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The problem is not NYS DOH here. 1) Managed Healthcare and Medicare- EMS has been a losing battle since the insurance compines are allowed to run around making the rules and deciding how much they are willing to pay. If a Paramedic unit picks up a patient and provides the best possible care which uses $800 of equipment and the insurance company turns around and says, ok we are paying you $400. This is also true with Medicare. 2) Not for nothing but Volunteering and keeping Volunteers around is not the answer. In todays society unless your a corrupt CEO or someone else who makes 400,000 a year, it is almost impossible to work only 1 job. Being a volunteer for 8 years I have seen the decline in members because of the family life and supporting the family. Most people work a second job and if they don't they are putting in 50-60hrs at the only job. Now working 50-60 hrs a week and having a family to see........the last place I am going to be is in a building waiting for a call to drop. 3) Making becoming an EMT easier and make requiremnts less...................Oh Good Answer there! I want someone coming to pick me up in an accidnet or something that has been put through a speed class and volunteers 1 day a week and does 4 calls a month as a volunteer. Being a paramedic I have put a ton of time and work into becoming what I have become. I find it ridiculous that the standards should be lowered just to get more unqualified people on the streets. Ugh, I can go on....................The answer is like every other State and County does. County Wide EMS systems...........Give people who want to do EMS for real a job and make the tax money that we pay go for something useful. Get qualified people in and make it a job. Take the 20-30 minute response times and get them down tp 8 min. Get the person who does 4 calls a month to a person who does 40 calls a month. Let the citizens feel comfortable that when they pick up the phone they will get an ambulance in 8 min and have people who know what to do.

Yeah Universal Precautions.........................Its called the Fire Dept. EMS has the job of standing by and not entering an unsafe scene.