Ambulance coverage is in dispute - Beekman

[RescueKujo 130]

I think a bigger issue in this article is that the national standard for ambulance response times is 12 minutes. What good does that do?

Chris,

I think the standard changed when fire departments started putting medics on their engines.

HFD219 wrote:

Those of you who know me and know what I do for a living may scratch thier heads on this one but inmates are entitled under law to the very same health care as me and you. And as much I agree with the methods and practices of the sherrif in Arizona I can tell you the one thing he can not take away is thier right to adequate health care.

As a dispatcher for a private company whose EMTs cover a jail complex, I can tell you they are covered just like anything else. If you do not send the closest unit on an emergent response, you are leaving yourself wide open to a lawsuit. The company will not back you up as you are probably violating company policy, so you'll be on your own.

[JTF429 37]

:angry: Just a few thoughts. If Beekmen could man their ambulance they would not have to contract Alamo. 19,000 a year can't cover an EMT salary so this is what happens when you under bid. Mabey it is time for a county wide system, and the Chief is doing whats excpected of him defending his company. I know alot of members from Beekmen and they like alot of other VOLUNTEERS are doing the best they can.

Change the name on the contract BUT this is always Alamo's statement:

As a member of Beacon Vol. Amb. (BVAC) I can tell you that the correctional facilities have paid contracts with private services. BVAC does not typical go to the facilities (Fishkill and Downstate - both maximum facilities) unless an employee forgets to call the private service and dials 911 or it is a critical emergency. We do go to Camp Beacon and transport from there. I must also say that the City of Beacon who responds on P1 & P calls no longer responds to Fishkill Corr. because they don't allow the engine in the gate unless there is a fire. We do transport correctional guards from all facilities.

We do not transport from nursing homes once again unless it is critical or (which is often the case), the private service is not available.

BVAC is not supported by taxes

While I understand everyone's points on this topic. If a facility contracts with a paid service, the paid service that has a contract with a municipality should not be sending the primary ambulance to a call at said facility unless it truly does immediately backfill the municipalities location. TherReason is because the paid service is getting paid twice for the same job. (I know that's not legal)

So I say to Beekman - Good Luck Bro.

[helicopper 1,050]

Chris,

I think the standard changed when fire departments started putting medics on their engines.

Are you saying that there is a NEW response time standard that is less than 12 minutes or are you saying that 12 minutes is the new standard because some FD's have medics on their engines?

If 12 minutes is the new standard, we're about 4 (or more) minutes behind the times! 12 minutes may be fine for 75% of the calls but the 1 in 4 that needs rapid intervention is screwed. As for the FD/medic subject, that is NOT (with one or two notable exceptions) the norm locally and can hardly be held as the benchmark for service.

:angry: Just a few thoughts. If Beekmen could man their ambulance they would not have to contract Alamo. 19,000 a year can't cover an EMT salary so this is what happens when you under bid. Mabey it is time for a county wide system, and the Chief is doing whats excpected of him defending his company. I know alot of members from Beekmen and they like alot of other VOLUNTEERS are doing the best they can.

JTF, you're right there are alot of volunteers in a lot of places that are doing the best they can. The problem is, and this is NO reflection on any of the dedicated volunteers anywhere, that all too often their best is not good enough to sustain a system. Municipalities continue to try to do EMS cheap - not WELL or RIGHT but cheap - and commercial services have a bottom line despite their catchy slogans or advertising. So, no matter who is providing the service there are problems and not a whole lot of answers. I, for one, would like to see EMS become a real issue and have intelligent people with no axes to grind and no ulterior motives develop a proposal for a real EMS system in our area. Wouldn't it be nice to have some job security? pay commensurate with your training and experience? not have to explain to the bank or credit card company why you've changed jobs 6 times in the last 6 years because municipal contracts keep changing hands?

As you aptly point out, it is time for a real system, be it countwide, regional or some other model that will appease most of the people involved.

A lot of people need to get off their high horses and recognize that as much as the spirit of volunteering is noble, it may not be viable for all communities in 2007.

Here endeth the rant!

[RescueKujo 130]

Are you saying that there is a NEW response time standard that is less than 12 minutes or are you saying that 12 minutes is the new standard because some FD's have medics on their engines?

If 12 minutes is the new standard, we're about 4 (or more) minutes behind the times! 12 minutes may be fine for 75% of the calls but the 1 in 4 that needs rapid intervention is screwed. As for the FD/medic subject, that is NOT (with one or two notable exceptions) the norm locally and can hardly be held as the benchmark for service.

Chris,

The standard that I am aware of for most contracts that have ALS on the engines is 11 minutes 59 seconds for the ambulance. And I agree with you about cookie cutter response times, what is acceptible in one location may not be in another. Frankly, my opinion is everyone, including the transport unit, should be there in 8 minutes or less. As has been posted, too many politicians want to do Fire/EMS on the cheap, and the public with their lack of knowledge passively allows this . What ever happened to doing what's right for the paitent??

[Guest alsfirefighter]

Who is saying that inmates don't deserve or are required to get the same adequate healthcare? Do you have a PA or a nurse available to you in your home 24/7? As far as the comment of not sending the closest unit and not to offend anyone who's made a comment to this effect, but how are you leaving yourself wide open for a lawsuit when there are many agencies who do not respond to calls for inmates. And if was such a big ordeal then show me one lawsuit about it already and also DOH would have stepped in and issued a policy already.

The argument some of you are trying to make holds no real water. If it did we would be at every call at every nursing home...but they use private ems. Why is "adequate health care" not a problem when they are treated and sent back to their cell or cell block instead of being brought to a hospital every time? Why is "adequate healthcare" considered being transported all the way to Mt. Vernon Hospital being they have a state contract for inmates? So send the closest ambulance but never mind the hour transport down to the Vern? Or how about the nursing home in Putnam (Patterson I believe it is in) I got sent to from Fishkill for chest pain? But the ambulance my tax dollars pays for should go to the prison right?

As far as being glad about having a jail and the jobs. Support jobs I'm sure are there but as far as CO's the state DOC can send you anywhere when you get hired. Not to mention the fact that creating jobs and EMS response are apples and oranges in regard to this conversation.

The issue of not being able to staff ("man" isn't a PC word for good leaders to use anymore) the Beekman ambulance and needing to contract with Alamo is a mute point. Bravo to the fact that they do contract, it isn't a bad thing or something to be looked down upon. I don't know where the 19,000 for an EMT comes from the contract is for an ALS ambulance 24/7. Boohoo on Alamo if they under bid..that's not Beekmans fault nor concern...what is in the contract is.

Chief...keep pushing the issue or get me someone in this town that can for my family and my neighbors. Then guess what? Alamo will still be coming in to do inmates...lol...not the "closest unit" because Alamo has the transport. Then we'll see what happens when its Pawling's unit getting pulled or doing what they should be doing and that is sending a unit from elsewhere anyhow.

[Danger 160]

Well, on my last day as a full time EMT I responded to GHCF from the City of Poughkeepsie and kept 34-79 in service.

[MerlinMedic 5]

alsfirefighter has some good points, and a few worth exploring more.

Do you have a PA or a nurse available to you in your home 24/7? Yup, inmates have this, and a doc on call 24/7. But for whatever reason, they end up going out with Alamo starting IVs, giving meds and such. But that is a question for our State elected leaders.

comment of not sending the closest unit and not to offend anyone who's made a comment to this effect, but how are you leaving yourself wide open for a lawsuit when there are many agencies who do not respond to calls for inmates.

Not the closest unit, but most appropreate unit for the call. If it is a P-1 or 2, that means the Beekman unit. As far as a lawsuit, as I posted earlier, the 14th Amendment garuntees all equal protection. Has anyone thought of it yet? Nope, thank God. But someone will, then what? If the Town of Beekman will assume liablity, that is their issue. I would be surprised if Alamo's mouthpiece would allow them to.

Why is "adequate healthcare" considered being transported all the way to Mt. Vernon Hospital being they have a state contract for inmates?

Sorry, if that is what you think is happening when they call 9-1-1. It is not. If they call 9-1-1 the patient goes to Putnam, Vasser, St. Francis or St. Lukes (from the Dutchess Co. prisions). Even if the COs want other wise. Those going to Mt. Vernon are non emergency transports and I have never heard of one coming in as a 9-1-1 call.

Or how about the nursing home in Putnam (Patterson I believe it is in) I got sent to from Fishkill for chest pain?

I hve no clue. Since you were with Alamo that day, did you ask?

As far as being glad about having a jail and the jobs. Support jobs I'm sure are there but as far as CO's the state DOC can send you anywhere when you get hired.

This was years ago. As I said, Beekman has out grown the need for prison jobs.

I don't know where the 19,000 for an EMT comes from

I think someone (the Cheif?) posted that Beekman pays nearly that per month, but don't quote me.

[fireman3484 1]

i have been reading these posts about our ambulance and there hasnt been any feed back from actual beekman members except our chief. alot of our problems lie with the way alamo manages their contracts. as you all know, alamo has a contract with the state to provide transport service to the inmates of the jail. they also have a contract with the center for rehab in pawling as well as the town of pawling (not the fire district) our biggest problem is not whether or not its an inmate or civilian that the ambulance is transporting. we have been concerned that our ambulance is being abused. there has been numerous times, and if i dug through the CAD's im sure i would have numbers to back this up, that 34-79 gets dispatched to GHCF and their on scene time is in excess of 60-90 minutes. we simply have asked why our ambulance is called for a medical emergency and is held for that long instead of waiting for a transport ambulance to come. our contract (yes ive seen it) states that alamo will provide a back fill if available, which i know sometimes it isnt and at no fault to the staff.

As for response times, we have never really had a problem with response times with alamo. once in awhile they get lost or are coming out of poughkeepsie, but there is nothing they can do with that. they go on an average for contract purposes.

Our 34-71...Many years ago, the fire district approved to have the town contract out for ambulance service because our squad was down to 3 members and they just couldnt handle the calls. It was a smart move on their part and alot of towns are taking the same initiative. our ambulance is in service from 6pm to 6am and will respond to calls with 34-79 and transport if its BLS or cover a 2nd call. someone said in a post, well get your ambulance out. well my reply is well come recruit for us if you think its so easy. our town has doubled in population since 1992. most of the people now are people who transport back and forth to the city everyday. and we do all that we can to recruit and it doesnt produce many people who want to sit in a 150 hour emt course. we do what we can and thats all we can do. people think we are a paid department and expect someone there as soon as they call 911. its pretty hard to tell them their family member has to wait becasue the ambulance is sitting at the jail waiting for an inmate.

as far as the 19K a month goes, well im not sure thats an accurate number. the contract is for a max of 60K a year and that pays for all town residents. it covers whatever expense the insurance company doesnt pay for or if you do not have insurance. i believe, and dont quote me here, last year they spent in the area of 38-40K. alamo asked for more operating money and the town gave it to them. the contract is up as of january 1,2008 and the fire district has speculated of taking it over from the town, but their have been no talks as of yet. the biggest concern is where they would house the ambulance because our building is full to begin with.

I dont want to sound like an alamo basher because im not. i am friends with alot of the employees and most of them are great people. there is a severe lack of communication between the alamo gods, the town and the fire district. to my knowledge, they were having a meeting once every 4 months and thats not enough. i know ive sat in a few of these meetings in the past and we have gotten yes answers to everything or "we'll check into that" and nothing ever gets accomplished. I dont believe that switching companys is a good idea but it has been rumored. all the companies in the area are stretched thin and there will be problems with whoever you have on the side of the bus. these are just my 2 cents and i am open to any questions or comments. thank you

[MerlinMedic 5]

".. that 34-79 gets dispatched to GHCF and their on scene time is in excess of 60-90 minutes. we simply have asked why our ambulance is called for a medical emergency and is held for that long instead of waiting for a transport ambulance to come."

And we ask GHCF the same question. Why did you call 911 if a) you are not ready it isn't an emergency. I have heard, but never seen proof, that Alamo dispatchers will turn a call over to 9-1-1 if they are short units. I have spoken to many Alamo dispatchers, who mostly are EMD quailifed, and to my satisfaction, they never call county for GHCF unless it is a P-1 or P-2 per the EMD protocols.

Unfortunetly, we can only speculate that we have to wait on scene because of safety issues.

Maybe part of the solution is to bring GHCF, Alamo, Beekman Town & FD, and the local State Senator/Assembly representative to a sit down. I think that would at least let everyone know what limits each player is working under.

[Guest]

Town officials passed a referendum to ban “their†ambulance (AKA Alamo) from responding to Greenhaven. WOW!!! Did they talk to their lawyers? They should read NYS General Municipal Law 209b. It states:

“Such general ambulance service shall be for the purpose of (1) transporting any sick, injured or disabled resident or person found within the contract district or area to a hospital, clinic, sanatorium or other place for treatment and care and returning any such person there from if still sick, injured or disabled and (2) transporting any sick, injured or disabled resident of such contract district or area from a hospital, clinic, sanatorium or other place where such person has received treatment and care to any other place for treatment and care or to such person's home whether such hospital, clinic, sanatorium or other place where such person has received treatment and care is within or without the contract district or area or the territory listed on the ambulance service certificate or certificate of registration as the usual territory within which the ambulance service operates. The city, town, village, fire district or the fire department or fire company thereof which is authorized to furnish such fire protection pursuant to contract shall have power to contract to furnish such general ambulance service.â€

Wow what will Beekman do if Alamo lawyers tell the management to start pulling that unit to Poughkeepsie to transport town residents from VBMC to their specialist in Manhattan? Pass a referendum banning “their†unit from leaving the district line? Maybe they could pass a referendum to start teleporting its residents. That would be neat.

[Guest alsfirefighter]

Town officials passed a referendum to ban “their†ambulance (AKA Alamo) from responding to Greenhaven. WOW!!! Did they talk to their lawyers? They should read NYS General Municipal Law 209b. It states:

I think they are still on hold while awaiting the copy to arrive from all of the other EMS agency's whom don't send their units to correctional facilities.

On a side note...again I ask...if everyone is so concerned about Beekman's quest to keep their ambulance where it belongs in town. Have all of you on the opposite side of the argument called the companies you work for or gone to you local agencies and demanded that you immediately answer all calls to all nursing homes, assisted living facilities and clinics in your areas that your employers were serving or those your agencies weren't because an outside agency was coming in? If so why not? If you have a hospital in your area...why are you allowing private companies to come in to do transports to other facilities? The closest unit is appropriate correct? Are they not entitled to get prompt and immediate service from the provider?

I'm still looking for someone to take on that answer...

The infirmary, medical bay or whatever you want to call it is no different than what is in that nursing home, clinic etc. I'm still looking for someone to change my mind. And I need more than just a GML section that a huge proportion of agencies don't follow either.

[pd125 0]

Well the problem for Beekman is solved. Empire Ambulance got the contract from Bliss.

Now can the town afford the ambulance sitting in the town?

[Goose 188]

So, Empire now has the GHCF contract?

[Guest Orpi442]

Yep Goose (I know who you are),

As I told you a min ago across the room. Empire G & C, responded to Fishkill or Greenhaven. C stated that they picked up a contract.

Hey anything on the drill yet

[Guest]

Just to clarify. Bliss is an independent, 3rd party billing service for the state. Empire and Alamo have been and still are the providers who are contracted with Bliss for their billing service (in this area). So technically Empire didn’t get the contract, Alamo just told Greenhaven to start using their other provider. Beekman finally got what they wanted. Now those calls from Greenhaven will be removed from the bid and it will cost more for the town residents to have the same service.

Another note, someone mentioned that Alamo was double dipping because of this “contract with correction facilitiesâ€, sorry but you’re mis-informed. The contract is with Bliss and Bliss alone. They bill to the state for the services Alamo (and Empire) rendered. This means that the municipality doesn’t get a bill for a person within their district. There is no contract with any corrections facility to provide transport.