Newburgh FD wants to start ambulance service

[16fire5 693]

The only restrictions that I have ever seen is that fire districts (as a direct taxing authority) can not bill for services. Technically fire departments dont bill the municipality does and that is legal. I can not find any mention of billing for service in GML 209.

The only way I found it was through a proposed bill.

http://www.assembly.state.ny.us/leg/?bn=A.%204310&sh=t

In § 209-b.

4. Fees and charges prohibited. Emergency and general ambulance

service authorized pursuant to this section shall be furnished without

cost to the person served. The acceptance by any fireman of any personal

remuneration or gratuity, directly or indirectly, from a person served

shall be a ground for his expulsion or suspension as a member of the

fire department or fire company.

[Bnechis 3,961]

The only way I found it was through a proposed bill.

In § 209-b. 4. Fees and charges prohibited. Emergency and general ambulance

service authorized pursuant to this section shall be furnished without

cost to the person served.

Thanks, I did see that. I know a number of municipalities that have been billing for up to 35 years. I believe they are doing it as a municipality billing for services it provides. THe Fire Department is prohibited from billing, but not the city or village. The bill you referenced has been brought up every year for at least the last 15 years. It was gear for the fire districts which are directly prohibited.

My city did the billing for its services for 26 years. We never ran an ambulance. The contractor billed the city a monthly fee and the city billed the patients. We looked into running it thru the FD as the "contractor" and the city still billing. We were advised by the comptroler that it was legal (we never ended up providing the service).

[16fire5 693]

I knew it came up a lot but never understood why it never passed. I always thought that if it passed some volunteer departments could use it to hire staff to provide better service.

[aviator70 16]

There is no money in EMS services, please, they will spend more time transporting skells for free. There may be money to be made in transports, but in just providing emergency transport and services, doubtful.

Edited June 11, 2010 by aviator70

[Guest alsfirefighter]

There is no money in EMS services, please, they will spend more time transporting skells for free. There may be money to be made in transports, but in just providing emergency transport and services, doubtful.

Sometimes..contrary to popular belief there is more to it then just money.

[aviator70 16]

Sometimes..contrary to popular belief there is more to it then just money.

Sure, I agree.

[antiquefirelt 994]

Sometimes..contrary to popular belief there is more to it then just money.

I think this is the essence of doing it right. If you see dollar signs first and improvements to care second, you'll soon find out this won't work out. On the other hand if you put the patients best interest as your primary goal 100% of the time with all other benefits second to this, you'll likely succeed.

There are some fundamental differences between the types of EMS providers, that preclude us from using the service model of one as a business plan for another. Here's what I've observed in my microcosm of emergency services:

Private EMS services very often utilize transfers to offset the expenses of emergency work. For private-for-profit service to remain viable there must be some profit. This means the buses must be moving as much as possible and costs must be a low as possible. Keeping buses moving means trying to have just enough staff and equipment to cover all bases, which when done profitably limits what's available for emergencies. A local island used to contract with us for transport from the airport to the ED, but found a cheaper deal with a private for profit service, yet we still do 50% of the calls as the private ambulances are often tied up. Sometimes patient care suffers at the hands of low costs, while some services provide stellar service. There are few opportunities for advancement in all but the largest systems, personnel burnouts is a real problem, few people actually retire from private EMS.

Non-profit EMS services must still remain in the black to function and suffer from many of the same issues as for profit privates. Often the combination of career staff and volunteers make these somewhat complex and quality and response coverage ebbs and flows over time. One that I am most familiar with in my area has a large trust of money that allows them to run in the red, and still only charge local municipalities minimal contract fees for service. They also offer some very interesting incentives for their employees and part time staff like the use of a Northwoods camp, frequent EMS conference travel, company vehicles, etc. They still have significant staffing issues requiring multiple tones and mutual aid.

Municipal EMS services can use taxpayer dollars to offset losses and can often survive on emergencies alone, requiring less "on the road time" for their buses. Short career ladders often seem to plague all but the largest of these. Similar burnout and lack of long-term employees seems to be common. The only ones in my area utilize per-diem staff only and even getting personnel to work per-diem is getting tougher as more services start competing for the same human resources.

FD Based EMS utilizes multi-role staff and are often able to get "free" fire response staffing while the ambulance is sitting idle. The taxpayers pay the difference between the dept's costs and the EMS revenue. Where I work this means the taxpayers enjoy a 4:30 response time to any call fire or EMS 24/7/365. Without 1800+ EMS calls there would be few or no career fire personnel as the work load minus peripheral duties wouldn't sustain it in a good year. We now have two EMS only employees who's positions are paid for out of a contract for services with an adjoining community. Luckily this contract covers 100% of their personnel costs yet yields only less than 1 call every three days, so on average we get 24 hours (they work 12 hr days) of "free" coverage time that takes a FF/medic off the ambulance and puts him/her back on a fire apparatus.

Again, this is what I see in my little corner of the US and in talking with others around the country. Just like anything there are many exceptions to the rules.

Edited June 11, 2010 by antiquefirelt