New director at Middlebury rescue brings money-making plans

MIDDLEBURY — This spring will certainly be a season of renewal for Middlebury Regional Emergency Medical Services.
The nonprofit organization has hired a new executive director who will be launching some new services aimed at making MREMS more financially stable. The new hire — Ric Lavallee — will also lead a fund-raising effort to replace one of MREMS’ aging ambulances.
Lavallee, 55, was one of around 30 applicants for a job vacated last spring by Bill Edson. Lavallee comes to Middlebury by way of Atlanta, Ga., where he most recently served as director of the American Medical Response (AMR) service of DeKalb County. It should be noted that AMR is a private, for-profit ambulance service. AMR’s DeKalb County division includes 400 workers answering an average of 120,000 calls annually among a population of 768,000 residents, Lavallee noted.
Though AMR is a much bigger operation that Middlebury Regional EMS — which has approximately 40 full- and part-time professionals answering 2,500 to 2,800 calls annually — Lavallee noted the two organizations face similar challenges. Both must look for new revenue streams to compensate for federal Medicaid and Medicare reimbursement payments that Lavallee said only cover 15 to 20 percent of the cost of services provided to clients receiving those benefits. He noted AMR has been able to boost its revenue streams by adding non-emergency amenities, such as trips to physician appointments and dialysis treatments.
“Private ambulance services are going to root themselves in profitable markets,” he said. “What we are dealing with here is a rural EMS system that has to support itself. There are only so many emergency response calls you are going to attend to.
“In order to sustain your level of services you have to look at other streams of revenue,” he added.
With that in mind, Lavallee is doing some market research in the MREMS service area to determine what non-emergency services are in most demand and what the organization could reasonably charge for such amenities. He plans to bring those new services on line, with a fee schedule, sometime during the next business quarter (April through June). Ambulance services in Rutland and Chittenden counties are already proving non-emergency transportation, according to Lavallee.
He acknowledged that branching out into the non-emergency realm will require MREMS to purchase some new vehicles, such as a service van and a wheelchair van. The organization will maintain its three ambulances, and rescue and heavy rescue vehicles for emergency calls.
“We’ve got the manpower,” Lavallee said. “What we need are these (different kinds) of vehicles.”
Lavallee is also recommending that MREMS add “critical care transports” to its list of services. These transports involve patients requiring care that must be delivered at hospitals outside of the Green Mountain State, such as in Boston. MREMS has three critical care paramedics — including Lavallee — who are qualified to staff such transports, which could add more revenue to the organization’s coffers.
“The idea is to add these (new) services with no debt,” Lavallee said. “It can be done, and I will find a way.”
Those coffers have been depleted in recent years, due in part to inadequate Medicaid and Medicare reimbursements and a former business plan that didn’t yield the expected revenues. As a result, MREMS last year discontinued its new billing service, worked out a new pricing schedule for its new communications service, and phased out a layer of middle management and redeployed those workers to providing direct patient services. The organization this March resumed asking for Town Meeting Day contributions from the 10 towns it serves.
Also on Lavallee and MREMS’s agenda: Raising the estimated $170,000 it will need to replace one of the organization’s ambulances. Officials are optimistic for a successful campaign.
Meanwhile, Ric and his wife, Dara, are settling nicely into Addison County. Their six grown children are now off on their own. Ric is an avid skier and his boat is primed for Lake Champlain — a body of water that he knows well. Lavallee was born in Nova Scotia, but raised in the eastern townships of Quebec.
Dara is an educator, whole foods nutritionist and chef.
“We both love New England,” Ric Lavallee said, citing a particular affinity for the quality of life that Vermont offers.
“The cold doesn’t bother me at all.”
He believes MREMS has a bright future.
“This is a great operation with great people,” he said. “The citizens here have something very special that other communities in the area don’t have — that is, a very progressive, advanced life-saving business.”
Mike Roy, chairman of the MREMS board, was pleased to welcome Lavallee aboard.
“We are thrilled to have Ric join us,” Roy said. “He was the unanimous choice of the search committee. He had the right combination of business management experience and an on-the-ground understanding of what it means to provide emergency medical services.”
Reporter John Flowers is at [email protected].

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