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Editorial - Suffolk needs better ambulance plan

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http://www.nynewsday.com/news/printedition/opinion/ny-vpbis064105072jan06,0,

111773,print.story?coll=ny-opinion-print://http://www.nynewsday.com/news/print...y-opinion-print

Suffolk needs better ambulance plan

BY DAVID BISHOP

(David Bishop (D-West Babylon) represents the 14th Legislative District in

the Suffolk County Legislature.)

January 6, 2005

Waiting for an ambulance in Suffolk County can be the ultimate crapshoot,

with thousands of calls each year taking more than 20 minutes to be

answered. And the problem will only get worse because the trend is toward

more 911 medical calls with fewer volunteers to respond to them.

To answer this challenge, Suffolk's volunteer agencies need to work with

the state and county, embrace change and welcome accountability.

So it is troubling that a significant portion of the county's volunteer

chiefs endorse a policy of stagnation. They're opposing new state

protocols to improve communication and county legislative efforts to

collect data comprehensively on all calls.

The volunteer system is just that, a system dependent on the generosity of

community volunteers. Those volunteers must be appreciated. But the 911

system is also a multimillion-dollar expense that performs government's

most critical public safety function. Lives are on the line. So county

government, responsible for public health, must demand improvement.

Suffolk County's ambulance system is unusual in America. Few other

jurisdictions of similar population rely so heavily on volunteer agencies;

almost everywhere else has paid EMS workers. The Suffolk system is

fractured, with 99 separate EMS agencies, each with its own procedures. A

typical service-delivery problem occurs when a jurisdiction cannot raise a

volunteer crew and, after critical time elapses, the emergency call

bounces to another jurisdiction that may also find it doesn't have

volunteers available.

Throughout the county, families tell gut-wrenching stories of standing by

a loved one, waiting long periods for an ambulance to arrive. There's the

mother of a toddler in Southampton who waited 33 minutes. The child died

of a heart defect. My colleague Legis. Bill Lindsay tells of his

brother-in-law dying of a heart attack after waiting about 30 minutes for

a response. In these and other cases, it's not clear that the victim would

have survived but clearly the system failed these families.

The heads of the volunteer Fire Chiefs Council and the Volunteer Ambulance

Corps Association manifest contempt for their mission when they come to

the county legislature and testify that the system is 96-percent

effective. It's not true. The 96-percent figure is inflated because the

current data-collection system is incomplete and fails to capture the

response times on calls that bounce to a different department. Those are

the calls where people wait the longest.

Besides the intolerable human toll caused by an undependable system,

Suffolk taxpayers can also expect the burden of paying for the inevitable

lawsuits, as EMS agencies operate under the county medical director's

license and are insured by the county. The county attorney has even

advised the medical director not to discuss specific failures of the 911

system before the legislature for fear of assisting victims' lawsuits.

To improve the system, there is a move in the county legislature for a new

system of data collection that would accurately and uniformly measure the

response time on every call.

It's been fought by many in the volunteer leadership. They acknowledge

that data is important but pretend recording it is a great burden.

Actually, the data rests with the dispatchers, not the volunteer

responders, so recording it is not the issue. Turning over the data is the

issue, and too many agencies are against that, fearing the accountability

that could result from knowing the response times. The agencies are also

fighting new state protocols that require quicker communication between

volunteers and dispatchers.

Many chiefs are embracing change. They understand that utilizing modern

tools like computer data analysis and instant communication will allow the

volunteer system to survive. Some chiefs, in Babylon Town and eastern

Islip Town, are considering systems that pool resources and break down

jurisdictional boundaries.

Most who oppose change in the system see a conspiracy to move Suffolk

toward an all-paid EMS system. Actually, embracing changes that will

provide better communication and data collection will let the volunteer

system repair itself and survive.

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Editor's note:

You can substitute "Suffolk" with "Westchester" or "Putnam" and pretty much get the same story.

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