EMS in Putnam County: "BLS 4"

[helicopper 1,050]

Recently I've heard Putnam 911 dispatching "BLS 4" along with the medic and VAC/VFD for calls. Is this the contract BLS unit and if so what response areas is it covering?

[smwells 7]

Chris,

BLS4 is covering the same general area that Medic 4 covers (Brewster, Put Lake, Patterson)

[Guest alsfirefighter]

So how many other "BLS #" units are there? Or is this another example of a geographic area of Putnam citizens getting abit more coverage then others?

[texastom791 31]

there's only one bls ambulance because of the call frequency like you said.

[helicopper 1,050]

there's only one bls ambulance because of the call frequency like you said.

So residents of Putnam County WEST are once again subsidizing a program for Putnam County EAST. Unbelievable! The EMS agencies in Philipstown recognized their own staffing problems and hired their own personnel to cover the day shifts but the agencies on the opposite side of the County are relying on the County to solve their problems for them. It's truly pathetic. The agencies in the east have much larger tax bases to draw from but they choose not to - what's up with that?

The Philipstown agencies ought to fire their people and petition the County to pay their bills too!

[EJS1810 7]

There is no additinal costs to Putnam County for the BLS transport unit. Stop the "West side whining" Please!

[Guest DADAY]

STOP! This is like beating a dead horse!!

[Guest alsfirefighter]

There is no additinal costs to Putnam County for the BLS transport unit. Stop the "West side whining" Please!

LOL. So if there is no additional cost then why not have equal coverage across the entire region?

I have to agree to with Chris...regardless of what the financial terms are for having a BLS ambulance on the east side of the county...why isn't Putnam on a county level working with Philipstown VAC to assist them financially or with personnel through the agency they are working with now with the coverage of their customers?

Dead horse or not...

[Medic137 6]

So residents of Putnam County WEST are once again subsidizing a program for Putnam County EAST. Unbelievable!

BLS 4 is supported by billing the patients it transports. It is the tax payers on the EAST side of Putnam that should be complaining. They are paying for ambulance service once in their fire district taxes and again when they are are transported by BLS 4.

[Medic137 6]

LOL. So if there is no additional cost then why not have equal coverage across the entire region?

Dead horse or not...

Because the number of calls that the local volunteer corps can't cover isn't large enough to support a BLS 1 or 2.

[helicopper 1,050]

Because the number of calls that the local volunteer corps can't cover isn't large enough to support a BLS 1 or 2.

I beg to differ. On the west side of the county there are TWO VAC's paying for coverage when the volume would be adequately covered by a BLS 1.

EJS, I'm not whining. I think it is ridiculous that the County is supporting only a portion of its population with a service that is paid for by the entire population. That's not whining, it's a legitimate gripe.

Medic137, you make a great point. The taxpayers of the districts that are unable to cover their own calls are paying twice for a service and that too is ridiculous.

Finally, we're not beating a dead horse. The issue of EMS in Putnam County is an ongoing one and it is time that a comprehensive strategy be adopted for the entire county rather than these band-aid fixes that don't actually address the underlying problems.

[irishfire2491 24]

The Philipstown agencies ought to fire their people and petition the County to pay their bills too!

EASY THERE Chris

[Medic137 6]

I beg to differ. On the west side of the county there are TWO VAC's paying for coverage when the volume would be adequately covered by a BLS 1.

I think a BLS bus would have to make 4 or 5 transports a day to cover its operating cost. I don't think Garrison and Phillipstown average that many calls. Even if the volunteers couldn't cover any of the calls, the county would have to contribute to a BLS 1. Yes, the VACs are paying for daytime coverage. But they are also billing for the transports. If all the runs were turned over to BLS 1, they would lose that revenue.

[ckroll 101]

LOL. So if there is no additional cost then why not have equal coverage across the entire region?

I have to agree to with Chris...regardless of what the financial terms are for having a BLS ambulance on the east side of the county...why isn't Putnam on a county level working with Philipstown VAC to assist them financially or with personnel through the agency they are working with now with the coverage of their customers?

Dead horse or not...

The horse is not dead, merely resting... it could be an arduous fall campaign. Life is not fair, and those who seek it are bound for disappointment. That said....One can reasonably ask that if not fair, that decisions should be just and that managers do the best with what they have. In this respect West Putnam has been sold short by decision makers who do neither. One can hope that if prospective vendors and management follow this site.... that better decisions might be made with resources at hand that might even..horrors...be money makers as well.

Putnam is complicated by population densities and topography. What is driving decisions at present is the transition from volunteer to paid service. East Putnam has the population density to break even/be profitable. West Putnam is low density with abysmal terrain. Expecting fair/equal coverage ignores the monetary and geographic reality that West Putnam is and will always be a money loser with extended response times. For-Profit agencies will, and should, be reluctant to take it on.

I hope that the upcoming contract will be for 2 BLS ambulances and 4 ALS flycars. Taking the longer view, if East Putnam solves its problems without tying up or displacing Medic 2, then the West side comes out ahead. If a BLS ambulance were stationed at Putnam Plaza and a second BLS ambulance were stationed at Mahopac Falls, then the Falls unit could backfill the Plaza unit as needed, but it could also backfill the West side and service the Taconic Parkway. I believe it would be a money maker and if it moved on initial dispatch, it could be in appropriate position to respond if any of the West side agencies failed to cover.

Six units, each in different locations can give most of Putnam coverage in a reasonable time, and yes, West Putnam should have access to BLS assist if their volunteer agencies fail to cover. It might not be there in 10 minutes, but second choice could be a paid service that was in motion from time of dispatch.

Maybe not ideal, maybe not fair, but it would work and might just make money......

[Guest alsfirefighter]

I think a BLS bus would have to make 4 or 5 transports a day to cover its operating cost. I don't think Garrison and Phillipstown average that many calls. Even if the volunteers couldn't cover any of the calls, the county would have to contribute to a BLS 1. Yes, the VACs are paying for daytime coverage. But they are also billing for the transports. If all the runs were turned over to BLS 1, they would lose that revenue.

I understand the point you are making and I completely understand. However I have to pose this question. Since when is (or when should) an emergency service decision be made based on "covering operating costs?" Does law enforcement cover their operating costs by writing tickets or with drug seizure money? What does the FD roll in? So in some aspects you can't look at it as simply covering operating costs but how much can you recoup to offset cost. So never mind if I were to live in Western Putnam county and have a massive MI and my primary agency doesn't get out...the mutual aid agencies take 15 minutes to assemble and respond and I get to the hospital some 60 mins later...but if I live in eastern Putnam...with exception of other call volume possibilities I would get there sooner, but not in western Putnam because there isn't enough call volume on that side to warrant the same service that my other fellow residents are getting...but yet part of my tax dollars go to paying for the system.

Christy...well thought out post with some excellent ideas. Maybe when companies stop trying to look at bidding the county during contract time and how to make money off Putnam to provide service instead of what its supposed to be about...service...maybe things will move ahead. But then again...it seems difficult to get some to understand that service is what it really is all about.

[Guest MVFD334]

CKROLL excellent points.

Not to long ago there was a pretty good debate on how long it was taking various agencies to respond. This fix (temp or not) hopefully has helped releived this without costing the county. As far as people paying twice, what about when you have ALS on board? Should that also be free because someone already payed taxes? Or should someone who is out of county get from an agency that dosent charge for bls transport.. These are all things that could be asked but I think overall the most important thing is to get the patient to the hospital in a timely matter.

[ckroll 101]

Providing [ meaningful - fair - equal - affordable - high quality -insert favorite adjective here ] EMS coverage for Putnam is complicated because Power, Money. Responsibility, Want/Need... the components that drive the equation... are all in different hands. The power to make the decision lies with PCBES, the money to pay for it comes from the County Legislature, the responsibility for providing EMS service lies with each Town [home rule] and it is the residents that want/need the service....and who ultimately ARE the ones paying for it. You wouldn't buy a house or a car this way. I'm not sure you could.

The towns need to take responsibility for EMS or have it forced onto them. So long as the mutual aid system is applied as de facto welfare... if the town won't do the job, the county will do it for them,.... then the towns have no motivation whatsoever to solve the problem. Mutual Aid needs to be managed, not as the never ending hand out, but like a line of credit. Mutual Aid agreements should be made with towns [not the agencies], who have both responsibility and the monetary resources to provide service. The towns need to agree that mutual aid is not a right, but an obligation that needs to be paid back. If a town needs to use more mutual aid than it can provide into the system, then there needs to be quarterly review of response by the county/mutual aid consortium. If a town is not paying into the mutual aid system with service, then it needs to make a monetary contribution or it needs to hire someone to provide service.

The role of the county should be to oversee the mutual aid system, set rules for membership and contract for reasonably priced service so that towns that need to pay can get competitive rates. Simply put, a town agrees that it will not use more resources in a year than it puts in. It also agrees in advance that if it does, it will pay a fee for those services or it will hire someone to provide these services. If a town does not like the rules, it does not have to participate in the mutual aid plan.

Consider Putnam EMS mutual aid like a community garden. There are seven families working in the garden. Everyone needs to eat. Some weeks a family has time to weed and some weeks it doesn't. If one family continually comes to the garden and takes vegetables but does not pay for seeds, or bring water or weed, then the group would tell the family not to pick vegetables or to pay for them or hire someone to do their share of the work. If the family protests that it needs to eat, the group will remind them that we all need to eat and we all need to contribute.

If the county steps in and buys the family pizza every week, it does help the other families who tend the garden, but then they might like pizza, too. And if in the end, the other families get the bill for the pizza, they might reasonably argue that the county is not only NOT solving the problem, it's making it worse by appearing to solve the problem but encouraging the family to continue to take handouts.

A better solution would be for the county to set rules for using the garden, to go to the family when they fall behind and tell them to pay for veggies, help in the garden or to hire the nice boys down the street who will weed for you if you don't have the time.

That's my idea for where the county management ought to be putting its efforts.