More Debate on Putnam ALS

[Oswegowind 17]

Putnam should go to a countywide EMS system with a combination department. If volunteers want to continue serving, they would "work" shifts that they are able to and participate in community events as well as man additional units during disasters or major incidents. Otherwise there should be a number of BLS ambulances on duty and Paramedic Fly-cars 24/7! The call volume and the staffing necessitates this.

[ckroll 101]

I can't speak for what part of Northern Westchester that you're referring to, but in the area that I work in, our system gives out much more M/A ALS then comes in.

Yes, you can. I was only speaking from my experience as a switch hitter. Working both sides, I hit south from north more than I hit north from south, but I do not hear Westchester fire medic dispatch, so you may well be correct about cross border ALS overall. In any event, debating numbers is without merit, they are what they are, so I will withdraw my observation pending hard numbers.

Also from ALS:

" There are times where you will have extended response times when your down to 2 units covering all that area. 10 minutes is not all that reasonable in my opinion and you still have to factor in driving safely, what the road conditions are etc. Its not about driving fast and just getting there, how come we never see statements that while it took 12 or 15 minutes the care the patient received was superb? "

Excellent points.

I do not know how those response numbers got to print in the Journal, but it should be obvious to all that when Putnam County is down to 2 medics that response times will be extended. I know I've logged response times close to 20 minutes as Medic 2 out of district. I do not know why that apparently is not reflected in the county statistics. Prudent driving is essential. It is even spelled out by PCBES: Alpha=BLS cold, Bravo= BLS hot, Charlie= ALS cold, Delta= ALS hot. Response times just can't be reduced by adding more accelerator.

What the patient gets when the medic gets there is an important part of EMS and arguably the most important part. The importance of quality and quantity of medic and equipment cannot be overstated. If the outcome is good, time to service becomes irrelevant and that appears to be lost from this discussion, so thanks for bringing it back.

If one sets as the only priority how little can be spent for ALS, we might well not be getting the ALS we need. Hence my comment some time ago that I saw the best options as doing ALS well or not doing it at all. When the 'fat' gets trimmed from ALS, we lose the tools, not required by part 800 or REMAC that often can save a life. A legislator who says " I got you ALS for 50 cents per person less a year, but you're going to die of shock because the medic can't fix that when he or she gets there." Well, that is not a good way to save money. Time to definitive care, not cost and not response time should be driving the ALS debate. Sometimes that's a hospital and most times that's a well equipped medic.

Either we get well trained, well equipped medics to scene in time to make a difference, or we let it go.

[eagle5473 7]

Dont you thinkg Putnam county should fix the BLS system first...? The BLS system has been dead for years and no one want to do anything about it........Why do we have to call 3-4 ambulances for every call that comes in???? And NY only requires 1 EMT? and a driver or am I wrong? The FD's should give up the EMS system as they have failed to properly staff and address the lack of not just daytime coverage but complete lack of 24 hr volunteer EMS in Putnam county......

[FD828 77]

I have dispatched for a county wide ems in NC. I think Putnam would be a great place for this kind of system. If of course the politicians would get their head out of their you know what and realize that their is a need for it.

I can't agree more. Just out of curiosity, where in NC did you dispatch? I worked for Wake County EMS till Aprill 1999.

[ckroll 101]

Dont you thinkg Putnam county should fix the BLS system first...? The BLS system has been dead for years and no one want to do anything about it........Why do we have to call 3-4 ambulances for every call that comes in???? And NY only requires 1 EMT? and a driver or am I wrong? The FD's should give up the EMS system as they have failed to properly staff and address the lack of not just daytime coverage but complete lack of 24 hr volunteer EMS in Putnam county......

In times of fiscal crisis-- and if we are not there already, we will be soon--, the only entity that can 'fix' a deficiency in services is the entity that is responsible for providing them. It is a question that no one wants to answer and perhaps it is time to ask NYS exactly what the answer is. My understanding from this site is that 'home rule' means a county cannot supersede a town. If so, then the county cannot arbitrarily step in and take over. If not the county, then is it the town who is responsible or is it the agency who is providing the service?

To use an analogy, think of this as a neighborhood with nice lawns. The 11 homeowners can each cut their own grass or they can hire someone to do it, or or the community as a whole can agree on a standard and have someone come in. Without some sort of standard and without knowing who's responsible, if Mr. Neat thinks grass should be 1/2 inch high and Mr. Messy doesn't care how long his grass grows.... then by what authority does the short grass homeowner tell the long grass homeowner that his grass is too long? He doesn't.

That said, if Mr. Messy comes over 5 times a week to ask Mr. Neat to cut his grass, and eventually Mr. Neat can't cut his own lawn because he's always next door...... then Mr. Neat needs to tell Mr. Messy to find another way to get the grass cut.

What started out as a very good idea, Mutual Aid, has evolved into something else entirely. No one entity can afford to staff resources for the rare days day when 4 auto accidents happen all at once. But 3..2...1? When does a helping hand become welfare? Neighbor helping neighbor was never intended to address the situation of one neighbor no longer able to take care of his family.

The county apparently cannot tell a town what level of service they should have. BES does write and administer the mutual aid plan. The ability to provide service to a certain level needs to be a prerequisite to entry into the mutual aid agreement. We all ought to have to put into the system in order to draw from it. Once a town is asking for aid on a regular basis and cannot provide aid to others, then they should lose access to the system. Or we should have a buy in option. A town 'pays' for mutual aid by providing it to the system 1 for 1 or it makes a cash contribution, say $1,000 a call. The county then gets vollies for free or the money to hire more county contract service.

If we did this, then a town who wants calls answered has to carry its own weight except on really bad days, and a town who likes things the way they are can opt out of the mutual aid system.

Obviously, we cannot leave people to suffer. I think it would be wise for the county in addition, to arrange with a commercial vendor so that agencies who do not participate fully in the mutual aid plan are entitled to assistance from the plan only for immediate threats to life [ delta/echo]. All Alpha, Bravo, Charlie calls will be forwarded to a commercial service who gets there when they get there.

This would reduce pressure on neighboring towns, it wouldn't cost the county anything in overhead, it would provide revenue to commercials paid for entirely by the user, and if a town or its residents don't like the level of service they can find a way to pay for better.

It might look like this: Town A participates 1 for 1. If they can't field a crew, they get mutual aid coverage from the system for free.

Town B couldn't cover a call if it was the second coming and Christ twisted his ankle. They don't get free coverage. Either they 'buy' coverage from the county by kicking $1,000 into the system or they get diverted into the commercial system where as soon as a bus is free, they'll get one right over.... sometime in the next 3 hours. If that isn't soon enough, the homeowner can call a taxi or drive POV to the hospital. When the irate homeowner in Town B storms town hall, they get an application to join the volunteers or they can petition the Town B to pay for better service. Then Town B sits down with its fire department and fire department B explains why coverage as it is is OK.

[eagle5473 7]

Putnam should look to Dutchess Cty.....There are plenty of towns that have Commercial providers that handle the calls, or the Commercial provider is started out on most runs and if the Volies cant get out then the commercial provider handles the call....Furthermore Putnam County is a VERY affluent County if the citezenship knew that they are essentillay without an Ambulance for the most part, do you think there would be an uproar? Many towns in CT have Hired crews and charge for service and MAKE money doing it.....Between billing and a County/town budget line there is no reason 4 or more staffed Ambulances can not handle most calls in the county with vol back up on busy days.

[ckroll 101]

Furthermore Putnam County is a VERY affluent County if the citezenship knew that they are essentillay without an Ambulance for the most part, do you think there would be an uproar? Many towns in CT have Hired crews and charge for service and MAKE money doing it.....Between billing and a County/town budget line there is no reason 4 or more staffed Ambulances can not handle most calls in the county with vol back up on busy days.

Not from around here, are you? We're not rich. We have decent ambulance service, both ALS and BLS. Some towns have excellent service. An agency covering something like 2 calls a day cannot make money staffing full time crews. It isn't acceptable to cover 'most calls' and the logistics of arranging for vollies on the busy days escapes me.

Something like 6 ALS ambulances, properly spaced across the county is a workable solution. That however, would require all towns participating in a combined district or a change to NY law, neither of which is likely to happen.

[eagle5473 7]

From wikapedia for Putnam County NY

"Putnam County is one of the most affluent counties in America, ranked 11th by median household income, and 47th by per-capita income, according to the year 2000 census."

"The median income for a household in the county was $72,279, and the median income for a family was $82,197"

Lets look to Litchfield County in CT Similar Population for the land area. There are at least 8 Towns that pay to staff there Ambulance when the Volunteers are not schedualed, the Town of Morris population 2500 pays 2 EMTS 6-6 every day and has for 4-5 years now....Putnam County's disregard for the Public Safty of its citizens baffles me...The largest hinderance to the EMS system in Putnam County seems to be the Fire Department control over most of it......If Mahopac can spend $6Million or more on the Huge new firehouse why can they not staff there ambulance?

Putnam Valley sounds like its the Dimond in the Rough in Putnam County for providing Ambulance service

Edited March 22, 2008 by eagle5473

[WAS967 97]

but it should be obvious to all that when Putnam County is down to 2 medics that response times will be extended. I know I've logged response times close to 20 minutes as Medic 2 out of district.

Reminds me of the good old days when we ran only 2 flycars for all of Putnam County on a regular basis. I logged 23 minute response times to Putnam Lake from Mahopac for a Cardiac arrest once. (We didn't have a termination of efforts protocol yet either).

[Guest MVFD334]

From wikapedia for Putnam County NY

"Putnam County is one of the most affluent counties in America, ranked 11th by median household income, and 47th by per-capita income, according to the year 2000 census."

"The median income for a household in the county was $72,279, and the median income for a family was $82,197"

Lets look to Litchfield County in CT Similar Population for the land area. There are at least 8 Towns that pay to staff there Ambulance when the Volunteers are not schedualed, the Town of Morris population 2500 pays 2 EMTS 6-6 every day and has for 4-5 years now....Putnam County's disregard for the Public Safty of its citizens baffles me...The largest hinderance to the EMS system in Putnam County seems to be the Fire Department control over most of it......If Mahopac can spend $6Million or more on the Huge new firehouse why can they not staff there ambulance?

Putnam Valley sounds like its the Dimond in the Rough in Putnam County for providing Ambulance service

72-82k.. The population and number of new dwellings has skyrocketed since 2000.. Add to that the average cost of these new houses being built are an easy 500k or more and are being occupied by people that have the money. Dont let those numbers account for the 25% who are very well to do and the rest you are barely surviving there mortgage payments. The town and especially the school taxes are unbelievable.

One thing that aggravates me is when people stand out and blame the politicians. The reason these people are in public office is because of us. 2nd, I see all the time politicians being invited to parties hosted by the FD/EMS community, arent these the same people who are trying to cut out our services? I can remember a certain politician who was against approving the extension of Putnams ALS's contract. That legislator then road along with (PCMED3) and PCBES's commisioner. After that ride her vote from no to yes. After speaking with her, she was never against the ALS system but after her encounter she realized how we couldnt be without it, even if just for a few weeks or months till a new provider was secured. And thats how it is with the rest of them. (And for the record I am not fond of most polticians. We would have a much needed surplus in money from them if they cut out the dinners and events they so desperately need to function and mingle among there constituents.)

Fusco wants to stand up and blow some smoke, let him, but he is in a rude awakening when its time to go fishing for a new provider. But in the meantime get his butt on a ambulance with a medic and have him go across the county to cover a call while another medic is out. Then maybe he would realize like others that instead of complaining about the system and its problems to start fixing it.

As far as Putnam having a paid BLS system that is a light and the end of a very long tunnel. Just look at how long it took to get the 911 system going.

[MoFire390 118]

72-82k.. The population and number of new dwellings has skyrocketed since 2000.. Add to that the average cost of these new houses being built are an easy 500k or more and are being occupied by people that have the money. Dont let those numbers account for the 25% who are very well to do and the rest you are barely surviving there mortgage payments. The town and especially the school taxes are unbelievable.

One thing that aggravates me is when people stand out and blame the politicians. The reason these people are in public office is because of us. 2nd, I see all the time politicians being invited to parties hosted by the FD/EMS community, arent these the same people who are trying to cut out our services? I can remember a certain politician who was against approving the extension of Putnams ALS's contract. That legislator then road along with (PCMED3) and PCBES's commisioner. After that ride her vote from no to yes. After speaking with her, she was never against the ALS system but after her encounter she realized how we couldnt be without it, even if just for a few weeks or months till a new provider was secured. And thats how it is with the rest of them. (And for the record I am not fond of most polticians. We would have a much needed surplus in money from them if they cut out the dinners and events they so desperately need to function and mingle among there constituents.)

Fusco wants to stand up and blow some smoke, let him, but he is in a rude awakening when its time to go fishing for a new provider. But in the meantime get his butt on a ambulance with a medic and have him go across the county to cover a call while another medic is out. Then maybe he would realize like others that instead of complaining about the system and its problems to start fixing it.

As far as Putnam having a paid BLS system that is a light and the end of a very long tunnel. Just look at how long it took to get the 911 system going.

well put MVFD. But now I have a question. Have any of the volunteer agencies thought about running their own ALS service? like becomming an ALS corp instead of a BLS corp? I see a medic ridding with PVVAC alot.