Eastern Dutchess EMS issues

[Guest Local596Secretary]

The following link is the a Poughkeepsie Journal article involving the Standfordville area and it's issues with EMS response.

Poughkeepsie Journal Article

Am I the only one that feels like this is ridiculous? While the article covers Stanford, Amenia and Pine Plains, and the Village of Millerton, the only run numbers given are from Stanford. You volunteers from Stanford please don't take this as a personal shot at you as these are the numbers I have. These problems exists everywhere.

68 of 176 calls MISSED!!!! Thats 39 percent or more importantly, 68 people who needed immediate emergency care that were left out in the cold. They are in talks to remedy the situation....by staffing the volunteer rigs with paid workers during 6am to 6pm hours. Of the 68 calls missed only 46 of them occured during these hours. That still leaves 32 percent or again more importantly, 22 residents left to wait for NDP. I can only imagine the other towns are similar.

With the DOH guidelines on stroke care, early access to defib, wound and fluid management, these long wait times for emergency care are outrageous. Why is the volunteer service so against progression and taking care of it's residents properly if it means they have to give up thier power? Why are they worried about the 46 residents but because there are still a few responders who have to be used they forget about the other 22 people they abandoned?

[markmets415 524]

Couldn't agree more, all you have to do is listen to the radio and see that it is not only the day calls or 12 hour block.

I will only speak regarding my own dept., we miss very few calls; NDP is simo dispatched on ALL our calls and have covered any of the ones we were not available for, which I believe is 2 out of approximately 70 calls, don't hold me to that.

As for us "giving" things up, again I will speak only of my dept., we addressed this very issue in the past and have never had an issue with going with a paid service, it is something that is higher than us, this is why we added NDP to all (even fire calls) our dispatches. I will not get into the politics of this issue here as this is not the stage, however as I said this is not anything new that we haven't already tried to address, at least on my organizations part.

[Guest DFD189]

The following link is the a Poughkeepsie Journal article involving the Standfordville area and it's issues with EMS response.

Poughkeepsie Journal Article

Am I the only one that feels like this is ridiculous? While the article covers Stanford, Amenia and Pine Plains, and the Village of Millerton, the only run numbers given are from Stanford. You volunteers from Stanford please don't take this as a personal shot at you as these are the numbers I have. These problems exists everywhere.

68 of 176 calls MISSED!!!! Thats 39 percent or more importantly, 68 people who needed immediate emergency care that were left out in the cold. They are in talks to remedy the situation....by staffing the volunteer rigs with paid workers during 6am to 6pm hours. Of the 68 calls missed only 46 of them occured during these hours. That still leaves 32 percent or again more importantly, 22 residents left to wait for NDP. I can only imagine the other towns are similar.

With the DOH guidelines on stroke care, early access to defib, wound and fluid management, these long wait times for emergency care are outrageous. Why is the volunteer service so against progression and taking care of it's residents properly if it means they have to give up thier power? Why are they worried about the 46 residents but because there are still a few responders who have to be used they forget about the other 22 people they abandoned?

I am not from the area in question, but am from an upstate volunteer department which had to address this issue a few years back.

Our town splits its ambulance service between two volunteer agencies. Between the two of them, they respond to around 5,000 calls per year.

We are backed up by a third agency, a local chemical industry which maintains a rig on its premise.

Between the three agencies, we never "missed" a call.

However, we were often "rolling" calls over from one agency to the other when a daytime crew could not be found. This means delayed response, which as you point out can be life threatening in certain cases (we do have full-time paramedics (paid) who respond to these calls in a seperate fly-car, but packaging and transporting the patient in question is still delayed).

We had no choice but to hire paid EMS staff to man two ambulances from one volunteer service, and provide an EMT/driver for the other. The third ambulance from the one service, and the second ambulance from the other, are still manned (as needed) during the day by volunteer crews. After 6 pm, and until 6 am, the staffing becomes all-volunteer.

While this is an expensive option, it was the only way to provide the care our taxpaying citizens required. It did not weaken the volunteer agencies in question, but rather made them more viable. While the daytime staffing is provided by paid personnel, the overall agency continues to be run by the volunteers. There are no serious conflicts between paid/volunteer crews, and there have been several occassions where we have run mixed volunteer-paid crews with no issue whatsoever.

In a high-volume service area, volunteer EMS providers will probably have no choice but to hire paid crews to make sure that they can get a rig (or rigs) off in a reasonable response time. It is a reality of the times, and not a poor reflection on the dedication of the volunteers involved. In my response area, we are getting around 8 daytime calls per day. Each call (if transport is involved) takes around 1.5-2 hours. Thats full-time work, not traditional volunteer coverage.

[Guest alsfirefighter]

Local...good post. Makes you see the issue in a completely different light. Getting the ones who need to see it is always a different story and different war. Then you'll get the "our call volume doesn't justify the staffing," comment...and I always ask what is the price of service?

[Guest Local596Secretary]

Very good responses and very good fixes for the problems that you were addressed with. 5000 runs a year is an awful lot and I am glad to see that you have taken the needed measures to supplement your runs. I can only assume that you already had adequate evening coverage and therefore didn't require the night time staffing.

Sounds to me like Markmets has a suggestion that should be taken into consideration. A simultaneous dispatch would at least get the ball rolling quicker on a mutual aid type of response. Mark, would you mind giving us an estimated response time for when dover responds as opposed to when NDP has to cover?

Also, DFD mentioned a paramedic fly car which is full time (was that day and night?). I think this option should be considered as well. There are alot of posistives a paramedic can accomplish prior to transporting rigs arrival. Perhaps we can tune this topic to be more along the lines of what similar companies in this situation have done to fix the problem. I do not intend on this ending up being a forum for volunteer bashing in anyway.

[FiftyOnePride 100]

I can honestly add that Millerton isn't near those numbers. I like the guys and gals over in Stanford, and it's a shame that they are in this predicament. That isn't to say that on occasion during the day we do not leave one for NDP, but it is not close to that number, and most definitely not at night during our duty shifts.

I like what Wahoo has done with automatic dispatch for NDP on everything, they are usually coming out of Sta 2 in our district so I think it takes them somewhere from the 5-15 minute range.

The medic flycar is something that I have seen elsewhere (Capital Region), and have seen its success, every ambulance call I have run across the paramedic is there minutes before the bls rig shows up to transport, and they have gotten a first set of vitals and started doing their magic.

Why is the volunteer service so against progression and taking care of it's residents properly if it means they have to give up their power?

You answered your own question.

[helicopper 1,050]

While simultaneous dispatch with a second agency, paramedic fly-cars, and mutual aid are all band-aids. None of them actually fix the underlying problem - inadequate staffing and failure of "management" to deal with the issue.

Relying on other agencies or paramedics is not a solution to this problem! Paramedics should be used when advanced life support is required and not to serve as the EMT for the basic agency that is unable to staff its ambulance.

The ultimate failure is at the Department of Health that allows agencies that can't provide the service they're chartered to provide to continue to exist. There must be some accountability and if an agency consistently and routinely is unable to get out the door, the DOH should step in with a warning. If they still fail to respond, they should have their operating certificate suspended until they provide an operational plan that insures adequate coverage and response. But the DOH is a nightmare and treats EMS as a distant afterthought so I doubt they'll ever step up. (This is not a criticism of any of the employees of the Bureau of EMS but rather a condemnation of the Department and how EMS is regarded by the administration).

The other entity that is culpable yet ignores their responsibility is the town/village/city board/council that allows this to continue on their watch. Though pitifully worded, the law requires that towns ensure emergency ambulance service is provided. So, where's the town? Are they turning a blind eye to the problem because the "good ol' volunteers are doing the best they can"? What about their constituents who need the ambulance for their emergency? Do they even know it is their responsibility?

What "power" does a volunteer EMS provider or administrator have to give up anyway? What would they possibly lose by insuring the service is responsibly and properly provided?

This is much bigger issue than a single town in a single county and I hope the members of that agency realize this is not directed at them personally.

[BIGD3265 0]

I don’t know the whole situation out in that part of the county with manning and the availability of people during anytime of the day or night. As we all know that is a problem not just in eastern Dutchess but rather a nation wide problem. I am career staff but I am also a volunteer and Love volunteering my time when I can. But I find it hard to volley as much as I used too working two jobs and trying to spend time with my family and my 2 year old. I do find it hard to make it out to some of the calls, but then again it’s the sign of the times we live in guys. Like said in other replies there are many ways to address this. Get a dual dispatch for a commercial and/or another near by towns volley ambulance for example. Just to add another concept in not sure if it works or how it works I am sure someone out there knows more then me on this one. What if a company went too paid on call where it gave a little something to the members that responded to call? Maybe it would help but there are pros and cons to everything its just an idea.

[Guest]

What good is a medic flycar if there is no ambulance to transport? I know they had a similar problem in New Milford, CT, so they have gone to paid staffing on one of there units from 6am-6pm, M-F. It seems to be helping.

[Guest Local596Secretary]

The other entity that is culpable yet ignores their responsibility is the town/village/city board/council that allows this to continue on their watch. Though pitifully worded, the law requires that towns ensure emergency ambulance service is provided. So, where's the town? Are they turning a blind eye to the problem because the "good ol' volunteers are doing the best they can"? What about their constituents who need the ambulance for their emergency? Do they even know it is their responsibility?

This is much bigger issue than a single town in a single county and I hope the members of that agency realize this is not directed at them personally.

First off, I second the statement about not taking this personally.

Second, you make an interesting point here regarding the "laws" as you put it that towns must uphold. I am curious as to where I would find this law and what its wording is. If you could direct me to where I may find it, I would appreciate it.

Edited April 29, 2009 by Local596Secretary

[Guest Local596Secretary]

What good is a medic flycar if there is no ambulance to transport? I know they had a similar problem in New Milford, CT, so they have gone to paid staffing on one of there units from 6am-6pm, M-F. It seems to be helping.

Does "seems to be helping" mean ALL the calls get handled properly? Why aren't the people responsible considering Full time Staffing supplemented by vollunteers? It just seems a waste of time and money to do something half-way.

[Goose 188]

Does "seems to be helping" mean ALL the calls get handled properly? Why aren't the people responsible considering Full time Staffing supplemented by vollunteers? It just seems a waste of time and money to do something half-way.

Local - i appreciate your concern. When i worked in Dutchess i saw some of this stuff (not just on the east) and my jaw dropped.

A medic flycar doesn't fix the central issue. Sure, the medic gets there and he/she can dump the whole drug box into the patient but this is just a stop gap. It's a smoke and mirrors excuse - staff the flycar to stop the clock and give the volunteers more reason to not address the real issue - why their bus isn't getting out.

I only was requested a few times into those areas and as such i am not familiar with the politics (i loved playing in Poughkeepsie too much). It will be a hard fight - i'm sure of that. But, regardless of call volume, those ambulances need to be staffed. A regional solution (ie: consolidation) is the best, but they don't have to look far to get some ideas:

BVAC - they contract through Alamo for EMTs to staff their BLS bus

Pleasant Valley - They have a ALS/BLS truck Mon - Fri during business hours staffed at the FD

This may have changed since i left Dutchess, but those are two examples of different organizations addressing their issues. And, during my time in Dutchess, Pleasant Valley Rescue was one of the best at getting a bus out the door!

Great topic, hopefully something is addressed.

Edited April 29, 2009 by Goose

[JetPhoto 626]

BVAC - they contract through Alamo for EMTs to staff their BLS bus

BVAC also pays for the medic now so the medic is now under our control (unlike before when the city paid for the medic coverage from the fly car was only in the city). This gives us another person to make up a crew if needed. So if our rig is driver alone we can respond in and take the call utilizing the medic (as an EMT if nessacary). This has helped to greatly reduce our response times and improve the calls made.

Now it's the third and fourth calls in the district that are killing us!

[Guest ab2se]

The following link is the a Poughkeepsie Journal article involving the Standfordville area and it's issues with EMS response.

Poughkeepsie Journal Article

Am I the only one that feels like this is ridiculous? While the article covers Stanford, Amenia and Pine Plains, and the Village of Millerton, the only run numbers given are from Stanford. You volunteers from Stanford please don't take this as a personal shot at you as these are the numbers I have. These problems exists everywhere.

68 of 176 calls MISSED!!!! Thats 39 percent or more importantly, 68 people who needed immediate emergency care that were left out in the cold. They are in talks to remedy the situation....by staffing the volunteer rigs with paid workers during 6am to 6pm hours. Of the 68 calls missed only 46 of them occured during these hours. That still leaves 32 percent or again more importantly, 22 residents left to wait for NDP. I can only imagine the other towns are similar.

With the DOH guidelines on stroke care, early access to defib, wound and fluid management, these long wait times for emergency care are outrageous. Why is the volunteer service so against progression and taking care of it's residents properly if it means they have to give up thier power? Why are they worried about the 46 residents but because there are still a few responders who have to be used they forget about the other 22 people they abandoned?

I'm sure all of those 68 calls were answered by someone, most likely NDP. A lot of those calls had an ALS unit on the initial dispatch. Does that make it allright? Absolutely not. If you tell the public that you are there for them when they need you, you better be there. Is this any different than the commercial provider who doesn't have enough units on to cover their obligations. Or the volunteer fire dept that can only get out to an alarm with 1 or 2 engines driver alone. Or the municipality with a career Dept that is so understaffed it can't properly fight a fire and that fire has to go to 2 or 3 alarms. How many of the career depts in this area have 20 FFs on their first alarms.

I don't think its a question of giving up "power". It's really about MONEY. Who is going to pay for things to be done properly. Does anyone really believe that any organizition, volunteer or paid, wants to do a half assed job? It takes money to do things right. The big question is who is going to pay for the proper service level? In most of these situations that means raising TAXES. What elected official wants to be responsible for higher taxes? Especially when their taxpayers are not complaining about the EMS/Fire service they recieve. I'd bet money that in the 4 towns from the article there were few if any complaints about ambulance service. This makes it very difficult for the Fire Depts to get the Towns involved in sharing the cost of PROPER EMS service.

[markmets415 524]

Very good responses and very good fixes for the problems that you were addressed with. 5000 runs a year is an awful lot and I am glad to see that you have taken the needed measures to supplement your runs. I can only assume that you already had adequate evening coverage and therefore didn't require the night time staffing.

Sounds to me like Markmets has a suggestion that should be taken into consideration. A simultaneous dispatch would at least get the ball rolling quicker on a mutual aid type of response. Mark, would you mind giving us an estimated response time for when dover responds as opposed to when NDP has to cover?

Also, DFD mentioned a paramedic fly car which is full time (was that day and night?). I think this option should be considered as well. There are alot of posistives a paramedic can accomplish prior to transporting rigs arrival. Perhaps we can tune this topic to be more along the lines of what similar companies in this situation have done to fix the problem. I do not intend on this ending up being a forum for volunteer bashing in anyway.

We in Wassaic are pretty lucky, our Rescue Squad Asst. Chief is allowed to leave work during the day calls from Taconic DDSO and we also have a member (our driver) that is allowed to leave from another very supportive business, the Pawling Corp so we usually are on the road prior to second dispatch which is 5 minutes. As Josh from Millerton has said NDP responds usually from the Millerton areas so depending on the response area and or call type it could be 7 to 15 minutes for them to arrive on scene. As I had stated, we know that this is not a solution and have realized that clearly there are some things that need fixing. We have asked to have these areas addressed but as of right now it has not so I give kudos to our past chief for actually thinking forward with NDP and coming up with a plan that at least gets a rig rolling until the other politics is set aside and the issue is finally addressed.

[markmets415 524]

.

I don't think its a question of giving up "power". It's really about MONEY. Who is going to pay for things to be done properly. Does anyone really believe that any organizition, volunteer or paid, wants to do a half assed job? It takes money to do things right. The big question is who is going to pay for the proper service level? In most of these situations that means raising TAXES. What elected official wants to be responsible for higher taxes? Especially when their taxpayers are not complaining about the EMS/Fire service they recieve. I'd bet money that in the 4 towns from the article there were few if any complaints about ambulance service. This makes it very difficult for the Fire Depts to get the Towns involved in sharing the cost of PROPER EMS service.

Tim you hit a home run, that is it in a nutshell, it's about funding and $$$$$$$$$$$$$$$$$$$$$$$$.

[Guest]

Does "seems to be helping" mean ALL the calls get handled properly? Why aren't the people responsible considering Full time Staffing supplemented by vollunteers? It just seems a waste of time and money to do something half-way.

I say seems to be helping because during the day, the town is guaranteed to have at least one ambulance in service, but for second calls in the district, its still not 100%. Perhaps maybe because of less 'burnout' from running calls during the day, the fail rate on first calls seems to be less as well, but the second calls are still a problem as they have historically been. But I haven't been around enough since it was implemented to know for sure just to the extent it has helped.

But as a note, the ambulance corps did not start the process of obtaining a daytime crew until after it was under investigation by the state DOH for response times and fail rates.

Edited April 29, 2009 by Slayer61

[Guest Local596Secretary]

I don't think its a question of giving up "power". It's really about MONEY. Who is going to pay for things to be done properly. Does anyone really believe that any organizition, volunteer or paid, wants to do a half assed job? It takes money to do things right. The big question is who is going to pay for the proper service level? In most of these situations that means raising TAXES. What elected official wants to be responsible for higher taxes? Especially when their taxpayers are not complaining about the EMS/Fire service they recieve. I'd bet money that in the 4 towns from the article there were few if any complaints about ambulance service. This makes it very difficult for the Fire Depts to get the Towns involved in sharing the cost of PROPER EMS service.

I believe you are correct in that funding and information are the largest problems that exist. I didn't quote it, but you mentioned the fire service both career and volunteer. As a union member and career firefighter myself, I for one spend every chance I get with my officials and citizens to explain the shortage of people. I applaud Chief Dennis Smith for making this situation public. Now that it is public knowledge that there is a problem, the citizens will be concerned. Questions will be asked of the officials and I am sure they will come to some agreement on the daytime staffing regardless of the cost.

The next in my long line of questions so far is this. Why don't all Chiefs stand up for thier community the way Chief Smith has? While I congratulate him on being brave enough to make this public, why not go a step further (since it is plain its needed) and request full coverage?

[citystation1848 15]

You also have to look at the Commercial agencies. Sure the rescue squads are one thing, but you also have to look at it from the other side of the window. If you need a medic and you have one coming from 15-20 miles away what good does that do? I understand the call volume up in some of these towns like Amenia, Wassaic, Millerton, Pine Plains don't merit their own contracted ambulance like 54-79, 34-79, 56-79 but still, agencies should place more units strategically.

[helicopper 1,050]

First off, I second the statement about not taking this personally.

Second, you make an interesting point here regarding the "laws" as you put it that towns must uphold. I am curious as to where I would find this law and what its wording is. If you could direct me to where I may find it, I would appreciate it.

NYS General Municipal Law Article 122-B

§ 122-b. General ambulance services. 1. Any county, city, town or

village, acting individually or jointly, may provide an emergency

medical service, a general ambulance service or a combination of such

services for the purpose of providing prehospital emergency medical

treatment or transporting sick or injured persons found within the

boundaries of the municipality to a hospital, clinic, sanatorium or

other place for treatment of such illness or injury, and for that

purpose may:

(a) Acquire by gift or purchase one or more motor vehicles suitable

for such purpose and supply and equip the same with such materials and

facilities as it may consider necessary for prehospital emergency

treatment, and may operate, maintain, repair and replace such vehicles

and such supplies and equipment;

(b.) Contract with one or more individuals, municipal corporations,

associations, or other organizations, having sufficient trained and

experienced personnel, for operation, maintenance and repair of such

emergency medical service or ambulance vehicles and for the furnishing

of prehospital emergency treatment;

(c.) Contract with one or more individuals, municipal corporations,

associations, or other organizations to supply, staff and equip

emergency medical service or ambulance vehicles suitable for such

purposes and operate such vehicles for the furnishing of prehospital

emergency treatment;

(d) Employ any combination of the methods authorized in paragraph (a),

(b.) or (c.);

(e) No contract shall be entered into pursuant to the provisions of

this section for the services of an emergency rescue and first aid squad

of a fire department or fire company which is subject to the provisions

of section two hundred nine-b of the general municipal law;

(f) Consider prehospital emergency treatment as that care provided by

certified emergency medical technicians or certified advanced emergency

medical technicians certified pursuant to the provisions of article

thirty of the public health law.

1-a. As used in this section:

(a) "Emergency medical technician" means an individual who meets the

minimum requirements established by regulations pursuant to section

three thousand two of the public health law and who is responsible for

administration or supervision of initial emergency medical assistance

and handling and transportation of sick, disabled or injured persons.

(b.) "Advanced emergency medical technician" means an emergency medical

technician who has satisfactorily completed an advanced course of

training approved by the state council under regulations pursuant to

section three thousand two of the public health law.

2. Such municipality shall formulate rules and regulations relating to

the use of such apparatus and equipment in the provision of emergency

medical services or ambulance service and may fix a schedule of fees or

charges to be paid by persons requesting the use of such facilities.

Such municipalities may provide for the collection of such fees and

charges or may formulate rules and regulations for the collection

thereof by the individuals, municipal corporations, associations, or

other organizations furnishing service under contract as provided in

paragraph © of subdivision one of this section.

3. Such municipality may purchase or provide insurance indemnifying

against liability for the negligent operation of such emergency medical

service or ambulance service and the negligent use of other equipment or

supplies incidental to the furnishing of such emergency medical service

or ambulance service.

4. Such municipality may provide for the administration and

coordination of such emergency medical service or ambulance service

including but not limited to operation of an emergency medical

communications system and medical control.

5. Fire districts, which, as part of a fire protection contract, may

provide general ambulance and/or emergency ambulance service pursuant to

section two hundred nine-b of this chapter and article thirty of the

public health law where a town or village has not designated itself as

the primary provider of or otherwise contracted for an emergency

ambulance, a general ambulance service, or a combination of such service

acting individually or jointly, may contract with one or more

individuals, municipal corporations, or other organizations having

sufficient trained personnel, vehicles or combination of personnel and

vehicles suitable to provide prehospital emergency treatment, for the

furnishing of supplemental personnel, equipment or service to cover

instances or periods of time when its service may not be readily

available.

The problem is the word "may" in the first paragraph. Doesn't really compel those who need to be legislated to do the right thing to do the right thing.

[Guest Local596Secretary]

Thanks Chris. Even with that dirty little word "may" at least it spells out what whould be done.

[JohnnyOV 2]

The answer is simple...A paid county EMS service, and remove ALL the local volly corps that continuously drop calls. Have one system in the county that addresses EMS and have them respond to all 911 calls, non emergency transports and other calls that ambulances run.

It works perfectly in other counties in the country, why couldn't it work here?

[citystation1848 15]

The answer is simple...A paid county EMS service, and remove ALL the local volly corps that continuously drop calls. Have one system in the county that addresses EMS and have them respond to all 911 calls, non emergency transports and other calls that ambulances run.

It works perfectly in other counties in the country, why couldn't it work here?

One Word.

Change

People don't want it. Does it makes sense? Yes. that would be the best thing for Dutchess. but you'd see all the commercial agencies put up a fit, and the rescue squad captains that love their ambulances that never gets out would be up in arms.

[64FFMJK 21]

Thanks Chris. Even with that dirty little word "may" at least it spells out what whould be done.

Yes what "SHOULD" be done is one thing and having it done are two totaly different things. EMS, Fire, and Law Enforcement should be paid what they are worth too but when it comes to a way for the elected officials to save a buck what do you think is going to happen either they pay for a EMS contact for the town or they pay their own salery and get a raise as well. Now were do you realy think the priorities are in the legislative body. :angry:

[gamewell45 258]

The answer is simple...A paid county EMS service, and remove ALL the local volly corps that continuously drop calls. Have one system in the county that addresses EMS and have them respond to all 911 calls, non emergency transports and other calls that ambulances run.

It works perfectly in other counties in the country, why couldn't it work here?

Why a paid county EMS service?? How about subcontracting out the work to the commercial EMS providers? You'd most likely save monies on benefits, sick calls, vacation and other perks that public employees enjoy.

[Guest]

Why a paid county EMS service?? How about subcontracting out the work to the commercial EMS providers? You'd most likely save monies on benefits, sick calls, vacation and other perks that public employees enjoy.

Because maybe that would help push the precedent in other counties and areas in the NY metro area, so that EMS could be a respected profession and earn a decent living wage. I doubt that it would happen, but it is definitely the way to go, if going for the best quality of care, instead of just the cheapest solution.

[Guest Local596Secretary]

Because maybe that would help push the precedent in other counties and areas in the NY metro area, so that EMS could be a respected profession and earn a decent living wage. I doubt that it would happen, but it is definitely the way to go, if going for the best quality of care, instead of just the cheapest solution.

Hear Hear!!

[Beekman 5]

Aren't we referring to the same County that wanted to eliminate the DCSO road patrols and have each town hire their own?

[Goose 188]

Why a paid county EMS service?? How about subcontracting out the work to the commercial EMS providers? You'd most likely save monies on benefits, sick calls, vacation and other perks that public employees enjoy.

I can't tell if you're kidding or not. Hopefully you are.

Most commercials are for profit - they pay sucks, the bennies suck, the rigs suck, the equipment sucks and the staffing will suck.

County EMS will give you a more robust budget to attract the best and brightest and pay them well (on par with FD and PD), county bennies & retirement, cutting edge education, cutting edge equipment, modern vehicles that are well maintained, vast expanses in resources - hazmat, USAR, PD support for SWAT entry teams, etc.

It won't even cost a whole lot - granted you eliminate all the useless duplication of resources. No one ever wants to cut FD, but you look at some of these departments in Westchester, Putnam and Dutchess and sometimes (most of the time) you just have to scratch your head. Probably could save a few million in needless apparatus expenditures. Consolidate smaller PDs into a larger regional/county system, do the same for school systems and add a dollar or two surcharge onto parking violations or other county/regional forms to benefit EMS. You can really fund it 1000 ways.

Check out Wake County EMS in North Carolina - see how it hails in comparison to the the NY Metro Area. It's a joke, we are living 20 - 30 years behind the times.

[gamewell45 258]

I can't tell if you're kidding or not. Hopefully you are.

Most commercials are for profit - they pay sucks, the bennies suck, the rigs suck, the equipment sucks and the staffing will suck.

County EMS will give you a more robust budget to attract the best and brightest and pay them well (on par with FD and PD), county bennies & retirement, cutting edge education, cutting edge equipment, modern vehicles that are well maintained, vast expanses in resources - hazmat, USAR, PD support for SWAT entry teams, etc.

It won't even cost a whole lot - granted you eliminate all the useless duplication of resources. No one ever wants to cut FD, but you look at some of these departments in Westchester, Putnam and Dutchess and sometimes (most of the time) you just have to scratch your head. Probably could save a few million in needless apparatus expenditures. Consolidate smaller PDs into a larger regional/county system, do the same for school systems and add a dollar or two surcharge onto parking violations or other county/regional forms to benefit EMS. You can really fund it 1000 ways.

Check out Wake County EMS in North Carolina - see how it hails in comparison to the the NY Metro Area. It's a joke, we are living 20 - 30 years behind the times.

Goose, I'm very serious. Every reason you've given as to why we would be better off with a county-paid service is fixable by the employees of the commercial services by organizing under the banner of a credible union and don't start to tell me it can't be done because i've been there before and have seen it happen. Everything you opine about can be addressed in a labor contract if its important to the employees--at the bargaining table--if they so choose. Additionally the commercial paramedics/EMT's receive the same training as their public counterparts in order to get certified by the state, so in essence medically they are equals notwithstanding pay, benefits, etc.

Public service employees are expensive to employ. All of their benefits; medical, pension, sick leave, vacation, 401.k, holiday pay, dental, life insurance, uniform allowance, longevity bonuses and other perks come from taxpayer's wallet and particularly given today's economic climate to broach putting EMS services under a county department would be ludricrious. Remember, as one poster in here mentioned, in Dutchess county, this is the same county that proposed to eliminate county road patrols and let each town make it's own arrangements. Other counties have probably taken note of that proposal and it wouldln't surprise me if you see more and more of that in the future if things don't improve economically. For most counties except possibly Westchester (they've historically had deep pockets) they wouldn't even give serious consideration to forming a county-wide system as some people in here dream about at night in their sleep.

If not consolidating under a county-wide system subcontracted out to commercial companies, then it should be left to the individual towns to hire a commercial company and this way it gives them more control over how much monies are spent and the quality of service their residents receive. It's all about being realistic. Thats all; nothing more.