Westchester EMS Mutual Aid Plan

[JohnnyOV 2]

I just found this gem: "Westchester County EMS Mutual Aid Plan - Rev. 2003."

Aside from already knowing that, god forbid, some massive MCI occurs, it will be mass and utter chaos for 99% of the county, when was the last time this plan was even looked at or reviewed? When was the last time, other then a county airport drill, have EMS department hosted or participated in an MCI drill? Do the leaders of VAC's even know about this plan, and has the plan been disseminated down to the EMTs who will be the first on scene of a major incident?

Biggest question is, has this plan ever even been tested? Anywhere? Who will fill the shoes of Medical Command, EMS Operations, EMS Safety etc etc. as listed in the plan? Who in any VAC has this required training?

God forbid there is a plane crash on final, shortly after takeoff from KHPN, the home department is in for one heck of a day...

Time for shameless plug - A county run EMS program needs to happen

MutualAidPlanDec03-v5.pdf

[Guest alsfirefighter]

I just found this gem: "Westchester County EMS Mutual Aid Plan - Rev. 2003."

Aside from already knowing that, god forbid, some massive MCI occurs, it will be mass and utter chaos for 99% of the county, when was the last time this plan was even looked at or reviewed? When was the last time, other then a county airport drill, have EMS department hosted or participated in an MCI drill? Do the leaders of VAC's even know about this plan, and has the plan been disseminated down to the EMTs who will be the first on scene of a major incident?

Biggest question is, has this plan ever even been tested? Anywhere? Who will fill the shoes of Medical Command, EMS Operations, EMS Safety etc etc. as listed in the plan? Who in any VAC has this required training?

God forbid there is a plane crash on final, shortly after takeoff from KHPN, the home department is in for one heck of a day...

Time for shameless plug - A county run EMS program needs to happen

There you go thinking. If you don't think about it, then you don't worry about it and if it does happen...you just gather a commission to make recommendations that you don't implement. Seriously brother...its on paper..isn't that enough? Or did the jedi powers wear off?

And no...a county ems system isn't necessarily needed...a better system is...I'm quite comfortable in my fire based system that works and benefits my municipality quite well for what we are limited to. The problem is everyone lives like they're on an island.

Edited May 18, 2011 by alsfirefighter

[joetnymedic 43]

at minimal maybe the radio frqs need to be changed? ya think-lol also are the CT Agencies involved equipped to handle communications now? Stamford Fire and EMS is digital encrypted I think Greenwich is 800. what does 60 and participating agencies have for interops? And communication is minor but also an important thing. if you can't communicate, you're screwed.

[JohnnyOV 2]

There you go thinking. If you don't think about it, then you don't worry about it and if it does happen...you just gather a commission to make recommendations that you don't implement. Seriously brother...its on paper..isn't that enough? Or did the jedi powers wear off?

And no...a county ems system isn't necessarily needed...a better system is...I'm quite comfortable in my fire based system that works and benefits my municipality quite well for what we are limited to. The problem is everyone lives like they're on an island.

If each VAC/FD got out of their little Silos, and started to work together, be dispatched together, set the same protocols together, same training, and actually participate in effective county drills with a good post-drill critique at the end (none of this, good job everyone, heres the free food), then I could see some progress take place.

But hey like you said, I'm thinking again. Those 52 PSAP points in Westchester county, and single agency dispatching protocols have been working for 50 years. Why progress now? Hell a consolidation study was even done back in 2001 by the county recommending that all PSAPs be consolidated.

http://www.usfa.dhs.gov/pdf/efop/efo33158.pdf

edit: incorrect PSAP Number change - and google is a wonderful tool

Edited May 19, 2011 by JohnnyOV

[barbosa10 7]

I feel interoperability interms of communications needs to be updated.. Effective communications is the key to successful operations

[comical115 32]

Stamford Fire and EMS is digital encrypted I think Greenwich is 800. what does 60 and participating agencies have for interops?

Banksville FD gets dispatched by Greenwich via 60 Control. So yes. There is a link.

I think there are some strong merits for a county run EMS system. For instance a county run EMS agency could interface and allow for volunteers to maintain their presence in their communities, but also allow their citizens a guaranteed response if they call for help.

I know if the agency I'm involved with calls for mutual aid, we are relying on other volunteer services. You have better odds in Vegas some days...

[Bnechis 3,961]

when was the last time this plan was even looked at or reviewed?

2007/8 and no revisions were made at that time. It is currently under review with major updates particularly in communications and ICS sections.

Do the leaders of VAC's even know about this plan, and has the plan been disseminated down to the EMTs who will be the first on scene of a major incident?

The leaders signed off on it. I do not if they disseminated it, you need to ask them.

God forbid there is a plane crash on final, shortly after takeoff from KHPN, the home department is in for one heck of a day...

The same is true for NYC, one heck of a day and they are clearly light years ahead of Westchester.

at minimal maybe the radio frqs need to be changed? ya think-lol also are the CT Agencies involved equipped to handle communications now? Stamford Fire and EMS is digital encrypted I think Greenwich is 800. what does 60 and participating agencies have for interops? And communication is minor but also an important thing. if you can't communicate, you're screwed.

The county Trunked Radio has worked very well for EMS interoperable communications.

I feel interoperability interms of communications needs to be updated.. Effective communications is the key to successful operations

They were.

The biggest problem is an almost total lack of participation in EMS planning and MCI training. I have said this many times, 99% of the providers & leaders have never participated in either.

[ckroll 101]

I just found this gem: "Westchester County EMS Mutual Aid Plan - Rev. 2003."

Aside from already knowing that, god forbid, some massive MCI occurs, it will be mass and utter chaos for 99% of the county, when was the last time this plan was even looked at or reviewed? When was the last time, other then a county airport drill, have EMS department hosted or participated in an MCI drill? Do the leaders of VAC's even know about this plan, and has the plan been disseminated down to the EMTs who will be the first on scene of a major incident?

Biggest question is, has this plan ever even been tested? Anywhere? Who will fill the shoes of Medical Command, EMS Operations, EMS Safety etc etc. as listed in the plan? Who in any VAC has this required training?

God forbid there is a plane crash on final, shortly after takeoff from KHPN, the home department is in for one heck of a day...

Time for shameless plug - A county run EMS program needs to happen

The requirement for a mutual aid plan descends from Public Health Law Article 30 and part 800 where an agency may not legally operate outside their CON unless under a mutual aid agreement promulgated by the region. My understanding is that participation is voluntary and every county has one. It benefits individual agencies insomuch as particpating in a county plan satisfies PHL requirements.

It serves a purpose. Once an agency accepts responsibility to provide a service, the question that must be answered is 'what will you do, if need outstrips resources?' Absent some sort of structure, significant emergencies will get overrun by freelancer/tourists who show up with an EMS shirt and a camera thinking it will help. A mutual aid plan sets useful structure for coordinating an EMS response.

The fire service tends to be unfamiliar with PHL and in many cases believe it does not apply to them. For the most part it doesn't, unless the fire service wants to engage in the provision of medical aid. The moment that happens, PHL is a factor. As mutual aid documents go, Westchester has one of the better ones.

If you want to vent over poorly written documents that desperately need an overhaul, get started on the 10 Commandments--coveting thy neighbors' donkey--- really? , the Constitution, and anything involving NIMS.

We cannot have county run EMS in New York State because New York is a 'home rule ' state, so you might want to add NYCRR to your list of things that need fixing.

[helicopper 1,050]

If each VAC/FD got out of their little Silos, and started to work together, be dispatched together, set the same protocols together, same training, and actually participate in effective county drills with a good post-drill critique at the end (none of this, good job everyone, heres the free food), then I could see some progress take place.

But hey like you said, I'm thinking again. Those 52 PSAP points in Westchester county, and single agency dispatching protocols have been working for 50 years. Why progress now? Hell a consolidation study was even done back in 2001 by the county recommending that all PSAPs be consolidated.

http://www.usfa.dhs....op/efo33158.pdf

edit: incorrect PSAP Number change - and google is a wonderful tool

I hope that I'm just missing the sarcasm you intended because if you're serious, I will dispute that the obscene number of PSAP's and the single agency dispatch protocols is severely outdated, in some cases is outright dangerous, and needs to evolve and improve.

[barbosa10 7]

They were.

The biggest problem is an almost total lack of participation in EMS planning and MCI training. I have said this many times, 99% of the providers & leaders have never participated in either.

So its the training between the various agencies that increase the effectivenes of interoperability not soo much communications. In this case its the particitipation between the agencies involved. What would be a way to increase participation? Make it a mandatroy trainingy regiment?

[Bnechis 3,961]

As mutual aid documents go, Westchester has one of the better ones.

Thank you

We cannot have county run EMS in New York State because New York is a 'home rule ' state, so you might want to add NYCRR to your list of things that need fixing.

Not true. While it is true that you can not have county run fire because of home rule. There is no requirement for EMS in NYS County, City, Town or village law. Since it is not mandated or for that matter even mentioned its not part of NYS municipal laws. Article 30 does not require EMS, only that once you provided it you must follow rules. Counties can and do hold CON's for ambulance service.

But you are correct NYCRR needs fixing.

[Bnechis 3,961]

So its the training between the various agencies that increase the effectivenes of interoperability not soo much communications. In this case its the particitipation between the agencies involved. What would be a way to increase participation? Make it a mandatroy trainingy regiment?

We now have a good radio system for interoperability in EMS. THe issue is not the radios, long before we had radios we would do a face to face com. to transfer info to manage MCIs. if you dont know how to run an MCI, & you cant communicate what is needed face to face (in a class room or drill) the best radios in the world will not help.

I wish I knew why EMS agencies do not participate. Only the state could make it mandatory and I see no move to do that.

[emp305 32]

OK, So whos up for an EMS exercise. Lots of comments have been made, none of them very positive. So if you are an EMS agency Capt, Chief, or training officer etc. and your agency would be interested in participating in an EMS led exercise or just taking part in some face to face general joint training events, please let me know.

Capt. Jeffries

Empress EMS

SOD

[Bnechis 3,961]

OK, So whos up for an EMS exercise. Lots of comments have been made, none of them very positive. So if you are an EMS agency Capt, Chief, or training officer etc. and your agency would be interested in participating in an EMS led exercise or just taking part in some face to face general joint training events, please let me know.

Capt. Jeffries

Empress EMS

SOD

Great offer thanks

Everyone needs to remember that an excerise is not the 1st step. I have seen many agencies try to hold an MCI drill and they fall flat on their face, because the members have not 1st trained in triage, ICS and MCI managment. Start small, if you cant handle a drill with 4 patients in a 2 car MVA, dont try for 30 in a school bus. Work up to it.

[61MACKBR1 222]

Why not pick a date (Maybe a Saturday) and plan out a Full Scale MCI Drill, say held at Yonkers Raceway, with all EMS, VAC, Fire Agencies, say in the Southern End of Westchester (to start) participating (Yonkers, New Rochelle, Mount Vernon, Pelham, Pelham Manor, Eastchester, Scarsdale, Hartsdale, Dobbs Ferry, Mamaroneck, etc, etc) in cooperation with all of the Local Hospitals in the area as wellas Jacobi and WCMC.

Then you oould plan something similiar to this in the Central Portion of the County and then again up in the Northern End of the County.

The only way to getting where you want to go is to START somewhere.

[billfitz 109]

should we include units from Rhode Island? - lol

Edited May 22, 2011 by billfitz

[x635 4,066]

The problem is, when an MCI does occur, everyone is going to want to go, and it's going to strip communities of EMS coverage, which is already strained in some places. There needs to be a task force concept.

An MCI would be useless without strong leadership, and that's where the training should start. Doesn't matter what agency, if everyone has the same training, especially the IC's, then it should flow normally.

Also, a large incident is NOT an MCI. An MCI is an incident that overwhelms your resources. Agencies like Empress and Transcare can pull other ambulances from their systems and completly handle the EMS portions. Same goes for Westchester EMS if there is a small MVA in Mount Kisco, especially with the hospital nearby. In the late 90's, there was a string of large school bus crashes in Yonkers, and Empress handled every one of them in house. Empress has also handled multiple other MCI's without needed mutual aid. Also, a Bee Line bus can be a simple solution for transportiing patients, and I believe that's why Bee Line was included in the new radio system.

Of course it should be practiced, but I don't believe the mega drills do anything for anyone.

[helicopper 1,050]

The problem is, when an MCI does occur, everyone is going to want to go, and it's going to strip communities of EMS coverage, which is already strained in some places. There needs to be a task force concept.

An MCI would be useless without strong leadership, and that's where the training should start. Doesn't matter what agency, if everyone has the same training, especially the IC's, then it should flow normally.

Also, a large incident is NOT an MCI. An MCI is an incident that overwhelms your resources. Agencies like Empress and Transcare can pull other ambulances from their systems and completly handle the EMS portions. Same goes for Westchester EMS if there is a small MVA in Mount Kisco, especially with the hospital nearby. In the late 90's, there was a string of large school bus crashes in Yonkers, and Empress handled every one of them in house. Empress has also handled multiple other MCI's without needed mutual aid. Also, a Bee Line bus can be a simple solution for transportiing patients, and I believe that's why Bee Line was included in the new radio system.

Of course it should be practiced, but I don't believe the mega drills do anything for anyone.

Liberty Lines was included in the trunked radio system so they could use federal transportation funds for the development and installation of the system. I doubt that there was anything altruistic about it; it was all about the almighty dollar.

You are definitely right that leadership is required for incident management and those leaders need to know how prioritize, delegate, coordinate, and communicate. They have to be good managers too and there's a severe lack of management, management training, and management experience in EMS.

This lack of experienced managers results in the common knee-jerk reaction of calling for more resources at a complex incident when in reality all that is needed is better coordination and oversight of the resources that are already there.

[helicopper 1,050]

Great offer thanks

Everyone needs to remember that an excerise is not the 1st step. I have seen many agencies try to hold an MCI drill and they fall flat on their face, because the members have not 1st trained in triage, ICS and MCI managment. Start small, if you cant handle a drill with 4 patients in a 2 car MVA, dont try for 30 in a school bus. Work up to it.

Barry is 100% correct! Jumping into a large full-scale exercise is not the way to improve disaster preparedness or MCI management.

People need to start looking at the exercise process and capabilities based training and exercise to develop a plan for system improvement. Just picking a Saturday and having a y'all come disaster "drill" isn't the solution.

There is a process for this and training to support it. Now we just have to get EMS (and other) people to take the training and implement it effectively

[x635 4,066]

Liberty Lines was included in the trunked radio system so they could use federal transportation funds for the development and installation of the system. I doubt that there was anything altruistic about it; it was all about the almighty dollar.

Liberty Lines did need the system. Before, they had horrible communications, and even if they worked with the EOC, a lot of drivers were using their own cell phones because the bus radios didn't work. One example I have is here in Austin, we have a combined communication center. Our bus system is dispatched from that location as well. There have been numerous times where having the bus dispatchers in the facility have helped, and having the ability to interface during situations like evacuations is crucial.

[61MACKBR1 222]

Chief Fitz - I don't think that you and YFD need any help or rigs from the Providence Fire Department to run a drill in Southern Westchester (maybe Mount Vernon, but thats another subject), but I will be sure to pass along your question to the PFD Fire Commissioner when I see him - LOL

should we include units from Rhode Island? - lol

Edited May 22, 2011 by 61MACKBR1

[Guest alsfirefighter]

If we do a county wide drill please do it either at 10 am weekday or at 2 or 3 am and see how that goes.

[ny10570 745]

If we do a county wide drill please do it either at 10 am weekday or at 2 or 3 am and see how that goes.

Won't need the raceway. Anyone have a big yard? Maybe we can even BBQ.

[Goose 188]

If we do a county wide drill please do it either at 10 am weekday or at 2 or 3 am and see how that goes.

with no prior notice...

[INIT915 1,119]

This thread is like Déjà Vu. We've seen how many threads with the same information?

1. We identity the problem exists. Check. No secret there. I'm not sure anyone with a modicum of common sense would disagree.

2. A bunch of people offer legitimate suggestions (or sarcastic, yet pertinent jokes about it.)

3. The next day, nothing actually changes.

I think a more productive thread would focus on how do we finally bring pressure to bear on the decision makers.

[v85 212]

This thread is like Déjà Vu. We've seen how many threads with the same information?

1. We identity the problem exists. Check. No secret there. I'm not sure anyone with a modicum of common sense would disagree.

2. A bunch of people offer legitimate suggestions (or sarcastic, yet pertinent jokes about it.)

3. The next day, nothing actually changes.

I think a more productive thread would focus on how do we finally bring pressure to bear on the decision makers.

I agree that the problem is no matter how many threads we make about the issues in emergency services here on EMTBravo, the solutions we talk about require action at a much higher level than our forum members (i.e. elected and appointed officials). Unfortunatley, I am not really sure how to bring pressure on the decision makers.

[61MACKBR1 222]

Sadly, you are correct and actions should be taken rather than simply having discussions regarding this on this forum. It is also important to note that there are members of EMTBravo.net community who are "Appointed Officials" who should be doing something about it. (Sadly, I think that the "Home Rule" is sometimes used and if pursued, many Fire District Leaders want the larger percentage of say in how their Fire District is used and/or impacted in such cases. This subject/discussion runs right into the Mutual Aid discussions that have been bantered back n' forth on this forum for years. Until we can get State Legislation to rule out the "Home Rule" and get rid of all of this Paid vs. Volunteer non-sense and have everyone on the same playing field, nothing will get done.

I agree that the problem is no matter how many threads we make about the issues in emergency services here on EMTBravo, the solutions we talk about require action at a much higher level than our forum members (i.e. elected and appointed officials). Unfortunatley, I am not really sure how to bring pressure on the decision makers.

[ckroll 101]

Liberty Lines did need the system. Before, they had horrible communications, and even if they worked with the EOC, a lot of drivers were using their own cell phones because the bus radios didn't work. One example I have is here in Austin, we have a combined communication center. Our bus system is dispatched from that location as well. There have been numerous times where having the bus dispatchers in the facility have helped, and having the ability to interface during situations like evacuations is crucial.

Here's another suggestion. Keep doing it until we get it right. When my high angle team trained, we did a scenario, got reamed out, changed up the players and ran it again. We never made the same mistakes twice, we made brand new ones and about the 4th time we ran it, it was fast and pretty.

My beef with every MCI drill I've been a part of is that the planners set up something way too complicated, it goes to hell in a basket and in wrap up we say, well, we learned something. How about smaller incidents and plan on working the scenario start to finish until we see what getting it right looks like?

[ckroll 101]

This thread is like Déjà Vu. We've seen how many threads with the same information?

1. We identity the problem exists. Check. No secret there. I'm not sure anyone with a modicum of common sense would disagree.

2. A bunch of people offer legitimate suggestions (or sarcastic, yet pertinent jokes about it.)

3. The next day, nothing actually changes.

I think a more productive thread would focus on how do we finally bring pressure to bear on the decision makers.

Then it is time for the masses to rise up. Run a flash mob MCI in front of the building where the powers that be are meeting. Trap a few decision makers in a building for an hour while we sort through 30 nuns on bicycles that have run into a hotdog truck carrying hazardous material.

[JohnnyOV 2]

This thread is like Déjà Vu. We've seen how many threads with the same information?

1. We identity the problem exists. Check. No secret there. I'm not sure anyone with a modicum of common sense would disagree.

2. A bunch of people offer legitimate suggestions (or sarcastic, yet pertinent jokes about it.)

3. The next day, nothing actually changes.

I think a more productive thread would focus on how do we finally bring pressure to bear on the decision makers.

I understand this thread is like Deja Vu. My personal goal is to make EMS in this county, a reliable, well oiled machine before I die. A VERY long term goal of mine. Fire in this county could use a little help too, but lets admit it, EMS is a joke. I admit that EMTBravo is probably not the best place to try and get this accomplished at, but you need to at least start somewhere, gather a group of individuals and actually get something rolling. What better place to start then right here with the conglomerate of emergency providers from around the area.

I've laid low after posting this topic, just to see where it goes and let other roll with it. Like the Capt and others have said, jumping into a massive MCI drill with every agency from the county spells out disaster. Like any other training, start with the basics and work up to professional level. Some agencies have difficulty staging with their own 1-2 ambulances in an area where they can easily leave the scene once the patient is loaded. Start with that, and scene security/accountability, and maybe we can move up to including 3 or 4 other agencies at another time. Once that comes as naturally as pouring milk into your cereal, then we can move up to a larger scale incident.

I think the one thing that everyone who's commented so far can agree on is that the status quo is not acceptable in this county for EMS. It is possible that the only way to actually get some agencies to change their ways, would be to involve the press, take out ads in the paper, and billboards on the side of the road and post facts. Maybe then a fire would get lit under the rear ends of certain individuals to change. Other then that, talking about it amongst ourselves generally yields zero advancement or progression. Getting the public involved and letting them know, "You have a very good chance you'll be waiting 20-30 minutes for an ambulance during your heart attack," or "If your bus crashes right now, we have 30 ambulances around the area that we own, but we can only effectively staff 5 of them total," might entice some public outcry for change.

Handling this in house and promoting positive change without involving the public would be the best course of action obviously, since John Q who has 0 idea about emergency service would offer their 2 cents on every little thing. So before some large scale event happens in this county, why not actually sit down and come up with a realistic plan of action? Make some progressive change that a majority of agencies can agree with, and bring it to the County legislator. Tell them what we'd like to accomplish, and see if it can get done. Will it be one of the most massive undertakings in this counties history, absolutely. But what better time to start then right now, by being assertive, rather then reactive?