Council Committee Exploring Cost of Adding a Second Fire Department-Run Ambulance

The Watertown Fire Department has run its own ambulance since 1975, and has offered paramedic service since 2017. The one ambulance cannot always cover all the calls, however, and the City Council is looking at whether to add a second ambulance.

Currently, when the WFD’s ambulance is not available, Watertown uses Pro EMS, a private ambulance company in Cambridge. Fire Chief Ryan Nicholson told the City Council’s Committee of the Budget and Fiscal Oversight that there is a significant difference in response time depending on which ambulance is dispatched.

“Regarding response times, National Fire Protection Association standards require emergency medical services to respond within 9 minutes 90 percent of the time,” Nicholson said, according to the Committee report. “He noted that Watertown Fire Department’s response rate was 96 percent within this timeframe, whereas outside ambulances only met the 9-minute standard 44 percent of the time.”

Pro EMS ambulances usually come from Cambridge, increasing their response time, the report said.

In 2024 Fire Department received nearly 4,400 ambulance calls, and about one-third were handled by Pro EMS or fire departments from surrounding communities.

To staff a second ambulance, Nicholson proposed adding new firefighter positions — two per shift. The estimated cost of the new positions is $855,000. The City gets a surcharge of $690 each time a WFD ambulance takes someone to the hospital. That would provide an estimated $400,000 in revenue to cover the cost of running a second ambulance.

Watertown ran a 2019 pilot program where a second ambulance was staffed with overtime, running for six months, but it exceeded the budget and was discontinued after six months. During this time, the program responded to 83 percent of EMS calls with an average response time of 5.6 minutes, Nicholson said.

The Committee asked for more information about the response times for both WFD and backup responders, the response times to the West End of town compared to other parts of Watertown (since Pro EMS is coming from Cambridge), data from the 6-month two-ambulance pilot, and ambulance services in other communities.

Committee members also asked for details about the cost and revenue of the ambulances, including:

• A breakdown of payer information across Medicare, Medicaid, and private payers, how it has changed over time

• The feasibility of staffing a second ambulance during peak hours rather than 24 hours a day to see if there could be cost savings

• An estimate of benefits and pension costs for employees

• A more accurate figure for potential revenue (the figure ranged from $400,000 to $600,000 at the meeting), and

• What the rules are for reimbursement under Medicaid, Medicare, and private insurance, and what happens in cases of financial hardship, and explore potential policies for fee waivers or other financial assistance for residents using ambulance services

The discussion of adding a second ambulance to the Watertown Fire Department will continue at a future Committee on Budget and Fiscal Oversight meeting.