JJB531

Having the shout box was nice, and I understand what you're saying about having a heads up so you can flip on the scanner and follow the incident. But if I did an IA for every pin job I get dispatched to, of which 90% of them are not pins, it would take away from the confirmed incidents if someone had to click on 10 unconfirmed/unfounded jobs before they got to an IA of a confirmed incident.

Very little of it. Ossining has full-time paid Medics & EMT's... by full-time I'm talking benefits, 401k, etc. Then there is a surplus of per-diem medics who primarily work the 36M1 fly car. There is still a small core of volunteers and the volunteer line officers who are still active within the agency and do staff the BLS ambulance primarily. As far as volunteer medics who are active, I can only think of 1 or 2 who still actively ride.

A tasered patient is not automatically an ALS patient. If there's an underlying condition, especially a history of recent drug use, then you have to consider "excited delerium syndrome", rhabdomyolysis, etc... but the deployment of the Taser does not automatically make the patient an ALS patient. If you've read any of the studies conducted where continual EKG monitoring pre-deployment, during deployment, and post-deployment of the Taser, studies have proven the Taser does not affect cardiac muscle tissue or the electrical conduction pathways. This is another one of those cases where a good history and information gathering techniques will assist in determining whether your patients requires ALS interventions or not.

I can think of a good example... But after thinking about it, it's not worth the arguement...

Here's that space case piece of cribbing I was talking about...

No prob, I completely forgot I had those photos otherwise I would have posted them earlier. When someone gets pinned between the platform and the train, we call it a space case. We use a flat piece of cribbing that has a piece of angle iron attached to it, the cribbing gets hung from the platform by the angle iron, and then the airbags get placed between that piece of cribbing and the train car. Usually a good idea to put a body bag underneath the aided because a lot of times all that's holding them together is the compression from the train. I'll try to take some photo of our space case board tonight when I get into work.

Very true, good point!

Fair enough, I can respect that, but maybe there is a more suitable forum to "liberally" question the practices of law enforcement instead of a board that is supposed to be pro-emergency services. It's one thing to ask why we do certain things a certain way, it's another to make judgements and then every police officer here has to defend the actions of our brothers.

Yes we should have a healthy discussion about incidents. In regards to this incident, that discussion has already taken place in a previous thread, and I think everyone, including myself, agreed that the Trooper was out of line. To me, I take this thread as another "thumbing my nose at members of the law enforcement community", since the overwhelming majority of the posts by the initial poster regarding law enforcement matters consistently have an anti-law enforcement tone to them, hence the "argumentative and attacking" nature of my post. If my initial post was too abrasive or straight-forward for some members here, then I apologize, but I still stand by what I wrote.

Yes, quite the "famous" case... and I'm happy that you appreciated the update, but just because you were happy with the update doesn't justify the initial posters intentions when posting it. Unfortunately, the majority of the initial posters comments on here in regards to law enforcement are more often then not in a negative tone, and he has, on numerous occasions, played the "I know my rights" game, even when discussing topics of blatent officer safety.

While I do agree that the Trooper was over the line in his actions, did you post this because you "bet folks might like an update" or because this is another opportunity for you to continue your anti-police agenda?

No prob, hope it helped. If you don't put that wedge in, when you start the lift, all your are going to lift is the suspension of the train. The wedge takes up the compression of the suspension so you lift the actual car and not just the suspension.

Just a few pictures I took to show the placement of the wedges to compensate for the lift of the suspension... hope they help.

We get assigned that job on a weekly basis... It's usually a chubby kid who tries sitting in an infant swing and gets their leg stuck in the hole.

If both are telling you to do stuff, you can only do so much. Personally, if you show up at a scene, and the FD chief tells you to do something, and then an EMT/medic asks you to assist in some form of basic patient care activity, one could reasonably argue you're still working under the FD, especially if you're in turnout gear, etc. Most firefighters are more then willing to assist at scenes with patient packaging, etc., and therefore eventhough they are performing "EMS duties", they are still technically operating under their FD's command. Basically I guess what I'm getting at is that once you are operating under FD's command and direction, I would imagine that would continue until you are either relieved of that FD duty or your FD IC releases you specifically from the incident as an FD member. If you wreck your car on the way to a job, will either cover you? I'm asking legitimately because I don't know how that works. Is the agency responsible for the way you operate your POV while responding to a job?

I would assume if you are engaging in firematic duties, then you are working under the FD. If you are engaged in patient care activities, then you are working under the VAC. Go to the scene and stick with one or the other so you know who you are working under.

From the Office of the Inspector General website: http://oig.hhs.gov/fraud/docs/complianceguidance/032403ambulancecpgfr.pdf "A city or other political subdivision of a state (e.g., fire district, county, or parish) may not require a contracting ambulance supplier to waive copayments for its residents, but it may pay uncollected, out-of-pocket copayments on behalf of its residents. Such payments may be made through lump sum or periodic payments, if the aggregate payments reasonably approximate the otherwise uncollected cost-sharing amounts. However, a city or other political subdivision that owns and operates its own ambulance service is permitted to waive cost-sharing amounts for its residents under a special CMS rule. (See CMS Carrier Manual, section 2309.4; CMS Intermediary Manual, section 3153.3A; see also, e.g., OIG Advisory Opinion No. 01–10 and 01–11.)" From what I have read, it seems that only a City/County/State owned and operated EMS system can waive collection of payments. Private EMS agencies, Volunteer Agencies that are not owned and operated by the local government, etc. are, from what I have interpreted, strongly advised not to waive collection of unpaid to prevent any suspicion of inappropriate practices. It's always been my understanding that "soft billing" is unlawful, but hey, I'm not a number cruncher, I'm 100% blue collar.

Well Aaron, this is one piece of information that I found from , I'm a little busy now, but I will research more in a little bit. The following is an excerpt from the following website: http://www.katzmanlaw.com/new/free/article.cfm?id=52&date=March%202003&keyword='' Background: On July 28, 2001, the OIG issued Advisory Opinion No. 01-10 (www.oig.hhs.gov/fraud/advisoryopinions/opinions.html) that authorized "insurance only" billing of residents who pay property taxes. The OIG is the federal watchdog for violations of the Anti-Kickback Act. A municipal fire district that owns and operates an EMS squad sought the Advisory Opinion, in order to avoid any fraud investigations / prosecutions. The Anti-Kickback Act makes it a federal criminal offense to give or receive anything of value in exchange for the referral of Medicare patient business. Violations of the federal statute can result in fines up to $25,000 and also imprisonment for up to five years, for each offense. The fire department can also be excluded from the Medicare and Medicaid Programs, thereby eliminating all billing of transports to these programs. In addition, there could be civil litigation brought by a private citizen "whistleblower" or by the federal government under the False Claims Act, with recovery of all falsely billed funds to the government and a "finders" fee to the whistleblower. The Advisory Opinion authorizes only fire & EMS departments that are publicly owned to "soft bill" residents of that fire district. Understandably, the federal government generally opposes any "waiver" of co-payments or deductibles, and therefore has not authorized "soft billing" of residents by private ambulance companies, since this may be an illegal "inducement" to use one private (for profit) service over another. Legal Lesson Learned: On behalf of a municipal fire & EMS department in Northeastern Ohio, we recently contacted the OIG regarding the city's desire to "soft bill" not only its residents who pay property taxes, but also non-residents who are employed in the city and pay a 2% income tax that helps pay for the fire & EMS department. We were advised that in March 2003, the OIG would be issuing an Advisory Opinion authorizing this practice for publicly owned fire & EMS departments. written by: Larry Bennett partner at Katzman, Logan Halper and Bennett, Cincinnati, OH

If you're doing it legally is the key statement... The idea of "soft billing", while not legal, is still practiced by local agencies.

You're not billing the residents, you're billing their insurance for reimbursement. Now if the split would result in a new EMS tax district, now we're talking about more money coming out of peoples pockets.

Anyone from Mohegan who can advise how the split worked for them? Specifically the financial end of it including start up costs, operating expenses, revenue collection? Now years later, does Mohegan think they made the right decision splitting into a separate ambulance corps? Was the split beneficial?

Your insults against Law Enforcement would hold a lot more weight if you used proper grammar, spelling, understood the VTL as it pertains to the use of emergency lights and sirens by Law Enforcement vehicles, and cited the proper syllabus for the EVOC course, as ALS has so kindly pointed out to you.

Are you seriously that "assamed" that you had to whip out your camera, snap a picture, an run home to post it in this forum? I mean really, like NY10570 said, if you were so "assamed" why didn't you man up and say something to this horrific offender of vehicle placement?

My link Editorial on a study that was conducted to look into the merging of several fire companies in Philipstown. Also mentions Cold Spring and Continental Village.