NWFDMedic

Hope its not verizon, my home phone line went dead the day they went on strike. They gave me the earliest available appointment, and its in 3 weeks. They also said that we would still be billed for any service we are not recieving.

Can you hear me now?

Replying to the earlier comment about Psych services not making much money... It is actually the way the hospital allocates cost to the unit. Here is an over simplified example:

A hospital has a 20,000sf psych unit. It's cost is relatively low because it requires very little specialty equipment, the staffing costs are low, and the overall amount of resources that are dedicated to the unit are low as well. Lets say the average daily census translates to a 90% occupancy which generates $10mil a year in gross revenue.

The same hospital has dual MRI machines that take up 5,000sf. The cost is excessive due to the cost of the machines, specialty staffing, maintenance etc but they generate $10mil a year in gross revenue.

Now the crux of it all... The hospital has determined that its overhead allocation per SF is going to be $400/SF which is applied pro rata to each unit in the hospital. So they allocate $8mil in costs to the Psych unit (20,000 X $400) and $2,000,000 in cost to the MRI (5,000 X $400). The hospital CEO says to the CFO why do we keep operating Psych beds when they only made us $2mil last year compared to MRI which made us four times that.....

If the hospital had allocated cost in a more equitable manor the true story of cost vs revenue would show that psych made more money than originally depicted. Many NFP hospitals do it this way because its easier and they're not playing with their own money. In the FP world cost accounting is a much more thorough process and that is why companies like Psychiatric Solutions (recently purchased by Universal Health) have no problem making money in the free standing psychiatric hospital business. You don't see many in NYS because its an over-regulated service area.

That's a great explanation. I'm working on my Master's degree in healthcare administration and in one finance class, we were taught to prorate the overhead in the same manner. When I mentioned the words 'cost accounting', I was more or less ridiculed about how cost accounting doesn't take into account the "true" costs of a service.

Is St. Vincent's In Harrison still in operation, or did they close with all the main hospital's operations.

Makes you wonder when you drive through Dutchess County, actually basically all of NY, and see all those abandoned psych facilities. and wonder where are all those inpatients now? Obviously, there's not a lot of money in psych services, which in turn places the burden on the rest of the medical community, the prison system, and the homeless.

I agree they need to be medically cleared, but what after that? Many of us know we go to the same psych patients routinely.

St. Vinny's in Harrison is still a behavioral inpatient facility (and I hate that run from SFH).

Agree with what WMC said. The "psych ER" at WMC is not an EMS receiving facility. If the patient is coming from the field they need to be taken to medical ER for clearance first. Only time you should be taking them directly to the psych ER is on a transfer. I always cringe when I hear a BLS call for an EDP and then hear them transporting to the Psych ER. It's a bit of a liability.

The list of abilities from the HVREMSCO protocols lists the following ERs as Psych capable:

Westchester - Mount Vernon, Phelps, Northern Westchester and WMC.

Hudson Valley - Saint Francis, Putnam, Bon Secors, Benedictine (didn't they close/merge into Kingston?), Good Sam, Catskill, Arden Hill (tho I know they are in the process of merging as well - I'd hope the new campus has abilities but this needs to be confirmed).

Orange Regional has both Psychiatric ER and admission services (Arden Hill is no longer a hospital). Kingston offers psychiatric ER services now and the admissions are transferred to Benedictine.

Why do we feel compelled to put firefighter above and in front of all else?

A tragic accident happens and we focus not on the victim and his family but the fact that he was a member of a fire department. While volunteer fire associations are important what makes them more important than the victims real job or membership in any other voluntary association like a library, rotarian, elk, VFW, etc.?

Just remember, the same (well due) respect that comes to those that put their lives on the line to save others comes with a microscope in the press too. It's never "Mayberry man indicted", it's "Mayberry Firefighter indicted".

Personal Opinion: The way that the Arrow Sticks are used on emergency vehicles today makes them nothing more than just another flashing light with all the others. They get lost in the blur of all the other lights on the vehicle it is on and those around it. A good idea, but works better when it is isolated away from the other vehicles with minimal additional lighting turned on. You could always turn the rest of your lights off to make it more noticeable, but that probably isn't a good idea either. With the cost of these (over $1,000) I say put the $ to good use with a decent (and not over the top) light package that will get the motorists attention and get them to slow down at which point they can determine how to proceed.

You're correct chief. They aren't used effectively. I think they'd work best as the sole rear-facing emergency lighting. Also, they need to get rid of those "funkify" modes and teach the apparatus operator to use the arrow stick properly.

Is grabbing the attention of drivers what we actually want? Or do we want to warn them and get them to avoid the area safely. Ever here that you will walk or steer in the direction you are looking? Or how about how is the lighting going to effect other drivers vision on approach or passing the scene. I've been washed out and couldn't see anything in a light rain just from a LED strip in the rear window of a car not so long ago. You want good visibility? Sometimes more isn't the answer. Go with amber.

An amber arrow stick will do a lot more than any of the stuff that departments are putting on the backs of vehicles these days. Not only will motorists see it, it will actually guide them on which way to go. I work all nights and I can't tell you the number of times I've pulled up to a scene barely able to see thanks to the lights some of these agencies have.

In the volunteer service, it truly would depend on the job description. If you have a lieutenant position strictly for ambulance maintenance and you're lucky enough to have a driver who is a diesel mechanic who volunteers his time, I don't have a problem with having him as an officer. However, I think I would change the name of the position from the traditional "Lieutenant" to something specific to the job duty (maybe Logistics Officer) and put it in a specific spot in the VAC chain of command. In a large scale incident, you wouldn't want this guy as the IC or Triage Officer, however, he may be the person designated to track vehicle uses, threats to vehicle in-service times, establishment of on-scene "quick" services as needed, etc. It would be more of a command staff position rather than a rank in a traditional chain of command.

Protocols rarely change based on one study, even if it is well conducted and peer reviewed. Even when they do, it's not always the best thing. Remember when the AHA knocked lidocaine down significantly in the ventricular dysrhythmia protocol based on the lack of evidence that lidocaine worked. We all knew that lidocaine worked but nobody was going to pay for a test on a cheap drug.

While 100% oxygen via NRB-FM may not result in serious respiratory issues for COPD patients in the length of an ambulance ride, I've often heard doctors relate that correcting the excessive PO2 complicates a patient's treatment and return to normal. Getting the patient to the hospital is a great goal to have and yes, most patients will not suffer ill effects due to high flow oxygen during that time. However, we should be striving to fit our care into a total care plan for the patient that allows them to have the best outcome.

We just voted on a union to represent us here at work. I work for the Federal Govt. The union will be representing us nationwide. Being a federal employee we come under the Right to Work Act were we do not have to join if we do not want to. My question is would you join a union that the local representing you was broke? Meaning they have no money. How broke you ask? So broke the President of the local can not even drive up to Westchester to meet with us.

I'm neither pro or anti-union, however, if your shop has become a union shop, it would behoove you to join. Even if you don't join, you're going to have money taken out of your paycheck to "reimburse" them for negotiating on your behalf. Essentially, you pay union dues either way. If you're going to be forced to pay, why not join so at least you can have a voice.

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.

Around here....

Code 3 is lights and sirens

Code 2 is lights and "minimal" use of sirens

Code 1 is normal flow of traffic

My personal oppinnion is that code 2 should be outlawed...

Your description of Code 2 is outlawed, at least in New York State. If your lights are on, your siren must be on.

Also I saw SORT 3 was on the alarm. Does that mean that MLSS has 3 SORT Trucks? what do they consist of? Are there any special requirments to be on the SORT truck?

Actually we have 5 SORT vehicles. 3 of the vehicles are equipped with MCI and Rehab equipment. The other 2 are our gator and golf cart used for special events.

Interesting points made by the second poster here and they are good ones. I thought it was interesting that I hard a commercial made by the president of the FDNY Uninformed Firefighter's Association the other day about the proposed closing of 20 fire stations, and the first thing mentioned in their sales pitch was first response to EMS, not fire. Of course, my question then becomes, why not hire more EMT's and medics instead?

Anyway, his point about OT is indeed a good one. Depending on your contract, it might also mean that firefighters picking up overtime will rack up more benefit or comp time, further increasing the problem of coverage. Combo departments are interesting because they could theoretically augment the "par" staff with volunteers but I would insist as a career guy, that the volunteers were maintained in-house like the career guys are.

You also have to make it clear what jobs don't get done when you are at "par" staff as opposed to optimal staff. This may not even be direct firefighting, but could include less training, maintenance, fire prevention, commercial inspections, etc.

Your question about mutual aid is a whole different topic. It is the command officer's responsibility to insure that your district is covered at all times (whether your primary guys are out mutual aid or even in district). If your 5 or 7 guys are committed and only 3 guys come to the station to cover, the command officer might better think about getting some mutual aid for coverage because it's already determined that a "minimum" response is 5 by district policy. If something else happens and they don't have those 5 guys to respond, lawyers will have a field day.

I think there's a big difference in the requirements placed on a volunteer firefighter versus a career firefighter in a department like FDNY. It is entirely possible that a person could be disability retired from FDNY and still able to perform as an interior firefighter in a small community like mine. There are several injuries or work related illnesses that might cause a doctor to say that a person cannot meet the demands of the FDNY job but could still do it in a department that does 150 calls per year, only a couple of which are actually fire-related. An FDNY firefighter might be expected to routinely climb 20 flights of stairs in full gear and be able to perform his full functions whereas my department may only expect a firefighter to be able to climb 3 flights of stairs and do the job. A small department may only require you to be able to perform firefighting functions for an hour at a clip while FDNY might require you to be on your feet for 12 hours running calls.

Many people have complained both on here and even on the state level about "different qualifications" and that firefighter is a single job description. Different communities have different needs and thus different requirements for their firefighters. I don't claim for a second that I could go down to FDNY and do the job but I'm pretty damn sure I can do it in my community. Saying that it's only "one job" is like requiring any car mechanic to have the ability of a NASCAR pit crew member.

Hopefully this tax cap will force communities to take a look at how much money they are wasting and start to fix it. For too many years, governments in New York have continued to spend money just to justify their existence.

My job has given me a Nextel to communicate and other than the direct connect feature, the thing might as well be a tin can with some string attached.

JBE, your assessment is spot on. However police precincts don't go away because you can cut units without shuttering precincts. There are absolutely fewer units on patrol now than there were just a couple years ago.

I'm not making any judgment on the city's services or whether these cuts are good or bad, but if they're cutting police units so much, why don't they close some precincts and consolidate? It seems to me that closing a building would take away a lot of overhead, potentially saving jobs of other cops on the street.

Do you have EZ Pass? That system records specific dates and times that you pass thru tolls. In speaking with guys on NYPD Auto Crimes Unit, the LPR does not record plates and locations. It will record plates that it got a hit on, and if IIRC the data base on the in car computer must be updated daily thru a WIFI connect at certain department facilities. The data base contains a list of registrations that are already marked by NYS DMV as being stolen, or suspended.

EZ Pass is a different story. You can choose not to have EZ Pass, so if you're cheating on your wife on the other side of the bridge, she won't be able to use that information in divorce court. However, there is no option other than to drive (in most non-urban cases). P.S. I'm not married, so this example doesn't apply to me.

I don't buy the idea that "if you're not doing anything wrong, there's nothing to worry about". If my license plate data were grabbed by someone, maybe an unscrupulous cop or someone who was able to hack the database, they would be able to tell that my house was empty between 2 certain times every day or week and rob it.

As a nation, we were willing to give up a lot of freedom after 9/11 with the Patriot Acts (which should also be challenged for constitutionality). People are starting to realize that their liberties are being stripped from them by government and technology one by one and are fighting to get them back. Just this week, Texas has passed a law to make the "pat downs" of airline customers illegal. Good for them!

The license plate issued to you is the property of the Department of Motor Vehicles and your information as the registrant for a vehicle is maintained in accordance with the Laws of New York and Rules and Regulations of the Department of Motor Vehicles. Upon cancellation of your insurance or transfer of ownership of the vehicle the license plates are, by law, supposed to be surrendered to DMV.

There is no expectation of privacy on a public highway and there is no intrusion from the capture of plate data by an LPR so what's the issue?

I think the benefits of being able to catch pattern criminals, detect stolen vehicles, and apprehend other offenders through the judicious use of this technology far outweighs any perceived inconveniences.

There is no expectation of privacy on a public highway? Excuse me? I for damn sure expect to have my privacy protected while traveling. The government has no right to know that I go to Hannaford shopping every Wednesday night. You may be willing to give up your privacy, but I certainly am not.

An automated system to run plates is one thing and I don't have a problem with that (although it does toss probable cause out the window). Storing the information is way, WAY over the line. It is not only unconstitutional but against everything this country has stood for for over 200 years.

I told the author of that article that the story was good, but I again question why the ACLU, and only the ACLU is asked for an opnion. I told the writer to also ask moderate and conservative groups their opinions next time so this way, the story is balanced.

The media does this time and time again, only the ACLU gets asked for an opinion.

Your license plate data is already stored in NYSPIN, so what is the big deal about this??? Are the opponents aware of smart phone tracking??? Are these the same people who post their life stories on Facebook???

My license plate data is stored in NYSPIN. You are correct. That simply tells them that I have a motor vehicle registered in the state. I also don't have an issue with the license plate readers getting the information from my plate and flagging me if I'm wanted. However, the problem I do have is storage of this information. If I pass a cop at the intersection of Main and Union and the reader says "yup, plate ABC123 is ok", that should be the end of it. I don't want these machines knowing that I went through Main and Market at 12:00 on 5/12/2011 three days later.

Smart phone tracking is different and so is facebook. If you choose to allow yourself to be tracked, so be it (and yes, I know it was recently found that some phones were being tracked without the user's knowledge and that is being or has been rectified). I don't want the government keeping a record of my daily travel habits simply because I own a car.

This concept can be applied to any of the 3 major emergency service divisions.

Well, $4.3M wouldn't be able to career staff Orange County, much less the whole state. I think the money would be better spent doing something else because quite honestly, I think it will be spent doing research or for some marketing program that will do little to help the situation. The rural areas of the state may very well be able to provide a satisfying level of fire protection with volunteer staff, but the suburban sprawl in the Hudson Valley has outpaced the real ability of the volunteer services to provide the service that is now expected in many areas. I have nothing against volunteers at all (in fact, I am one) but there are some places that need to take a long, hard look at the service they are providing and the expectations of the community. There are some departments that should have taken this same look 10 years ago and still haven't. There is absolutely a lot of cost involved but certain segments of the area serviced by EMTBravo really need to bring their concerns to the community and let them know 1) what service they are really getting now, 2) what service can be provided, and 3) how much that additional service will cost. Let the communities decide.

Every system is designed a little differently. These articles don't provide enough information to make any judgment about the need for the FD service or if it is fiscally prudent. I just hope that the decision was made using real analysis instead of the unilateral decision of a politician with other motives.

Be careful up there. I'm glad that my old fraternity house is up on top of a hill.