"EMS in Critical Condition"

[INIT915 1,119]

http://timesunion.com/AspStories/story.asp?storyID=718445

As Brenda Wood was driving home after undergoing radiation treatment for breast cancer, her pager rang. Someone had called 911, so Wood, a Rensselaerville Volunteer Ambulance Service EMT, answered the emergency call, because if she didn't, who would?

"It's kind of pathetic that we had to rely on her that bad, but that's how it works," said her son Brian, the Albany County Sheriff's Department EMS unit coordinator.

[mikeinet 37]

You know -- it's articles just like this that really make me gripe. I actually (this past week) just moved to the Albany area. I contacted numerous volunteer agencies in my area (pretty much all split daytime paid/night time volunteer). Due to work, i'm only going to be in the area until February. With that being said, I was met with red tape everywhere I tried to volunteer. I've been an EMT for 4 years and an ambulance driver for 5 years... so it's not like I'm straight out of EMT class. Each dept I spoke with told me that it's not worth their time to train me since I won't be in the area that long.

Makes me laugh seeing a 3 page article was written about how they're short staffed... They say they're short staffed, but are they? Or are they being too picky.

[Remember585 815]

No one needs to look any farther then right here in Westchester County to see how unreliable, undependable and unwilling to change EMS is around here!

One needs only a scanner to listen to the multiple page outs, Mutual Aid requests and calls "saved by the Medic riding" there are every day - specifically in northern Westchester County.

It's a shame, because there are people around who can do the calls but choose not to.

[Goose 188]

Make it all paid, that will solve the problem.

[towerladder2 22]

Yup.......Paid.........Problem solved.....

[firemoose827 324]

You know -- it's articles just like this that really make me gripe. I actually (this past week) just moved to the Albany area. I contacted numerous volunteer agencies in my area (pretty much all split daytime paid/night time volunteer). Due to work, i'm only going to be in the area until February. With that being said, I was met with red tape everywhere I tried to volunteer. I've been an EMT for 4 years and an ambulance driver for 5 years... so it's not like I'm straight out of EMT class. Each dept I spoke with told me that it's not worth their time to train me since I won't be in the area that long.

Makes me laugh seeing a 3 page article was written about how they're short staffed... They say they're short staffed, but are they? Or are they being too picky.

Wow...I live near Albany, mind sharing with us exactly WHICH depts turned you down?? Maybe I can help you get in one, I know a lot of people around here, so tell us who turned you down.

[jack10562 414]

Make it all paid, that will solve the problem.

That solves only ONE problem, but it actually creates another, bigger problem...who is gonna pay?

The up-state and back-woods towns have no money, and that exact same situation probably can be applied just about everywhere else, even here in affluent Westchester.

NY'ers are probably among the most taxed people in the country, if not the most.

My property/school/county/village taxes have easily doubled in 12 years since I moved into my house, and I only have a small piece of the rock.

I can't imagine how much more we would have to pay to include costs for full-time paid FD and/or EMS.

[smwells 7]

If the problem was only short-staffed then yes a paid or partial paid system might work, unfortunately internal politics is causing a sizable amount of the issue in many departments.

I have seen it firsthand that longtime members (20+ yrs) are taking a backseat intead of dealing to the BS going on in many departments. Can't blame them for getting frustrated.

[Guest alsfirefighter]

If you have somebody who wants to volunteer, no matter what you should take them in and not push them aside or deny membership.

I couldn't disagree with this statment more. Just because someone has the best intentions doesn't always mean they are the best fit. This is public service we are talking about here....pride and wanting to do good doesn't always equate to proper service or high quality. I see on a weekly basis what good intentions versus actually being able to do equates to.

I always love the same comments no matter where you are.

Retention rates are high, officials say, but new recruits are hard to attract, which is why some officials envision a day when EMS volunteers will be replaced with fully paid staffs, at taxpayers' expense.

Envision? Take off the rose colored glasses gang...you have a problem right now...look at the article. The system in one town relies on one person? Retention remains high? So what the 10 or 20 you have now with "spotty" coverage collapses and then you scramble and have to find big $$$ in the budget instead of finding the means to phase in the eventuall full coverage you envision? Boy does this sound familiar....and why "full paid"? Why not still welcome those to work with the crews and within the system itself for those who wish to remain and serve?

"If things continue as they are as far as recruitment and retention," Mulleedy said, "there's no question that day is coming."

Hate to let you in on this..but that day is here. The same person that said the above quote also says earlier in the article

"It has become increasingly apparent that we just don't have the people that we really need to do the job comfortably well," Mulleedy said.

Which one is it...you don't have enough people now to do it "comfortably well" or the day is coming? So its ok to sweat it out? Or hope that someone doesn't have a moderately bad illness or episode that delayed transport ability doesn't kill them? Why is it so hard for agencies to see that and self justify? I deal with agencies just like this.."well we only have problems on this day or that time." Not a problem...remind your family not to have a significant injury or illness at those times. Yet again...find a way to maximize the system and phase in your needs to reduce the budget burden! Why is it that there are places all over down south and out west that have full or nearly full paid combo systems that still have volunteers that supplement the system and guess what???? Their taxes are lower then the BS we pay in this state! And they have more they can do for patient care!

"The writing is on the wall now," said Tim Mirabile, executive director of Regional Emergency Medical Organization, which operates EMS in Albany, Columbia, Greene, Rensselaer, Saratoga, and Schenectady counties. "You see many squads now going to pay crews, especially in the daytime hours."

Maybe they all need to speak with this guy...but then again you can only see what you want to see grasshopper.

Not only would it be more expensive, the way you'd go about funding of the system would have to change pretty dramatically."

Apparantly finding the way to do this...in addition to non-traditional means to help is much more difficult then sitting and listening to a pager go off over and over again for multiple agencies. Then again that's just a radio transmission...they aren't sitting there with the patient trying to reassure them everything is ok or trying to keep them entertained because quite frankly its pretty damn embarrassing and frustrating to have to wait on what should be a basic service.

[Goose 188]

The villages/towns/cities and, insurance companies, medicare/medicaid? It works pretty well in southern Westchester and some agencies do 3x the call volume of some northern agencies in less than a month...

Edited September 9, 2008 by Goose

[Guest feraldan]

I couldn't disagree with this statment more. Just because someone has the best intentions doesn't always mean they are the best fit. This is public service we are talking about here....pride and wanting to do good doesn't always equate to proper service or high quality. I see on a weekly basis what good intentions versus actually being able to do equates to.

If that's not hitting the nail on the head, I don't know what is.

Also I'd like to point out that not everyone who volunteers has positive motives as well. Sometimes having an excessive number of volunteer members who leech off the organization can actually be a drag, particularly if your organization has incentive programs in place such as pensions. How many people show up to parades or free events but never show their faces when you actually need them? How many join a volunteer corp only to sit idle and never advance, never train and never learn actual EMS skills?

I used to think that more could never hurt, but nothing could be further from the truth. Quantity certainly does NOT replace quality. There are so many examples of this. Votes that are improperly swayed because non-medically trained individuals outnumber those with actual certification. Apathy towards advancement in equipment and procedures because they don't know any better. Frustration because non-trained members impede the professionalism and success of a call.

Most wouldn't try to join a police department if they had no interest in law enforcement.

Most wouldn't try to join a fire department if they had no interest in putting out fires.

Why do volunteer agencies allow members who have no interest in EMS? Why do we clog our ranks with the unfit, shady and disinterested?

[ex-commish 490]

Also I'd like to point out that not everyone who volunteers has positive motives as well. Sometimes having an excessive number of volunteer members who leech off the organization can actually be a drag, particularly if your organization has incentive programs in place such as pensions. How many people show up to parades or free events but never show their faces when you actually need them? How many join a volunteer corp only to sit idle and never advance, never train and never learn actual EMS skills?

I call them sponges because they join and soak up everything they can than if they last 5 years they become exepmt benevolent members for life and are entitled to whatever benefits the benevolent offers.

[gamewell45 258]

Make it all paid, that will solve the problem.

And where does the funding come from? Peoples pockets are only so deep. At some point they are going to say enough is enough. I've already seen one fire district which wanted to hire paid firefighters to supplement the all-volunteer department and the referendum was defeated by the taxpayers.

The bottom line is, unless you have a money cannon to aim at the problem, the chances of converting every Rescue squad into a paid force is nefarious at best.

[Guest MVFD334]

If that's not hitting the nail on the head, I don't know what is.

Also I'd like to point out that not everyone who volunteers has positive motives as well. Sometimes having an excessive number of volunteer members who leech off the organization can actually be a drag, particularly if your organization has incentive programs in place such as pensions. How many people show up to parades or free events but never show their faces when you actually need them? How many join a volunteer corp only to sit idle and never advance, never train and never learn actual EMS skills?

I used to think that more could never hurt, but nothing could be further from the truth. Quantity certainly does NOT replace quality. There are so many examples of this. Votes that are improperly swayed because non-medically trained individuals outnumber those with actual certification. Apathy towards advancement in equipment and procedures because they don't know any better. Frustration because non-trained members impede the professionalism and success of a call.

Most wouldn't try to join a police department if they had no interest in law enforcement.

Most wouldn't try to join a fire department if they had no interest in putting out fires.

Why do volunteer agencies allow members who have no interest in EMS? Why do we clog our ranks with the unfit, shady and disinterested?

Maybe because some members can not handle blood, death, broken bones.. And Im not speakin of those who can and choose not to. It is up to dept heads to set forth rules that make people who are only there for the fun that are active (not an associate member) be disqualified from certain events should they not meet certain criteria's such as calls, and or house duty and drill. Everyone bitches about this problem but who steps up and says something?

As far as quanity and quality, remember beggers cant be choosers. You take what you get, be thankful and train them and put them where they best fit. Maybe some arent compitent fire fighters, or emts but last I remember it dosent take much to roll hose or grab an O2 bottle from the ambulance. I understand some points people are making on here, but s*** be grateful for what you have. Instead of making up threads in which EVERYONE knows the deal, post one that shows something that was put in place to help the problem and speak about the pros and cons. I feel recruitment and having a good running dept is affected by the attitude of its leaders.

As far as going to an all paid EMS service.... Full time work at part time pay.

[nycemt728 49]

I think people are mistaking quality control for inflexable tradition. I have seen first hand volunteer agencies turn down badly needed, qualified assistance simply based on an archaic rule or pride. No one would advocate placing an unqualified person on the road, but at the same time, we are in vital roles, people depend on us. Given a choice between answering a call or not having the adeqaute staffing, I know where my choice is. The situation needs above sounds like agencies need to swallow their pride, accept the offer, and make it work for everyone's best interest. There have been multiple threads here on the lack of volunteerism, recruitmemt issues etc...you can't have it both ways, if you have a willing volunteer. esp someone with qualifications, you do what you must to make it work, not spew a bunch of junk about how long its going to take to bring that person up to your standards. Mikeint, kudos for your willingness to volunteer in your temporary neighborhood!

[DR104 141]

I call them sponges because they join and soak up everything they can than if they last 5 years they become exepmt benevolent members for life and are entitled to whatever benefits the benevolent offers.

Use a point system!!!! And inforce it!!!!!!!!!!!!!!!!!!

[gamewell45 258]

If that's not hitting the nail on the head, I don't know what is.

Also I'd like to point out that not everyone who volunteers has positive motives as well. Sometimes having an excessive number of volunteer members who leech off the organization can actually be a drag, particularly if your organization has incentive programs in place such as pensions. How many people show up to parades or free events but never show their faces when you actually need them? How many join a volunteer corp only to sit idle and never advance, never train and never learn actual EMS skills?

I am amazed that there are departments out there that would allow that to happen.

In my department, if you don't get your points (and that doesn't mean just showing up, but participating)you get absolutley none of the benefits (LOSAP, membership rights, pool passes, etc) that you'd normally get. Those who do nothing, and show no viability in doing such, should be invited to tender their resignation.

[5slow 9]

picky,.....................who knows.. Maybe its because they want an agency where everybody is alike? If you have somebody who wants to volunteer, no matter what you should take them in and not push them aside or deny membership.

sounds like a break down in organization and bad leadership..............

I'm not sure why it's a breakdown, but you must not be around very long. There are certainly some people who want to volunteer who shouldn't be brought into any department. How are you in law enforcement at such a young age? I know NYS minimum age is 21 years old...

[ny10570 745]

The villages/towns/cities and, insurance companies, medicare/medicaid? It works pretty well in southern Westchester and some agencies do 3x the call volume of some northern agencies in less than a month...

But that call volume is why it works. Without the call volume they cannot generate the revenue to fund an ambulance 24/7.

[Bnechis 3,961]

But that call volume is why it works. Without the call volume they cannot generate the revenue to fund an ambulance 24/7.

And the smaller call volume communities can do it if they are willing to merge with surounding communities.

The public cares about having good service, the only one who cares about defending turf is the local agency.

[E58RET 24]

Way to go Barry!People have to realize that you can no longer depend on the "other guy" who is an EMS member to be there 24/7 .Having worked both side of the equation the higher the call volume the more need for paid staff

[Goose 188]

But that call volume is why it works. Without the call volume they cannot generate the revenue to fund an ambulance 24/7.

So merge with surrounding towns/villages. It's 2008 for christ sake, there really is no excuse.

Edited September 10, 2008 by Goose

[ny10570 745]

Consolidation is a much bigger animal above and beyond switching from volly to paid.

[Goose 188]

Well other agencies have done it here in Westchester. Just because its hard and may take some solid leadership doesn't mean it shouldn't be done. And if things are that resistant to change up there, the County should step in and do it themselves.

[ny10570 745]

As has been covered in every consolidation thread, NYS is a home rule state. The county cannot force anyone to consolidate. They can entice communities with services or cash, but they cannot force anything. Who has consolidated?

[Guest feraldan]

Maybe because some members can not handle blood, death, broken bones..

Then volunteer at an animal shelter or soup kitchen. Why EMS? Why try to bang a square peg through a round hole? It just doesn't make any sense.

Everyone bitches about this problem but who steps up and says something?

I can tell you that I've tried with my own volly agency and I was shot down. When you have unqualified, non-medical personnel running the show, its easy to be knocked down. If you can reap all the benefits of taking on a position of power and get all the credit, why bother taking the responsibility that goes with it? Why waste your time sitting through classes and training?

As far as quanity and quality, remember beggers cant be choosers. You take what you get, be thankful and train them and put them where they best fit.

If you're not getting out the door because there are no EMT's or Driver's available, what good does another 50 untrained "assistants" make? You could have a 1000 members but if you have no EMT's, what good does it do? I've sat in HQ waiting for a Driver to arrive and literally had 7 other people show up who couldn't do ANYTHING. They all wanted credit for the call but they were neither EMT's, nor CFR's, nor qualified Drivers. The call had to be sent mutual aid because we had a bunch of people sitting around who didn't want to take on the responsibility of a necessary position and they were 100% backed by a set of policies and procedures that supported such apathy.

We do need to collectively embrace quality. We need to embrace those with the drive to advance and obtain certification. You can't train someone who doesn't want it, who doesn't give two craps about EMS.

[Guest alsfirefighter]

Maybe because some members can not handle blood, death, broken bones.. And Im not speakin of those who can and choose not to. It is up to dept heads to set forth rules that make people who are only there for the fun that are active (not an associate member) be disqualified from certain events should they not meet certain criteria's such as calls, and or house duty and drill. Everyone bitches about this problem but who steps up and says something?

As far as quanity and quality, remember beggers cant be choosers. You take what you get, be thankful and train them and put them where they best fit. Maybe some arent compitent fire fighters, or emts but last I remember it dosent take much to roll hose or grab an O2 bottle from the ambulance. I understand some points people are making on here, but s*** be grateful for what you have. Instead of making up threads in which EVERYONE knows the deal, post one that shows something that was put in place to help the problem and speak about the pros and cons. I feel recruitment and having a good running dept is affected by the attitude of its leaders.

As far as going to an all paid EMS service.... Full time work at part time pay.

As far as quality...yes you can choose. You can either choose to have obtainable standards that require personnel to be able to operate at a minimum standard set forth by the department "leadership." The quantity part should fall into line with both the legal and standards that are out there and I don't buy into the old regime thought process of quantity over quality either. Set the expectation and you will have those that will rise to it. The ones that don't will generally hinder the operation and/or make you look ridiculously bad in the process. With the majority making excuses as to why they can't do this or that or talking a good game of how great they can do something but have a mysteriously bad day when it comes time to put up. I'll still get more done with 4 competent firefighters then I will 2 competent and 2 that "aren't compitent" being the 2 that are up to snuff will have to either hold the hands of the 2 incompetant ones or do their work entirely over. Again this is public service and an activity that has a little more at stake then just pride.

Instead of making up threads in which EVERYONE knows the deal, post one that shows something that was put in place to help the problem and speak about the pros and cons.

Why is it that far to many of us keep wanting to look left, right, up and down for an answer from someone else or sit around and not recognize the problem or at least not want to, hope it doesn't happen, or maybe is ignorant to what could happen or hope for divine intervention? There isn't any one answer or one agency or situation to look at that will fix anyone else's problems unless there is one extremely close to home as issues encountered or climate to look at how to deal with the issue is at a state, regional and local level.

Some different thought processes I've discussed or thought about over the years:

1. A small percentage surcharge to automobile insurance, that would work similarly (but not exactly like!) the 2% monies the fire service receives, but it would go to EMS and be required to use directly for staffing/equipment. Not handcuff the BS that 2% can only be used for now.

2. A small $2 to $3 surcharge on all DMV transactions that again is earmarked for EMS.

3. On local levels and this becomes a problem when you have 3rd party agencies as many areas with VAC's do, limiting the oversight government officials have, which in turn unless you work with them openly you could meet resistance. But the amount of transactions for things like building permits etc could also be found to have a small surcharge that goes directly to assist in funding for quality emergency services.

4. Other options that are not as well received but I've seen every once in a while....billboards on stations, cell towers, advertisement on units etc. that generate montly, quarterly or annual returns.

5. If taxes are such a big issue...do the numbers ahead of time and explain why something is needed and make a stand alone ambulance district to be able to tax for funding and show how little the impact actually is per household compared to the benefits and need.

6. Find out if there is a legal ability to charge an annual surcharge to nursing homes and other extended facilities...911 or not. If municipalities can charge to empty their dumpsters when they pay taxes...why shouldn't EMS be able to charge something. Again...not greedy...looking to offset costs.

The amount of money made is important to offset the "call volume" argument in regard to billing recoup and to offset the "burden" on taxpayers. As far as seeing a fire district that voted down having paid staff...I'm willing to bet it wasn't sold with all the much furor either. Of course we could all just sit around and keep saying it will never work....

Is that enough different ideas?