Endicott Mayor Stops Fire Crews From EMS Calls

[PFDRes47cue 653]

Doesn't make much sense to me.

ENDICOTT, N.Y. -- It's another battle of the Endicott firefighters union versus the village's mayor. The sticking point this time, the mayor's decision to stop the firefighters from responding to EMS calls.

"You were hired as firefighters and you're going to be firefighter as far as I'm concerned," said Mayor John Bertoni.

YNN Article

[lad12derff 283]

Doesn't make much sense to me.

YNN Article

Makes plenty of sense to me. The number of BS EMS runs we do is crazy. It wears down the Men, Rigs and is a total abuse of what we should be doing. 60 control to E 123 respond to 321 Smith st for a general illness. Way to go Mayor!!!!!

[Bnechis 3,961]

There is a lot more to this story than is being listed here. No mention of the fact that in January this mayor suggested closing the only firehouse to reduce overtime costs. When questioned about who would provide fire protection he he suggested maybe they could merge the fire dept. but its unclear if anyone wants to merge.

Also this is not just reponding to EMS calls as a 1st response. The plan is to get rid of the FD ambulance. For such a major change, the mayor has yet to tell the public who will take over this service and what it will cost.

[50-65 205]

http://www.pressconnects.com/article/20110504/NEWS01/105040408/Endicott-pulls-plug-EMS-program?odyssey=tab|topnews|text|FRONTPAGE

Another link to the story from the Binghamton Press, the local newspaper there. Unfortunatly, the state doesn't allow a fire dept to say we will only respond to x-type calls and still keep an EMS agency number. In their opinion, it's all or nothing.

[NJMedic 96]

Apparently its costing the taxpayers more already to run EMS. How can a fire department consider EMS as a CORE mission but receive extra money to perform EMS?

A town close to me recently did the same thing. They ran two rescue ambulance with three guys on the ambulance and each received more money for it. If an engine company went on an EMS job the firefighters on that Engine received a hourly boast in pay for the time they were on the EMS job. The town council realized they were paying the average 5 year firefighter, thats makes a base salary of $87,000 a year time and a half to run EMS calls. They said screw this and increases the amount of third service ambulances on the road by taking EMS response from the FD.

[NWFDMedic 58]

Every system is designed a little differently. These articles don't provide enough information to make any judgment about the need for the FD service or if it is fiscally prudent. I just hope that the decision was made using real analysis instead of the unilateral decision of a politician with other motives.

[FD828 77]

Makes plenty of sense to me. The number of BS EMS runs we do is crazy. It wears down the Men, Rigs and is a total abuse of what we should be doing. 60 control to E 123 respond to 321 Smith st for a general illness. Way to go Mayor!!!!!

Not for nothing, but the number of fires are going down, the number of EMS runs are steadily on the rise. Maybe the FD doesn't need to respond to all EMS calls (maybe only priority ones), but as a 1st responder that is what they are there for. Not to mention without doing any EMS calls, don't you think there is a strong argument to reduce manpower/equipment for the probably 50% decrease in responses? The fire departments NEED EMS like it or not.

[lad12derff 283]

We need legitamate EMS not BS calls. A certain city in Westchester use to do 1500 runs a year with over 200 firefighters and now does 9000 with 155 firefighters. I would say that city fire dept is holding up to their end of the productivity agreement but not the city. I don't think you will find one person on this board, including myself, who would not be willing to do any and all real EMS calls. It is the general illness calls, the runny nose calls, the twisted ankle calls that happened at 4:00 in the afternoon and they need a ride to the hospital at 2:00 am calls. We all know the calls I am talking about. I have been around a little while.

Edited May 7, 2011 by lad12derff

[FD828 77]

Agreed, the FD's should only be sent to priority calls (Chest pain, SOB, unconsc) or when a mutual aid agency has to be called. However the mayor from Endicott wants to stop ALL FD response to medical calls. How is that worthy of praise? Those residents will be S.O.L. waiting 20 mins for someone to respond. Hope the public gets involved...... or moves somewhere else.......

[lad12derff 283]

Agreed, the FD's should only be sent to priority calls (Chest pain, SOB, unconsc) or when a mutual aid agency has to be called. However the mayor from Endicott wants to stop ALL FD response to medical calls. How is that worthy of praise? Those residents will be S.O.L. waiting 20 mins for someone to respond. Hope the public gets involved...... or moves somewhere else.......

I did not read the artical only his quote about hiring firefighters to be firefighters.

[lad12derff 283]

The city still needs to provide EMS to the residents.

[INIT915 1,119]

Agreed, the FD's should only be sent to priority calls (Chest pain, SOB, unconsc) or when a mutual aid agency has to be called. However the mayor from Endicott wants to stop ALL FD response to medical calls. How is that worthy of praise? Those residents will be S.O.L. waiting 20 mins for someone to respond. Hope the public gets involved...... or moves somewhere else.......

The key is also having FF's that want to be there and take action. Having a crew of four guys stand there with you while all five of you wait the 20 minutes for a bus is not much of a step up from waiting by yourself.

[FD828 77]

The key is also having FF's that want to be there and take action. Having a crew of four guys stand there with you while all five of you wait the 20 minutes for a bus is not much of a step up from waiting by yourself.

Except the FF's can perform life saving interventions whether they "want" to be there or not.

Edited May 6, 2011 by FD828

[sympathomedic 383]

There are parts of this issue I have never fully understood:

In many (not all) systems in Westchester that send FD units on EMS runs, this arrangement was begun in the last 20 years or so, and was done, again in many but not all cases, at the FD's request. If the FD wants to stop running on calls they feel are beneath them, simply get yourselves deleted from the EMS response protocol. Un-due what you did.

I have read in data gathered from the Emergency Care information Center in Escondido Ca (sorry no link) that about 35% of EMS calls are serious enough to need ALS. About 3% of EMS calls are "life and death". In my personal experience, less than 1% of fire alarms are working fires. (hose, hydrants, air-packs). The fire service never complains about the smoking dryer belts, steam from the shower, furnace burps, light ballast, forgot to open the fireplace flu type of work that makes up many of their alarms.

It is no ones fault but ours that we over-respond. I have heard a bloody nose on the Sprain get 1 BLS bus, 1 ALS car, GPD, NYSP and I think 4 large fire units from two departments. It is US that make the decisions about what to send. It is the public that pays. In my job as a paid EMS guy, I was once called to a town bordering our primary area for some minor complaint. I asked them why they called us, not their own 911 agency? They said they had done so in the past and were ovewhelmed with the 2 EMS 2 PD and 2 FD units that came. In Massachusetts the Governor at the time(Romney I believe) issued an executive order allowing nursing homes to call private EMS agencies for emergencies. That was done at the NH industry's request, as they did not like the multiple lights, loud radios, idling deisel and whatever else a large response brings to a quiet home. In response, the Mass State FF union sued him to get the order recinded. I read all this in an article about the Boston FD LT killed when the brakes on his ladder truck failed returning from an EMS run. I do no know the outcome of the lawsuit.

Not trying to anger anyone here. If you feel EMS work is not good enough for you, I would appreciate it if you found a way not to do it. The patient and I would appreciate it.

Bill

[16fire5 693]

We have in the past few years started publishing prehospital saves by engine companies in department orders similar to unit citations. The numbers are pretty impressive. I would say we do have a positive impact. Does it suck that that a segment of the public abuses ems and the first responders? Yes. But realize many of the things being complained about here were put in place for responder safety. The units are sent on the highway to provide protection. Also having fire with you many times gives you safety in numbers. I really can't see how anyone can make the case that a 2 person ems crew is better off by themselves at a serious call.

[ny10570 745]

There are parts of this issue I have never fully understood:

In many (not all) systems in Westchester that send FD units on EMS runs, this arrangement was begun in the last 20 years or so, and was done, again in many but not all cases, at the FD's request. If the FD wants to stop running on calls they feel are beneath them, simply get yourselves deleted from the EMS response protocol. Un-due what you did.

I have read in data gathered from the Emergency Care information Center in Escondido Ca (sorry no link) that about 35% of EMS calls are serious enough to need ALS. About 3% of EMS calls are "life and death". In my personal experience, less than 1% of fire alarms are working fires. (hose, hydrants, air-packs). The fire service never complains about the smoking dryer belts, steam from the shower, furnace burps, light ballast, forgot to open the fireplace flu type of work that makes up many of their alarms.

It is no ones fault but ours that we over-respond. I have heard a bloody nose on the Sprain get 1 BLS bus, 1 ALS car, GPD, NYSP and I think 4 large fire units from two departments. It is US that make the decisions about what to send. It is the public that pays. In my job as a paid EMS guy, I was once called to a town bordering our primary area for some minor complaint. I asked them why they called us, not their own 911 agency? They said they had done so in the past and were ovewhelmed with the 2 EMS 2 PD and 2 FD units that came. In Massachusetts the Governor at the time(Romney I believe) issued an executive order allowing nursing homes to call private EMS agencies for emergencies. That was done at the NH industry's request, as they did not like the multiple lights, loud radios, idling deisel and whatever else a large response brings to a quiet home. In response, the Mass State FF union sued him to get the order recinded. I read all this in an article about the Boston FD LT killed when the brakes on his ladder truck failed returning from an EMS run. I do no know the outcome of the lawsuit.

Not trying to anger anyone here. If you feel EMS work is not good enough for you, I would appreciate it if you found a way not to do it. The patient and I would appreciate it.

Bill

Its not the perceived emergencies that burn people out and turn people off of EMS runs. Its the out right BS runs that we continue to encourage. The tooth ache call, the sniffles, I missed my Dr appointment, etc. Firefighters get just as annoyed at the automatic alarms, malicious false alarms, etc. While only 1% of all runs are major fires the burned out ballast, burner back puff, etc are all real enough where you can understand why someone would call 911.

[50-65 205]

Agreed, the FD's should only be sent to priority calls (Chest pain, SOB, unconsc) ....

Therein is a problem. According to what I was told by HVREMSCO, in order to have/keep your EMS Agency code, the state requires, among other things, that you respond to ALL medical calls, not just priority calls. You can't pick and choose which calls to respond to.

We used to do just that. We will still respond if EMS requests us, but we have fewer and fewer members who are trained/certified providers now because we don't run EMS calls anymore.

[FD828 77]

Yes everyone hates going on the BS runs both EMS and Fire alike. However there is a term that we all need to remember. Job security. 16Fire5 is 100% correct about the safety aspect as well. Safety on the roadways, safety in numbers. Even to have extra hands for lifting and carrying equipment as well. Would we all like just going on the "real" calls? Sure, but that is not reality. BS calls are part of the job.

[Bnechis 3,961]

In many (not all) systems in Westchester that send FD units on EMS runs, this arrangement was begun in the last 20 years or so, and was done, again in many but not all cases, at the FD's request. If the FD wants to stop running on calls they feel are beneath them, simply get yourselves deleted from the EMS response protocol. Un-due what you did.

Are you sure it was "at the FD's request"? or was it the mayor, manager, or board wanted more productivity and this was a way for them to provide "more" service for little or no additional funds?

In many cases it is now contractual and one can not just "get yourselves deleted from the response". This is like saying you can un ring a bell.

In my personal experience, less than 1% of fire alarms are working fires. (hose, hydrants, air-packs). The fire service never complains about the smoking dryer belts, steam from the shower, furnace burps, light ballast, forgot to open the fireplace flu type of work that makes up many of their alarms.

The Fire Service not only complains about many of these alarms, particularly steam from the shower (poor detector location), malfunction of alarm and set off by workers, in most communities we have fought for ordenences to fine property owners and often on a high sliding scale so repeat alarms will result very high fines, which will encourage repairing or replacing faulty alarm systems.

It is no ones fault but ours that we over-respond...... It is US that make the decisions about what to send.

Thats not completely true. While we have determined how many apparatus we will send to an EMS call. We have made multiple requests to use EMD to screen calls and reduce the number of apparatus that is sent. 60 Control has advised us that they can only use the EMD protocols when they can screen the caller and that in most cases they only get a 9-1-1 transfer in 20-30% of the calls. This means that in 70-80% of the calls we have no decision, since 60 control will be dispatching us.

I was once called to a town bordering our primary area for some minor complaint. I asked them why they called us, not their own 911 agency? They said they had done so in the past and were ovewhelmed with the 2 EMS 2 PD and 2 FD units that came.

I have also gotten requests to not do all that ALS stuff and just drive fast to the Hospital, or I dont want to go to the trauma center I want to go to the hospital that my cardiologest is located, or "its just a little fire can you only send 1 fireman in a pick-up. That does not make the citizens request correct. Why are you recieving calls from a neighboring community? I would assume you correctly referred they to the proper agency.

We have also run into this in a number of cases when the home owner refuses to acknowledge that they actually live in the city of X not the village of y. Years ago I remember a 2nd alarm fire in a residential home that was clearly in my city and the community was outraged that our FD was fighting this fire and why wasent the village FD here. Even after they admitted that they pay 100% of the property tax to our city, they still claimed they lived in the village next door.

In Massachusetts the Governor at the time(Romney I believe) issued an executive order allowing nursing homes to call private EMS agencies for emergencies. That was done at the NH industry's request, as they did not like the multiple lights, loud radios, idling deisel and whatever else a large response brings to a quiet home.

1st - Is it really the noise issue? In many cases "Skilled Nursing Facilities" (a poor choice of words) has a financial interest in freeing up beds and turning over patients as many have paid a large upfront fee and then use medicare for "maintenance".

2nd - Over the years we have gone round and round with our "Skilled Nursing Facilities" about this and found they often use 9-1-1 for direct admits when it suited it and other times they would call for a commercial tx unit for a chest pain. I find the argument of what they vs. what is in the best interest of thier patients and the community at large is the real issue here.

I read all this in an article about the Boston FD LT killed when the brakes on his ladder truck failed returning from an EMS run.

The issue in Boston was a poor maintenance program, not that they had been on an EMS call. That riging and almost the whole fleet had unsafe breaks and a crash was coming.

If you feel EMS work is not good enough for you, I would appreciate it if you found a way not to do it. The patient and I would appreciate it.

The same could be said for some of the EMS providers who really want to get out of EMS and can not. I would appreciate not having to deal with the issues that come up in those cases.

I would also appreciate for EMS providers to stop cancelling other resources when the patient would benefit from the additional help, particularly if the reason for the cancel is we want to "be nice" to the FD/PD etc.

[bad box 371]

The key is also having FF's that want to be there and take action. Having a crew of four guys stand there with you while all five of you wait the 20 minutes for a bus is not much of a step up from waiting by yourself.

Are you saying that you have personally witnessed F.D. personnel who responded to the scene of an EMS incident and did not provide the level of care that they are certified by the state to provide?

[helicopper 1,050]

Are you sure it was "at the FD's request"? or was it the mayor, manager, or board wanted more productivity and this was a way for them to provide "more" service for little or no additional funds?

In many cases it is now contractual and one can not just "get yourselves deleted from the response". This is like saying you can un ring a bell.

Thats not completely true. While we have determined how many apparatus we will send to an EMS call. We have made multiple requests to use EMD to screen calls and reduce the number of apparatus that is sent. 60 Control has advised us that they can only use the EMD protocols when they can screen the caller and that in most cases they only get a 9-1-1 transfer in 20-30% of the calls. This means that in 70-80% of the calls we have no decision, since 60 control will be dispatching us.

1st - Is it really the noise issue? In many cases "Skilled Nursing Facilities" (a poor choice of words) has a financial interest in freeing up beds and turning over patients as many have paid a large upfront fee and then use medicare for "maintenance".

2nd - Over the years we have gone round and round with our "Skilled Nursing Facilities" about this and found they often use 9-1-1 for direct admits when it suited it and other times they would call for a commercial tx unit for a chest pain. I find the argument of what they vs. what is in the best interest of thier patients and the community at large is the real issue here.

The same could be said for some of the EMS providers who really want to get out of EMS and can not. I would appreciate not having to deal with the issues that come up in those cases.

I would also appreciate for EMS providers to stop cancelling other resources when the patient would benefit from the additional help, particularly if the reason for the cancel is we want to "be nice" to the FD/PD etc.

These are all system problems and if we had a real EMS "SYSTEM" in New York we'd be able to correct each problem. Where are the medical directors? Where are the agency managers? Where are the providers who are supposed to be advocates for their patients?

The 9-1-1 system in Westchester County has been flawed since it's inception but it has only gotten worse since the shift from land-line phones to cellular phones. The system in Westchester County never evolved to keep up with the changes in technology or the societal changes. Some counties have done a remarkable job considering their financial limitations and they have better systems than our "highest taxed county in the nation". EMD is the standard yet we stll have agencies not providing it and actually fighting against changing to it.

[helicopper 1,050]

Are you saying that you have personally witnessed F.D. personnel who responded to the scene of an EMS incident and did not provide the level of care that they are certified by the state to provide?

Yes. I've witnessed this with FD personnel, PD personnel, and even EMS personnel.

I'm sure you have too.

[INIT915 1,119]

Are you saying that you have personally witnessed F.D. personnel who responded to the scene of an EMS incident and did not provide the level of care that they are certified by the state to provide?

More times than I care to count.

[sympathomedic 383]

Barry, my computer skills do not include those cool, green cut and quote things, so I will try to reply in an organized way:

#1.YES in two departments that I work with, it was the FD's request. I have been under the impression that EMT Bravo does not approve of doing specific department names, so I will not. Both were in lower Westchester, how's that?

#2: if it now contractual, I believe most contracts expire. If they guys want out of EMS, don't put it in the next contract. Done.

#3: If your 911 PSAP has an SOP to transfer live callers to 60 control and they are not, then that can be easily fixed. Next.

#4: How does 4 men on a class A pumper free up beds any faster than an ambulance crew?

#5 I am 100% positive the elderly couple who called us knew just where they lived. It was NOT a border issue. They did NOT want a 10 person, 6 vehicle response for a man who fell the day before, and could not bear weight today. THAT is why we got the call.

#6 I am aware the Boston truck had bad brakes and the EMS run was just a chance happening. I put that in my posting in case someone wanted to check my facts about the Massachusetts State FF union sueing the Governor to force SNF's to call 911. I have found the folks on this board to be a pretty smart groups of people, and some of them may want to find the article. I think it was in the Boston Globe.

#7. Maybe I am getting deaf in my old age, but my perception when the topic comes up is that FF's very seldom complain about non-sense fire work. But since wwe are stepping on toes here, let me step on my own: Of all the various medical tech jobs- X-ray tech, EKG tech, lab tech etc it seems that the Emergency Medical Tech is the only one who complains that certain patients are not worth their time. (goes for EMT-P's also).

#8: How can you want to get out of EMS and cannot?? Should we post a form letter of resignation here, so folks can print it, put their name on it and turn it in? (This does remind me of a favorite scene in "Brining Out The Dead" where Frank's boss refuses to fire him, and Frank insists that he is late and the boss promised to fire him if he came in late again, and he begs to be fired).

Anyhow, sorry for the ranty post. I will shut up for a month or two now.

Bill

[bad box 371]

Yes. I've witnessed this with FD personnel, PD personnel, and even EMS personnel.

I'm sure you have too.

Your post seemed to speak only of F.D. personnel, thanks for clarifying it for me. While waiting on the civil service list for firefighter, I worked for NYC EMS for three years back when it was part of HHC. Way too many of the EMS employees back then 'hid' from calls (didn't call back in service for extended periods, didn't answer the radio, walked diff. breathers & chest pain pt's. down multiple flights of stairs, transported trauma pt's. from auto collisions in stair chairs rather than taking spinal precautions, I even had a 'partner' who refused to assist me with CPR at the scene of a witnessed (by CPR certified civilians) arrest with civilian CPR in progress... It was not uncommon back then for those members of NYC EMS who gave a s--t about their pt's. as well as civilians who knew how to get help quickly in an emergency to pull the corner fire alarm box or dial the 7 digit # for the FD Boro office. I never found the responding FD personnel to be anything other than professional & helpful (as a matter of fact, over 2,000 FDNY Firemen back then attended EMT training on their days off voluntarily and became certified). Often the FD transported pt's. on their apparatus due to very extended response times for EMS buses. The PD did not provide pt. care & many officers would admit openly that they didn't understand why they were sent on medical calls. I guess it just depends on where you work, I'm sorry to hear of the experiences that you are having in your response area. I can't imagine that any municipality in this day & age would tolerate PD, FD & EMS personnel who refuse to provide the level of care they are certified for. Stay safe ...

Edited May 9, 2011 by bad box