Legislating quicker ambulance times-New York

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Legislating quicker ambulance times- Suffolk, New York 

 

Newsday 5/23/04

Saying more than 2,000 Suffolk County residents were forced to wait more than 20 minutes for an ambulance after making a call last year, a county legislator plans to file unprecedented legislation that would compel agencies to take concrete steps to bring their response times in line with national standards.

"The current system needs to adjust because the status quo is too dangerous," wrote Legis. David Bishop, the West Babylon Democrat who wrote the proposal, in his letter to Babylon Town chiefs.

The county's ambulance agencies are generally providing more skilled service, faster, than 15 years ago, records show. But few, if any, manage to answer calls within 9 minutes, 90 percent of the time, a goal adopted by the National Institutes of Health and the county's regional emergency medical services council. Precise information about Suffolk response times isn't being collected, another problem that would be addressed by the bill, co-sponsored by West Hills Republican Legis. Paul Tonna.

Departments that took steps called for in the legislation would get $2 million in increased county liability coverage. Those that defied the requirements would be referred to the state to have their credentials reviewed and would lose their county-sponsored liability insurance.

The bill's sponsors say they expect opposition from the volunteer community. David Fischler, the county's commissioner of fire, rescue and emergency services, said recent initiatives, such as requiring volunteers to call in to say whether they are on their way to an emergency, should be given time to work. "I do not support penalizing the volunteers," he said.

Richard Vella, president of the Suffolk County Volunteer Firemen's Association, said that while he was unfamiliar with the details, he didn't like the measure's mandatory sound.

"We really don't know if they have the authority to make a protocol like that," he said. "If it was going to be a guideline, we could probably live with it."

If the bill is filed, it would be the first measure seeking to compel Suffolk volunteers to improve performance, said Chief Deputy County Executive Paul Sabatino. Bishop and Tonna are term-limited and won't be running for office.

"It's time to take this issue on," Tonna said. "We pay enough taxes. You can have all the best equipment and best-trained people, but if they don't get there in time, what good is it?"

Marian Myra, 66, experienced how frightening ambulance delays can be the morning of June 6 of last year when she suddenly felt her cheeks go numb and found she couldn't speak. She was having a stroke.

Her husband dialed 911 and a police officer arrived promptly. But Copiague couldn't find any volunteers, nor could Lindenhurst. More than 39 minutes later, a crew from Amityville arrived.

Fortunately, Myra's attack was a ministroke, one that gradually subsided in a few hours.

"Every time we called back, they kept saying, 'It's on its way, it's on its way,' but we'd never hear the sirens or anything, so obviously nothing was on its way," she said. "I understand that they are volunteers, and thank God for them, but by the same token, when you need them, where are they? This is all we have to fall back on."

In a letter to Bishop about Myra's case, Copiague Chief Peter Sayevich said the delay was the first of such length in the department. But he said the case "demonstrates a clear difficulty ... throughout Suffolk County during those hours where volunteers are typically at work."

Emergency medical volunteers practice under Suffolk County's license, and the county also provides ambulance services with dispatching, equipment and $1 million in liability insurance.

But Bishop emphasized that his legislation does not mandate a paid service to replace the volunteers.

"Volunteers, paid, Martians -- I don't care who they send as long as the call gets answered," Bishop said. "They want the responsibility? Solve the problem." 

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Ambulance measures rejected

Town board votes down county directive requring volunteers to let dispatchers know if they'll respond to emergency calls

BY ELIZABETH MOORE

STAFF WRITER

June 2, 2004

Two measures aimed at speeding up ambulance response in Suffolk County have met a blast of opposition from the Town of Southampton, which calls them "irresponsible" and probably illegal.

After getting an earful from angry East End ambulance volunteers, the town board voted last Wednesday to reject a county directive requiring volunteers to let dispatchers know if they're coming in to answer emergency calls, so another agency can be promptly called if needed. The county's Regional Emergency Medical Services Council "exceeded its authority" in approving the directive, the board said, adding that a confirmation system would add unmanageable expense.

The town board's resolution also opposes a measure filed yesterday by Legis. David Bishop (D-Babylon) that would withhold county certifications and liability coverage from ambulance agencies that don't move to speed their responses.

That bill is an "unfunded mandate," board members say, and would discourage volunteerism, force hiring and bring on higher property taxes. It's unneeded, they say, because the East End doesn't have the response problems that western Suffolk does.

The board resolution also urges other East End towns to follow suit in opposing the changes.

"We don't want to go paid on the East End of Long Island," said Southampton Town Board member Linda Kabot, who sponsored the resolution. "If there is a response-time problem in some area of western Suffolk ... those agencies should go paid. But don't force a cookie-cutter approach on the East End."

Bishop plans to make some revisions in his bill to assuage some volunteer chiefs' concerns, including making exceptions for ambulances that are responding over the longest distances, an aide said.

Southampton dispatchers do not record ambulance crews' arrival times, making it difficult to assess how well they meet the county benchmark of getting to 90 percent of their calls within nine minutes or less. A Newsday analysis of incomplete 2001 data indicated several departments in the town had average response times of 10 minutes or more.

The town board maintains that rural East End communities cannot be expected to follow protocols designed for urbanized western Suffolk. It maintains the county would be in breach of contract and violating state mandates if it pulled any of its liability coverage.

Dr. Jeanne Alicandro, the EMS medical director for the Suffolk County Health Department, said she knew of cases of serious delay in getting help to East End patients. The point of the directive is to make sure help is on the way, she said.

"There are geographic differences, but the human brain can only survive so long without oxygen," Alicandro said. "The 'cookie cutter' approach is because patients are the same."