City Council - Ways & Means Committee Hearing on Dockets #0733-0740, FY27 Budget: BPHC

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Good morning. For the record, my name's Ben Weber. I'm the District 6 City Councilor and the Chair of the Ways and Means Committee. Today's May 21st, 2026, and the exact time is 10.15 a.m. Apologize for the late start. So I have a few preliminary things to go through and then we're going to have a presentation from the panel and then questions from My colleagues, this hearing is being recorded. It's also being live streamed at boston.gov slash city dash council dash TV and broadcast on Xfinity Channel 8, RCN Channel 82, and FIO Channel 964. Council's budget review process encompasses a series of public hearings that begin in April and run through June. We strongly encourage residents to take a moment to engage in the process by giving public testimony, which they can do in a few ways. First, for a full hearing schedule,

Please look at our website boston.gov slash council dash budget. You can give public testimony by attending any one of our hearings. You can attend in person or virtually. If you're here in the chamber to give public testimony, please sign up on the sign-in sheet near the entrance and you'll be called on In the order you've arrived, if you are looking to testify virtually, please, you can sign up using the online form on our Council Budget Review website. or by emailing the committee at ccc.wm.boston.gov or by emailing Karishma Chauhan at karishma.chouhan.boston.gov. Once you're called on, you'll have two minutes to testify. Please tell us your name, where you live in the city, and if you're with an organization. Your affiliation and you'll again have two minutes to make comments.

You can also testify in person or virtually At the fourth of four of our listening sessions, our last one will be Tuesday, May 26th here in the chamber at 6 p.m. Again, you can testify at that. Hearing, in person or virtually. In lieu of testifying at one of the hearings, you can email written testimony to the committee at ccc.wm.boston.gov. You can also submit a two-minute video of your testimony through the form on our website. For more information on the City Council budget process and how to testify, please visit the City Council's budget website at boston.gov slash council dash budget. In person testimony, again, will be taken following the first round of counselor questions. And each person will be given two minutes to testify. Again, if you're online and looking for a Zoom link,

You can get one by emailing our Director of Legislative Budget Analysis, Karishma, at karishma.chouhan.gov. for the Zoom link and your name will be added to the list. This morning's hearing is on docket number 0733 to 0740, an overview of the fiscal year 2027 operating budget for the Boston Public Health Commission. This morning's hearing will cover topics including the BPHC overview, emergency medical services, recovery services, and homeless services. This is one in a series of hearings to review the fiscal year 27 budget. This afternoon, we'll be hearing from the Boston Public Health Commission where we'll be covering the topics of infectious disease, child, adolescent, and family health. of Health, Violence Prevention, and Behavioral Health and Wellness. So if your questions are on those topics, we can save those for the afternoon.

Again, that hearing is starting at 3. Usually we start at 2. We start at 3. Advocates, I think, wanted to come and speak, and so I really want to thank BPHC for being accommodating to that. It really helps us do our jobs. So these matters were sponsored by Mayor Michelle Wu and referred to the committee on April 8th, 2026. This morning I'm joined by my colleagues in order of arrival. We have Councillor Flynn and Councillor Breadon. We have received letters of absence from Councillor Santana and Councillor Louijeune. I believe we may also have questions submitted by Councillor Coletta Zapata. who gets special dispensation for being on maternity leave. I will read her questions for you to That is not. Unless somebody is on maternity leave or paternity leave, I am not extending that invitation to any of my colleagues. So don't get any ideas. So I'm just going to introduce the panel and then hand things over.

We're joined this morning by the Chief of Public Health Commission, I don't know if I got that right, Dr. Bisola Ojikutu. We're joined by the Public Health Commission Budget Director, Chris Valdez, and we're joined by the Chief of Emergency Medical Services and my constituent, Jim Hooley. Nice to see you. And I believe you're my constituent. Do I have that wrong? Oh, no. Ward 20, Precinct 14. Yeah, I think that's me. But if you were in Pepén's district, you're now in mine. So, okay. Well, thank you very much. It's really nice to see everyone. If you have a presentation, the floor is now yours.

Great. Good morning, Chair Weber and distinguished counselors. I'm honored to be here today before you on behalf of the Boston Public Health Commission and our over 1,400 dedicated employees who are working every day to build a healthier Boston. For the record, my name is Dr. Vissola Ojukutu. I am the commissioner of public health for the city of Boston and the executive director of the Boston Public Health Commission. This morning, I'll be providing an overview of the commission's work and detailing some of our accomplishments over the past fiscal year. specifically focused on the areas of recovery services and homeless services. I will also provide an overview of Live Long and Well, our city's first population health equity agenda, which is focused on closing gaps in life expectancy in our city. I am joined by our budget director, Christopher Valdez, who will discuss details of our FY27 recommended budget. Then I'll have the honor of passing it over to Chief Hooley of Boston EMS so that you can hear more about the many accomplishments of Boston EMS

which is one of the Boston Public Health Commission six bureaus and a key partner in our efforts to protect and promote the health and well-being of Boston residents. During this afternoon's hearing, I will provide further details on our work relating to infectious diseases, child and adolescent family health, violence prevention, and behavioral health and wellness. So this was a year of many challenges. Public health has been under significant threat from the federal government, and we have faced national debates about the efficacy of vaccines, decreased support for populations who've been made vulnerable, Thank you. Thank you. Thank you. are unwaveringly focused on our mission, which is to work in partnership with communities to protect and promote the health and well-being of all Boston residents, especially those impacted by racism and systemic inequities.

I want to thank all of you and the many people who've made it possible for us to maintain focus on our mission. So something's not... Oh, sorry. Okay. So is it going to work going forward? Okay. So sorry about that. Yeah. Our efforts are centered around the idea of making Boston a healthy home for everyone. This idea unites the six bureaus, four offices, and more than 1,400 employees that comprise BPHC. BPHC carries out our mission under the supervision of a seven-member Board of Health, and the Board of Health is made up of leaders in healthcare, public health, and organized labor. They provide strategic guidance and recommendations to BPHC's leadership team and staff.

BPHC also acts as the city's chief health strategist, organizing cross-sector partnerships and collaborations to advance health equity and to address the social and structural determinants of health inequities in our city. I'm very proud of our work over the past year, and I'm looking forward to the year to come. And now I will turn it over to Chris Valdez.

CHRIS VALDEZ Thank you, Dr. Ogikutu, and good morning, Councilors. In the next few slides, I'll be speaking about our FY27 budget, including its formulation, touching on our external funding, and providing a brief update on some of our capital improvement projects. Now, as has been widely discussed, the increasing cost of certain components of our fringe benefits will be stressors on our FY27 budget, specifically the SBRS pension expense and health care premiums. Now, unlike most city departments, BPHC is expected to fully cover its own fringe expenses as part of its operations. And our appropriation includes a component intended to cover just the fringe costs associated with internal staff, namely the staff whose roles are funded by the appropriation. Staff that are grant funded or otherwise externally funded must have their fringe costs recovered by way of a fringe rate. In FY27, our pension expenses now scheduled to go up by 5% and our healthcare premiums by just over 20%.

Had we applied the Mater's Target Reduction Guidance for FY27 using our existing FY26 appropriation, These increases would have necessitated service cuts of over $4 million before applying any target reductions. Recognizing this, OBM partnered with us to develop a process to treat our appropriation in the same manner as other departments which should not include fringe in their budgets. This was accomplished by first removing the FY26 values of our pension, healthcare premiums, and other post-employment benefits, also known as OPEB, from our FY26 appropriation. Then a targeted reduction was applied to the balance as part of the mayor's departmental reduction guidance. Finally, the new values for our Pynchon healthcare premiums in OPEB were added back along with any departmental transfers to get a total FY27 appropriation value. The targeted reduction was primarily achieved by increasing the budget for specific revenue streams, such as EMS transport billings, which are a direct offset to the appropriation value.

The end result is a year-over-year increase of 1.6% that preserves staff and services while also meeting the goals of the Mayor's call for departmental reductions. I'll now switch from internal to external funding for FY27. The city appropriation is just one component of our total annual budget. For FY27, we expect the appropriation-related revenue streams to account for 72% of this budget. Federal sources will account for 15%. State Sources 8% and other sources which includes the opioid settlements will be 5%. For federal funds specifically, most of our funding does come from the Department of Health and Human Services. Within this, the majority is from the Health Resources and Services Administration, or HRSA, which includes the Ryan White HIV AIDS program in our Infectious Disease Bureau. Now the federal funding levels for BPHC did decrease between FY26 and FY27 but this was expected due to the wind down of ARPA activities. We continue to monitor federal actions and litigations as part of our preparedness activities.

And thus far, BPAC has not had any federal grants formally rescinded. Finally, a few notes on our planned city-funded capital activities. The expected completion of a new EMS station on the South Boston waterfront will be in 2026. This will improve EMS response times in that area. A state of good repair project at the Northampton Square Garage is expected to progress a key asset for BPHC employees, Boston EMS, BMC employees, and tenants of the property's residential building. Boston EMS continues efforts to modernize the department's radio infrastructure Replacing outdated equipment, strengthening system reliability and coverage, and enhancing coordination with police and fire. Lastly, in partnership with DoIT, EPHC completed phase one of a server infrastructure upgrade. Phase 2 begins in FY27, ensuring BPHC data and systems remain reliable, secure, and cost-efficient. I'll now hand the presentation back to Dr. Ojukutu.

So in 2025, we launched Live Long and Well, our city's first population health equity agenda. As you all are aware, we have stark inequities in life expectancy and health outcomes across our city. We often talk about data, but Live Long and Well is really about action. We are a city committed to closing these gaps and addressing health disparities. So on this slide, we included components of the Live Long and Well initiative. So we lead with data. We're establishing new partnerships and strengthening old ones, sharing decision-making power with communities, focusing on upstream social determinants of health, supporting place-based strategies to address local needs and investing collaboratively. The ultimate goal is ambitious, to close Boston's life expectancy gaps, which exist by both place or neighborhood and by race. By 2035, but we certainly believe that given the fact that these gaps are so stark and so inequitable, we cannot afford to be anything other than ambitious.

OK, so turning to our city's life expectancy data, just so you can see, some of you all are probably well aware of this. If you look at life expectancy across our city, black Boston residents have the lowest life expectancy of all Boston residents among black Boston residents black male life expectancy is lowest it's nine years lower than all other men in Boston and just for reference the top four causes of death amongst black men from 2023 to 2025 are drug overdose heart disease cancer Most of them preventable, and Homicide. So turning to recent Live Long and Well investments, I believe that the entirety of our work actually functions to support living long and well in our city. But I wanted to show just a few special investments or recent investments that I think are important. So last July, in partnership with the Atrius Health Equity Foundation and the Boston Community Health Collaborative, which is our Chinat chip, We announced a $5 million investment in four community-led partnerships.

There are actually 12 total organizations in the partnership groups, the purpose of which is to build wealth and economic security in Dorchester, Roxbury, and Mattapan. And those are the three neighborhoods with the lowest life expectancy. The second of the total $10 million, because we're receiving $10 million from Atrius Health Equity Foundation, will be released in 2028. Secondly, we designated $1 million from the declaration of racism as a public health crisis To focus on black men's health, given the data that I just referred to, we will have an RFP that will be released later on in June. For those of you who are not aware, we are holding a Black Men's Health Activation Summit on June 3rd where we'll talk through interventions that we believe are most important to address that life expectancy gap.

And then thirdly, in a new partnership with Dana-Farber Cancer Institute, we're investing $1 million in cancer prevention, connection to treatment, and community-based education and outreach. So again, our work is about following where the evidence leads. And there are a few ways that we do this. I wanted to mention a number of strategies just because I think that they're important and they make our health department somewhat unique. So the Boston Public Health Commission is the convener of the Boston Community Health Collaborative. Again, that's Archana Chip. It's a multi-sector collaborative of Boston health institutions, community organizations, and residents. and over the past year this collaborative completed a citywide community health needs assessment and drawing from that collected data published a community health improvement plan. So I think it's important to, again, emphasize that this is a big deal for our city. As I said, Boston is unique in the fact that We are collectively bringing all of these folks together.

We often talk about how Boston is resource rich, but coordination, maybe collaboration poor. In this instance, we are rich in both coordination and collaboration, and we're rowing together. in our efforts to combat health inequity. The Community Health Improvement Plan identifies four key priority areas for collective action in the City of Boston. They are access to healthy and affordable food, Access to Care, Housing, and Economic Mobility. I do want to move on to the Recovery Services Bureau, but I also want to mention on the previous slide We do have a Center for Public Health Science and Innovation, and that's where we do all of our Health of Boston work. I'm sure you all are familiar with that work over the years. We do have a number of reports that will be up and coming, and we look forward to sharing that data with you. But I'm going to switch gears now to talk about our Recovery Services Bureau.

So the issues surrounding substance use disorder, as we all know, are deep and they're complicated and a challenge for us to address, but I think that we continue to make progress. I'm particularly proud of our staff who are working every day to address these issues under very difficult circumstances. So this slide provides an overview of our programs and services through the Recovery Services Bureau. Through each one of these, we are committed to using every single touchpoint as a way to engage folks in the continuum of care and to hopefully move them along the path to recovery. In coordination with our city partners, we're continuing to adjust our work to advance the mayor's priority, which is the goal of ending outdoor drug use and improving quality of life for Boston's residents. Over the long term, we're confident that well evidenced public health strategies and approaches are most effective in moving people along the path to recovery and stability.

As we enter the warm weather season, I think that there are a few initiatives that I do want to highlight to you today. First, the Boston Public Health Commission is going to be leading the high-utilizer table This is a new initiative that the city launched in the fall of 2025. It's modeled on successful Boston Police Department hub tables. Essentially, what it's doing is intensive case management for individuals who are Thank you. Thank you. Work that's being done on a weekly basis and connecting individuals with the services that they need So to date, since the fall of 2025, the table has case managed 30 individuals and 22 of those individuals have been connected to services.

We're also working to enhance CRT, the coordinated response team's diversion strategy by partnering very closely with clinical providers to develop a system that will expand the treatment and stabilization supports that are offered to individuals. And our goal there is to ensure that individuals have access to the full continuum of care, including medication for addiction treatment. We are also hoping to ensure that there's good communication with our providers. They are quite important to the work that we're doing. And finally, we continue to convene the Nubian Square Task Force, which is a group of providers and community members who meet biweekly in the Nubian area to address issues including substance use disorder, homelessness, and mental health concerns. In addition to meetings we coordinate outreach walks and a series of community events. So I'd like to talk a little bit about syringe collection, which continues to be an area of focus.

I think it's important to be clear that discarded syringes on our streets are never acceptable. So we take a multi-pronged approach with a number of different strategies that are listed on this slide. So on the slide, you actually see four strategies. One, the MobileSharps team. These individuals respond to 311 requests and they do proactive sweeps. They're working seven days a week, 365 days a year. We also have our outreach team. Some of you all know them as the Red Shirts. Again, they work seven days a week, 365 days a year, with 18 hours of coverage on the weekdays and 13 hours of coverage on weekends. We also partner very closely with Newmarket. and that is the back to work program. This is a sustained partnership with the New Market Business Improvement District.

We have a 25 person team that we're covering, paying for essentially who work throughout the South End, Nubian Square, and other nearby neighborhoods. And then lastly, we have kiosks stationed throughout the city where anyone can dispose of syringes. I think at a previous meeting I spoke also about a peer collection program that works at our homeless shelters. We are looking to move that forward because any additional help that we can get to ensure that there are no syringes on our street is quite important. So all of these strategies are ongoing and really important to our effort. I also want to mention that our goal at the Boston Public Health Commission is to strengthen the continuum of treatment and care for individuals living with substance use disorder. So in FY26, we continue to provide pathways to recovery and to strengthen our work in treatment access.

So our PAS program piloted a new program to help clients actually stay in care. PAS, as you all know, is an open door, one stop referral service that provides immediate, barrier-free access to substance use disorder treatment, recovery services, and support. In FY26 through April 30, PATHs made 1,274 client placements. Secondly, on our Mattapan campus, we have worked to enhance our services. And through April 20th, we made 621 patient admissions to our transitions program, which is a site where we do short-term residential substance use disorder work and provide those services to adults living with substance use disorder. This year we also strengthened our partnership with the Community Caring Clinic to increase access to psychiatric and mental health services on-site. We also made permanent a former

That was a pilot. Well, it was a pilot program, and now we've made it permanent. That is focused in on residents being able to take methadone home, so they're not leaving the site to go get methadone. It's actually available to them, so that's really important. And then lastly, we have Entre Familia, which is another residential program on our Mattapan campus. It provides bilingual and bicultural gender-specific substance use disorder treatment to pregnant women and women who are postpartum. Their children can also stay at the site. So this year we invested in staff training and also launched a new outreach marketing program to help educate providers around the city on the services available at Entre Familia. So this slide shows you some of, I think, the most important results of our efforts across many different areas. We continue to note a decrease in overdose mortality in our city.

And I want to thank the Recovery Services Bureau for all their efforts to educate, decrease stigma, and move people into recovery and distribute Narcan throughout our city. So from 2023 to 2024, we noted a 39% decrease in overdose mortality and we've seen a continued decrease 2024 to 2025. It's about, it's close to 9%. So turning to the Homeless Services Bureau, Essentially, what we're doing in that bureau is trying to make homelessness rare, brief, and non-recurring. As you all well know, we operate two shelters, the 112 South Hampton Street Shelter for Men and Woods Mullin for Women. These are city-run shelters staffed by city workers. Oh my gosh, sorry about that. They're staffed by city workers, and we are one of the largest providers of emergency shelter in New England.

So I want to emphasize that our shelters are about more than just a place to stay overnight. We actually work intensively with guests, provide case management to prevent ongoing homelessness We provide stabilization services, medical care, workforce development, and support pathways to permanent housing and recovery. Two of our low threshold sites are located within our shelters, so the Friends floor. is at 112 South Hampton, and Willows is at Woods Mullen. So these sites provide shelter, harm reduction, case management, stabilization, and housing navigation to individuals living with substance use disorder. Secondly, I'll mention our Workforce Development Program, which provides job training and case management to homeless individuals. This program follows a work-first framework, so placing individuals into employment

Irrespective of their perceived readiness and providing them with a training ground where they can navigate employment while living with co-occurring illness, substance use disorder, mental illness, and other concerns and challenges. I also want to mention that because of all the work that we're doing, we have been successful in placing individuals into permanent housing. And that's really our goal, to stabilize individuals and put them into permanent supportive housing. In FY26 to date, 80 clients have moved into permanent housing and nine clients have moved into long-term treatment. So I think these are really good outcomes. Well, I actually had one more slide, but it seems to be missing. I just want to tell you guys one last thing, because I think it's important. At the Homeless Services Bureau, I think we're doing really well.

I gave you some statistics already, but I just want to add that in FY26 through April 1st, 2,884 unique individuals stayed in our shelters, and that's throughout the fiscal year. We actually served 643,942 meals. We've had 182 individuals formally over the course of the year placed into permanent housing and 163 individuals received job training and workforce development. So there's an enormous amount of work that's occurring within our shelters. Okay, so that concludes my presentation. I know that was quite a lot, but I'm going to turn it over to Chief. I do want to take a moment to thank him for his many years of service and leadership, and I also want to thank the dedicated personnel of Boston EMS. I want to emphasize that the work of EMS is really deeply connected to the remainder or the rest of the work at BPHC and particularly Live Long and Well. So I'll turn it over to Chief.

Thank you, Doctor. Let's see. All right, well, good morning, Chairman.

Madam President, Councilors, thank you, you know me, Jimmy Uli, Boston EMS, and It's been my pleasure to serve as the Chief of Boston EMS for a couple of years now. And we're the city's 911 pre-hospital provider and Bureau of the Boston Public Health Commission. Whoops.

That was too quick. I'm going to go back.

There we go. All right, our mission, and you can read it there as well, is to compassionately deliver excellent pre-hospital care while protecting the safety and health of the public. And we do routinely have a foot in public safety and in public health, as you'll see through all these presentations. Okay, just some quick numbers for you. Although we're a relatively small public safety service in size compared to police and fire, we're still one of the busiest Busiest, if not the busiest, municipal service in New England. Our department includes 440 uniformed members and 32 non-uniformed personnel.

We support the city's 911 EMS dispatch center and we deploy 22, no, I'm sorry, we operate the city's 911 EMS center in conjunction with the Boston Police Department's 911. and we deploy 22 basic life support and five advanced life support ambulances during peak day and evening shifts with a reduction on the overnight when call volume decreases. BLS units are staffed by two EMTs. Our ALS units are all staffed by two paramedics. When many communities have gone around to reducing staffing, some of them to providing one medic with one paramedic, BMS provider, and in some cases, some ambulances with one EMT and one lesser certified personnel. Boston has never embraced that.

In calendar year 2025, our members responded to more than 141,000 distinct clinical incidents resulting in 95,503 patient transports. Our Alternative Response Model Units, each staffed by one EMT and one Boston Emergency Services Team Behavioral Health Clinician handle over 1,830 patient encounters involving individuals from school-age children to older adults. Boston EMS Special Operations Team supported emergency medical coverage for nearly 1,000 events and through our community initiatives program, we assisted more than 170 families with childcare seat installations and coordinated over 68 CPR and AED certification classes.

Most recently completed updated training and service for all the municipal officers in this facility over at Court Street. We'll be doing the same at the library and other sites because it's important. We consider them first responders. Several successful resuscitations in this building thanks to the training that's been offered and I'm sorry the training that members in this building have undertaken. We thank them for that. All right, managing volume and response times. There's one little logo you'll see up there that shows that we are, in fact, pretty busy. If we check in the...

The logs, the mileage for if you take all of our ambulances added up in 2025 alone, we logged enough miles to circle the globe 37 times in a city that's only 48 square miles. To address rising call volume and the continued impacts of the county hospital closure, we did officially add a 24-hour ambulance in Dorchester this fiscal year. We were doing it from the beginning when Kearney closed. We were doing it with spares and with people on overtime. That's been adopted. It's an official part of Regular Coverage, where it's part of minimum staffing now, Ambulance 21. Additionally, the department expanded night shift coverage in Jamaica Plain and Roslindale by making Ambulance 17 which is based out of the Faulkner, an additional regularly staffed unit.

And while we anticipate heightened demand during such upcoming FIFA, South Boston events, Fourth of July, Boston Marathon, and other things, we increase our resources throughout the city. Not just for those events, but to make sure that our neighborhoods are protected. To date, we've supported more than 3,000 patients who have experienced low acuity behavioral health needs through the Telebest 911 call transfers from our dispatch center. and from dispatch of our alternative response model or ARM units. In 2025, we expanded the ARM unit operation to seven days a week, 16 hours a day. And that was an addition to our, and the call sign for that unit is during the 90s, Squad 91. Well, why don't I do it during just a different unit doing it that day or that shift.

Squad 80 last year was expanded from days to evenings as well. Squad 80 handles a lot of the Homeless, some of the substance abuse and some of the encampment type calls that we may get around the city. One thing we talked about when Dr. Ochikuta was mentioning about the services for outreach, needle pickup, squad 80, and We have supervisors and deputy superintendent who's on daily check-ins every morning with the street outreach teams, with the Boston Police Street Outreach. Representatives from Boston Public Schools to look at, hey, where are there either new spots cropping up? Is there more activity on Park State over at Jim Rice Field? Or is there something else going on at Nubian? or is it perhaps a new encampment coming up off of West Ford Street?

And they share that information five days a week, and they use it to... We're not just hearing about it weeks after something is reported To date, I'm sorry, although call volume continues to rise, and it does, our priority one median response times have shown steady improvement, dropping from 7.5 citywide to... To 6.8 minutes this calendar year from January 1st to mid-May of 2026 compared to the same time last year that represents a 9.3% reduction. which was good because we had been steadily increasing citywide. And that reduction has held true across all the districts.

So we're happy to say that as well. personnel. Two slides for that. Our personnel are highly skilled, trained clinicians who are deeply committed and on average, our current department members now have served 10 years. Prioritizing our personnel isn't just a value that we talk about, it's reflected in How we budget and allocate our resources. More than 89% of our budget dollars goes directly to members, wages, associated fringe benefits, The remaining funds support essential investments such as uniforms, personal protective equipment, medical supplies, ambulances, and other resources that equip our members to perform their duties safely and effectively. Prioritizing our personnel is also investing in them as people, including their wellness, their professional development, and their advancement within the department.

In 2025, we promoted 22 members into paramedic supervisory and command ranks, and we provided 14 paramedic school scholarships to our department EMTs. We're currently in the process of another round of paramedic promotions. We have six paramedics who are will be shortly entering internships, doing their training with us and getting clinical internships provided for us through Tufts Hospital, Tufts Medical Center. Over the last three years, our non-retirement attrition, not people who are leaving because they've attained retirement age, but our non-retirement attrition among badge members, uniform members,

has steadily decreased from 40 members in 2022 to 15 in 2025, which would represent a 160% increase. In 2025, Boston EMS continued our year-round recruitment efforts. with a full-time deputy superintendent and program manager who attend countless events, career fairs, schools, They've interviewed hundreds of candidates, and we've awarded 120 scholarships for EMT courses at the Boston EMS EMT class, which we conduct twice a year. and a partnership with Cambridge College.

For individuals that are interested in working with us but they've not yet attained their certification as EMTs, the scholarships are funded through grants secured in partnership with the Worker and Parliament Cabinet Here at the City of Boston. Like the Cadet Program, that's another pipeline to employment. The Cadet Program is great for young folks, city folks who are looking for Careers in EMS and it's a at the most a six-month program typically they've and many more.

They get a lot of realistic training alongside of our members here, so they get a real flavor for what it's like to then join us as recruits. Unlike the other cadet programs in the city, ours is butter, Six-month max, which then would, if you pass everything, it would qualify you then to apply for our recruit program. and it should put you in a good position for it. Unlike the other departments where the statute is they have to give two years of service for that preference. The scholarship program is Thank you.

Thank you. They know somebody who's in EMS, and they've been maybe a little bit intimidated, or they look at the cost of some of these EMT programs, and that's a bar. Some people, maybe they already have young families, whatever. This way they can keep their day job at... working in the bank or working as a server or a bartender in many cases or something else. They're able to take that part-time EMT program and we're also able to keep an eye on them as they go through there. We find out who's who's really interested in us. We've had some good recruiting efforts through that. And the reason we've been able to close some of the gaps in our hiring is

In total we hired 30 cadets last year and 67 new EMTs in 2025. We just started another Recruit Academy in April and we plan to start another one in January of this coming year. We are also currently accepting applications for an upcoming cadet program which should start this late this summer. equipment and systems. As I said, the ambulances, we put miles on them. As our members, we're frustrated at the rate of delivery from our vendors.

We're not frustrated with the support that we've received from this body and from the mayor and from the Public Health Commission because we do have... 26 ambulances on order and we've with the funding that's been secured. And we look forward to getting those in. During the manufacturing delays, Boston EMS took receipt of 14 ambulances this fiscal year. which had been ordered in 2023 and will receive ambulances ordered in fiscal years 2024, 2025, and 2026 over the course of the next fiscal year FY27, which hopefully is going to account for 26 additional ambulances in the coming 12 months, which will be a welcome infusion to the fleet. We'll be able to retire some of the trucks that have given us a long service.

It'll be good also to help our mechanics maybe draw We're also in the final stages of a multi-year C-Med, or Central Emergency Medical Direction System Upgrade, which will go live next month. That's a system that allows us to speak, communicate with all patients. Licensing and Meal Services within Region 4, which is, I believe, 61 cities and towns in Metro Boston, coordinate with all the hospitals, assist in disaster management, throughout the region. We're also in the final stages of our multiple year investment in the We have a radio upgrade system here along with Boston Police and Boston Fire. They've been building out

Transmitter and Reception Sites across the city, putting in redundant recovery pathways so that you have like two fall over layers of backup, which will really help in times of Any kind of system outage anywhere. Also, After multiple years of investment in fiscal years 25, 26, and 27, all members of Boston MS will soon have upgraded encryption-enabled The Boston Police, in part of their radio upgrades, on their patrol channels, and certainly for some or other, they're more and so on. patrol channels.

It's important to have interoperability and public safety so that we can either speak or hear or listen to each other. We already can do that up in dispatch. We made sure that that was done. We've already added encryption to all of our supervisors' command staff radios so that we can all... Thank you. Thank you. Thank you for joining us. I messed up. I went too quick. I don't know how to go back.

We can help with that. Okay, that's all right. It was just a diagram, a drawing of the South Boston Waterfront Station. I just want to give you a quick update on that. This summer, we look forward to the opening of the new Two Bay Air Mail Station in the South Boston waterfront. We're grateful to the city, particularly I want to mention Councilor Flynn for his longtime support and advocacy for a station. that won't just help his district in South Boston, but that's gonna help us with downtown. It'll help us in backing up East Boston as well, too, as all of our units Constantly, as we see on the mileage, get moved around to back up each other in other areas. We try to dynamically redeploy units where we need them.

So it's an important capital investment and it shows the investment to our department and to our personnel. We will have it open this summer. We haven't had a date for a I just want to conclude by wishing everyone and especially our members here today and anyone who may be watching. Happy National EMS Week and extending the gratitude to the members of Boston EMS who continue to rise to the challenge and meet the needs of the city of Boston. and its residents every day. I know you all offered a resolution yesterday. Thank you for that. And with that, I'm ready for questions.

Okay, thank you. I have some more slides now. Okay.

That's for the afternoon.

Okay, great. Okay, well, thank you very much. We're going to go to councilor questions. If anybody is here to give public testimony, we're going to have that after the first round of questions. I'd just like to acknowledge, in terms of constituents, we're joined by Lord Mayor Richie Gormley. Thank you for being here. It's nice to see you. See any other Lord Mayors in the room, so I'm not going to introduce anyone else. Okay, so order of arrival. We have been joined by Councilor Fitzgerald, Councilor Pepén, and Councilor Culpepper. We're going to start with Councillor Flynn. There's a lot to cover, so we're going to go with seven minutes, Councillor, and then get to the second round. You don't have to use all seven minutes.

Thank you, Mr. Chair, and also want to welcome Rich Gormley, a decorated Vietnam veteran, but also a strong veterans advocate throughout Boston, throughout Massachusetts. I want to say thank you to my friend Richie. To Dr. Ojukuchu and to Chief and to the Budget Director, thank you for being here for your important work. I just did some research about and I have a strong respect for the EMS workers that are out there every day. A lot of calls that come in every day from residents, visitors, Average about 90 to 100 priority one calls a day, probably over 400 total responses a day. Certainly, it gets busier during the weekends and other times as well.

Let me ask a brief question, either doctor or chief, if you can answer it. And just a quick question because we don't have much time. Time response from that. From the time that comes in, for the ambulance to arrive, to be on scene, be on site, is the time response up? Is it down? No difference?

No, uh, bring up the exact numbers here again. Uh, but we, uh, excuse me. I'm sorry, Councilor, thank you. No, in answer to your question, yeah, when we look at our response times, the one we do key on is for our priority. Once we have priority one, 2, 3, and even some other lower priority calls that may not I don't necessarily even have a response associated with them, but priority ones are the ones that are more urgent, that they pop to the top of the dispatcher's screen, that the call type dictates it, you know, for example, a cardiac or a pedestrian struck although we do have a law code for that as well too if it's somebody just reporting an injury afterwards say but

A median priority one response times had been 7.5 and it has dropped to 6.8 minutes last calendar year, which, you know,

7.5 minutes was previous.

Was previous.

And now it's 6.8.

It's down to 6.8, which when you look at the volume of calls, it still took a lot to... and many more. Our goal that we set many years ago was six and we were routinely attaining that until probably back Back before COVID, when call volume kept going up, staffing, and then the numbers of ambulances that we were fielding out there, they weren't adequate. We did put in for additional personnel for several years in a row and thank goodness we were able to get approval for that. and now with the conclusion of these upcoming classes we'll actually get to to a staffing level that that was approved over the last couple of

Okay, non-priority one, has the time response gone up or down or stayed the same?

I can get those exact numbers for you, but I think the lower priority ones have probably stayed about the same, the priority. One of the things that also helped Council was a lot of, we've been able to Make available units a little bit more for the priority one calls by utilization of some of the other services such as units, the non-transport like Squad 80, Squad 90. When we talk about the a couple of thousand calls for people with maybe either some behavioral health or People who may require, say, a best team intervention. A lot of those patients don't necessarily need to go to emergency rooms. In fact, that's probably not the best place for them.

Many times we can get people transferred to the Call in and do some telemedicine with them, with telebest with them. But if not, we can go out and spare an ambulance from going to a call to keep them available.

Okay. I'm going to go over to Dr. Ojukutu. Thank you, Chief. Dr. Ojukutu, I've been working with you and your team for a long period of time on doing a study about the Asian community. I want to say it hasn't been released, it hasn't been published, We made significant progress. Want to thank you and your team for being professional, for working with me. More importantly, working with the community to identify what the challenges are and how we can support them. Do you have any any

Thank you so much Councillor Flynn for your leadership in this regard and we have been working very closely with you and your team on revising Redoing, actually, a study on the health of the Asian population in Boston. Because of your advocacy, we met with more than 50 partners, stakeholders in the Chinatown area specifically, but you know even more broadly to really think through who it is that we are not capturing and really take a good look at the data and I think the product that we will deliver sometime toward the end of the summer I believe is our timeline is going to be better than what we started with and will really be an asset. So thank you for your support.

Thank you, doctor. Thank you to your team. My final question, and I'll come back at the next one. Doctor, one issue that I've worked on for a long period of time, HIV. My father was probably the first mayor in the country that established a needle exchange. Very controversial if you think about it. At the time it was very controversial. But HIV is an issue that my family has been very involved in. What are we doing in terms of supporting people with HIV or AIDS, but also providing education assistance to people that might be susceptible But how do we prevent it and what are we doing on some of those initiatives?

So thank you so much again, Councilor Flynn, for your question and for your support in this area. As you know, I'm an HIV doctor and infectious disease physician at MGH, and it's something that's very important to me also. We within our Infectious Disease Bureau have a number of different programs that are both looking at prevention, so issues related to education and access to PrEP, and We do a wide array of work across the continuum. I think we've been successful in many ways, though we always have more work to do. One of the things that we are very much so invested in is the ending the HIV epidemic program and we receive funding as a jurisdiction where We know that there are people at risk, so we've been working very closely with communities, particularly communities who are at higher risk of HIV infection.

So we can talk more about the specifics of programming, but it's certainly a priority at the Boston Public Health Commission.

Thank you, Dr. Ojukutu. Maybe after the budget is over, could I meet your team just to go over Get an update on HIV outreach. Absolutely. Okay. Thank you, Doctor. Appreciate it. Okay.

Thank you, Councillor Flynn. Councillor Breadon.

Good morning, everyone. Good to see you all. I'll probably start with Dr. Ojukutu. In terms of public health tracking of infectious diseases, I know every day we hear of some new thing happening somewhere in the world and people travel and there's always that. I'm just wondering in terms of the support from federal government for Tracking of infectious diseases. Public health, that's one of the foundational roles. Do we see a cut in funding and are we still doing wastewater monitoring for infectious diseases?

All of that. Absolutely. Thank you, Councilor President Breadon, for that question. Another one that's incredibly important to the work at the Boston Public Health Commission. So I'll answer a couple of those. First, in terms of the federal support, I think that's been an ongoing concern, particularly as we've seen this hantavirus cluster that came with the Dutch cruise ship and now the The uptick of cases in Ebola cases that have occurred primarily in the DRC. The CDC essentially convenes these partner meetings that we attend, and we hear updates. But a lot of what we're hearing now, because the CDC is not the lead agency, is secondhand. So that has been a challenge. And I think everyone across the US has noted that that is an ongoing challenge and wondering why we are not part of the WHO and why we're not deploying immediately to lead the response. But we are trying to stay on top of things. I mean, we are in a city where we have many, many experts in all of these areas.

And we will actually be holding a convening I believe next week to talk about hantavirus and Ebola and think about how we should as a city prepare. And the Boston Public Health Commission is leading this in conjunction with the state and with Mass Medical Society. Thank you for joining us. It's a quintessential aspect of our work. It is what we're doing in terms of surveillance, particularly as we look ahead to the World Cup and many people coming to the city. You know, Tall Ships, everything that's happening this summer, that is a main part of what we're doing in terms of surveillance. We have other components, but that is a main part of it. Continuing to look at respiratory viral diseases, certainly along with measles, the typical COVID, flu, and RSV, but also measles. And then we've added a list of other infections so that we will be, again, leading the way on the cutting edge of understanding what's happening in our city.

It's a sad state of affairs that the U.S. has not taken a lead in the World Health Organization and helping other less resourced countries respond to potential outbreaks. I had a question for Chief Hooley about the She said that the median response time citywide was 6.8 minutes. And I'm just curious, because I just did a quick check. I'm wondering about advanced life support service for Alston Brighton. How long it takes an ambulance to get from Brigham and Beth Israel As I understand that's the base to Ugg Square. I just did a quick Google search for how long it would take me to get from Ugg Square from the YMCA to It was 21 minutes at 11 o'clock this morning.

I'm really wondering, I know this is a median response time, what is the longest time it takes for and Advanced Life Support Ambulance to get to the Oak Square end, right on the edge of the city, like out to Oak Square or Cleveland Circle.

Good morning. There's probably a lot of factors, obviously, that can influence that, you know, time of day, where units are coming from. You know, similarly to Units going to Hyde Park, Lowell Mills, anywhere else, right? Some of this depends where you're... Point A to Point B, right? Starting out. I don't... We can do a little bit better than 21 minutes.

I would imagine even at your very best you would be doing good to make it in 10 but that would be cutting the time in half but

I think even not as ambitious. We currently do have two other units assigned to cover the Austin and Brighton areas. Granted, they're BLS, but as I was pointing out earlier, our clinicians there are also very good, very well trained, very well equipped.

So the population of Alston Brighton is now 87,000 people. And we have about 8% to 11% of those folks are elders. Concentrated a lot of the time in senior living buildings. I'm just wondering in terms of your estimation of the service level that we would expect for a population that size. Is there any plans to increase service to that area? And I know we've asked for two. We were hopeful that we would get a two-bay ambulance station with Stewart Healthcare at the former St Elizabeth's. I think that's probably in abeyance right now. We also hope that we get a new two-bay over on Western Ave in the basement of a lab facility, and that's not happening. All our hopes to have a new facility have been dashed recently.

In terms of the EMS facilities action plan, Produce several years ago. What's the plan moving forward? What actions might we anticipate with improving our infrastructure in Alston Brighton? Because I do know that the EMS station is in pretty rough shape out there. Thank you very much. potential opportunities that we thought we had.

Okay well for Austin and Brighton we as you said we've always explored trying to get Additional sites out there. The current site that we have, on the one hand, it's It's roomy. We've been able to on times be able to deploy, certainly we are able to deploy additional units out of there. We've run training trucks out of there if we need to or when we have supported Some special events in Austin and Brighton have been able to deploy out of there as well, too. So it is a good asset for us. Yes, it's a older building. It's owned by Harvard. We have a... We've had a reasonable lease there. We've had a long partnership. We maintain a lot of the stuff on the inside. You know, clearing out a lot of different things over there, but with the idea of we're still in there.

Just an update on the lab building. A lot of stuff has slowed down on Arvids Development over there. But it is still very much in the agreement that's in place with BOSS, with planning or I guess it was BPDA back then, was that that was part of the whole mitigation that they had to provide that space The two bay in there for us. So that's good. They also, part of the deal that's over there was that service would remain uninterrupted so that even if they are ready to and bring the wrecking ball in and clear that spot out. Before they would do that, There's the swing space, which, again, not a palace, but it's a two-bay facility right on Speedway.

70 yards up the street from there. So the idea is they'll be able to keep our service out, at least our presence out there. Uninterrupted while they do any new construction. So that was good. And that was represented by senior vice presidents over at Harvard. That was their desire. They knew that was their obligation. So I have some confidence in that. And they also entertained, I think, two 25-year leases or something.

No, that's good, but I think as well, given that all of those lab construction is basically halted, I'm not holding my breath to expect that that'll happen anytime soon. Thank you, my time's up, but thank you.

yes but but one last thing that like basically any place if we can if they build it we will come you know uh like the line from the the movie there but uh similar to like if this Part of the study that was done with the city, too, was like, if there's any other new facilities going up somewhere where you have a chance to partner, come in with them, be it a library, be it a school, be it Any sort of facility. If there's economies of scale by jumping our public works or updates, that would give us the ability to house additional units. We could do it. And with what I mentioned that we're adding An additional six paramedics to our ALS ranks. We do want to expand to be able to put an additional ALS unit on.

You know, it has been determined like where's the optimal site to launch that from, but we are in the process of expanding our ability in that as well.

Thank you. Thank you.

Thank you. Thank you. Field of dreams. Yeah, thank you. Field of dreams. Okay, Councillor Fitzgerald. Seven minutes.

Thank you, Jim and Cosma. Dr. Ojukudu, Chief Hooley, thank you so much for all you do. I know we both talk a lot. Dr. Ojukudu, as the chair of the Public Health Committee here, we talk quite often, and so appreciate all the work that you guys do in our collaboration on a lot of the issues. So many places to begin, but I guess I'll just sort of jump right in. You talked about a new pilot in your Paths program. Could you just elaborate more on what that new pilot is? I don't know if I'm as familiar as I should be with that.

Well, let me start by thanking you, Councilor Fitzgerald, for your support in a lot of the work that we're doing. I think it's been incredibly important to have your leadership at the table for a lot of these discussions. So just to clarify, so PATHS is One of our, I think, most important programs because essentially what we're doing is directing people to treatment. And we're doing so on a voluntary basis for the entire city, not just for Mass and Cass. So I think that's really, really important. and as I said PASS has made you know more than a thousand client placements and I think it's been going on for a long time so I think that's incredibly important. One of the things that we've tried to do this year is Thank you.

Part of this new program is to really think about how we keep clients in care as opposed to just referring them off to care. And so that is really what we've been doing is focusing in on client follow-up and navigation. And that's part of this pilot to kind of see how that works and how much effort it takes to put that kind of system in place because as you know, that's the major issue is that oftentimes we have people bouncing back and forth and yeah. So PATH has been around for some time, but this pilot... Oh yeah, PATH has been around for a long time, but this is a pilot that we're working on to strengthen our efforts.

Mattapan Campus

Right, so you're asking about the two sites that I mentioned, Transitions and Entre Familia.

Yes, yes.

So we have a full continuum of services that we offer through the Boston Public Health Commission. And the pieces that we are focused in on on the Mattapan campus would be transitions, which is 65 bed facility. We have men and women there. This is a TSS transitional support services for short term residential treatment for substance use disorder. and then we have Entre Familia which is specifically focused on women who are either pregnant, postpartum, have children, who are living with substance use disorder.

Great, thank you. Obviously, especially at Mass and Cass, but really citywide, to your point again, we've been working with CRT a lot. They're not mentioned, but still I know an important component to the work they do. How do they fit into paths? Because I know that there's their own and other selected providers we're working with and trying to get placement. And I think there's some decent numbers. I don't have this as a fact, but since the fall, You know, putting about 900 people in a recovery with about, I think I heard last night, it was like 65% of those people go on to the next level of recovery, which is, I think, actually the more important number, right? It's not just detox and back out. It's sort of saying who's taking that next step in recovery. Is there coordination there with PATH as well?

Yes, there's coordination with CRT. We're all in partnership together. As you know, CRT, NEST, Boston Public Health Commission. What we're doing is, again, for the entire city, and it's something that's been very long-term, and it is about putting people in treatment for a variety of different substance use disorders. Just for opioids and certainly not just, again, for the mass and cast area. So it's different in that respect. but I think we're working hand in hand and sometimes CRT refers to PAVs because PAVs is looking for detox beds in the same way that CRT is. So I think we're working together just meeting this overwhelming need. So I think we have to maintain both strategies.

And so the individuals that paths place, the type of treatment that they go to, that is mostly TSS?

No, no, no. So we refer straight to detox, similar to CRT. We send to CSS. We send to TSS. I think we do the continuum. And we try to get people on medication for medication-assisted treatment. for Opioid Use Disorder. We really look at the entire services that may be available and do what's in the best interest of the patient.

Sure. And transportation to these programs, is that provided through you all?

Yes, we do offer transportation to programs. Okay.

Um... Within the CSS and recovery-based programs, what safeguards, supervision standards and clinical protocols are in place to protect the individuals actively working towards recovery from exposure to the ongoing illicit substance abuse that could occur? Because if I... Or just to, you know... I guess the ones that we run, right? There's still some issues of use on site, things like that.

Oh, I see.

How is that documented? How is that... You know, to make sure it doesn't happen and what is the sort of protocol around when it does.

So I'm just gleaning from your question. Maybe you're referring to like our low threshold that's inside of our shelters, for example. Yes, most specifically. Right, exactly. So just... to say, you know, in 112, we do have 75 beds, friends floor, so that's low threshold within 112, a very large facility. Similarly, in Willows, you know, we have a number of beds. So I think that's a challenge. We established these low-threshold spaces because we wanted to provide a space, a spot, for people coming out of the tent encampments. And I think we did that, and we did it well. It's been successful. But it is a challenge to provide people with this sort of separation, per se, from people who are living in recovery. and for some people I don't know that that makes a huge difference, but some people of course it does. So it's an ongoing challenge and I don't think that there's a perfect system per se for anyone.

Gotcha. Thank you very much. A couple of things. I know in the state budget, we were looking to get some money to go towards some of what the mass and cast working group was working towards. I think, hopefully, I think there's $8 million going into BSAS that I hope that we can use. I know that's statewide, but I hope that there's a, I would ask for your help in lobbying for A concentration of that money, at least, to go towards the efforts that we do here in the city, given that this is probably the biggest one. So look forward to your collaboration on that. And I'll just lastly say, I also want to get our working session on Kratom scheduled so we can work towards that because I'd prefer to get that citywide ban and get that stuff off our city. So I just want to not forget about that either, so just wanted to mention. Thank you very much. I do have more questions, but I'll get them to you in the next round. Mr. Hooley, thank you so much. Thank you, Chair.

Okay, thank you. Councillor Pepén, seven minutes.

Thank you, Mr. Chair. And good morning, everyone. Thanks for being here, Chief, Director-in-Chief. I'm really excited for this hearing and also just congratulations to the MS on your week. Yesterday at the City Council meeting I was able to introduce the resolution and I'm just very thankful for the work that you all do. I was able to visit last year your headquarters over in West Roxbury and I fell in love with everything about EMS. I even thought I wanted to become an EMS employee and then I got in the car with Deputy Superintendent Sean Alexander and I said, maybe not. No kidding, shout out to him. It was just so much adrenaline. We were driving, and I'm saying this not honestly as a joke, but seriously. I don't know how you do it.

You don't know what's expecting you behind the other side of the door. How are you going to respond to that? I did it for a couple of hours, and I was shaken. I was like, wow. I was just so impressed with the work that EMS does. So just thank you to every single one of the employees, to anyone out there listening. You guys do heroes work. And I do want to give a specific shout out because this happened very recently in my district. I'm going to read it super quickly. Where are you? I'm taking my time because this is important. So on Friday, May 8th, Boston EMS Lieutenant Ed McCarthy He rushed into a building on Cummins Highway in my district. And he did that while the building was literally on fire, knocking on doors, making sure that people were getting out. And he did all of this before the Boston Fire Department even showed up on scene. So I just want to thank him for that.

He helped save a lot of residents in my district. So thank you for that. I want to, obviously, I'm going to focus some Good portion of my questions towards EMS specifically. I get a lot of questions from residents, especially in Hyde Park, about the timing, about the access to hospitals. If not the neighborhood, one of the top two neighborhoods furthest away from hospitals, especially with the closure of the Kearney and then we either have to go to Milton or the Faulkner in JP or RIC anywhere else. I was able to get some updates from you all last year. I wanted to ask if there's any updates or any improvements on the timing of Ambulance is showing up from a resident's home to a hospital. What is that looking like? What is the potential of expanding or adding a second ambulance to the Hyde Park region? Shout out to the A18 ambulance. They do a great job. But why don't you just put that question out there to see what you guys were thinking about?

Okay.

Thank you. And thanks for your kind words. Thanks for the resolution yesterday. And yes, Lieutenant McCarthy did a great job that night. I was actually, I was coming back from a, well, I was awake, I was listening to it on the radio, it was one of our members' mom who had passed, and I heard it all going on live on the radio, and it was, thank God it wasn't like five in the morning, Thank you. Thank you. Little shell winded himself a little bit, but then insisted on staying and then was back on the job the next morning. So thank you. I'll pass it on to him with your personal remarks.

Yeah, as I was mentioning earlier, we have seen some reductions. Again, we've moved the needle a little bit, and certainly in the priority one response times. In every section of the city. Less than a minute, but we've At least we've been able to turn on a tide that had been going the other way for a while. We've seen in Ross, travel times, like for example, I know in Dorchester, but I could also, I could look at the travel times from, say, Rossendale Singh. My transport times went up certainly in Dorchester because you took the Connie out of it, but our actual response times got a little bit better with the addition of The additional ambulance that was out there. So it does make a difference.

We did formally add the ambulance 17, which is principally for Rosendale but is based out of the Faulkner and Jamaica Plain. On the night shift we added that on there as well as the We've been routinely adding additional units in the 20s, like a 22 or a 23, and a lot of the ones we do try to keep out that end because we know that between Hyde Park and West Roxbury, That even if the call volume, say, is not as much as, say, maybe Central Dorchester or downtown, the travel times are longer. and the transports to the hospitals over the longer and then getting units back out there. So that is something that we have very cognizant of and when we do add additional units, we really do take that into consideration. and we will be looking for that. We do have another recruit class coming out. We would love to be able to add to the

Standing compliment, minimum staffing as we call it, and we always take a real careful look at that where we can do that.

If there's anywhere that I can advocate For the new graduating class, potentially a couple to go to Extra High Park, I would love to advocate for that. I don't know if that's a letter or something, but yeah, we'd love to advocate for more. Potentially a second ambulance in the A18 area.

Yes, or what we call like zone impact units that would be out. Again, they're not just I'm here just for Hyde Park, I'm here just for Ross, you know, for West Roger, where somebody, you move the resources around. We started doing that several years ago downtown where ambulance aid is supposed to be a backup to A1 to wait 15, what have you. or 287, but there's clearly the need for us to add at least another zone impact unit or two, and that's usually what the ones in the 20s are right now, but we'll... I'll get back to you on specific plans for that.

Thank you. Appreciate it. Thank you.

Okay. Thank you very much. Councilor Culpepper, seven minutes. Thank you, Mr. Chair.

Good morning, Dr. I remember when my first week here, someone said to me, make sure you meet Jim Hooley. He's the best we got. I just want to thank you, Director Hooley, for joining us this morning. Dr. Ojukutu, I wanted to really commend you for that. The community-led mental health crisis response pilot that looks like it's going to get up and going. And I wanted to especially recognize the Work that went into it by the Boston People's Response Campaign, the City School, and the Boston Liberation Health Group. And to all my City Council colleagues who have continually fought to

Thank you. Thank you. We talked a lot to the Boston Police Commissioner about mental health responses and working on Some hearing orders dealing with the response from the dispatcher for the Boston Police Department when there's a mental health call and being able to identify Whether that's a mental health call, once you do, how do you handle it? Do you call the EMTs? Do you send the police? So we're working on that.

Yeah, sorry, Councilor Culpepper, I'm pausing your time. So we're having two hearings today with BPHC, and maybe this isn't your question, but mental health, we will be talking about that this afternoon. That's where you're going.

So I can't talk about the mental health pilot?

You can talk about it, and I think Dr. Ojukutu may be able to talk, but there will be plenty of time to talk about that this afternoon.

Do you want me to hold the pilot until this afternoon?

Yes, I think that is for this afternoon. which I announced at the beginning. They may just defer. You can ask your question. They may just say, well, we can answer that this afternoon.

If I defer until this afternoon, then I'll get Double the time to talk.

Divided in two, yes. You'll be getting double divided by two.

Well, I just want to commend you and even Councilor Webber, I'm commending you too for The work to help to get this pilot off the ground. I'll save these questions, doctor, for later. We can talk more about the mental health crisis response pilot. But when you look at your budget, and we know that the opera funds are now gone, and they were 15% of your total budget. The opera funds.

The 15% of our budget is federal funding, but that's not all ARPA. Actually, it's very little of that is ARPA. How much of that was ARPA? In FY27, It's going to be probably, our projection is going to be less than a million probably because the ARPA has to be spent by December 31st of this year. So most of our ARPA spending happened this fiscal year, not next year.

Right, for fiscal year 27. That's what I'm talking about. For next year, they'll be down 15%?

No. The total budget will be down 15%. No, our total budget, 15% of our total budget will be made up by federal funding.

Right, but it will be down in fiscal year 27, that 15%?

No, no, no, it's down. It was around $50 million in 26. It'll be $40 million total in 20. $41 million.

Yeah, in 27. And so when you look at the loss of those funds, what specific programs... will be impacted by the loss of those funds.

So many of our programs are actually transitioned already because this was expected. A number of our recovery programs are actually being funded by the opioid settlement. One of them was actually the wastewater work, and that's being transferred onto our city project under the health science and innovation.

How much was that opioid settlement?

The opioid settlement right now, we have a four-year plan to spend just under $18 million, but the entire value is currently expected to be around $40 million, but that's up until 2040.

About $40 million?

Yeah.

I heard you mention, Dr. Ojukutu, the syringe collection workforce. Yes. That's a 25-person team.

Right. So we actually have four different programs to collect syringes. We have our mobile team, our Team that actually goes out and responds to 311 requests.

Are those the red jackets?

So yeah, we also have the registers. So that's our outreach team. And so they do proactive sweeps throughout playgrounds, parks, schools. And then we also have the New Market bid team, and they have individuals who are responding to concerns, but they're also doing proactive work throughout the neighborhoods. and then we have kiosks where people return syringes. So we have four different ways to pick up syringes.

And so under the Back to Work program, how many are there under the Back to Work program? Is that the 25-person team?

So we cover. We pay for 25, but there are additional FTEs, and I would have to get back to you on the total number.

Okay. Fiscal year 27, are you going to expand that more into the Nubian Square? Because we're now beginning to focus. More, Nubian Square. Can you just talk about that a little bit?

Sure, absolutely. Thank you, Councilor Culpepper. I think there's been a lot of intentional effort to meet the needs in Nubian Square and, you know, broader in Roxbury, not just in Nubian Square. So Newmarket actually, the Back to Work program, actually already expanded into Nubian. So they're working there as well as our outreach teams and other services. Certainly we respond to 311s in Nubian. Interestingly, if you look at our 311 data, which we follow very closely, we've seen a decrease in 311 calls compared to this time last year. So I think we're doing the proactive work to pick up needles in the area. But certainly, you know, we are very intensely focused on, you know, the Roxbury area as well as all of our neighborhoods to ensure that there are no needles that are anywhere on the city streets.

26 seconds. I got it. I know my time is winding down. I want to talk a little bit about the laundry services for the homelessness shelter. And there was a proposal that the group of students proposed for doing laundry services in-house. We know that, well, let me ask you this. The laundry services for the homeless were about a million dollars.

I'd have to get back to you on that exactly. Let me look up real quick.

Okay. Can we assume that it was about a million dollars? That's the information I have. It was about a million dollars. And so the students, a group of students... I created a proposal to bring laundry services in-house that would significantly reduce the cost. Are you aware of that proposal that the students proposed?

So I am not aware of it. However, I think any workforce development opportunities are a good thing, and we'd be happy to review any proposal that the students have developed.

Yeah, I've got the proposal right here. Wonderful. During the break, we can look at it. Great. Mr. Chair, with all due respect to you and my Colleagues, I will wait until the second round for my additional questions.

Thank you. Thank you very much. OK. And again, I've got a couple of questions from the from East Boston here, from District 1 Councilor Coletta Zapata, who, and I'm only doing this if you're on Maternity Leave or Paternity Leave. So please, none of my colleagues get any ideas. So I'm going to ask some questions from Councillor Coletta Zapata. I'll have a couple of questions, then we'll go to public testimony. So in the, again, this is Councilor Coletta Zapata. Okay. In the fiscal year 27 budget, what resources or staffing are being allocated towards the domestic and Sexual Violence Prevention Initiative. Is that for this afternoon?

That's for this afternoon, yes.

Okay, sorry. Are there... Okay, I think this is also this afternoon. Could you discuss drink spiking this morning? What are we doing in terms of victims of drink spiking? What resources do we have in place?

Well, what I will say about drinks spiking, and I think it's an incredibly important issue, is that we're in preparedness mode for FIFA and World Cup and all of the activity and travel that will come into the city. And we've created some community education materials Thank you.

OK. OK. I apologize. And the community safety programming, is that?

This afternoon.

Okay, this was this afternoon. And then, I don't know if this is BPHC's role in addressing Public Health Impacts from Persistent Noise Issues.

That's also, I can talk about that this afternoon because it's Community Initiatives Bureau.

Okay, I'll put those aside until this afternoon. Thank you very much. Okay, so just a few questions here from the chair. Can you talk about the National Opioid Settlement Fund? So what's the status of that? We hear from advocates and maybe that that's not being allocated or there's money being held but I I'm just trying to figure out what what's happening with the fund I know on the website it's like 18 million has come in and we've Allocated it, but is there any money being held back or do we have plans for what's coming in each year?

So as it stands right now, we have a little under $18 million available, and we've allocated that, budgeted that out for the next four years. That's being budgeted in a number of different categories. So one is housing. Two is case management. Three, community activities. So community outreach, and that's primarily Narcan distribution. And then we also have just general distribution of Narcan community education and supports. We do have some money that is available and that we are going to put out for RFP soon that will go to communities to do What we call boots on the ground sort of services, particularly around overdose response and awareness and decreasing stigma. So that's the opioid settlement fund dollars that we currently have available. There's no money beyond that that's unbudgeted at this time.

Why does it take so long? I mean, we have the money now, 18 million. I think we get a million a year for the next 10 years or so. Why would it take four years to get that money out the door?

Right. So get it out the door. I would say that all of the money is officially We have folks at Elliott Community Services who've received funding. We have folks in low threshold, particularly You know, victory programs who are running, you know, one of our low threshold sites. They're receiving funding. It's just spending it. So it's out the door. It's not, you know, sort of sitting with us unutilized. It's definitely being used. I think it's been very successfully being used, particularly given our decrease in overdose mortality and the other metrics that we've been following.

For the, I guess, the coordinated response team, can you talk about, like, what's the, it's been a great resource. We've reached out to them a couple times in Jamaica Plain. There's sort of, you know, especially in the warmer weather, there's some, I don't know whether there's encampments or just areas where people gather around the Forest Hills T Station. How is that team working and what's the plan for it?

So the coordinated response team is within the mayor's office. It's not within the Boston Public Health Commission. We do work with them. And mainly what we do, we try to provide additional supports as needed, particularly around transportation and referrals to treatment, but then also working with providers and the high-utilizer table that I mentioned. So they are doing their work, their deflection program, and they're doing that in conjunction with NEST and BPD. That's the coordinated response program.

And is it, I mean, like, what's your, in your, Is that an important part of this network of services that we can provide? How does that play in terms of your planning for addressing these issues?

So I think it has been important in moving people. It has been effective, I should say, in moving people out of particularly the Mass and Cass and sort of South End area. It really is focused in on the mayor's goal, which is to end outdoor substance use and improve quality of life in that area, as well as in other areas, as you mentioned, because other neighborhoods are certainly called. So I do think that that is of critical importance. As I presented and then responded to a couple other questions, we have lots of pathways that are focusing on the full spectrum of substance use treatment and supports, as well as co-occurring mental health issues for people. So I think Our focus as the Health Commission is really on health, though obviously I'm concerned about, you know, quality of life and of course I mentioned harm reduction and syringe collection.

Okay. And then I guess... Just another area in my district, talking about low threshold housing. And I've been supportive of the Lindia and the Envision. Hotel, sort of transition to more long-term housing. How have those facilities, are they providing the services? Are they helping sort of deal with this problem? Are you exacerbating it? What kind of role do those facilities play? I don't know, the city's ability to deal with these issues.

So I think that's a great question. These facilities were established as we were trying to move people out of the tent encampments into more stable settings. and unfortunately, we had six. We now have three locations for them, including the Envision Hotel and 112 and Willows. So we do have some beds, but not as many as we had before. We've looked at outcomes, and we're still looking at outcomes for people going into those sites. We've noted improvements in access to medical care, psychiatric care, access to MAT or Medicaid-assisted treatment for opioid use disorder. improvements in quality of life, quality of sleep, lots of great data there. And we've moved 200 of those people on to permanent supportive housing. So they are moving onward. Envision Hotel will move, as I understand it in talking to Sarah Porter and Victory Programs. They are, you know, that's the longer term plan. But it is good to have places where there is, you know, sort of

If you will churn, meaning people sort of coming in and out as opposed to staying currently so that if we do have people who are on the street and people in encampments, we do have a resource available to them. So I think it's an incredibly important intervention in the grand scheme of all the things that we've done for the city.

Okay, and we've lost space, is that?

We have, yes.

Okay, so more important than... Before, when we had extra space. Yes. Okay, just trying to figure out how to respond to questions about that in the community. So I guess for Chief Hooley, Rivermore, the facility. Do you have data on how that has impacted response times? Has it helped with response times? I know there's something that was discussed when it was opening.

In the long run, the strategic run, it's certainly helping because we've been able to run successive training programs out there, Train more people to be EMTs, train more recruits, field more people out on the street. Shorter term, with the addition of a couple of ambulance bays out there, Which was a real bonus. The Academy itself was a godsend, but being able to get a couple of bays out there was... also very logistically important for us. We were able to relocate Ambulance 5, 24-hour ambulance from the Faulkner facility, which is and technically JP. Put them out there to start and end their shifts every day from there.

Ambulance 17, which was the principal of the ambulance that covered Rossendale, that they used to have to change out of 2001 River Street down in Mattapan, pick up the truck there, drive back, go back there, shift change. and do that. Two times a day. Now, they begin and end their shift out of the Faulkner, so that brings them that much closer to a response zone that we usually want to have them in. and then again we've been able to add that on to and a night shift on out there as well. And so a lot of that we get all say is one of the bonuses of having Rivermore between the training site and the garage. with the additional bay that was out there too. We've been able to routinely field other ambulances out there.

Principally the last year it's been When we put training trucks out, the ones we call the May 90 something, that series, that's two recruits and a training officer. We put them out, deploy them from there. Sometimes we're able to run two of them out of there because we have a third bay that we use to do simulation training, but that can be pressed into service Thank you for joining us. Reduction in the response times and for West Roxbury as well.

So it's certainly helping. Okay, thank you very much. So we're going to go to a public testimony and then for a second round of questions from my colleagues. Okay, Jason Yudkins, Miles Royal, and sorry, Rory, Doering and James McKee. In that order, you can use either one of these microphones. Whenever you're ready, you'll have two minutes. Just introduce yourself, and I'll start the timer after that.

So I'm requesting from the council an additional couple minutes because there's seven of us. A lot of them would like to yield their time to me so I can go through my entire speech if that's okay with the council.

That's okay, just a little closer to the microphone.

And then I know there's two people that have submitted testimony to you, Councilor Weber, and then someone on Zoom, just so that it's on the record.

Okay, I'll set the timer. I mean, I understand you're going to give five people's testimonies. How much time are you looking for?

Probably about four minutes.

Four minutes. I'll set it for four minutes. Thank you very much.

Thank you, Councilor. First, I want to start off and thank you for recognizing Boss EMS during EMS week. I know our membership appreciates your support and appreciation all year long, but especially this week when you recognized us. So good morning, Council. and all of our distinguished guests here today in our panel. My name is Jason Yuckins. I stand before you as president of the BBPA EMS division. representing the EMTs and paramedics of Boston EMS. We recognize Boston's in a difficult financial climate right now, but let's be clear, Boston EMS cannot be placed BOS EMS cannot be placed where the City chooses to cut, freeze, or delay any investment. We have allowed this to happen in the past, quite frequently, and often out of professionalism, sacrifice, and the belief that goodwill, that we will do more with less, eventually will be recognized, appreciated, and corrected. Yet we continue to wait. The demands placed upon our EMTs and paramedics have grown too great, the consequences too serious, and the needs of the city too urgent.

EMTs at Boston EMS are incorrectly compensated every single day. Let me reiterate that for this council, because it is so important for all of you to know. Our EMTs that I represent are not properly compensated in so many different ways. We're the front line of public health in this city. When someone has nowhere else to turn, they call us. When someone can't afford primary care, they call us. When someone overdoses, stops breathing, suffers traumatic injuries, experiences psychological crises or collapses into cardiac arrest, They call us. No matter the neighborhood, no matter the hour, no matter the danger or stress involved, Boston EMS comes. We need continuous investment into our system so we stay operational. We need more ambulances, personnel, modern EMS stations, improved personal protective equipment, and a reliable infrastructure. Historically, EMS is often treated as an afterthought. But when crisis occurs, Boston EMS is always there and is always ready.

We proved it during the Boston Marathon Bombing, Major City Events, Active Shooter Incidences, COVID-19, and this summer with the 250th anniversary Tall Ships and FIFA. Our EMTs and paramedics are against all odds and they will rise yet again to the occasion to be yet another example of how Boston EMS will function with limited funding. We do this all because we care deeply about the citizens of Boston and because human life matters. But there comes a point where dedication and goodwill can no longer justify inequities. Today, a five-year EMT at Boss EMS is paid nearly 60% less than a firefighter. Sixty. Despite responding to many of the exact same emergencies, standing shoulder to shoulder, while often handling significant higher call volume and enduring constant physical, emotional, and psychological stress, explained to me how this is possible, and yet were asked and told to quietly accept it. And this is why retention continues to suffer.

Dedicated professionals leave because they simply can't afford to stay. I'll repeat it, dedicated, experienced, compassionate professionals leave Boston EMS every year because they simply can't afford to stay. That should be alarming to everyone in this chamber. Wages is one factor, and I'll remind you, 60% less. We're here today to ask, does Boston want to continue to have a world-class EMS system capable of meeting the growing needs of this city? Are we willing to allow for a subpar department to blossom from the lack of funding or direct support? I ask all of you today, do not place EMS on the back burner. I know you all would want highly trained, experienced professionals arriving quickly, equipped properly, staffed adequately, and operating at the highest level possible. If you want the best, demand it. Stand beside us. Support us. Fight for what we deserve. All we want is to be treated equally.

Because until you are standing in someone's home during a cardiac arrest, a pediatric arrest, with the family yelling, crying, praying, begging for their child to breathe again, while everyone else that responded to that same call looks towards those EMTs and paramedics praying they will do the impossible. You cannot fully understand what Bar CEMS carries for this city. Property can be replaced, human life cannot. So I urge this council, invest in our growth, improve our infrastructure, support retention and recruitment. The members I represent perform one of the most difficult, thankless jobs in public safety with remarkable professionalism, compassion, and heart. The people of Boston deserve the best EMS system possible. Help us continue to provide it. I'll be here if you guys have any questions for me.

Okay, thank you. Miles, Rory, then James. You get two minutes and if I try to make you wrap up, you can blame Jason. Thank you very much.

Good afternoon. My name is Miles Royal, and I am an EMT with Boston EMS, working ambulance for in the South End and our EMS legislative aid for our union. First, I'd like to say happy EMS week to all the working members of Boston EMS and across this great nation. Thank you for the opportunity to speak today in support of Boston EMS and our emergency medical services across the city. Every single day, Boston EMS responds To the most critical moments in people's lives, we answer calls in homes, schools, shelters, nursing homes, facilities, businesses, highways, and on sidewalks. We respond to cardiac arrests. shootings, overdoses, mental health emergencies, traumatic injuries, respiratory distress, and calls involving our most vulnerable residents. Boston EMS responds to 140,000 plus Thank you for joining us. Budgets or staffing shortages.

They're expecting highly trained professionals to arrive quickly with the equipment, medication, and support needed to save a life. That expectation only becomes reality when Citi continues to invest in EMS. Funding improvements for EMS means investing in advanced life support paramedics, BLS support EMTs, New and more additional ambulances to the fleet, updated medical equipment, modern station, and continued training. All of this so providers can deliver the highest standard of care possible. It means ensuring that ALS units are available when seconds matter during strokes, heart attacks, or severe trauma. It means improving response times and reducing the strain placed on already extended crews. Supporting EMS not only is about ambulances and equipment, it's also about supporting the people behind the uniform. EMS providers regularly experience traumatic incidents that most people will never witness in their lifetime.

We carry the weight of pediatric deaths, suicides, violence, overdose, and repeated human suffering while being expected to immediately move on to the next emergency. The mental and emotional toll of this work is real and I wanted to thank you all for being here. Thank you.

Okay, thank you. Rory and James.

Good morning, Council. My name is Rory Deering. I'm an EMT with Boston EMS. Boston EMS crews spend long hours inside and around ambulances every day, and an aging fleet creates growing concerns not only for reliability, but also for health and safety. Older ambulances often produce increased tailpipe exhaust emissions, exposing providers, patients, and the public to diesel fumes and poor air quality while vehicles idle at hospitals, on scenes, and at stations. These emissions can contribute to respiratory irritation, headaches, and long-term health concerns for frontline workers who already operate in high-stress environments. Modernizing the ambulance fleet with newer, cleaner vehicles is an investment in public health, workforce safety, and a healthier environment for the communities we serve across Boston. In the meantime, regular proactive vehicle maintenance for the fleet that we have is the best strategy to protect our workforce, our patients, and the public. Thank you.

Okay, thank you very much. Okay, James, last up.

Hello, my name is James McCabe. I'm the Vice President of the BPPA EMS Division. We represent the EMTs and paramedics that work for the City of Boston. First off, I want to thank all the city councilors, Chief Hooley and Mayor Wu, for all the advancements and staffing that we have had recently. Boston is a world-class city that is known as a medical hub for not only North America, but the world. We want to ensure that EMS system for that city remains at the forefront of the country to be commiserate with that world-class medical attention that Boston has become a beacon for. A professor of mine would routinely use the phrase, the devil is in the details. That being said, the unfortunate violence that occurs In this city, throughout the year, the victims of that violence are treated by our members. And the positive outcomes for that treatment is the thing that has been touted time and time again about Boston being the safest city in the country. Without the skill and knowledge and the ability of our members, those numbers would be drastically different.

I know the members of Boston EMS are amongst the most humble people you will ever meet despite their daily life-saving care that is a positive trait. But we as a service have not touted our excellent work that has been done in the past. And unfortunately, I think being humble has led to a massive disparity in pay received for our members. and in comparison to other first responding agencies of the same responding, sorry, the same responding agencies that we arrive with on the vast number of our calls. And speaking on disparity, currently EMS is not considered essential work Our people and our work are essential for the daily functioning of not only our city, but every city across the country. We see the news and we are aware of the economic challenging decisions that you in this room will face in the coming weeks. And we are here to ensure that our service continues forward to reflect being at the forefront of medical treatment and the ability to respond to all the citizens and the visitors of the city of Boston to assist in their medical needs and is not halted but continues pushing forward.

Thank you for your time.

Okay, thank you. Okay, yeah, is that it? No? Okay. Thank you very much for your testimony. We have one person virtually. If you're online you'll get an invitation to join as a panelist. Nicole May. Oh, no, maybe. Oh, yeah.

Sorry. Can you hear me now?

Yes, we can hear you. I'm sorry, this is George May. Okay.

I thought I changed that.

Yeah, no, my daughter had control of my I was on Zoom for a while and I was coming on as some, you know, some strange fifth grade fictional character, but okay. So whenever you're ready, you get started. I'll start the timer. You'll have two minutes to speak.

Thank you very much. Good afternoon, and thank you for allowing me to take a few minutes of your time to speak about Boston EMS. My name is George May IV. I have worked at Boston EMS since 2006, so about 20 years. I'm a state certified paramedic and my current assignment is A7 Knights out of East Boston. I'm passionate about my job My career and the careers of all EMS employees and also about the people of Boston. Yes, I did do the work. I did do the call, that awful call at the airport and at the Boston for the bulk call last week. Sorry, it's a little hard for me. Excuse me. This call was a very dynamic call working with Matchport Fire and State Police.

One piece of equipment that was missing from the Boston EMS employees that were on scene with myself and my partner was an individual PFD, a life jacket. We had to transverse multiple objects, rocks, and get into a boat to assist the patient with the severe injuries and also traverse back to the ambulance. and bring the young lady to the hospital. Equipment is a very important part to all staffing members of Boston UMass. Our own PPE Our ballistic vests, turnout gears, our USAR equipment, to name a few. I hope you take this into your consideration outside of your most important assets, which is all your employees of Boston EMS.

Again, thank you for your time and your consideration in this matter.

Okay, thank you. Flynn. Okay, so we're going to go to a second round of questions. I don't know if the panel had any, Mr. May, no? Okay, any response to that? Okay. Councilor Flynn, Let's see, we're gonna go with five minutes for a second round. Okay, whenever you're ready.

Thank you, Mr. Chair, and thank you again to the administration team that is here. Respect the work you're doing. I listen closely to every comment, including the public testimony from the frontline workers, from the frontline EMTs and paramedics. They highlighted some concerns that I was aware of, but it's important for the public to be aware of as well. They talked about retention. They talked about recruiting. They talked about A salary that at times is not all respectful to them and their families, unable really to support a family. They're going, they're saving lives every day.

They're saving lives of residents and visitors that come to our city and the salary is still low in... Well, let me ask a question. Chief, or to Dr. Ojukutu. Why is the salary low? And what are we going to do about increasing the salary?

Well, the established practice since I got hired here was I've always been a member of, well, a couple of different unions. AFSCME, then BBBA. We also have the superintendents, the deputy superintendents there in SENA and all of the All the wage scales, wages, hours, working conditions are all part of the collective bargaining agreement. And similar to police, fire,

Public Works, there's a collective bargaining process. That's... Yeah, no, so that's the reason the salary is established, but I don't know if there is something that the city officials in terms of elected officials are not doing. And I'm not blaming senior leadership at your department. I don't necessarily think elected officials understand how important this job is and because we don't understand how important this job is we don't advocate for the right resources the right support the right Training, the right equipment, and salary. Yes, the salary is negotiated through collective bargaining. We all support collective bargaining.

but it's also even probably more important that city officials have to acknowledge that the salary of I remember when the salary of the police was very low. I remember when the salary of firefighters was very low. I was born and raised here, so I remember those days. But to me, the salaries increased at police, the salaries increased at fire. But here we are with EMTs and paramedics still trying to put food on their table for their kids. So I don't think it's a collective bargaining issue. I think there has to be a resolve from elected officials in Boston that We value EMTs. We value paramedics.

We value their professionalism. We have the best hospitals in the world. These EMTs and paramedics are providing exceptional medical care, certainly, but they're still not receiving a decent wage. When you don't receive a decent wage, you start looking for other jobs because you just can't afford to put food on the table for your kids and for your spouse to pay your electric bill, send your kids to an after-school program. I think we have to come together as elected officials and finally acknowledge we have failed. We have failed to address the needs of EMTs and paramedics as it relates to Thank you, Mr. Chair.

Thank you. Okay, Councillor Brayden.

Thank you, Mr. Chair. And just to follow on from where Councillor Flynn has left off, I'm just curious How much, what's the sort of salary for an EMT and a paramedic at this point in time?

I don't have my contract book with me, the current one, but at least I know the starting for EMTs, FY26, base pay is $1,315.98. A week plus 115 cents hazard duty per week. So step one for EMTs when they come on is 74-4-18. This is some of the differentials.

74-4-18? Yeah. Yeah. Okay. The other question I had is, does the EMT service generate revenue coming in for services provided? Like if you transport someone to a hospital in an emergency situation, Do you bill their insurance to pay for the service? And how much money does that bring in?

Yes, we do.

It brings in... It's just under $40 million, but that's actually in our budget. But $40 million? Yeah.

And where's that in the budget book?

In the budget book, there's a line that says program revenue EMS, and it's a negative number because it actually reduces our appropriation because it offsets the amount the city pays.

$40 million? Yeah, it's roughly $40 million. Okay, and then the other question I had was, I know we had a shooting on Memorial Drive, I know the shooting's all over the city, but this is across the river in... In Cambridge, we had someone shooting at cars with a long gun. What sort of preparedness do we have for incidents of mass casualties, like if there's an incident at the airport or There's a multiple pileup on the highway. How do we train and prepare for those incidents? And what sort of preparing are we doing for the summer? Like we've already mentioned infectious diseases, but Have we prepared for any possible mass casualty events around all the events that are happening this summer?

Yes. We start in the academy and we routinely do it up with the idea that large events, you might have a larger You know, maybe a unified command structure to begin with, but everything really starts from the ground up. First Unit, a scene of a multi-car accident or a bus involved. They do, whether it's EMT, BLS, supervisor, they do a scene size-up. Look for hazards, access, how many number of patients do we have, what are the acuity, start sorting it out. Establish command, establish sites direct, call for what resources you need. and then it keeps growing from there.

There's different phases of mass casualty or multiple casualties. It doesn't have to be hundreds to stress the city. Two dozen serious, right? Or several critical. Or maybe somebody who's entrapped that might take a lot of work for a couple people to get one person out versus the people that you can... Yeah. Assist over at the curb. So, but yes, we try to do that. And we've recently been doing Refreshes with people, you know, with spot visits in the field for that.

I'm going to try and get another question in to Dr. Ochukutu, so I'm going to speak quickly. I'm going to run out of time, Jim, so I will follow up. Thank you. It just sort of illustrates the incredible work that you folks do every day. Immigration Enforcement. Are we seeing deterrence of immigrant families seeking health care? I know a lot of the burdens may be picked up by our community health centers, and how are we supporting them? Breadon.

So yes, we are seeing situations where immigrant families are not seeking out care. A lot of this we are hearing from the community health centers, but we're also hearing it from the hospitals, and some of it is obviously anecdotal reports at this time about people just being afraid. And it's not that necessarily that there's immigration present, visibility present. But people are certainly afraid. And I think that's been documented across the country over the course of the last year since all this immigration enforcement has occurred. In terms of supporting them, so we do meet with our community health centers and we have been discussing strategies, education, outreach to non-US-born individuals.

and certainly through our mayor's health line we've been working to provide people with guidance and support as well as you know health make sure that their health insurance is up to date but really providing them with assurance that they need to be seeking out care and that Our community health centers and our hospitals, they are safe spaces for people. Yes, that's been the messaging.

Yeah, very good. Thank you. Thank you, Mr. Chair.

Okay, thank you. Thank you, Councilor Fitzgerald. Five minutes. Thank you, Chair. And if people have questions, we can come back for a third round after this.

Chief, thank you for being here. What do we think of the biggest operational challenges that EMS faces currently that additional funding, if used appropriately, could help address? Like if you, you know, if you had an increase in the money, how would you use it? What would it go to to think, you know, if you had to prioritize the issues that EMS does have internally, what would be the best way to apply that funding? to get the biggest bang for your buck. All right.

Well, obviously, as you've heard... Not just from the membership, but from my earlier remarks, close to 90% of our budget goes for personnel. And our personnel are what really makes whether the trucks have 5,000 miles or 100,000 miles on them We still need two EMTs, two paramedics, what have you, right, to work in them. And if we want to put additional units on, we've been trying to keep pace with... Staffing and approving. We've been able to add folks almost every single year. Last year, it was 12 additional ones that get provided this year with

and some of the constraints on the budget. We're holding at that, but we haven't completely realized the ones that were approved for last year, but we're getting there. So obviously if we were able to have more sites to deploy from. We're talking about where do you start and end your shifts, where do you put them, and where you... The number of units out there, making sure we're being strategic about where we're going to put resources, what shifts where, what type of resources. Those are things to, you know, Yes, from a fiscal point of view, yeah, we want to do that responsibly. I know you didn't say, like, oh, if I just give you a wish book. But as far as, you know, you're given thoughtful things to do it, yeah, it would be personnel- Thank you.

Thank you. To the emergencies. But as a Several of you that have been out and who have written or observed, hey, not everyone's going right to an operating room or right to a CCU. Some people wind up in waiting rooms for hours because of What's happening in hospitals? So are there other things we could do to get people to alternate care? and some of the things that we have been doing with some of these other models that could make everybody's life a little bit easier and make the whole system more efficient.

So if I could, in summary, then...

But we need people for that.

Yeah, in summary, personnel first and foremost, whether it's keeping, retaining, giving raises, et cetera, to those that are there now. But then you think about adding locations would be the second piece, right?

Adding locations, yeah, helps where we're starting, yep.

And in that, I know you said there's a 24-hour Dorchester ambulance now? Yeah, ambulance 21. Is that the one that's out of the Kearney, or is that a...

That's paramedic three. They're 16 hours right now. They're day and evening. They're the ones that have been in there since that garage was put. Amos 21, I believe they shift change out of River Street over at Lowell Mills, up by there. So that's the 24-hour one? So yeah, typically, if they were clear, they'd maybe be told to post down at Cardman Square. But again, they're usually going to or coming from somewhere else.

Okay. Do we support expanding the 24-hour ALS in the neighborhoods, in high-demand neighborhoods like Dorchester?

Yes.

Yes.

That's part of our plan.

Thank you. Thank you. Thank you. It's more of a philosophical question than a statistical question, but I guess all to say with the work that you guys do on the front lines, Does the budget match up correctly to the work that's being done?

I'm trying to think. I don't know if I ever thought, like, say, if it took a number of calls divided by dollars, but as far as... Again, we have a budget. We do... We work to maximize every part of it.

You work within your means, and that is your job. But I think just to Councilor Flynn's to advocate with him, too. I would think that I would prefer to see and knowing we're in tough fiscal times now and everybody wants to see a higher budget it's extremely difficult on our end in these past several weeks to try and manage through all this stuff but That the work that these guys, men and women do, deserve to be compensated more because it's not until you or a loved one needs them, right? Do you really go, gee, I wish they were paid well and motivated and trained properly. Thank you so much.

For the record, there's no disagreement here on what you said for me. But no, I understand that. As a matter of fact, in my tenure coming in to these hearings, We've never come in looking for less. That's certainly not. But sure, you know, we try to take into account that. And again, certainly if... Hit you up? Is that maybe not the right thing? But explain why we sought a lot of help with a lot of the capital improvements, the rate of 20-something million for the radio infrastructure. Yes, I know that's not... Money in People's Checks, but that's... It's quality of service.

Well, yeah, but it's money that's not in the operational, which isn't necessarily taken away from that, so I'm just trying to... Whatever we can do things here, or anything we can do to enhance revenue without... and again we don't do anything crazy we use that but we still you know come to the city looking for a sizable Supplement every year.

Understood. Thank you so much. Thank you, Chair. Okay. Thank you. You sure, Chief Hooley, you could distinguish yourself from all the other panelists that we hear from by just asking for less for your department?

Yeah.

You make a name for yourself. I can't promise that'll happen anytime soon. No, just kidding. Again, thank you for all the really important work that you're doing. So, Councilor Culpepper, five minutes for a second round. and then you will have time for a third round if people need it.

Thank you, Mr. Chairman. Dr. Odut-Kutu, I just wanted to go back to that the issue dealing with the Laundry cleaning for the homelessness and what I have here is that it costs in fiscal year 25 $937,607 and 76th Sense. And this study, the feasibility study that was... Are you familiar with this?

I am now.

Okay. And so... Where are we with it? I think the proposal from some of the students from Harvard with regard to this was to bring down the homelessness And so with the feasibility study and this proposal, Have you considered this?

So I'd like to take a look at it.

I can give it to you when we break.

Okay, good.

It's pretty extensive. It's 20 pages. It goes through the whole gambit of laundry for homelessness. And it talks about what it would cost, what the range was. So I'll just put these aside. I can give this to you when we take a break. Mr. Hooley, I was looking at the number of vacant positions that were vacant for more than six months. I think there was 32 vacancies for more than six months. Are there still 32 vacant positions?

So the list that was provided did not include any of the uniformed positions because they go through a special... Or did not? No.

Okay, if you included that, how many more vacancies would there be for more than six months?

Well, that's the problem. The six-month period is the problem with those. Pardon me? I mean, these vacancies aren't six months old is the problem. That's the difference with the uniform vacancies.

Right. Well, let's just stick with this. 32 positions, the ones you gave us. And how many of those have now been hired of the 32 that were on the list that you gave us?

That have been hired as of now? No, they're vacant as of now. Oh, so they're vacant as of now?

Yes. And so none are going to be removed for fiscal year 27? No. Okay. Of the non-uniform, how many... Councilor, I'm confused. This is a separate under five submission.

Okay, but I mean, we don't have... This is commission-wide. Yeah, he's addressing the entire commission.

I'm not aware of... Was this the entire commission, the list that we have here?

Yes, that was commission-wide.

I thought this was, yeah.

But it does exclude all uniform positions from it. Okay. Okay. So it does not have any of the EMTs or lieutenants or captains on that list.

But there are six lieutenants, three captains. Five deputies, superintendents, two superintendents, and six paramedics. I'm just looking at the information you gave me. With regard to the 32, provide the number of vacancies, your response was provide to the number of vacancies that are longer than six months, unless the job title was 32. Those were the Boston Health Commission across the board. Yes. Okay. I wanted the same information if you have it for the... Emergency EMS. Do you have it? I can provide that to you. Okay, okay, okay. So let me move on to something else then.

But uniform FTEs, I don't believe we have any vacant. No, we don't treat them that way. Yeah, no, I mean, we have an academy class that's in. They're not... Counting towards the regular compliment in the field right now, but we've actually, we've...

I was looking, no, I was looking at that information. Okay. But that's not where I was going. I was looking at it. But you can talk about it if you want. I wasn't really going there, but you can talk about the Academy class. My next question was going into the diversity of the Academy class and talk about those numbers a little bit. Yeah, that last question.

Can he answer? Yes.

Okay. Thank you, Mr. Chair. And we'll have a third round, right? Yes. Okay.

I don't have the exact breakdown for the current class and I'm not sure I could Try to get that from the commission, I know, but they do. People self-report that when they file an honest, we can get those numbers for you.

Right, through the chair, if you could. All right, let's pass that through the chair. That's the way we get the information, Mr.

Chair. Okay, all right, yep, no, absolutely. We could do that with recruit class, with everything. We could do it by rank. Positions. We'll break that all down for you. Race, gender.

Thank you. Yep. Okay. Thank you very much. Just from the chair, just set the timer, for... In terms of long-term vacancies, I think for BPHC there's some positions that are like epidemiologists maybe and a couple sort of Recovery Clinicians. So what is the strategy for, are we going to be able to fill those vacancies? How are we going to, what is the problem that it's We don't pay as they could earn more elsewhere. What's the issue?

So I think there are a number of issues. We do have a residency requirement. We also... Comparable pay may not be comparable to other places. I think that we offer exciting opportunities. We do a lot of recruitment work. But we haven't been able to fill a number of positions. They have been unfilled for a period of time.

So I guess if you had to, how much of the of the challenge is the residency requirement and not the salary, if you could sort of sort by those. I mean, is it like some epidemiologist is working out I would say that it's really both, and it's hard to tease them apart. Okay. Do you think we'll be able to fill those positions? What's the strategy, I guess, to just hold those positions open?

Well, I think that there are a couple of things. So we are really working hard through our HR department. to do outreach, to do recruitment. We do widespread searches and certainly national searches for the more managerial and higher level positions. So there is a strategy. We want to make sure that we are updating our postings, making it more desirable in terms of what we're offering people. We have put forth an effort to do Thank you. BPHC, a place where people do want to work and I'm hopeful that we will be able to hire those positions that have been unfilled for an extended period of time.

Okay, and then we're talking about masks and casts. I think it's the camping ordinance. Is there supposed to be...

The tent ordinance.

Yeah, I'm sorry. There's supposed to be like an annual reporting. There is a reporting requirement. It's for an annual hearing. Do you have reporting on that? Have you given a report since this was passed three years ago?

Yes, there is an annual reporting requirement and we have been reporting on a regular basis about, you know, strategies, implementation, and outcomes.

Okay, I guess then what are you seeing from, what's the outcomes?

Right. So we've definitely seen less outdoor congregation. We've noted more people being Thank you. Thank you. Decrease in, or decrease in syringes and increased quality of life, you know, that's been reported by the surrounding neighborhood. So those are all the sort of outcomes that we're looking for. That report actually comes through the mayor's office. It doesn't come through BPHC. So we can follow up with them to follow up with you so that you can have a better sense of the specific details.

OK. Okay, thank you very much. That's this morning's questions. That's it for me, but my couple colleagues here, it looks like third round, so how about I'll give you three minutes and see if we can... to wrap up this morning's hearing and come back this afternoon. Councilor Flynn. Sorry, we have a technical issue. We're just going to take a quick recess just on the microphone.

Thanks for watching!

Again, quick third round here, and we're coming back at three. Councillor Flynn, three minutes. and then Councilor Culpepper. Okay.

Yeah, Don. Thank you, Mr. Chair. And to Dr. Ojukutu or to the Chief, I've listened to the testimony of one gentleman He referenced something I wanted to follow up on, that he responded to a call at the waterfront area, but there was a piece of equipment. I don't necessarily, I didn't necessarily hear it all, but there was a piece of equipment that was not available to him.

I heard life jacket, but that's... Oh, it was a life jacket?

Yeah. Can you give me some background information on that? I wasn't aware of that. If that life jacket... I just wanted to ask, what happened, Chief?

Well, prior to today, we did not have Personal flotation devices stocked in every ambulance. That was something that we did endeavor to take on. We financed that through a UASI grant and actually I got a message during this that they were actually being Put in the units today. Based on that incident? Well, no, based on prior time. It took a little while to get the stuff in. We've always had floatation devices down for the We have people in the harbor unit. We assign them to any, whether it's the Boston police, the state police, or the Coast Guard. Those we've always had. We keep a cache down there in case we're putting people out.

Similarly, when we put people out on the harbor unit, Boats, anything to do with Operation Sail or Parade of Sail. But there was a specific request and a need to find a spot in the ambulances where regardless of whether you're working in East Boston, Waterfront. This could be a... You know, Turtle Pond up in Yannick King Parkway. You know, the idea would be if you're going out and about the water, we get it out and I got to make sure I get a policy out with to when it'll be required and... Supervisor's responsibility to ensure that people do use them when they go near the water.

Thank you. Thank you, Chief. That's very important. Something I support. We'll do everything I can. to advocate for that in the budget and any other type of critical equipment that we need. One final question, and I know we've talked about this in the past, and I know my time is up, Whether it's traffic enforcement officers or EMTs and paramedics or Boston police, like you, I have zero tolerance for anyone assaulting a city employee How serious of an issue is it for Boston's EMTs and paramedics? They're responding every day and every night to violence in the city, a shooting, a stabbing, a hostile crowd. How serious is assaults to EMTs and paramedics and personnel?

And what is the policy of your team in ensuring that We provide the safest environment and I was on the city council when that person stabbed a paramedic or an EMT right near the Right down the road here from the courthouse. What are your thoughts, Chief?

Well, it starts from, well, starts from the beginning from the time a call comes in. You try to identify, you know, if there's any obvious hazards, risks, right? violence, fight, or something unseen. And sometimes there isn't. Sometimes it could be just somebody who hears a loud disturbance in the background Which is supposed to be maybe somebody portrays somebody's having a medical emergency. Lots of times our dispatchers, our call takers, who are our EMTs, not dispatchers, I think what this thing will take is they'll pick up even in the background that hey, hold off, don't go in. Sounds like something could be going on in the background. So we try to communicate that out. A lot of the calls then automatically are dueled with the Boston police, or in some cases it could be

We also have a lot of call types. If we recognize something at the scene, you know, if It's okay to, you know, not go in. It's okay to back off, call for assistance, right? So what we try to do there is to everywhere that we can to identify the unsafe situations before you walk into them. Then, but we do also, anytime there is any report of somebody who gets even threatened, but if there is an assault, if something happens, We do look for law enforcement to pursue it.

We do make sure that, one, that we support our members, that we Get them prepared to come back to work but also to follow it through sometimes months later when it does go to court or if it does come to a hearing or somebody's trying to We want to plead up to a lesser judge. We want to make sure that the justice system knows what happened. You know, the threats that were either made and also the fact that people lost time or what it could have done to make somebody even want to change their careers. And usually the judges are pretty good about...

Thank you, Chief. I'm out of time. I've literally seen EMTs and paramedics on scene at a call in Thank you for your time. Even as they're in a difficult environment, a dangerous environment, I should say. So I just want to say thank you to our EMTs and paramedics. My point is they don't get the recognition or respect that they have earned from the residents of Boston, from the city of Boston, I should say. I think the residents of Boston certainly respect them, but we have to make sure the city of Boston does as well. Mr. Chair, thank you.

Okay, thank you very much. Councillor Culpepper?

Thank you, Mr. Chair.

Chief Hooley, I had a couple of follow-up questions with regard to the EMS community. The course, the EMS community course?

Yeah, the community assistance team, I'm sorry, community training.

EMT course. Oh, the community EMT class, yes, yes. And you had 80 students in it last year? Yes. How many were students of color?

I can also get you down that breakdown as well. I will tell you that the ones that were worried Recruiting, we're for that. We try to be very... Very forward in mind that we are looking for diversity. We are looking to bring in people from the various racial backgrounds, people with language capability. That's something that despite what we might hear from Washington, Isn't that anything that we've ever backed away from? That it's something that... We believe it's necessary, not just the right thing to do or something that we should do, but it's necessary. It's necessary if we're going to deliver the care.

That we, you know, espouse what we want to do, that we want to make sure that we have the capability to recognize a lot of different situations, to be able to support the programs, the Boston Public Health, Commissioner has going as far as health equity, because if we're not all in on that point, then we're going to be missing something. We learned a lot from our employees of color, from our employees who come from, who grew up with, Creole spoke at home, or whatever. You learn by working with those folks, and that helps you when you're trying to examine that next patient.

So you hired 67 new EMTs in 25? In 2025 you hired 67?

Yes, we graduated two recoup classes that came to that number.

How many of those were graduates of color?

And I I promise I will get you that as well too. We do track that and we do, again, we work very hard to that end. We recruit... A lot of the scholarships for the EMT class, whether they are at Bunker Hill, we look to that to really help diversify our ranks.

We had 22 promotions in. 2025?

Yes.

Can you give me what the promotions were and then the breakdown by a race? Yes, happy to do that. Mr. Chair, I had one question for Dr. Ojukutu regarding the boots on the ground RFP. You talked a little bit about when will that be released?

So just to make sure everybody, so I'm, Councilor Culpepper is referring to the opioid settlement dollars community response RFP. So in June, we are planning to release it, so it's rather soon.

And how much will the RFP be for? How much are you going to release?

The total is $600,000.

Thank you, Mr. Chair. Thank you, Dr. Odukutu and Chief Hooley and Budget Director Valdez. Dr. O, I'll give this to you when we take a break. Looking forward to it. Are you giving me more time?

If you have one more question or something, you know, but we are coming back this afternoon.

No, I'm good. I'll come back at 3, okay?

Okay.

Thank you, Mr. Chair.

Okay, thank you very much. We'll try to get the data... Hopefully to you before three. I think so. I think all this data should be readily available on I'm going to adjourn this hearing. So this morning's hearing is adjourned. We'll come back at 3 o'clock for the other subjects. Okay, so thank you.

Thank you. Thank you, Mr. Chief.