Early April musings

Like the News Nuggets of yore, but not as newsy.

  Really gratifying response to the "Older and wiser" piece.  That just fills me up and keeps me going, so thank you all very much. 

  Sent the SB an April Fools e-mail last week, about how I was going to start tightening up agendas by scheduling items in shorter increments, using a stopwatch to keep time, and speaking faster as necessary.  Apparently, it was all too in keeping with my, um, orderly style of meeting management, and no one knew it was a joke.  Should I worry?

  Stan Rosenberg's annual municipal conference was Saturday at the Clarion in Northampton.  This was my second time.  Fascinating presentation of info from a Franklin County study on school regionalization (PowerPoint available here.)  No good news in the session on Federal Stimulus.  Others went to the Municipal Relief session, and if there was anything hopeful there, I'm sure I would have heard about it by now.  Senate President Therese Murray ended the conference with her keynote about how utterly broke the State is, and how the fiscal picture seems to get worse every day.  I think the whole thing depressed me, even though this wasn't exactly new information.  I went home and took a long nap.

  Nice League of Women Voters event last Friday evening at the Amherst Woman's Club.  It was a joint celebration of the Town's 250th birthday, the League's 70th birthday and publication of the seventh edition of "Your Amherst Government."  The new edition doesn't seem to be on the web site yet, but the previous edition is here.  Like all the League publications, the new one is a tremendous resource, and so well done. 

  On the subject of cool local links, have you checked out Digital Amherst yet?  Great info.  Or how about Alison Donta-Venman's Amherst By the Numbers blog?  She was Chief Data Cruncher for the Facilitation of Community Choices Committee, and she really knows her way around a spreadsheet.

  The Red Sox head to the West Coast later this week, and Monday's Oakland game is at 10:05 p.m.  Last night's SB meeting ended at 10:04 - warrant articles! - so if next week is similar, I'll still see the game.

  Is it just me, or does Dave Keenan seem to be in the paper all the time these days?  What's up with that? 

  The warrant review meeting was Friday morning (not the League/TMCC one - the one with Town Counsel, the Moderator, Fin Com Chair, etc.)  It was primarily to familiarize everyone with what's on there and to identify any questions or problems.  We also tweaked things a little bit, trying to give the optimal order to articles so that the budget consideration can start June 1st.  We're down to 30 articles total, with 20 to do before the budget.  The current draft article list is here.  The SB signs the warrant next Monday, 4/13.

  Last night's Select Board meeting featured a visit from a noisy drunk guy.  When he first came in to the Town Room, it seemed like he might be doing maintenance or setting something up - he was carrying a bunch of stuff, and seemed to be unpacking it.  But he got a little stranger and noisier, so Larry went to check it out.  Just a drunk guy doing who knows what, and "waiting for a friend."  Larry asked him to wait in the hall, but eventually he came back in.  He was sitting quietly for a while, but started making noises again.  You can hang out at SB meetings to your heart's content (heck, I did...) but you can't be disruptive.  Another wacky Monday night at Town Hall. 

  Perhaps the best news I've heard lately:  Larry is in discussions with Cooley-Dickinson to open an emergency room or urgent care facility in Amherst.  Imagine!  Think about how far away CDH is from here, especially in traffic on Rte. 9 and on Damon Road in Northampton.  Lucky us - and MANY thanks! - for our amazing EMS folks, but what a difference to have local emergency care.  I'm thinking about how great that would be for seniors - and it would help make Amherst an even more attractive retirement community.  It would really be a major quality of life enhancement for all of us, and I am excited about this possibility. 

  Are you a local artist?  The Public Arts Commission is seeking proposals for art to be displayed in Town Hall and to decorate the columns in the Boltwood Garage.  Click here for details.  If you do the columns, you have to be prepared for people to mar your work by accident, with their car doors and mirrors.  Don't ask me how I know this.


Larry Kelley said:

Nothing about the recent 'Only In Amherst' dust up over an unconstitutional Bylaw passed ever so long ago preventing four unrelated individuals from renting a humble home together?

Yikes! Batten down the hatches. A BIG storm is on the way.

Anonymous said:

Batten down the hatches? Thar she blows.

Eva Schiffer said:

The thought of an urgent-care facility on this side of the river is exciting -- if only it can be made to happen this time around. It was proposed and explored some 8-10 years ago, at which time Cooley Dickinson had reasons not to endorse or pursue it. Thanks to Larry Shaffer for trying -- and may he succeed!

But WHY-OH-WHY does every good idea in this town take SO LONG from conception to implementation???!!!

Count me in as another vote for emergency care on this side of the river.

PS: Getting the latest version of Your Amherst Government up on the lwvamherst.org web site is at the top of my todo list...

Anonymous said:

Would the emergency care facility be a place that ambulances are legally allowed to take a patient or just for "walk in" care? Would they provide 24 hour care? Is there somewhere on the town website that Mr. Shaffer has posted what he hopes to negotiate for Amherst?

Anon - My understanding is that the intent would be to accommodate ambulances. I don't believe the Town Manager has posted any information about his plans. Discussions with CDH have just begun -- again, apparently (thanks for that info, Eva) -- so specifics are few right now, but stay tuned.

Dave Clooney said:

My understanding is that the intent would be to accommodate ambulances.

I don't see how this could possibly work. When paramedics bring someone with a serious illness or injury to the hospital, it is in large part because of the things that the hospital can provide. For example, a patient with chest pain may will likely have blood drawn and sent to a laboratory to check it for enzymes associated with cardiac damage. They will also get a chest x-ray. The hospital may have a cardiologist come down to consult with the emergency department doctor. Then the patient might go up to a Cardiac Care Unit (CCU), or just be admitted to a hospital bed. Will an Amherst clinic have an x-ray, a lab, cardiologists, and beds?

There are similar questions that arise with other types of patients. Stroke patients need CT scans. Some trauma patients need surgeons. An emergency department is part of a hospital. Paramedics and EMT- Basics bring patients to hospitals through emergency departments, but the ED is often just the gate to the overall hospital system. Simply building a small clinic and calling it an emergency department is not going to make it an emergency department. There aren't many patients that need an ambulance that don't need a hospital, so it is very difficult for me to see how a stand alone facility could improve the workings of the Amherst Fire Department, which provides ambulance service for Amherst and the surrounding area.

-Dave Clooney

Dave, thanks for commenting.

I couldn't begin to refute the points you've made, and few among us have anything approaching your expertise in this area. But I do hope that exploration of this concept would be embraced. No doubt, this would be a big change to how things currently work, and as such, it would mean that all kinds of different challenges and issues would need to be addressed. If exploration showed that this was generally unworkable, or that the negatives outweighed the positives, the concept obviously wouldn't advance. But if it showed that there are ways to make this work, it could be a major benefit to our community. We can't know which until the idea gets due consideration and analysis.

Jeff Parr said:

While the idea of an urgent care facility on the Amherst side of the river does certainly seem like an excellent idea, I would have to echo the concerns raised by Mr. Clooney. If the intent of the project is to "accommodate ambulances", I would suggest that someone consult the state Department of Public Health, Office of Emergency Medical Services. The reason for this would be to determine if it is even legal for ambulances to transport to a free standing clinic. Although I am not 100% certain, I suspect that it is not, I would hate for there to be too much excitement and for talks to progress too far on a project that would not be capable of achieving its intended goal. That having been said, a walk-in clinic in Amherst is certainly a great idea and would be a benefit to local residents regardless of its availability to ambulances.

Jeff Parr

Eva Schiffer said:

Just for the record, Dave: CDH's satellite facility on University Drive already has x-ray and lab facilities. As for the rest of your concerns, they sound familiar from when the idea was raised years ago.

Still, as Stephanie says, it's worth exploring thoroughly and making sure that all pros and cons are clearly understood and weighed.

Anonymous said:

Who should violations of the cohabitation bylaw be reported to?

Zoning enforcement is handled by Building Commissioner Bonnie Weeks.

I was an EMT in Cambridge for 4 years. It's true that ambulances can't take patients to any facility, but special arrangements can be made. For instance, we were allowed to take students to Harvard or MIT health services if we thought the issue was minor, and called ahead to make sure the staff there agreed. I don't know how to go about making those arrangements, or what kinds of services need to be provided, or what kinds of services would be useful to have in amherst versus northampton. I would guess, though, that having a place for ambulances to go in amherst isn't needed as much as simply an urgent care for less serious conditions, such as UMass health services offers.

Anonymous said:

What we need is a place for them to drop off the drunk students at 2AM so they can be available to respond to the real emergencys here in town.

Marcy said:

I think that this service could prove to be a great resource to the elderly housing/assisted living facilities in town. My mother in law, who lived at The Arbors for a few years, was sent by ambulance several times to Cooley Dick for "just in case" kinds of scenarios (a spell of GI trouble, faintness, symptoms that turned out to be the result of urinary tract infections, etc.). None of these were life threatening, but did require monitoring, lab testing and professional assessment. I agree that urgent care is the better definition of what we could conceivably provide in Amherst, as opposed to comprehensive emergency services, but that alone would certainly be an improvement--and hopefully enable us to save ambulance time/money. To be really effective, though, I think it would have to have some degree of 24 hour coverage. A lot of the urgent care situations that lead to 911 calls happen after hours, when other avenues of medical care and consultation are unavailable.

Anonymous said:

anom 9:35 whatever yopur views may be regarding students and drinking....when someone is unresponsive due to alcohol intocxication...they need a medical emergency room not a place to drop people off...

Kay Moran said:

A 24-7 urgent care center on University Drive would be nice, but the state Department of Public Health requires ambulances on emergency calls to take patients to an "Appropriate Health Care Facility [which] means an emergency department, either physically located within an acute care hospital licensed by the Department ... to
provide emergency services, or in a satellite emergency facility approved by the Department ... for providing emergency medical care." I suspect it would not be cost-effective for Cooley Dickinson Hospital, or for health care in general, to establish an emergency medical facility in Amherst only nine miles from the one in Northampton.

Lots of good information here from folks who really know what they're talking about -- thank you! I remain hopeful that even if full emergency care is not possible, some kind of urgent care option might be. There are many issues for the Town Manager and the CDH President to work out, but I appreciate that both are pursuing this.

John Coull said:

There is a for-profit medical facility in town (Valley Medical Group) which might be brought into this discussion. I can't say that the would be interested or find it conceivable to provide a level of trauma service, but they have a significant facility and certainly some capacity to offer.

YourAdmirer said:

Here's an interesting link to DOT Sec'y LaHood's blog that your cyclist readers (including Jonathan and John) may appreciate:




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