Need For Municipal Paramedics In New Castle?

[Guest]

FROM THE JOURNAL NEWS TODAY

Town should have dedicated paramedic

(Original publication: May 31, 2006)

Four New Castle Town Board members, against the advice of Supervisor Janet Wells, in April went from supporting a paramedic in town to voting against the highest level of pre-hospital care. Certain New Castle residents receive this through Ossining. They provide a paramedic and EMT on every call without tax dollars. The rest of New Castle residents contribute toward a $1.5-plus million budget for just three cars with seven other towns covering one-third of the county. Mount Pleasant and Yorktown wouldn't join the consortium. Their residents get dedicated town medics. The paramedic agency Westchester EMS, part of Stellaris, was created for the towns in the consortium. Employees on that payroll cautioned the board against having town medics.

Neutral taxpayers spoke. Dr. Mark Silberman, board-certified ER physician and professor of the prestigious Columbia Presbyterian Hospital, started the paramedic flycar for Greenburgh, and is medical director for four volunteer ambulance corps. Professor Stephen Nardozzi, the chairman of Emergency Medical Services at Westchester Community College, started as a Chappaqua volunteer ambulance member, worked all areas of pre-hospital care. They spoke advocating for patient care through dedicated service in town, significantly reducing response times when seconds count. Putnam County headlines referenced improving response times. They have four paramedic flycars costing a total of $445,000. That cost could give these eight towns each a medic and save over $600,000. Why argue against a 911 service providing a paramedic with the EMT on every call?

[Guest]

I think the reason that towns don't think to have paramedic service as they do other services is due to lack of education/understanding the public has about EMS. They know they have an ambulance when they call 911 and thats it. They don't understand that response times and level of provider can make a difference in life and death till it happens to them. They are surprised when you tell them that if you had a cardiac arrest and you had a doctor and a medic they would be following the same ACLS protocols. EMS needs to be recognized and compensated for their importance that they bring to the community and not just during EMS week.

[dadbo46 50]

Lets not stop there. How about a firehouse on every corner and an ambulance in every garage ? Maybe a cop in front of every house ?

Lets get real here ! Let the emotions go and look at this issue from a management and fiscal perspective.

You need to balance the delivery of service with cost vs ability to pay vs need. Where these three lines meet in a graph is the level of service to be provided.

While everyone is proud, and rightfully so, of their individual community, unecessary duplication of services whether they be fire. EMS or police (not to mention others) is a waste of taxpayer $$. Look at the BIG picture and address your needs accordingly.

[LCFD994 8]

Its funny, actually it really isnt, but many communities if not all of them will balk and fight improvements in their EMS systems or fire and police departments. But you never seem to hear them argue about sanitation, or cable tv, cost of water if that is applicable.

Like someone else mentioned its all about education of the public, maybe we are to blame because we dont get out there enough to educate the public or the politicians. Considering the actual cost it would be, per household, for a 24/7/365 day dedicated Paramedic for your community is pennies, isnt that worth your life.

I am not knocking any local service, but adding a Paramedic or dedicated service to your community cant be over looked anymore.

Most people feel like well I will never need it so why should I have to pay for it all of the time. Well you pay for Insurance all of the time, and do you use it everyday, probably not.

I personally would pay, in some areas, it would be like a $ 1 a month to have a dedicated Paramedic sitting in my community even if they never left the station.

JUST MY LITTLE RAMBLE

[Guest alsfirefighter]

For most municipalities in my experience, it is both a balance of not understanding the EMS system and fiscal overload. I'm all for having dedicated Paramedics on a municipal level, outside the fact that I believe in Fire based EMS overall. But when politicians and town/city managers look at the $$$ signs involved with salaries and benefits it is temping to look at a smaller number printed on a contract with a 3rd party company. But at what cost? I agree with Steve (Nardozzi). Having dedicated services will increase response times and give any municipality better control over who is taking care of its citizens. Control you will not have when you contract out. You don't know who is in what flycar and what their overall ability or skill level is and what that company does about weaker paramedics whom just don't cut it in the field or even amongst their "colleauges." I don't understand what one post mentioned about duplication of services. If they get their own EMS managed through the town, how is that duplication of service? Why is it that cities and towns often pay for all sorts of employees and titles but not for dedicated EMS services?

[WAS967 97]

Oh talk about one sided. Lets take this one line at a time shall we.

Four New Castle Town Board members, against the advice of Supervisor Janet Wells, in April went from supporting a paramedic in town to voting against the highest level of pre-hospital care.

The highest level of prehospital care would be a doctor on the truck, not a paramedic. How much would that cost?

Certain New Castle residents receive this through Ossining. They provide a paramedic and EMT on every call without tax dollars.

Do they do it for free then?

The rest of New Castle residents contribute toward a $1.5-plus million budget for just three cars with seven other towns covering one-third of the county.

Just? JUST?

Mount Pleasant and Yorktown wouldn't join the consortium.

Does that make the consortium a BAD thing?

The paramedic agency Westchester EMS, part of Stellaris, was created for the towns in the consortium. Employees on that payroll cautioned the board against having town medics.

With good reason.

Neutral taxpayers spoke. Dr. Mark Silberman, board-certified ER physician and professor of the prestigious Columbia Presbyterian Hospital, started the paramedic flycar for Greenburgh, and is medical director for four volunteer ambulance corps. Professor Stephen Nardozzi, the chairman of Emergency Medical Services at Westchester Community College, started as a Chappaqua volunteer ambulance member, worked all areas of pre-hospital care. They spoke advocating for patient care through dedicated service in town, significantly reducing response times when seconds count.

So two people with a lot of prestige makes for a good flycar system?

Putnam County headlines referenced improving response times. They have four paramedic flycars costing a total of $445,000. That cost could give these eight towns each a medic and save over $600,000. Why argue against a 911 service providing a paramedic with the EMT on every call?

Ask a company in Westchester to provide a town with FOUR flycars for $445,000. They will laugh at you. FOUR flycars do NOT cost that little. Anyone who thinks so has thier head in the sand.

Oh Christy. Next time you post an EDITORIAL make sure you add who SIGNED it.

Celia Fishman, New Castle

Edited June 1, 2006 by WAS967

[CAM502 6]

WAS,

I am not too familiar with New Castle. Why is it so bad for them to have their own Medic?

[WAS967 97]

Who said it was a bad thing?

[JohnnyOV 2]

The real questing is, How many ALS calls does new castle receive on a daily, weekly. monthly and yearly level. One reason that Yorktown has its own medics is because of the amount of ALS calls run.

If the medics are just going to be sitting around on their butts all day, then when they get a run, it's only a BLS run, it doesn't make sense to hire medics just for one town.

[N1Medic 69]

Very misleading and biased editorial!

The editorial fails to mention or acknowledge the diffence in CALL VOLUME and POPULATION of the Yorktown and Mount Pleasant cars, BOTH of which cover a large area and multiple jurisdictions as well.

And why do you need a paramedic on every call? That is RIDICULOUS as well! What happened to strong BLS being the foundation of EMS?

It also neglects to reconize how the paramedic is dispatched.

Why fight so hard against the consortium (and beat a dead horse), instead of fighting to make it better??? New Castle HAS dedicated paramedics, and let's not forget, New Castle is right down the road from Northern Westchester Hospital.

[WAS967 97]

Also why reduce the number of cars you have available from three to one? The system provides three flycars 24/7 to a LARGE area. There have been times where multiple calls have been ongoing in Chappaqua and a second (and maybe even a third but I can't remember the last time that happened) paramedic car was called in. In fact another article in the Journal News mentioned a 20 minute response time to New Castle. What it neglected to mention was that that was an EXTREME case and was also a second medic responding from Somers (not to mention a medic new to the system and not intimately familiar with the geography of the area like the rest of us).

If a second call goes out with a dedicated Paramedic car who provides the second medic? Your right back to the consortium again a good amount of the time. Also if you look ad the geography of the area we cover in New Castle you will notice that it wraps nicely around Mount Kisco. We can head both south and west from where we are and get to a good number of the calls in under the 9 minute mark. I can't remember the last time it took me longer than that to get to a call in New Castle that wasn't in Millwood (which is STILL a hike even from the center of town).

[Guest]

What may happen when these towns get their own Paramedic service is they hire per diems/part timers. No benefits, poor pay. Stellaris Health provides good benefits and competitive pay. Keep in mind that Stellaris [WEMS] is a non profit company. Many other companies have put in bids where they are losing money. Not the way to improve our stature. WEMS also supplies three fly cars and on some occasions four, manned by a supervisor. When people quote long response times it is because multiple calls came in at the same time and this is a rare occurance.

[mpgfire93 4]

new castle residents that recieve als service from ossining are billed through revenue recovery if the call is ALS. However, one might think that if they have to pay taxes to the Town of New Castle then they might be paying for the service from that town already.

on a side note, the people we serve are only getting more sick, having more medical emergency problems that require management by a helathcare professionals, ie emt, b,i, or p and this will only become a larger problem as the the baby boomers get older. So town boards might not understand theses critical times and what healthcare providers are faced with and YES HEALTHCARE WILL COST MONEY, lots. i feel it will take time but in the long run one thing must be made clear, EMS rigs wheather it be an ambulance or a fly car service BLS or ALS need personnel so that is can role and provide the neccessary care that is needed.

[Guest]

At over 1.5+ million for 3 cars or over $500,000 a car they could hire a doctor though I feel the education and training the medics get will suffice pre-hospital wise.

So two people with a lot of PRESTIGE!!!! try with a lot of education AND no monetary gain to be had. Gee it sounds like having EMS recognized as a vital service that towns should be responsible for providing and paying for like they do for police doesn't seem like something you would advocate. I assume you will continue your noble fight AGAINST job security and recognition similar to police and career fire. We don't want to recognize EMS as a vital service like fire and police. We want to continue having a shortage in this area with people leaving to go to police to earn better salaries and have job security. Medics shouldn't get higher salaries and civil service benfits to sit on their butts all day. And they definetly should work sometimes 2 jobs to make ends meet. I guess I am foolish to feel that medics DESERVE to receive compenation like other healthcare workers. I must be retarded to think they should only need to have one job and lead a normal life with regular hours.

How many medics cover the other 2/3 of the county?

Municipal/county paramedics with pay, job security, and civil service benefits inline with PD is should be the goal.

WOULDN'T IT BE A GOOD THING TO HAVE SALARIES IN LINE WITH FIRE AND POLICE WITH JOB SECURITY AND CIVIL SERVICE BENEFITS...AND WITHOUT BECOMING A PO? DON'T MEDICS WANT TO ACHIEVE THAT STATUS AS OPPOSED TO WORKING FOR $19-20/HR. THERE ISN'T CRIME RUNNING AMUCK IN THESE NORTHERN SUBURBS YET THERE ARE PLENTY OF POLICE OFFICERS...AND FIRE. HOW MANY WORKING FIRES ARE THERE? AND ISN'T IT SAID THAT FIRE WANTS EMS UNDER THEIR JURISDICTION SO THEIR #S ARE HIGHER? NO ONE BLINKS AN EYE WHEN FIRE DEPTS EXPAND/REBUILD THESE MASSIVE STATIONS AND DON'T EVEN LIVE IN QUARTERS WHEN ON CALL...AND WRITE THEIR OWN BUDGETS WITHOUT EVEN ASKING IF THE CITIZENS OBJECT...BUT WE SHOULDN'T HAVE TOWN MEDICS FOR LESS THAN A CUP OF COFFEE A DAY. THINK OF THE COMMUNITY HEALTH PREVENTIVE PROGRAMS THAT CAN BE STARTED AND EXPANDED SCOPE OF PRACTICE THAT THE FUTURE OF EMS MAY BE HEADED TOWARDS AS HOSPITALS BECOME OVERWHELMED AND GO ON DIVERSIONS. OR IF SOME UNFORSEEN EPIDEMIC OR OTHER HEALTH CRISIS OCCURS AND WE HAVE TO DEPEND ON OUR OWN RESOURCE A STAFF OF WELL PAID DEDICATED MUNICIPAL PROVIDERS AS OPPOSED TO 3 MEDICS COVERING 1/3 OF THE COUNTY. FIGURE OUT WHAT A CAR COSTS FULLY LOADED LESS THAN 70,000...SO WHY IS A FLYCAR OVER 505,000? IF EVERYONE CANNOT LOOK AHEAD TO THE POTENTIAL BENEFITS A MEDIC IN THE TOWNS CAN PROVIDE THINGS WILL NOT GET BETTER AND MEDICS WILL BE PULLING 80-100 HOURS A WEEK TO LIVE IN THIS COUNTY AND THE SHORTAGE WILL PERSIST OR WORSEN.

[Guest cya69]

What may happen when these towns get their own Paramedic service is they hire per diems/part timers. No benefits, poor pay. Stellaris Health provides good benefits and competitive pay. Keep in mind that Stellaris [WEMS] is a non profit company. Many other companies have put in bids where they are losing money. Not the way to improve our stature. WEMS also supplies three fly cars and on some occasions four, manned by a supervisor. When people quote long response times it is because multiple calls came in at the same time and this is a rare occurance.

←

If you had followed the discussions of the Town Board a little more closely you would know New Castle's intentions were to have dedicated Town paramedics, hired by the Town of New Castle which would make the system non-profit. The second option they had was per diems which would have been paid at a higher rate than WEMS medics and most other agencies in the area. Too many people make the connection that non-profit means they can not make money - this is not the case it simply means any profit must go back into company operations and not someone's bonus check. The fact is the are WEMS covers is getting busier by the day and multiple calls are coming in more frequently and not the rare occurance you claim. Bottom line is New Castle has the need, opportunity and resources to supply their residents with the best possible pre-hospital care so why shouldn't they? Let's look at this morning when 45 medic 1 was on an ankle injury and 45 medic 3 was on a general illness leaving 45 medic 2 to cover the rest of the vast territory is this reasonable? is this is the best interest of the patient having an MI in the south end of New Castle or Vista? maybe if WEMS utilized it's resources better it would be a step in the right direction but things are not changing for the better and the patient suffers in the end.

[N1Medic 69]

maybe if WEMS utilized it's resources better it would be a step in the right direction but things are not changing for the better and the patient suffers in the end.

←

How is this all WEMS fault? WEMS is complying with a contract. How do the individual particpating VAC's not have a responsibilty as well? Things need to be changed in the whole system, and the problems shouldn't be unfairly pinned on WEMS.

There is one FD VAC in their jurisdiciton that is the largest user of ALS...shouldn't they be forced to pay for another car, instead of sucking it from the rest of the system? Dont they play a role in this as well? Why aren' they to blame?

Yes, we agree that medics should have parity with fire and EMS, of course! ut is this about New Castle, or is this about a further "cause"....or maybe a crusade? Everyone knows in New Castle there is one person who is stirring the pot on this issue and has no interest in a real resolution, only an interest in getting the current provider out for vendictive reasons.

cya69, what town board discussions were you reffering to? The medic's weren't going to be hired by New Castle, the only other option they were considering is bids from a cheaper dedicated provider, and Empress was the only other bidder. They had no serious intentions of hiring their own medics and starting their own ALS agency at this point.

I'm also curious why these "crusaders" aren't concerned about career BLS? If they talk so much about ALS response time being so important, what about BLS response time and EMT's getting compensated fairly?

And please, those who want to talk about prices please get a CLUE and base your comments on FACT when you quote prices about flycars!!!!!!!!!!!

Stop with the fabricated propaganda, please.

[FF402 133]

Let's get something straight here. The career PD and FD's are not compensated so well because they are civil service, it's because their UNIONS fought for them to be compensated fairly.

If EMS doesn't want to unionize and fight for themselves and their communities, then they are going nowhere. They are just going to continue to be stepped on.

Do people actually want to take responsiblity and risk to make things better, or whine and throw blame? It should be, it should be, it should be never got anyone anywhere.

[WAS967 97]

Show me an EMS union that actually DOES something for EMS and I might be interested.

FIGURE OUT WHAT A CAR COSTS FULLY LOADED LESS THAN 70,000...SO WHY IS A FLYCAR OVER 505,000?

Are you for real? What fantasy land are you living in? $70,000 a year for a flycar? I LOL at you.

Edited June 3, 2006 by WAS967

[Guest]

If you had followed the discussions of the Town Board a little more closely you would know New Castle's intentions were to have dedicated Town paramedics, hired by the Town of New Castle which would make the system non-profit.  The second option they had was per diems which would have been paid at a higher rate than WEMS medics and most other agencies in the area.  Too many people make the connection that non-profit means they can not make money - this is not the case it simply means any profit must go back into company operations and not someone's bonus check.  The fact is the are WEMS covers is getting busier by the day and multiple calls are coming in more frequently and not the rare occurance you claim.  Bottom line is New Castle has the need, opportunity and resources to supply their residents with the best possible pre-hospital care so why shouldn't they? Let's look at this morning when 45 medic 1 was on an ankle injury and 45 medic 3 was on a general illness leaving 45 medic 2 to cover the rest of the vast territory is this reasonable? is this is the best interest of the patient having an MI in the south end of New Castle or Vista? maybe if WEMS utilized it's resources better it would be a step in the right direction but things are not changing for the better and the patient suffers in the end.

←

[Guest]

Show me an EMS union that actually DOES something for EMS and I might be interested.

Are you for real? What fantasy land are you living in? $70,000 a year for a flycar? I LOL at you.

←

Contact Greenburgh and ask what it costs for a totally equipped state bid flycar! Just under 70,000 for their new Tahoe.

[N1Medic 69]

Contact Greenburgh and ask what it costs for a totally equipped state bid flycar! Just under 70,000 for their new Tahoe.

←

Do you even know what your are talking about? Please, check your facts before posting, your obessive, false, and clueless agenda is becoming obvious to us all. A "fully equipped" state bid flycars DOES NOT include lettering, lights, radios, ALS equipment, staffing salary + benefits, insurance, fuel, maintenance.

Edited June 3, 2006 by N1Medic

[Guest]

Yes, we agree that medics should have parity with fire and EMS, of course! ut is this about New Castle, or is this about a further "cause"....or maybe a crusade? Everyone knows in New Castle there is one person who is stirring the pot on this issue and has no interest in a real resolution, only an interest in getting the current provider out for vendictive reasons.

cya69, what town board discussions were you reffering to?  The medic's weren't going to be hired by New Castle, the only other option they were considering is bids from a cheaper dedicated provider,  and Empress was the only other bidder. They had no serious intentions of hiring their own medics and starting their own ALS agency at this point. 

Stop with the fabricated propaganda, please.

←

WHAT ARE YOU TALKING ABOUT...STIRRING UP THE POT? WHERE DO YOU GET YOUR GOSSIP FROM WITH THIS NO INTEREST IN A REAL RESOLUTION AND ACTIONS DICTATED BY AND FOR VINDICTIVE REASONS. WHAT VINDICTIVE REASONS COULD SOMEONE HAVE? HAVE YOU SPOKEN WITH THIS SUPPOSED ONE PERSON? IS IT CONCEIVABLE THAT THIS PERSON WANTS TO SEE ALL EMS GET THE FAIR RECOGNITION WE DESERVE? AND YES THE TOWN WANTED TO HIRE THEIR OWN BUT THE EXPERTS STOPPED THAT AND STOPPED THE POSSIBILITY THAT MEDICS WOULD GET WHAT THEY DESERVE. MY UNDERSTANDING IS THE PAY AND BENEFITS WOULD HAVE BEEN THE BEST IN THE COUNTY. I BELIEVE ON PAR WITH PD! A TRUE NOT FOR PROFIT! THE EXPERT VOLUNTEERS WITH NO BACKGROUND IN HEALTHCARE AND WHO DO 12 HOURS A WEEK AND THE STELLARIS EXECUTIVES WITH THEIR BIG 6 FIGURE SALARIES MADE SURE THAT WOULDN'T HAPPEN SO ALL THE $$ WEMS MAKES WILL CONTINUE TO OFFSET COSTS IN THEIR ORGANIZATION.

[EMTbravo 312]

Enough's enough. This thread is now CLOSED.

We've had numerous debates in seperate threads on this one issue on this board, mostly initiated and propeled by one member over and over again.

If there is fresh FACTUAL information to be had on this issue, start a new thread. Want to discuss EMS parity or ALS coverage in general? Start a new thread on it! We're done beating the New Castle and WEMS consortium topic to death. I WIIL NOT continue to allow anyone to use this forum to bash or push their issue, especially using tatics such as multiple usernames, thread hijacking and inciting member conflict. I also will not tolerate members intentionally posting falsehoods and mistruths, and attempts to use this board to grandstand- repeatedly. Take the BS somewhere else!

PS: I will discuss the closing of this thread with VERIFIED members ONLY. If you want to hide behind a screename, don't bother sending me an email regarding this.