Expert warns Wethersfield plan would rely heavily on mutual aid, cites operational risks; favors Aetna

Mister Gunderson, an EMS system designer and expert witness, told an administrative hearing on Jan. 23 that the Weathersfield Emergency Medical Services Association (WEMSA) plan would rely on mutual aid for roughly a third of calls and raised doubts about WEMSA’s staffing, supervision and quality-management arrangements.

The expert said the hearing record includes an 11-month data exhibit showing Aetna responding alone on 836 of 2,361 calls—“roughly a third of the time,” he said—which he interpreted as evidence that WEMSA units were unavailable on those occasions. Gunderson also testified that Southbury, offered in the record as a comparison, differs in ways that reduce its comparability: Southbury fields three ambulances and has fewer major roadways, he said, and it requested mutual aid far less often.

Gunderson told the hearing the core operational concerns were mutual-aid reliability, paramedic staffing and supervision, and quality management. He said WEMSA’s plan contemplates two staffed ambulances and relies on mutual-aid agreements with adjacent communities that are mostly basic-life-support providers with subcontracted ALS (advanced life support). “If you're going to rely on mutual aid for a third of your responses, you really need a pretty robust mutual aid arrangement in place,” he said.

On paramedic staffing, Gunderson said the record left questions about whether the staffing company WEMSA proposes has prior experience providing paramedic-level staffing to other ALS providers in Connecticut; he said he found no clear evidence in the agreement itself and that confirmation would “allay that particular concern.” He also expressed concern about supervision if a subcontractor supplied paramedics: “Just because you're a paramedic doesn't automatically make you a supervisor,” he said.

Gunderson contrasted the two plans on cardiac-arrest response using the “pit crew” concept. He said state protocols identify multiple roles that responders should fill and that Aetna’s approach routinely deploys two ambulances and field supervisors to cardiac arrests, increasing on-scene personnel. By contrast, WEMSA’s model, as described in testimony and exhibits, routinely sends one ambulance and would send a second only if available—“but then both ambulances could be committed to that one call,” he said, leaving the town vulnerable to concurrent emergencies.

He also flagged quality-management concerns. Gunderson said testimony from WEMSA witnesses suggested the base-hospital relationship was used infrequently and that robust ALS quality management typically requires a more active, regular relationship with medical control.

When asked about reliance on ad hoc mutual aid versus written agreements, Gunderson said ad hoc dependence for a high volume of calls is unwise: “In the absence of having a written, you know, formal mutual aid agreement, you're leaving an awful lot to chance,” he said, adding that inequitable mutual-aid arrangements tend to break down over time.

On the record, Gunderson stated a preference for Aetna’s model: “I still believe that, Aetna is the far better option,” he said, citing experience, resources, routine ALS deployment, and a lack of a subsidy request in Aetna’s plan for the first five years (the hearing officer later struck only the witness’s isolated reference to subsidy from the record because Gunderson had testified he did not examine costs). Gunderson said his comparison was based on operational evidence in the record, not on price.

The hearing was otherwise procedural: the officer released Gunderson as a witness, said a written order on post-hearing briefing and proposed findings would follow, and noted that objections to a motion to stay or dismiss were due Jan. 31, 2025. A request by one party to late-file full 2024 PSAP call data was opposed and the hearing officer declined to order the late filing.

The record contains disputed factual points that the hearing officer will resolve, including whether Aetna or WEMSA can reliably provide ALS mutual aid, the practical effect of the staffing contract language, and how regularly ALS mutual-aid partners would actually respond. Counsel cross-examined Gunderson on his assumptions about dispatch, who was called on specific runs, and whether WEMSA had in fact been dispatched on the calls flagged in Exhibit 71; Gunderson acknowledged those points exposed uncertainty in some assumptions.

Gunderson’s testimony and the exhibits he cited will be part of the hearing record and are referenced repeatedly in post-hearing briefing requests the officer said he will schedule.