Would This Be A Temporary Fix To Westchester's EMS Staffing Issues?

[x635 4,066]

I've seen so many agencies lately trying to put on a "band aid" fix to their staffing issues.

While a County agency would be the best possible option logistically in my opinion, right now I don't think the County is in any place to lay the groundwork anytime soon.

Instead, why doesn't the County solicit bids from commercial EMS providers (like they used to do with Stat Flight when they ran it when the were WCMC) to provide staffing solutions? The requirements could be that the winning bidder must supply an EMT and/or Paramedic to staff an ambulance from 6p-6a or 6a-6p. Any agency in Westchester can participate, short term or long term.

This bid allows for the position of Coordinator to be staffed to run the program. It would also allow EMT's assigned to this to have 911 experience, EVOC experience, and all other neccesary traning. All the HR would also be handled by the contactor. Things like GPS and centralized dispatch would also be included by the contractor. And, a supervisor would be on the road 24/7.

As for the physical ambulance and equipment, the contractee could decide what they want used, and if need be, their equipment or the contractors.

Again, this would be available to any volunteer agency in Westchester, at a cost to be determined by a fee schedule.

I know it's very idealistic, but it's a start.

[Guest alsfirefighter]

Ok I like the thought you're putting into it...but how do they decide where to staff? What do you do if it flips that way and in my instance...we aren't going anywhere and are established.

[x635 4,066]

Ok I like the thought you're putting into it...but how do they decide where to staff? What do you do if it flips that way and in my instance...we aren't going anywhere and are established.

Westchester County is allowed, I believe, to make law over or more restrictive the NYS law and local law. Someone could finally step up and say to the legislators that we need help, and create a "franchise agreement" needed to operate EMS in Westchester. Part of that franchise agreement would require a minimum response time. Cable companies need to present and prove certain things to operate in a community, and Westchester County's Bee-Line is technically run by contractors (Liberty Lines Drivers). For hecks sake, a taxicab,garbage truck, etc are more regulated in Westchester. But not a life-saving service? Bee-Line is one of the top transit systems in the country in "On-Time" pickup status. If Westchester schoolkids buses were late or their garabgae wasn't picked up, it would be a giant issue. But they have rules and polocies in place and mandated.

Yet, waiting for an ambulance in a timely manner is not a guarentee, and neither is the level of care or crew you're going to get. Sometimes, you may get pre-arrival instructions and a appropriate response. However, if you go to a friends house in the next town over, you may not get lifesaving pre-arrival instructions and the ambulance may take forever.

Or, this could be an opt-in program.

Taking a fire engine out of service or police car off the street to provide ALS isn't a good solution to supplement staffing.

I know it's not as easy as I'm saying, but it could work.

[Guest alsfirefighter]

Westchester County is allowed, I believe, to make law over or more restrictive the NYS law and local law. Someone could finally step up and say to the legislators that we need help, and create a "franchise agreement" needed to operate EMS in Westchester. Part of that franchise agreement would require a minimum response time. Cable companies need to present and prove certain things to operate in a community, and Westchester County's Bee-Line is technically run by contractors (Liberty Lines Drivers). For hecks sake, a taxicab,garbage truck, etc are more regulated in Westchester. But not a life-saving service? Bee-Line is one of the top transit systems in the country in "On-Time" pickup status. If Westchester schoolkids buses were late or their garabgae wasn't picked up, it would be a giant issue. But they have rules and polocies in place and mandated.

Yet, waiting for an ambulance in a timely manner is not a guarentee, and neither is the level of care or crew you're going to get. Sometimes, you may get pre-arrival instructions and a appropriate response. However, if you go to a friends house in the next town over, you may not get lifesaving pre-arrival instructions and the ambulance may take forever.

Or, this could be an opt-in program.

Taking a fire engine out of service or police car off the street to provide ALS isn't a good solution to supplement staffing.

I know it's not as easy as I'm saying, but it could work.

Funny I wrote an article about NJ when they were doing a bill for cable tv appointments requiring a time window and how nothing is like that for emergency services.

As far as taking units out of service to supplement staffing...I don't supplement staffing...I am the staffing...and if an apparatus is on a BLS run...if needed to be there they are out of service and resource management is a departmental issue and in my case one that is addressed through staffing. If that's the system as it is..then that's what it is. There are tons of FD based EMS systems in the country that work just fine and are some of the best we have. Again I like the thought process...as with anything its a start..but very complicated. We don't have ALS response issues...we have some of the best staffing in the county in my area and have the support of our main municipality...but if an outside agency thinks they will walk into where I am...there's gonna be problems when we do our job...and like it or not...are union to boot.

[helicopper 1,050]

Funny I wrote an article about NJ when they were doing a bill for cable tv appointments requiring a time window and how nothing is like that for emergency services.

As far as taking units out of service to supplement staffing...I don't supplement staffing...I am the staffing...and if an apparatus is on a BLS run...if needed to be there they are out of service and resource management is a departmental issue and in my case one that is addressed through staffing. If that's the system as it is..then that's what it is. There are tons of FD based EMS systems in the country that work just fine and are some of the best we have. Again I like the thought process...as with anything its a start..but very complicated. We don't have ALS response issues...we have some of the best staffing in the county in my area and have the support of our main municipality...but if an outside agency thinks they will walk into where I am...there's gonna be problems when we do our job...and like it or not...are union to boot.

Playing devil's advocate for a minute, you mean to tell me that you and your union would oppose a system that would allow you to add FF to the roster every day while EMS is being provided at or above the level it currently is?

For my own information, are your medics still assigned to apparatus or are you dedicated to strictly EMS?

Looking forward to your response!

[NWFDMedic 58]

If the county were to do something like this (and they won't), who pays for it? If a town or city already contracts for ALS coverage 24/7, why should their tax money go to this other staffing? Or if Town A needs this staffing for 100 calls a year, and Town B needs this staffing for 500 calls a year, should Town B pay more? Or maybe, just maybe, if the commercial agency is going to be allowed to do billing recovery, should Town B pay less because their volume creates more profit while Town A has idle hours?

I'm not saying it shouldn't be done. In fact, I think you're heading down the right track. I'm just playing devil's advocate.

[x635 4,066]

This system could be specified and sent to bid for a contractor to provide those services. In return, they get to bill, and the exclusive franchise rights to certain nursing home and transports, and special events.

If Westchester County can run an amusment park (and I think that's pretty cool even though they have no idea the potential cash they can make with some improvements and events, but I digress), then they certainly send an EMS system out to bid. All agencies could remain as first responder services if they wish, or shut down their operations. If they want to participate in EMS, fill out an application with the contractor. Maybe the language could include the VAC people "dibs" in their own area.

[SRS131EMTFF 471]

This system could be specified and sent to bid for a contractor to provide those services. In return, they get to bill, and the exclusive franchise rights to certain nursing home and transports, and special events.

If Westchester County can run an amusment park (and I think that's pretty cool even though they have no idea the potential cash they can make with some improvements and events, but I digress), then they certainly send an EMS system out to bid. All agencies could remain as first responder services if they wish, or shut down their operations. If they want to participate in EMS, fill out an application with the contractor. Maybe the language could include the VAC people "dibs" in their own area.

The county cannot even run its amusement park. Playland has been operating at a loss for the past several years, roughly at a cost of $4 million annually. Not that your idea can't work but playland is a bad example if you are looking for an example of a county run service. Obviously EMS is not supposed to be a profit driven industry but if a contractor was going to bid on an EMS contract it would have to prove to be economically viable, something that the counties amusement park is not.

Edited June 22, 2011 by SRS131EMTFF

[x635 4,066]

The county cannot even run its amusement park.

My example was that the county could be making millions of dollars off the park, by adding resturants, shows, festivals, re-opening unused sections, etc but, like many things, the County doesn't tap at the potential right in their own backyard.

[NJMedic 96]

http://www.mycentraljersey.com/article/20110621/NJNEWS/306210023/Union-launches-new-EMS-squad?odyssey=tab|topnews|text|FRONTPAGE

Union launches new EMS squad

One of two such county operations in N.J.

Written by

Mark Spivey | Staff Writer Filed Under

News

UNION COUNTY — Despite what was described as an “overwhelming” cry for help in improving emergency medical service coverage, those involved with the launch of one of New Jersey’s first county-sponsored EMS squads still weren’t quite sure what to expect until the switchboard started lighting up on June 1.

“I honestly thought it would take a little while longer to catch on,” Union County Director of Emergency Management Christopher Scaturo admitted. “The first couple of days they (municipal emergency response personnel) were like ‘Who are you?’ But each day it’s pretty much been three-plus (calls for service).”

The new squad is a one-year pilot program, with an estimated cost of just under $213,000 recently approved by the Union County Freeholders. But emergency officials across the county are hopeful it can become a permanent shot in the arm for a mutual aid system that has been stretched to its breaking point due to high call volume.

At more than 5,000 residents per square mile, Union is one of the state’s most densely populated counties. But sagging volunteer support and the closure of several local hospitals — most critically the 2008 shuttering of Muhlenberg Regional Medical Center in Plainfield — have contributed to the squeeze, officials said.

“When we first looked into this project ... I was shocked learning what the response times could be,” county Division of Intergovernmental Policy and Planning Director Cherron Rountree said, noting that in severe cases, 911 calls for medical service are being followed by waits of 45 minutes or more. “We had various administrators, elected officials from municipalities and even residents approach us about it ... judging from all of that, clearly this need is real.”

The service currently consists of one ambulance and crew based at the county’s Public Safety Building in Westfield; the squad will operate from 6:30 a.m. to 6:30 p.m. Monday through Friday, ready to respond to emergencies in any municipality in Union County (less than two weeks after its launch date, crews already had responded to dozens of calls from 10 of the county’s 21 municipalities).

[sympathomedic 383]

Seems to me the County runs a fine PD, a good trauma center, solid waste and sewer districts, a DES, a good parks department... An EMS agency is well within their capabilites and sorely needed. I think local governments can seee that this would be best handled at the County level, just like the stuff I mentioned above. We could do it Like Nassau's County PD: Jump in at the start or you are on your own. Run it up the flag pole and see who salutes.

PS: I worked at and continue to love Playland.

[Bnechis 3,961]

This system could be specified and sent to bid for a contractor to provide those services. In return, they get to bill, and the exclusive franchise rights to certain nursing home and transports, and special events.

Nice idea, but "exclusive franchise rights" may violate the CON requirements under NYS DOH.

Seems to me the County runs a fine PD, a good trauma center........

Its been a long time since they ran WCMC and got out of it because of poor financial $$$$$

I think local governments can seee that this would be best handled at the County level, just like the stuff I mentioned above.

Great, but most EMS in Westchester is provided by VAC's or Fire Districts, neither answer to local government. The main communities that are "providing" service already use the commercail service (NR, MV, WP & Yonkers)

[gpeifer 89]

CCCrraaccckkkkkkk!!! That was the sound of the can opening....here come the worms. Back in the 80's (most of you younger guys don't even recall EMS in the 80's) Ted Tully proposed a county wide EMS system. What a great idea!!!! Except the vollies all cried that it would be taking away their beloved ambulance calls. Now these same agencies cannot respond in a timely manner, many are hiring (isnt that the same as paid), bill for service, and most contract out the ALS service. The time has come for change...hasn't that been the catch phrase lately. I commend all volunteers..but patient care NEEDS to be the priority, not the green and or blue light you get to use when the tones go off. Wackers rejoice...if you want to be an EMT or paramedic, than be a career EMT or paramedic. Volunteer EMS dilutes the system, lowering wages for those that depend on it for their livelihood. Where are the volunteer doctors and nurses? Doing EMS as a career makes for better EMT's and paramedics as you gain more experience.

The county should look into a Public Utility Model for areas outside of the large cities. Other areas are doing well with this approach.

Guy

[helicopper 1,050]

CCCrraaccckkkkkkk!!! That was the sound of the can opening....here come the worms. Back in the 80's (most of you younger guys don't even recall EMS in the 80's) Ted Tully proposed a county wide EMS system. What a great idea!!!! Except the vollies all cried that it would be taking away their beloved ambulance calls. Now these same agencies cannot respond in a timely manner, many are hiring (isnt that the same as paid), bill for service, and most contract out the ALS service. The time has come for change...hasn't that been the catch phrase lately. I commend all volunteers..but patient care NEEDS to be the priority, not the green and or blue light you get to use when the tones go off. Wackers rejoice...if you want to be an EMT or paramedic, than be a career EMT or paramedic. Volunteer EMS dilutes the system, lowering wages for those that depend on it for their livelihood. Where are the volunteer doctors and nurses? Doing EMS as a career makes for better EMT's and paramedics as you gain more experience.

The county should look into a Public Utility Model for areas outside of the large cities. Other areas are doing well with this approach.

Guy

Ironically there was a series in the Gannett newspapers at the time describing response time issues, staffing shortages, and a "patchwork" approach to EMS that meant, according to their headline, "Where you live could cost your life". And, if I recall correctly, Ted Tully was villified for proposing a real system for the County and not supporting the dysfunctional "system" we relied on then and... wait for it... continue to rely on today.

Isn't it funny how much things have (not) changed?

I must say that the one thing that has improved since that series is the proliferation of ALS coverage. Today most of the County has dedicated ALS units but there are still major problems with the rest of the system.

[Bnechis 3,961]

CCCrraaccckkkkkkk!!! That was the sound of the can opening....here come the worms.

[Guest alsfirefighter]

Playing devil's advocate for a minute, you mean to tell me that you and your union would oppose a system that would allow you to add FF to the roster every day while EMS is being provided at or above the level it currently is?

For my own information, are your medics still assigned to apparatus or are you dedicated to strictly EMS?

Looking forward to your response!

He'll no we wouldn't fight it. But there would be some seriously upset dudes if we got cut out of our services and dump 2 years of schooling down the drain. Yes we are.