sympathomedic

I have heard that 1/3 to 1/4 of SFD EMS runs are into Heritage, and that number sounds right. More in summer, less in winter. Heritage has a contracted security service, Command Security. They take the EMS part of their work very seriously, and most if not all of their staff are EMT's. Before Somers stopped staffing their own first rig, we would frequently use HH security as an EMT on the SFD bus. Sometimes they even got 'tech-knapped' into doing a call on the way back home. In some cases the WEMS medic confirmed an ALS call and teched the bus with a SFD driver. That kind of thing is gone now: two emt's on the first bus now. HH residents already pay for EMS two times: once in their fire taxes, and once with their medicare taxes. I don't think they would take well to paying a 3rd time to hire a WEMS standby bus- BUT if they did and set it up that at the end of the year, whatever funds that bus generated from insurance billing was subtracted off the annual cost, that would work because that crew would do several insured runs a day... but wait! That's kind of what I am proposing for a Town-wide system, and boy do the powers that be seem peeved about it, saying it'll never work. Course, they said that about horse driven rigs and steam powered pumps too. Bill

When I worked in New Rochelle under Empress, NR paid a flat annual fee for the ambulances (1 24 hrs a day, the other 17 or 18). We gave copies of the PCR's to a clerk for billing out- same clerk that billed false fire and burglar alarms I think. Story was that if you didn't pay, they would turn off your water!! Could be a famous case of EMS exaggeration, though. Bill

OK folks, I am the Bill in the article and here is the thinking on this: Our idea is for the TOWN to establish an Ambulance Department. Unfortunately it will the name "SAD" Somers Ambulance Dept. It is legal for the Fire tax district to transfer ALL of its EMS stuff to the Town. A NYS Supreme Court judge needs to sign off on it. So there goes a big chunk of start-up costs. The Fire tax district would need to transfer the operating license to the SAD. Meanwhile, 80% of EMS calls in Somers are being done by WEMS EMT's, using the SFD ambulances. So the new SAD would have to pay WEMS, taking over as the contractee for WEMS. That is about $400,000 per year for two EMT's 24X7. Then the folks who want to volunteer will need to incorporate a VAC Inc. The SVAC would manage the SAD, and staff it as much as possible. Our survey of the SVFD members indicated that under a VAC we could staff in house crews 50% of the time. Even if that is 50% off, we could still staff 25%, saving $100,000 per year. Somers also pays WEMS $200,000 a year for dispatch. That's right, they pay for what 60 does for free. The SAD would use 60. The Fire Tax District also has 5 (FIVE) people staffing the office 0900 to 1300 daily- a secretary a clerk a treasurer a purchasing agent and a computer servics guy. That last guy is a former Fire Tax District Commissioner who we worked very hard to get voted out. They made up a job for him, never posted it, and hired him. He now gets paid to set up the new multi site SFD repeater system that is 100% reduntant to the 60 trunking system the taxpayer already bought. The Somers VFD staffs and manages the fire and EMS efforts of the Fire Tax District. There is no reason a VAC could not manage the EMS effort of a Town Department. We could do it cheaper and more effectivley and possibley with fewer paid tours. We would also collect the $400,000 annual insurance reimbursement that the SFD nows turns down every year. I urge my EMT Bravo brothers to weigh in on this. Right now, Somers taxpayers shell out about $1 million dollars for EMS a year, and all they are promised for that is ONE BLS crew. No promise of ALS availibility (I did a BLS arrest less than a year ago- she lived) and no certainty of a 2nd BLS crew. (that $$ is for WEMS medics, WEMS EMT's WEMS dispatchers, a new HUGE bus every two years, gear, fuel, repairs, service contracts etc). All this while the insurance companies get a 'get out of paying free' card on every call Somers does.

Not my area of expertise, but I did read somewhere that for every dollar of taxes a development adds to the tax base, it consumes $1.40 or so in service costs. Makes sense- 10 acres of woods pays a tiny amount of taxes, but requires NO services. 10 acres of stores and housing kicks in a lot of taxes, but demands a TON of PD, FD, water, sewer, sewage, signage, paving plowing etc. Not to mention, I would be certain that Yonkers gave this place a large tax break, so unlikely that there will be any real tax money production soon. But hey, the world needs more chain stores, movies and acres of paved lots.

Vinny, Seth said very well. I only met your dad onc time and briefly. He must have been a great dad, cuz he raised a great son. Bill

Barry, my computer skills do not include those cool, green cut and quote things, so I will try to reply in an organized way: #1.YES in two departments that I work with, it was the FD's request. I have been under the impression that EMT Bravo does not approve of doing specific department names, so I will not. Both were in lower Westchester, how's that? #2: if it now contractual, I believe most contracts expire. If they guys want out of EMS, don't put it in the next contract. Done. #3: If your 911 PSAP has an SOP to transfer live callers to 60 control and they are not, then that can be easily fixed. Next. #4: How does 4 men on a class A pumper free up beds any faster than an ambulance crew? #5 I am 100% positive the elderly couple who called us knew just where they lived. It was NOT a border issue. They did NOT want a 10 person, 6 vehicle response for a man who fell the day before, and could not bear weight today. THAT is why we got the call. #6 I am aware the Boston truck had bad brakes and the EMS run was just a chance happening. I put that in my posting in case someone wanted to check my facts about the Massachusetts State FF union sueing the Governor to force SNF's to call 911. I have found the folks on this board to be a pretty smart groups of people, and some of them may want to find the article. I think it was in the Boston Globe. #7. Maybe I am getting deaf in my old age, but my perception when the topic comes up is that FF's very seldom complain about non-sense fire work. But since wwe are stepping on toes here, let me step on my own: Of all the various medical tech jobs- X-ray tech, EKG tech, lab tech etc it seems that the Emergency Medical Tech is the only one who complains that certain patients are not worth their time. (goes for EMT-P's also). #8: How can you want to get out of EMS and cannot?? Should we post a form letter of resignation here, so folks can print it, put their name on it and turn it in? (This does remind me of a favorite scene in "Brining Out The Dead" where Frank's boss refuses to fire him, and Frank insists that he is late and the boss promised to fire him if he came in late again, and he begs to be fired). Anyhow, sorry for the ranty post. I will shut up for a month or two now. Bill

There are parts of this issue I have never fully understood: In many (not all) systems in Westchester that send FD units on EMS runs, this arrangement was begun in the last 20 years or so, and was done, again in many but not all cases, at the FD's request. If the FD wants to stop running on calls they feel are beneath them, simply get yourselves deleted from the EMS response protocol. Un-due what you did. I have read in data gathered from the Emergency Care information Center in Escondido Ca (sorry no link) that about 35% of EMS calls are serious enough to need ALS. About 3% of EMS calls are "life and death". In my personal experience, less than 1% of fire alarms are working fires. (hose, hydrants, air-packs). The fire service never complains about the smoking dryer belts, steam from the shower, furnace burps, light ballast, forgot to open the fireplace flu type of work that makes up many of their alarms. It is no ones fault but ours that we over-respond. I have heard a bloody nose on the Sprain get 1 BLS bus, 1 ALS car, GPD, NYSP and I think 4 large fire units from two departments. It is US that make the decisions about what to send. It is the public that pays. In my job as a paid EMS guy, I was once called to a town bordering our primary area for some minor complaint. I asked them why they called us, not their own 911 agency? They said they had done so in the past and were ovewhelmed with the 2 EMS 2 PD and 2 FD units that came. In Massachusetts the Governor at the time(Romney I believe) issued an executive order allowing nursing homes to call private EMS agencies for emergencies. That was done at the NH industry's request, as they did not like the multiple lights, loud radios, idling deisel and whatever else a large response brings to a quiet home. In response, the Mass State FF union sued him to get the order recinded. I read all this in an article about the Boston FD LT killed when the brakes on his ladder truck failed returning from an EMS run. I do no know the outcome of the lawsuit. Not trying to anger anyone here. If you feel EMS work is not good enough for you, I would appreciate it if you found a way not to do it. The patient and I would appreciate it. Bill

Yes. Empress provides coverage as needed. There is a set schedule of shifts the paid EMT's cover. With 24 hour notice, Empress will add or remove 1 or two EMT's, say if the regular volly EMT is sick or away. But I believe this is a daytime arrangement only, as there are no paid EMT's working nights. I do no know why that is. Bill

I thought a bridge on the Beacon had been taken out by a truck that had knocked it down last summer. Was that fixed, or am I mis-thinking?

I believe that an old NYS law prevented a new owner of an ambulance from re-registering it as an ambulance after it was 10 years of age. The original owner could run it forever, and a person who bought it at less than 10 years of age could re-register it forever. But after 10 years, it could not be sold to a new owner for use as an ambulance in NYS. A small attempts to limit fleet ages. Now I have heard that law was removed, and it was for ambulances only, not non-transporting units. As the previous poster said, it is a law of economics. OR, if a vehicle failure leads to loss of life- the defibrillator that was going to save my client burned up on I-287- it becomes a rule of liability. Bill

With NYS lay-offs, Xmas, new years and snow delays, it could be longer than in the past. I don't think scoring EMT tests is the same priority with NYS as it is with the NYS EMT candidates! Mine has always taken 31-35 days.

At least in NY state, the number on non drivers is a small % I think. There are many non-vehicle owners that drive OTHER folk' cars- taxi drivers, etc. I took drivers ed and I still use the stuff I learned in that class as I make driving decisions today. 25 years driving EMS and the occasional tower ladder with barely a tap to my name. (oops big mistake I know!) I hate the idea of MORE spending ( that is what you ask for when you say "someone should do something...), but in this case, I bet it would pay off in terms of fewer crashes, less loss of life, less money wasted on the cost of carnage. We do fire prevention classes. Consider this a crash prevention class. No better time than in High School. The only folks that drive worse then them are us. Bill

Somers FD 2098 total. I will work on the breakdown of Fire/ EMS. Usually 4 to 1. Last year was less than 2000 runs. Increase is in EMS. About 4 real fires. I use a high standard for "real", like ya gotta pump water through a fire hose while wearing an air-pac. Flaming oven dealt with via dry-chem doesn't make the cut. Cost to taxpayers = $2.7 million. Empress used run # 64262 as last of 2010, but each pt gets a number on multi-pt runs, including RMA's. MANY of those are private, non-emergency runs. Yonkers runs = about 16,000 a year. Cost to Yonkers $0. Bill

I am nobody's expert on burning stuff, but these come to mind: large portable batteries of various chemical make-ups, burning reacting drugs if it was an ALS unit, water hitting the main electric panel, the spare tire blowing (ambulances keep them in odd spots), aerosol spray can blowing, head-up strut on the stretcher... When I worked in Ma, they had a brand new diesel burn- 1st model year diesel. Guess what did it? Driver adjusted his set and let the seat-adjust release snap into place -(remember the old ones slid left, not up like today's). When it snapped back, the rigid wire piece that pulled the teeth out of the gears on the other track of the seat popped out of its hole and hung down- right across the under-seat battery switch terminals!! It got hot and melted and fell into the carpeting under the driver seat. Total loss of unit.

The general mood out there is the public wants a smaller government, run on the cheap. Don't expect someone else to fund our expensive public education campaigns or even make signs. Though that one on the W/B 287 for the DOT guy with the imitation grave and the "Give 'em a brake" sign makes me slow and shiver every time. We (can) do public education: demos, fire prevention month, EMS week, Trauma awareness month (May), Police week, open houses, annual parades... the venues and opportunities to teach the public are plenty and should never be wasted. If we don't do it, no one will do it for us and it simply won't get done. I can tell you that I will add this law to my shpeal at public events from now on. Wouldn't hurt to ask your state officials (if they are not in jail yet) to ask the NYS DMV to add a question or two about this law to the learners permit exam. Kids study that book. As they become drivers the law will be known more widely. I will send an e-mail. We all should.

I was on that job too. I will always remember how the NYSP troopers held it together. If one of MY partners was burned to death in his rig and I was there, I would phone in my resignation and walk home. As I recall, the kid that caused the incident was highly intox and died in the crash. Doubtful the law would have had any effect, sad to say. He had already broken a biggie just by driving. Not often that you have 'spare' officers at these scenes poised to chase a driver who fails to move over. If WE in the ES community educate the public about the law, WE may reap the benefits of safer scenes. Nothing good happens without hard work. Bad stuff happens all by itself. Bill

To paraphrase Izzy, a Union is not an energy source, it is a magnifying glass to focus energy. If your job has no energy, the glass is useless. As for a single Union, that could go both ways. A big Union could better influence laws like one requiring a more crash-worthy ambulance that congressmen from Ohio always block. But a single EMS national with no competition could lead to bad service. Why work hard if you are the only game in town? For those readers not in a Union, a Local Union can leave it's National and affiliate with another National if it feels it is not getting good service- such as lawyers and negotiators. My dues are about $12/week, which I pay and forget about. I don't expect to get anything for nothing, and this is the cost. It the the price I pay to leave the job better for those that will follow- a responsibility I feel we all have. I just hope those that follow can get off facebook and texting (and EMT Bravo) long enough to appreciate it. (I can't make a winky thing, so you'll have to imagine me winking!) Bill

I have been at Empress for my whole career, 22 years. We had a union that was bad. We got rid of it and were non-union for quite a while. We rejected 1199 at one point. Then we organized with IAEP. I was VERY opposed to any union. I feared it would keep us from firing people who needed to be fired, and we all know who those folks are. That has happened one or two times. BUT we also saved some folks who needed a break. I was afraid the union would insist on dumb work rules (ever seen the guys who still operate automatic elevators in the city?) That has not happened, and in fact we have some good rules that keep our folks from being made to do stuff they really should not be doing. It is work. A local needs to be fed, watered, fertilized and on occasion; prunned. Many folks use EMS as a holding pattern to get jobs with PD, FD RN etc. Because they are visitors and not residents, they don't invest in fixing the place up, so it doesn't happen. It takes a lot of time to run our local, and I am very thankful for our union officers- we are lucky to have them. As our benefits improve- they have steadily with each new contract- ($100 contribution to flex-beneifit plan, higher % match for 401K, more extra pay for nights/weekends, $75 annually for uniforms above and beyond the uniforms themselves. This is a topic that is ripe for discussion. It can be a very emotional issue. When we rejected 1199, some very good friends did not show up for my wedding because of my position against it. I hope this thread continues, and good information gets out. Oh, and thanks for that "quality gig" comment. I am going to fantasize that I get some credit for that rep! Bill

Does anyone with knowledge of the fine print know if there is a claus releasing off duty MOS or city employees out of this? Will FDNY be billing NYPD and FDNY members in MVA's? Ranking officers? What about fleets and rentals? Just curious.

Ambulances are public health, not public safety. Though the rules are always changing, we have always accepted healthcare as a cost, but safety has been covered by taxes. This could be a very slippery slope for the fire service. If they are going to charge, someone may get the idea of doing the same thing for le$$, and under-bid them. Sound like Rural Metro? But can you imagine getting into a fender push and someone with with a cellphone calls it in. Dispatch protocols insist an engine goes. Now you get a tow fee, vehicle storage fee, car rental costs, repair fee, taxi fee, maybe a summons, insurance increase, the deductable AND a big ,um, engine company fee? What next, a kitty litter fee? What if I call myself and insist that I do NOT want a FD response. It is recorded.