Voluntary Hospital EMS Closures

[EMT348 12]

I heard a bunch of people talking about voluntary hospital EMS programs closing shop and turning back over to the city. Now with EMS Exam 2004 being called up within the next few months, how much impact does the hospitals closing impact the staffing of FDNY*EMS? How many units are currently operated by Hospitals that run 911 in the city?

[nycemt326 6]

*DISCLAIMER* This is not a Hospital vs FDNY response.

Currently, there is about 125 Voluntary units in the system. Montefiore North (Old OLM) so far has been the only hospital to drop their EMS system without the entire hospital closing.

While I have heard the same stories about fdny pushing the hospitals out of 911, I don't think at this point in the City's budget or FDNY resources, they would be able to handle putting out 125 trucks to cover all at once. I do know that the fire department does want all 911 EMS to be run by them eventually, but when is hard to say. You have large networks like NY-Presby and LIJ that won't get pushed out by operating fees.

As for staffing, they would need to hire a lot more EMTs and Paramedics.

[Rescue97 6]

Some hospitals are to big to push out like Presby, but i belive the city will eventually run about 80-90%. FDNY picked up all of OLM (Monti North) 100% both ALS and BLS and has been pumping out classes like rabbits. Granted alot of members are expected to go to fire. Cassono is very pro EMS because they make ALOT of money for NYC. I heard that FDNY stopped one of the downtown hospitals from putting out another ALS by the fire department making a new rescue medic unit. They can charge a hospital up to 1 Million dollars a year to run 911 units. Once people stop paying there hospital bills or medicad stops paying out as much i belive you will see a decline in hospital based 911 units. Tho i don't want to see anyone lose there jobs in this shitty situation, its good to have the job securty.

[EMT348 12]

I only ask because I'm on the FDNY list for Exam 2004 and I'm trying to figure out the numbers. Just how many people they're trying to hire, ect. I mean, I don't want anyone to lose a job. Luckily they're unionized so that even if they lose their job at one, they could potentially roll over to another union shop. God willing.

[ny10570 745]

Some clarifications. First, the city doesn't give a rats behind who runs the ambulances. Neither does the city council. The fire department would like to run the entire system, but that is a very expensive proposition. The only people actively pursuing an all FDNY EMS system is Local 2507. EMS DOES NOT TURN A PROFIT IN NYC. Not for the FD and not for the hospitals. The only people making money are the commercial operators, and their 911 profits are razor thin. Senior Care only began going after 911 when their growth in the transport sector stagnated. By becoming a hospitals 911 provider they also become the primary transport provider.

No matter what anyone working for FDNY*EMS says the dept has no desire to suddenly take over EMS. They don't have the equipment, budget, or staffing to make it happen. The usage fee that is to be assessed upon all of the hospitals was not designed to chase them out of the system. If it was, then why not charge something astronomical like $1 million per unit rather than the thousands per unit they settled upon? Because they wanted to get as much money without any added responsibility. This was a measure to close a budget gap. If you think chasing voluntary units out of the system helps that, please see above.

The dept has no ability to unilaterally take over EMS. They tried to kick transcare out of the system years ago, but lost badly in court. The hospitals have a contract with the city and as long as they uphold their end of the deal they keep their units.

EMS is currently "overstaffed". We were approved to hire above head count for two reasons. The first is the financial house of cards many Brooklyn and Queens hospitals are currently dealing with. Several hospitals are very close to bankruptcy proceedings or outright failure. There have been informal conversations about shuttering EMS operations and what that means to hospitals and their bottom line. The second reason for being flush with members is the revolving door that is EMS. For the past 6 years except for a few pauses we've been hiring constantly. Part of that has been the expansion of the system but a lot is also in response to a hiring binge and system expansion 25 years ago. We have a large number of members coming up on retirement. We also have members frequently leaving for other careers. The biggest destination in the coming years is going be to fire where we will see several hundred current members go.

Since St Vincents closed NY Downtown has been chomping at the bit to pick up more tours. They added an overnight coverage to one of their ALS and another 24 hour BLS. The rumored addition of a Rescue unit to lower Manhattan is not to prevent another unit from operating. Their operation is funded by federal grant money and at this point is still a rumor. The dept is not preventing anyone from running more units. Bronx Lebanon added an ALS and I believe there were two new voluntary units in Brooklyn last year.

I would expect EMT hiring to continue at its current pace. Another 60 EMTs were pulled from the streets to go to paramedic training starting today and there has been more and more BLS overtime available recently.

[mtnmedic 36]

ny10570 has a perfect summary, though in the time that has elapsed since his post and now 01Rescue has officially been announced, and starts running on July 1.