NY Times Article: Bankruptcy of TransCare Strains New York’s Emergency Services

[x635 4,066]

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At every moment, the population explosion of New York rolls across the city in not-so-slow motion. Last year, nearly 1.7 million people called 911 for medical help, the most since humans started answering telephones. On average that’s about one call every 20 seconds.

On the evening of Feb. 25, a radio message came to 911 dispatchers from an ambulance in the Bronx:

 

“Out of service.”

 

It was the first of many such messages that night

 

 

http://www.nytimes.com/2016/04/15/nyregion/bankruptcy-of-transcarestrains-new-yorks-emergency-services.html?_r=0

[SECTMB 612]

According to the story, the bankruptcy of Transcare left the City short by 81 tours made up of 200 EMS professionals.  There was money from somewhere paying those 200 EMS professionals.

 

So, why didn't the City just hire those former Transcare workers and have the money that was funding them redirected to City coffers? There must be some way to waive or sidestep, legally, civil service hiring rules for a declared public health emergency.  If there was a compensation disparity between Transcare and City compensation, the City would have to make up the difference, but given that we are only talking about 200 workers, the difference can't be more than a ripple in a budget the size of NYC's.

 

It would seem to be a win/win, the workers keep their jobs, the City gets State certified, trained and seasoned EMS professionals and the Public gets to keep the EMS workers familiar with their neighborhoods.

 

I don't know how many buses are involved with those 81 tours, the Transcare physical assets aren't as readily obtainable as released employees, but I imagine the City must have spares or if they must, buy some stock/demo units from whomever has them to get by.

 

Where was the crisis management plan? Weren't there rumors of issues about Transcare's long term viability? Was it necessary to overwork existing crews? I have no doubt I am oversimplifying a possible remedy, but I also don't think this needed to be more than a speed bump for an EMS response.

[roofsopen19 34]

12 hours ago, SECTMB said:

 

So, why didn't the City just hire those former Transcare workers and have the money that was funding them redirected to City coffers?

It would seem to be a win/win, the workers keep their jobs, the City gets State certified, trained and seasoned EMS professionals and the Public gets to keep the EMS workers familiar with their neighborhoods.

 

 

Because they had a fresh class of 180 PROPERLY TRAINED EMTs (with no bad habbits or egos) who earned the privilege of wearing that patch on their sleeve through time and commitment.  The City is picking up the slack just fine with another beefed up class to follow.  They may not be street smart right now but they have the proper training to meet the Cities expectations of the best pre hospital care in the world with academic reinforcement of human anatomy & physiology.  The FDNY expects all EMTs to be trained for all the job entails and is done so through the academy....NYC & NYS BLS protocols, Hazmat scenarios, subway safety, driving emergency vehicles, Vehicle extrication, donning specialized PPE,  highway operations, understanding chain of command, fire scene operations,  etc.  Give the graduating probie class a week or 2 in the bronx and they will be plenty street smart.  

 

If they wanted a secure job they should of signed up in September rather than rely on a private,  for-profit company.  Just my opinion.  The option is always there. Every september the test seems to come out. 

Edited April 16, 2016 by roofsopen19

[trauma74 111]

Supposedly in the next 2 weeks, SeniorCare & Citywide are going to be rolling out their 911 units from Bronx Leb & St. Barnabas Hospitals

[FireMedic049 597]

22 hours ago, SECTMB said:

According to the story, the bankruptcy of Transcare left the City short by 81 tours made up of 200 EMS professionals.  There was money from somewhere paying those 200 EMS professionals.

 

So, why didn't the City just hire those former Transcare workers and have the money that was funding them redirected to City coffers? There must be some way to waive or sidestep, legally, civil service hiring rules for a declared public health emergency.  If there was a compensation disparity between Transcare and City compensation, the City would have to make up the difference, but given that we are only talking about 200 workers, the difference can't be more than a ripple in a budget the size of NYC's.

 

I wouldn't exactly call this situation a "public health emergency" in the terms that you seem to be insinuating.  No doubt this caused some pain, but in the grand scheme of things, 81 tours is a small portion of the daily staffing in NYC.

 

The civil service system is there for a reason and you simply don't just ignore it because you need to hire a bunch of people all of a sudden.  In a city the size of NYC, I would imagine that they pretty much always have an active civil service eligibility list and routinely run new recruit academies.  So, I would expect that they would be well positioned to immediately hire and train the personnel they need in a timely manner while utilizing overtime coverage in the short-term.

 

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It would seem to be a win/win, the workers keep their jobs, the City gets State certified, trained and seasoned EMS professionals and the Public gets to keep the EMS workers familiar with their neighborhoods.

 

I don't know how many buses are involved with those 81 tours, the Transcare physical assets aren't as readily obtainable as released employees, but I imagine the City must have spares or if they must, buy some stock/demo units from whomever has them to get by.

 

Where was the crisis management plan? Weren't there rumors of issues about Transcare's long term viability? Was it necessary to overwork existing crews? I have no doubt I am oversimplifying a possible remedy, but I also don't think this needed to be more than a speed bump for an EMS response.

 

Not sure why you seem to be insinuating that there was no plan in place to deal with this situation.  I've read from more than one source that FDNY did have a contingency plan in case this situation happened.  As I understand it, the short-term plan included immediately putting additional FDNY units on the streets with existing personnel working overtime and that's exactly what they did.  So, yes, it was necessary for existing crews to work extra hours, but what constitutes actually being "overworked" is a subjective thing.  Working an extra tour or two per week isn't the same thing as having to work a double every day. 

 

They also made an emergency acquisition of several "in-stock" ambulances to help ensure they had enough units available for use while awaiting delivery of the numerous units already under construction and any add-ons necessary due to this.

 

Yes, the uncertainty of Transcare's viability was known, but you can't start hiring additional people in that quantity because something might happen.  Additionally, I would imagine that the hospitals have some sort of contract with FDNY to provide units for the 911 system that prevents FDNY from removing their units from the system based on rumor.  Why would the hospitals commits the financial resources to running their own EMS units if FDNY could just decide one day to immediately eliminate them?

 

So, I'm fairly sure that FDNY didn't have the legal ability to conduct a mass hiring, put additional units on the road and eliminate Transcare's units.

[SECTMB 612]

The Times article made it seem that the City was unprepared as it had to 'scramble' and was burdening their existing EMS workers with extra shifts out of their normal districts.

 

It might have been more assuring to the public if they had mentioned that a class of 180 FD EMS personnel was getting ready to hit the streets with another to follow shortly.

Of course that would be predicated on whether the article was intended to alarm the public rather than allay any concerns. 

[FireMedic049 597]

4 minutes ago, SECTMB said:

The Times article made it seem that the City was unprepared as it had to 'scramble' and was burdening their existing EMS workers with extra shifts out of their normal districts.

 

It might have been more assuring to the public if they had mentioned that a class of 180 FD EMS personnel was getting ready to hit the streets with another to follow shortly.

Of course that would be predicated on whether the article was intended to alarm the public rather than allay any concerns. 

I didn't get the vibe that the city was unprepared from the article.  It struck me more as they are having difficulty managing the situation without "enough" resources mixed with a touch of the fear mongering that seems to be standard for the media these days.

 

It also had a healthy dose of the typical misguided belief that declining working fires and increasing EMS calls means that fire resources should be redirected towards EMS responses.  Sure, on the surface it seems reasonable that the area that makes up 70-80% of your department's responses should get the lion's share of funding, but it ignores some very important factors and usually one undeniable truth:

 

1) While fires are "down", incident responses aren't.  FDNY (as do all FDs) responds to much more than just working fires.

2) Fires do still occur (quite frequently in NYC) and when they do, they still require the same number of personnel arriving quickly.  In fact, recent scientific studies suggest that today's fire may require more personnel arriving even more quickly.

3) There are fundamental differences in necesssary staffing and apparatus/equipment costs between fire and EMS that impact how the funding pie is divided.  A single EMS unit in FDNY is significantly cheaper to acquire, equip and staff 24/7/365 than a single fire unit.

4) The problem may not be that too many resources are directed towards fire response.  Maybe the problem is just that too few resources are directed towards EMS response?

 

 

[trauma74 111]

SeniorCare - St. Barnabas Unit 18X just went in service this morning

[letsgo1547 50]

I spent 5 years working a busy bls unit in the Bronx. I could easily do 7,8 even 9 jobs in an 8 hours tour. Where the ALS units in my station would do 2 maybe 3 if the were busy. What the fire department should do is get rid of the double EMT double medic unit and staff it,one medic and one EMT. This way every unit goes to everything. You could have a medic unit sitting on your block and it won't respond to your broken leg or cut arm,you will wait the 10 plus mins for bls. Then you have a cardiac arrest, you get an engine company, bls unit,ALS unit and a conditions boss,waste of resources

[velcroMedic1987 330]

On ‎4‎/‎16‎/‎2016 at 8:46 PM, SECTMB said:

According to the story, the bankruptcy of Transcare left the City short by 81 tours made up of 200 EMS professionals.  There was money from somewhere paying those 200 EMS professionals.

 

So, why didn't the City just hire those former Transcare workers and have the money that was funding them redirected to City coffers? There must be some way to waive or sidestep, legally, civil service hiring rules for a declared public health emergency.  If there was a compensation disparity between Transcare and City compensation, the City would have to make up the difference, but given that we are only talking about 200 workers, the difference can't be more than a ripple in a budget the size of NYC's.

 

It would seem to be a win/win, the workers keep their jobs, the City gets State certified, trained and seasoned EMS professionals and the Public gets to keep the EMS workers familiar with their neighborhoods.

 

I don't know how many buses are involved with those 81 tours, the Transcare physical assets aren't as readily obtainable as released employees, but I imagine the City must have spares or if they must, buy some stock/demo units from whomever has them to get by.

 

Where was the crisis management plan? Weren't there rumors of issues about Transcare's long term viability? Was it necessary to overwork existing crews? I have no doubt I am oversimplifying a possible remedy, but I also don't think this needed to be more than a speed bump for an EMS response.

 

 

The civil service process prevented them from "just hiring" the former TransCare employees.  It's not an ideal scenario but they have to abide by the rule of law or we'd all be complaining that some political patronage morons were taking all the jobs.