when we need to be working together.”

When Lane is tied up, the department does have its own ambulance — Medic 71 — but it can only be staffed part-time because of staffing and operating costs.

The Vindicator mistakenly reported on Tuesday that Pitzer had concerns about Lane wanting to send its own ambulances when the first two are in use, rather than dispatching Medic 71 when it is staffed.

While that was a concern for him with the 2022 contract, Pitzer and Lane both said Friday that the issue has been remedied in the new agreement.

Lambert said that during the holidays, they also purposely staff a third ambulance in Boardman.

“We will bring a third unit in during peak hours, to accommodate the shopping season. We do it because we know it’s going to be a busy day and we plan for it,” he said.

Pitzer and officials from other local communities have acknowledged that in Mahoning County, where 11 ambulance companies used to operate, there are now only two.

Lane and his staff — and Pitzer, too — know there are reasons for that.

“It’s changed since COVID,” Lambert said. “Hospital wait times are higher, there’s limited staffing, and this is not limited to Mahoning County or even just Ohio, it’s a nationwide problem.”

Fewer and fewer people are becoming paramedics and EMT’s. Ambulances get stuck at the hospital when there are no beds available because the paramedics have an obligation to stay with the patients until they are admitted.

There are other costs too. Medicaid and Medicare reimbursements are decreasing and becoming an unreliable revenue source. New laws in the state prohibit medical bills from being sent to collection agencies, so ambulance companies and hospitals cannot recoup costs as easily as they once did.

Haddle said the price of ambulances — not counting staffing — isn’t getting cheaper either.

“Our cost for a fully stocked ambulance is around $300k,” he said.

Those units have an expected lifespan of four to five years because they run constantly. The cost of equipping and maintaining one unit over that time is about $120,000, Haddle said.

Lane pointed out that last year, two of his ambulances were in crashes that totaled them, taking two units off the road.

“The bottom line is, in this world of EMS, you need to have volume because you know you’re not going to get paid for everything,” he said. “You need to have a big enough company that you can weather those financial situations.”

Lambert said they don’t pass on their costs to the township like other communities deal with from their ambulance providers.

“Youngstown pays a couple million to have EMT, and other communities may pay per capita, but

we have not passed that on to Boardman. They haven’t asked us how they can help to subsidize a third vehicle, but it also hasn’t been necessary,” he said.

Pitzer and the trustees said the struggles Lane faces are exactly why they favor a township-based program through the fire department, and coordinating similar programs with neighboring communities — a process known as regionalization.

Last year’s 4.5-mill levy that would have generated about $6.1 million for ambulance services through the township was defeated, so Boardman is left with one option for now, Pitzer said.

The new contract allows for any grievances or complaints about service to be addressed in good faith between the company and either the township or any individual resident. It also allows Boardman to opt out with 60 days notice, should the township find another means of providing ambulance services.