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Massachusetts Ambulance Association


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  • June 13, 2016 12:36 PM | Amanda Riordan (Administrator)

    Interview with Ron Quaranto, COO of Cataldo Ambulance Service, Inc. and Vice President of the Massachusetts Ambulance Association

    What is community paramedicine?

    The initiative behind community paramedicine is to provide quality care to high-risk patient populations (e.g. congestive heart failure, pneumonia, MI, etc.) at a controlled cost. We want to avoid unnecessary ambulance rides, ER visits, hospital admissions and observation when a patient does not necessarily require all that additional care and expense, and could simply receive some type of intervention and management in the home environment. That is a driving force behind community paramedicine.

    How did Cataldo begin its community paramedicine program?

    When community paramedicine became a hot topic here in Massachusetts, about half a dozen ambulance services lobbied the state to allow for a special project waiver in order to trial community paramedicine. Massachusetts regulations, the way they are currently written today, do not allow ambulance services to treat and not transport. With community paramedicine, we want to treat patients at home and preferably leave them at home with good treatment. Both Cataldo and Eascare Ambulance Service were successful and were granted a special project waiver. In order to get the waiver we needed to have a partner, and Cataldo chose the Beth Israel Deaconess Medical Center to do our trial with.

    Tell us about Cataldo’s community paramedic program.

    About three years ago, we began the development of our program, SmartCare. Our approach, unlike other community paramedic programs out there, was not to use our existing ambulance fleet, but to instead use dedicated vehicles and clinicians who are specially trained in providing care for the high-risk, more complex patient populations. The vehicle we use is not an ambulance – it does not have lights or a siren. It is a minivan style vehicle that is fully equipped at the ALS level, so paramedics have everything that an ambulance has (all of their equipment, intubation, IV, medication, etc.) but in a non-emergent vehicle. The vehicle also has advanced technology with teleconferencing and data sharing, and a modem so laptops can connect wirelessly and transmit that data.

    While there are other agencies out there, like home care agencies and visiting nurses associations, which are all incredibly valuable and which we work very closely with, our program is slightly different. We do different interventions and have different skill sets. We have identified vehicles and community paramedics who are specially trained to do advanced treatment on these particular patients. When we identify a patient in need (meaning a patient who does not require 911 services but does require some attention), we deploy the community paramedics. They go to the home, evaluate the patient, and in the end make a determination on whether or not the patient can remain at home or should go to another healthcare facility, be it an urgent care center, the ER, or the primary care physician’s office. All treatment and evaluation is done based on pre-established protocols that we’ve collectively developed with the care team so they know what intervention they can do and at what points they need to stop and consult with the care team. There is always a high-end interaction between our community paramedics, the ordering nurses, and the primary care physicians, and the community paramedics are able to do a lot of data sharing, such as the electronic patient care report, test and lab results, etc., right from the patient’s home. We also have the ability to utilize teleconferencing, so we can bring the physician or nurse face-to-face with the patient for follow-up on a specific issue.

    Another value of the SmartCare program is that our communication center is available 24 hours a day, 7 days a week. Most healthcare facilities/institutions have systems in place that are available during the day, but are not necessarily available during evenings, nights and weekends. These are the times when there is a demand and the limited availability of care causes people to call an ambulance and go to the hospital when they may not need to. By having SmartCare’s resources available at these times, community paramedics can go directly to the patient, evaluate him or her, and then make the decision on whether or not the ER is the correct destination, or if he or she can remain home and avoid the expense and stress. Patients usually do not want to go out and sit in the ER waiting for what is often a minor diagnosis, and then come home faced with copayments and other bills. Being able to see a healthcare provider in the home setting and get the same results, in many cases, saves patients both time and money and allows for a better quality of life.

    Does SmartCare have any patients scheduled for regular visits?

    Unfortunately, one of the things that the special project waiver prevented us from doing was that proactive approach. We want to identify patients who are considered high-risk and enroll them in our program for regular evaluations, both in-person with a community paramedic as well as over the phone. While this proactive approach is an integral part of community paramedicine, we’re not allowed to do it yet, though we’ve requested to and I’m confident we will be granted the ability to once regulation is rewritten for community paramedicine here in Massachusetts. Massachusetts has only recently signed Mobile Integrated Health into law and the state, along with the Department of Public Health, created an MIH workgroup to finalize the regulations and protocols under which community paramedics will practice. Once that is complete, we will have the ability to treat patients both proactively, prior to them in need, as well as more urgently should they have a situation that requires immediate attention but not emergency 911 response.

    Was it difficult to get the special project waiver? Was it a long process?

    It really was quite challenging. It was new and there was a lot of pushback from some of the outside agencies who felt threatened that we were going to take away from their responsibilities – their patients and their transports – which certainly wasn’t the case and has proven not to be the case. We’re looking to work collaboratively with these other services. Even though Cataldo is a transportation provider, we made it clear from the beginning that our intent is not to provide all the transportation, even for the patients who may need it. For a community where Cataldo is not the provider, we call that community’s provider to make sure they maintain the transport. Though the intent behind our program is not to steal transportation volume and revenue, it was a little bit challenging to convince everyone. It took quite a few presentations for the leadership to grasp community paramedicine here in Massachusetts. It’s still a work-in-progress, but we’re confident that in the next six months or so we’ll be fully operational without special project waivers.

    As for the timeline of the process, it took about a year of presentations, meetings and development. We submitted our initial request in November 2013, and were issued a special project waiver which ran from October 2014-November 2015, and then were granted an extension until regulations are finalized.

    Since the program began, have you received any feedback from those outside agencies that were originally pushing back?

    Yes, we’ve had great responses from both the municipalities and the other mobile healthcare agencies. We’re required by the state to report monthly on our interactions, and so far we’ve had great patient outcomes and all indications are that everyone is very pleased with the special project waiver, hence why they are moving forward with more formalized regulation. With ACOs being developed and new regulations that manage hospital readmissions, the SmartCare program has been a good thing for everyone – we can all control costs better while maintaining the quality care that patients deserve.

  • June 08, 2016 11:51 AM | Amanda Riordan (Administrator)


    CONTACT: Jim Farrell, PR First, 781-681-6616jfarrell@prfirst.com

    Fallon Ambulance names Gregory A. Davis as Director of Mobile Integrated Healthcare Services & Community Initiatives


    QUINCY, MA, ISSUED JUNE 6, 2016…Fallon Ambulance Service (www.fallonambulance.com) today announced the appointment of Gregory A. Davis of Barnstable, MA, as Director of Mobile Integrated Healthcare Services & Community Initiatives.


    Davis will lead the Fallon Ambulance effort to expand the company’s Mobile Integrated Healthcare Services offerings, working with the senior management team to establish additional relationships with healthcare providers throughout the Greater Boston area to provide expanded out of hospital healthcare services in the home and the community.  Mobile Integrated Healthcare Services (MIH) are an emerging trend in the healthcare industry that leverages the expertise of Paramedics and EMTs in caring for patients in the out of hospital environment against the rising use of hospital acute care services. In other words, these services seek to align the patient with the most appropriate clinical care for their needs which includes, among many other things, providing certain types of care for patients in their homes.


    Patrick Sean Tyler, Executive Vice President and Chief Operating Officer at Fallon Ambulance, said that Paramedics and EMTs will play an increasingly pivotal role in an integrated care environment. “Historically, EMTs and Paramedics are seen as the healthcare providers who respond to an emergency, provide stabilizing treatment and transport the patient to a care facility, such as an emergency room.” He continued, “In many cases, though, emergency rooms treat individuals for conditions that could be handled either at a clinic or through home care. The goal is to provide an integrated model of (health) care that aligns the patient with the best care working through the auspices of the patient’s primary care provider. As emergency rooms become increasingly crowded the healthcare community looks for alternatives that can help. The increased use of EMTs and Paramedics, who are highly-trained and experienced medical professionals, can play an important part in an integrated healthcare environment.”

    Davis speaks from experience when describing how the concept of Mobile Integrated Health Services works. He comes to Fallon Ambulance from Eascare in Dorchester, where he worked for the previous eight years. During his tenure, he started an MIH program of providing non-acute urgent care in the patient’s homes, thereby reducing the number of trips to area hospitals.

    A Paramedic since 1990, he said he hopes to develop similar programs at Fallon Ambulance.

    Davis’s resume includes more than 25 years in the EMS field. Prior to his work at Eascare, he was a Paramedic for American Medical Response (AMR) working out of their Plymouth, MA location.

    In addition to having developed a program for Mobile integrated Health Services, Davis has spoken on the topic at several conferences, nationally and internationally.

    Davis, who earned the Paramedic of the Year award in 2000, resides in Barnstable with his wife Barbara. They are parents to four children. In his spare time, he enjoys photography, traveling and spending time with his family.

    Davis said, “This is an important direction for the EMS industry. Mobile integrated health services allow the Paramedics to work not only with emergency room professionals but with primary care, behavioral health, palliative and hospice as well.” He continued, “What you often see in ER visits is long waiting times, particular on the weekends, when primary care physicians may not be available. The introduction of Mobile Integrated Health Services will provide opportunities where an EMT or Paramedic can come into the home, initiate certain treatments, and discuss the treatment plans with the doctors.”

    Davis noted that the Commonwealth’s Department of Public Health is working on regulations to allow more such programs to commence. “We will be reaching out to providers in the medical community to see where we can introduce this service and bridge any gaps that might otherwise occur in the home or out of the hospital.” He said that he anticipates working with a number of agencies to see how these services can be introduced and integrated.

    Tyler said, “We welcome Greg to our team. He has very strong knowledge and experience with Mobile Integrated Health Services, and we know that he will be an integral part of this effort as we introduce this concept to the region.”


    About Fallon Ambulance

    Fallon Ambulance Service was founded in 1923 by James R. Fallon, Sr. Mr. Fallon’s son, James R. (Ray) Fallon, Jr., served as President and owner from 1974 until 2000. Today, Timothy J. Fallon, grandson to the founder,  serves as CEO.  Tim’s sister Kathleen Mackie, step brothers, Peter Racicot, Senior Vice President and Normand Racicot, Vice President, also represent the third generation of this family business. And a fourth generation represented by 7 great grandchildren of the founder is working in various capacities in the organization. Fallon Ambulance is the largest privately owned and operated ambulance service in the Northeast. Fallon Ambulance employs more than 600 personnel, operates more than 150 vehicles and responds to over 160,000 emergency and non-emergency calls per year.  Fallon Ambulance is the 9-1-1 provider for the municipalities of Milton, Brookline, Weymouth, and Dedham and provides primary backup to Boston and Randolph. Fallon Ambulance Service additionally provides medical transportation for a number of area medical facilities including nursing homes, hospitals, and HMOs throughout Greater Boston, the South Shore and Metro West region. It is headquartered at 111-115 Brook Road, Quincy, MA and operates satellite offices throughout its coverage area. Fallon Ambulance Service has been recognized many times by various business and community organizations for its exceptional service.  For additional information about Fallon Ambulance Services or programs that the company offers, contact Peter Racicot, Senior Vice President, at (617) 745-2117 or visit www.fallonambulance.com.

    Jim Farrell

    PR First

    2048 Washington Street Suite 1

    Hanover, MA 02339


    Cell: 617-429-7990

    Twitter: @jimprfirst

  • June 03, 2016 8:17 AM | Amanda Riordan (Administrator)

    Don't miss the fantastic editorial, Save lives, not seconds, in Wednesday's Boston Globe. Written by Cataldo's Tom Kimball, it gets to the heart of many issues with using response times as the only performance metric. (Emphasis below is ours.)

    Many cities and towns in Massachusetts still judge the performance of their ambulance services using metrics like response times, which can miss the point. An additional two minutes waiting for an ambulance will rarely make a difference for a trauma patient facing emergency surgery that may take hours. 
    Patient outcome is a more valuable measure of whether a medical service is doing right by people. In many areas of health care these days, it is the gold standard, a key factor in determining how much insurance companies pay service providers. Changing the terms of ambulance companies’ contracts to make good patient outcomes the goal could greatly improve the quality of medical care across the state — and save lives.
    Read the full editorial over at the Boston Globe.
  • May 19, 2016 2:12 PM | Amanda Riordan (Administrator)

    Congratulations to MAA member Fallon Ambulance!

    Fallon Ambulance Service (www.fallonambulance.com), the region’s largest independently owned ambulance service provider, has been recognized by the American Heart Association for its excellence in response and treatment for heart attack victims in the field.

    Fallon Ambulance received the highest level of commendation, the American Heart Association’s Mission Lifeline Gold Award.

    Fallon is the only individual private ambulance firm in the Commonwealth of Massachusetts to achieve this level of recognition. Qualifying was based on data collected throughout 2015, specifically cases where Fallon Ambulance responded to 9-1-1 calls for ST elevation myocardial infarction (STEMI), the most deadly type of heart attack caused by a blockage of blood flow to the heart.  

    Learn more about Fallon at http://www.fallonambulance.com/about-us/fallon-news.

  • May 15, 2016 9:13 AM | Amanda Riordan (Administrator)

    Happy EMS Week from the Massachusetts Ambulance Association. Thank you for all that you do for the communities of our state.

    If you are hosting any special activities this week, MAA would love to share photos! Please email maa@the-aaa.org or reply to the forum post requesting pictures.

    Thank you again for your service.

  • May 10, 2016 2:13 PM | Amanda Riordan (Administrator)

    Attention, Massachusetts Ambulance Association members! If you missed the May MAA meeting, read the minutes on our new Meeting Documents page. (To access the page, login using your email and secret password.)

  • May 10, 2016 10:41 AM | Massachusetts Ambulance Association (Administrator)

    Thank you for visiting the new website of the Massachusetts Ambulance Association. Although the new site is still under construction, we are excited to share with you new functionality, including a membership directoryonline discussion forum, and a special members-only section.

    We thank you for your patience as we work to establish the MAA's new online home. Thank you for your support, and happy holidays!

    Need help? Please contact maa@the-aaa.org for assistance.

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