AMBULANCE, BASIC LIFE SUPPORT SERVICES (BLS)

Ambulance Service, Edgemont Community

The EIC plan omits Ambulance Transport and BLS in its entirety. Who will ensure our life safety?

THE CURRENT GREENBURGH EMERGENCY MEDICAL SERVICE CORP, EMS, CONSISTS OF :

15 EMERGENCY MEDICAL TECHNICIANS (EMTs)
25 PARAMEDICS
2 ADMINISTRATIVE STAFF
8 EMERGENCY MEDICAL DISPATCHERS (EMDs)
5 AMBULANCES
6 ADVANCED LIFE SAVING VEHICLES (“FLYCARS”)

Although the EIC has been informed several times by Chief McNerney and other Greenburgh Town officials, that Greenburgh will not provide EMT (Ambulance/Basic Life Support) Service to a new Edgemont Village, the EIC continues to erroneously and emphatically state, the opposite.

The EIC Feasibility Study reflects the following:

“As a village, Edgemont will have the same or better medical emergency services compared to what it receives now as part of unincorporated Greenburgh.”

The EIC’s refusal to accept the loss of EMS services as a reality and its refusal to incorporate the costs of funding an Edgemont Ambulance BLS unit, at an approximate net cost in excess of $1,000,000.00 per year is extremely troubling.

THE REALITY

Discussions with Greenburgh Police Chief McNerney, supported by James F. Tardy (Senior Attorney from The Division of Legal Affairs/Bureau of House Council) for New York State, explain clearly that Edgemont would need to provide its own EMS service, generating annual net budget costs in excess of $1,000,000.00, for 24 hour, two person coverage and vehicle and equipment associated costs, less insurance reimbursement.

NYS Senior Attorney Tardy agrees that an Edgemont village must provide EMS Services: 

“It is my understanding that the Town of Greenburgh Police Department is not obligated to provide for ambulance services for the newly incorporated village without a contract with the town. “Mutual Aid” as referenced in regulations and statute refers to agreements between ambulance services where both agencies agree to assist each other when needed. It sounds to me that the new village lacks any EMS agency to form a mutual aid agreement with. Even if it did have its own EMS agency, the town would not be compelled to join a mutual aid agreement, especially if it seems like it would be abused.”

POLICE CHIEF MCNERNEY

In several meetings with Chief McNerney, the Chief made it clear that Greenburgh would not be providing EMS services to a newly incorporated Edgemont Village. The Chief also explained that none of the incorporated villages utilize Greenburgh EMS. In terms of the concept of Mutual Aid, he went further and explained that based upon his expectation that Edgemont would fund a single EMT ambulance/crew and what he believes will be a serious reduction in the Greenburgh Police/EMS force, due to the loss of Edgemont’s property taxes, he would have difficulty entering into any mutual aid agreement, believing it would be one sided to Edgemont’s benefit and in fact could not guarantee the same level of Mutual Aid. 

THE EVEC REPORT OF 2005

The findings of the “Edgemont Village Exploratory Committee,” performed in 2005 unambiguously state that an Edgemont Village would be responsible for funding EMS services.

After substantial research the EVEC report states the obvious:

“Certain emergency personnel and services are provided on a town-wide basis. The town-wide budget includes payments for a paramedic supervisor, eight paramedics and seven emergency service technicians, as well as at least one emergency vehicle to transport paramedics.

As for ambulances, the Town currently provides four ambulances for transport to hospitals, for use in the unincorporated area of Greenburgh. The villages provide their own ambulances. The Town’s ambulance service for the unincorporated area is provided through the Police Department. The Fire District also provides certain emergency medical services, including EMT Service, to Edgemont residents.

In the event of incorporation, the emergency personnel and services provided by Greenburgh on a town-wide basis would not be affected. After an interim period of no more than eighteen months, however, the Village of Edgemont would have to arrange for ambulance coverage. Such services could possibly be provided through the Police or Fire District (which would become a fire department in Edgemont), or through a third-party service provider, another municipality (if it were willing to do so), or the Town under certain circumstances. The pro-forma budget accounts for this transport in the Police budget.”

Essentially, the opinion of Chief of Police McNerney, the EVEC report and the legal opinion from NYS Dept. of Legal Affairs, independently agree that the Town of Greenburgh would NOT be mandated to provide Ambulance/EMT services to the new Village of Edgemont. The fact that none of the other 6 Villages of Greenburgh receive these services and each has its own volunteer or paid service reinforces the other opinions. These facts would indicate that it would be a requirement for the new Village of Edgemont to create its own Ambulance/EMT service and cause the EIC to add $1,000,000.00 to its proposed budget.

The additional option exists to hire an outside for-profit ambulance provider. However, such a contract can not be negotiated or let until after a new government is elected. That cost is also missing from the EIC study.

THE FIRE DISTRICT

Is it reasonable to expect the Fire District to assume any part of the Greenburgh EMS role?

The current staffing levels of the fire district include 24-hour shifts with 7 men/women on-duty, including a Captain, a Lieutenant and 5 Fire Fighters.  If Edgemont were to have to provide its own EMS services and decided to incorporate those services into the Fire District while maintaining existing fire department levels of service, it would be necessary to provide additional staff, comprised of 2 EMT personnel 24/7 in order to properly staff a new ambulance, which would need to be purchased, while maintaining the service levels for the fire department. In order to fill that need, it would be necessary to hire approximately 9 EMT trained staff (to account for vacations, sick days, etc.) 

At an annual salary projected at $60,000 per employee, plus benefits as projected by the EIC report of 55% of salary, the personnel cost alone would translate to $837,000 per year.  There would be the added costs of supervision, overtime, supplies, providing housing for and maintaining the ambulance, as well as the capital cost of approximately $250,000.00 for a new fully equipped ambulance. These costs would dramatically increase the budget of the Fire District. It should be noted that NYS regulation restricts FDs, unlike PDs, from charging for ambulance services.

SUMMATION

This report is intended to inform the community that the EIC is not listening nor providing correct information regarding Ambulance Service and that the added net cost of Ambulance/EMT services, $1,000,000.00, by itself, is enough to place the EIC projected first year budget into substantial deficit, causing the clear need for increasing our property taxes.

NOTE, RESPONSE FROM GPD CHIEF CHRIS MCNERNEY RE: EMS SERVICES 

  • We are extremely proud of the Emergency Medical Services provided to the residents of the unincorporated Town of Greenburgh. We continue to save countless lives and help thousands of residents each year during their medical emergencies. We are confident that we provide the best EMS service in the area.
  • The Greenburgh Police Department is the primary emergency medical provider in the unincorporated Town as authorized by the New York State Department of Health. Police department personnel provide Advanced Life Support (ALS) and Basic Life Support (BLS) and Ambulance Service to residents of the unincorporated Town and Advanced Life Support (ALS) to the residents of the incorporated villages.
  • The police department designed the current two-tier EMS system (used in the unincorporated Town) and invited the professional fire departments to participate. The professional fire departments were recommended to become BLS providers by the police department and were subsequently authorized by the New York State Department of Health as BLS non-transporting providers.
  • The two-tier system was designed for one reason: to get trained emergency medical personnel to our residents in the shortest time possible. Police officers are on the road twenty-four hours a day and can usually arrive at a medical emergency faster than anyone-provided they are not on another call for service that they cannot leave. Town firefighters generally have low call volumes and are usually free to respond to emergency medical calls when dispatched from their fire houses. This system has worked very well and thousands of unincorporated residents have benefitted as a result.
  • In 1997, the police department expanded the Advanced Life Support Services to the incorporated villages in the Town. All incorporated villages maintained the responsibilities of providing Basic Life Support and patient transportation (ambulance service) to facilities providing hospital services. The Basic Life Support and patient transport responsibilities in all of the villages were (and remain) the duty of volunteer ambulance corporations or volunteer fire departments. 

INCORPORATION EFFECTS ON EMS SERVICE:

  • The EIC Feasibility Study did not include a chapter on Emergency Medical Services so their estimations on the cost of an EMS program are unknown.
  • Edgemont residents would lose the BLS ambulance service they currently receive as unincorporated residents from the Greenburgh Police Department. Incorporated Edgemont residents would have to acquire ambulance service from another entity if the Greenburgh Police Department does not provide police protection.
  • The EIC states that an incorporated village will have the same or better EMS service than it currently has. They have failed to state how.
    • Residents of the unincorporated Town currently have 15 Emergency Medical Technicians and 25 Paramedics on staff with the Greenburgh Police Department who provide EMS service.
    • We also have approximately 5 ambulances in service, at a given time, that are available to respond to medical emergencies.
  • The EIC states that Edgemont’s access to Advanced Life Support Services (ALS) from the Greenburgh Police Department will not change after incorporation.
    • There is no guarantee that our specialized services, including Advanced Life Support, will remain unchanged after incorporation. Eight (8) police officers are currently paramedics and have a duty to respond to the incorporated villages if multiple Advanced Life Support calls are received from any of the six (6) incorporated villages. If police department positions are lost, the town-wide Advanced Life Support program must be evaluated to ensure safe minimum police staffing levels in the unincorporated Town.
  • The EIC misrepresents the number of Emergency Medical Technicians that the Greenburgh Police Department has on staff.
    • The Greenburgh Police Department has 15 Emergency Medical Technicians on staff and 25 Paramedics. Our emergency medical personnel are considered line personnel performing day to day operations.
  • The EIC misrepresents that all Greenburgh Police personnel are afforded an opportunity to become EMT’s.
    • For fiscal responsibility, only personnel assigned to the patrol division may attempt to become certified as EMT’s. Also, the maximum number of the EMT’s permissible in the police department is 25. The aforementioned provisions are to preclude supervisors and other sworn personnel who are not performing the line function of EMS from collecting additional EMT financial stipends and to limit the potential financial exposure to the Town.
  • The EIC misrepresents that the Greenville Fire Department is “almost always the first responder on the scene” and the “Greenburgh Police are frequently not in Edgemont when they get the call.”
    • The above statements are completely unsupported by facts and are not accurate. I am unaware of any data that supports either statement.
    • The police may arrive secondary to Greenville Fire Department personnel and that confirms our belief that our two-tier system is working. One cannot conclude that the police department’s secondary response is due to a unit not being in Edgemont at the time of the call. We respond to approximately 60,000 calls for service each year. If our unit is on a call, it clears as quickly as possible or a unit is sent from a neighboring sector. The fire department has significantly less call volume and is usually free to respond. One distinction is important: If Greenville Fire personnel are on a fire call, it is likely that they cannot respond to an EMS call at all.    
  • The EIC misrepresents that when an EMS call requires a transport to a hospital, the Greenburgh Police, as a local police provider, calls for an ambulance.
    • When our dispatch receives communication of a sick or injured individual in the unincorporated Town, an ambulance is immediately dispatched at the same time as all emergency responders.
  • The EIC misrepresents that the Greenburgh ambulance travels from 119 in Greenburgh  to the local Edgemont emergency pick up.
    • This statement is misleading and not accurate. While this happens, possibly even more often than not, one cannot state unilaterally that our ambulances travel from Route 119 to Edgemont all the time.
  • The EIC has stated that the Greenville Fire Department may handle ambulance service in the event of incorporation.
    • For at least the past 22 years, we have repeatedly asked Greenville Fire personnel to assist with transports to hospitals as needed. Greenville FD supervisors have consistently refused to assist on transports, stating that they cannot transport as that would put them under minimum manning for their fire apparatus. They continued that if a fire call were to come in while their firefighter was on his way to the hospital with a patient, it would delay firefighting operations and it cannot be done. To that end and from my personal experience, Greenville is unable to provide ambulance transports without significant increases in staffing.