Hudson Valley Paramedics ALS License

[emd2726 0]

I just wanted to share this with everybody. I thought it was important to get the information out so that we can keep the record straight.

Sent on behalf of Dr. Nicholas DeRobertis, Westchester REMAC Chair/Regional Medical Director

To: All Regional ALS Services

Re: End of Hudson Valley Paramedic Services (HVPS) ALS Suspension

As of this afternoon, it has been determined that Empire State Ambulance, dba Hudson Valley Paramedic Services (HVPS), has enough Westchester REMAC credentialed paramedics to support 24-hr staffing in our region. In recognition of their ability to meet the requirement per the Westchester REMAC Medical Control Plan, the suspension of intra-regional ALS operations has been officially lifted. HVPS is now authorized to resume full ALS services in the Westchester Region.

If there are any questions regarding this announcement, please contact the Regional EMS Office at 914-231-1616.

Katherine O'Connor, BS, EMT-P/CIC

Program Specialist, EMS Division

Program Coordinator, REMSCO

Westchester County Department of Emergency Services

[celticmedic643 2]

Now if they could get some medics to work in Putnam and Dutchess counties. I have been hearing a lot of ALS assist calls to Hudson Valley Paramedics lately. I hear the Putnam medics going to Putnam Ridge all the time to assist a HVP BLS unit with a ALS call. And just this afternoon I heard Alamo ALS assist to HVP BLS unit at Green Haven. If they dont have the appropraitly staffed units why are the sending them to ALS calls? I know staffing is an issue for all, but lets not put our patients in jepordy by sending a BLS unit from far far away when someone is having chest pain. I know people think nursing home pts and prisoners are different. But my grandmother is in a nursing home for rehab are you going to tell me she is not entitled to the same care as she is when she is home??? There is a time when you should turn the call over to the closest appropriate agency. Just my 2 cents.

Edited December 9, 2008 by celticmedic643

[Guest beentheredonethat]

Now if they could get some medics to work in Putnam and Dutchess counties. I have been hearing a lot of ALS assist calls to Hudson Valley Paramedics lately. I hear the Putnam medics going to Putnam Ridge all the time to assist a HVP BLS unit with a ALS call. And just this afternoon I heard Alamo ALS assist to HVP BLS unit at Green Haven. If they dont have the appropraitly staffed units why are the sending them to ALS calls? I know staffing is an issue for all, but lets not put our patients in jepordy by sending a BLS unit from far far away. There is a time when you should turn the call over to the closest appropriate agency. Just my 2 cents.

Ill give you a dollar on that one

I was going to say the same celticmedic643.....

The other agencies should send them bills!!!!

Edited December 9, 2008 by beentheredonethat

[Remember585 815]

How many times recently have the ALS units in Cortlandt, Ossining, Yorktown, WEMS area been sent to cover for them? I hope they get the revenue they are entitled to for their ALS care.

[celticmedic643 2]

How many times recently have the ALS units in Cortlandt, Ossining, Yorktown, WEMS area been sent to cover for them? I hope they get the revenue they are entitled to for their ALS care.

I dont know much about their Westchester ops, but it seems they have the same problem with their entire service area. So what are they doing with Regional EMS?

[Guest beentheredonethat]

Its the like the Titanic. Its going to come down to someone dieing or a Major lawsuit before something is done. If the region cant handel it. Im glad my family knock on wood will not be affected ny the ignorance

[NWFDMedic 58]

Now if they could get some medics to work in Putnam and Dutchess counties. I have been hearing a lot of ALS assist calls to Hudson Valley Paramedics lately. I hear the Putnam medics going to Putnam Ridge all the time to assist a HVP BLS unit with a ALS call. And just this afternoon I heard Alamo ALS assist to HVP BLS unit at Green Haven. If they dont have the appropraitly staffed units why are the sending them to ALS calls? I know staffing is an issue for all, but lets not put our patients in jepordy by sending a BLS unit from far far away when someone is having chest pain. I know people think nursing home pts and prisoners are different. But my grandmother is in a nursing home for rehab are you going to tell me she is not entitled to the same care as she is when she is home??? There is a time when you should turn the call over to the closest appropriate agency. Just my 2 cents.

If your grandmother is in a nursing home for rehab and you feel that she may be affected by some of the situations you mentioned, she can request that a specific service is contacted if she needs EMS. My grandmother was in a nursing facility and they were contracted to a certain service and there was specific instruction in her chart that the EMS provider of her choice was to be contacted. They initially gave my father and I a hard time but when we educated them about patients' rights, they did comply with her wishes.

I just hope that providers that are being put in these difficult situations realize that their cards (and personal liability) may be on the line if something goes wrong. If the agency is acting so irresponsibly by dispatching you to a P-1 emergency from far away to assess and decide if ALS is "really" needed, do you really think they are going to stand behind you when the lawsuit comes?

[prucha25 76]

I have a quick question about laws. This could have been answered a bunch of times before but I've never seen it asked. As an EMT or a marked ambulance you have a " duty to act". Such as if I was walking around in my XYZ Dept Job Shirt with an EMT patch on it I'm identifying myself as an EMT and therefore I have a duty to act god forbid something happens that I come across. So getting to my point how does the Identifying yourself thing go for instance this is not a shot whatsoever, but if a Hudson Valley Paramedics ambulance ( a BLS unit) came across a MVA with heavy trauma, assuming they did all they could on a BLS level. Could that Company or EMT-B's be Liable because it says "Paramedics" on their ambulance and on the shirts they wear but however cannot perform ALS functions, in any case not just an MVA?

[trauma74 111]

I am going to go out on a limb here and say that just because their company name has the word "Paramedics" in it, it does not mean that you have a duty to act as a paramedic if you are not certified at that level and that they are not required to have a paramedic on every single call, especially if the call is a BLS call.

I would say it is like in a VAC where you have members who are not certified as EMTs, they are drivers. They wear a "VAC" jacket that says "Whatever VAC" on it, if they are not certified as CFR or EMT, they are not required to act.

Also, someone asked about Regional EMS. Regional EMS is handling all of the same areas they handled before with ALS units and they are still providing daytime BLS staffing to the agencies they had contracts before they were taken over by HVP.

[NWFDMedic 58]

I am going to go out on a limb here and say that just because their company name has the word "Paramedics" in it, it does not mean that you have a duty to act as a paramedic if you are not certified at that level and that they are not required to have a paramedic on every single call, especially if the call is a BLS call.

You are correct Doug. If the rig was labeled as "paramedic unit" or "paramedic" otherwise, but the company name doesn't really apply. Our old lettering scheme at Mobile Life had "Paramedic Unit" on the sides and when we had a BLS unit we would put magnets over the words. I'm not quite sure of the laws, but truth in advertising would at least be nice. HVP might as well change to Hudson Valley Paramedicless. Then again, I remember seeing a BLS FD unit that has something like "Medic Unit" on the side of it.

[Medibart 55]

From NYSDOH EMS Policy # 98-05 "Certified persons have NO authority or responsibility to respond independently. In NY there is no duty to act as an individual citizen, regardless of certification or licensure. Individuals may respond only as a part of an authorized agency's response system and within an EMS system."

You have no Duty To Act unless you are "on duty".

If you are a volunteer and consider yourself always "on duty" you would only have Duty To Act in your department's area, though I would suppose there is room for interpretation as to what it means to be "on duty" as a volunteer if your department does not have duty schedules.

I have a quick question about laws. This could have been answered a bunch of times before but I've never seen it asked. As an EMT or a marked ambulance you have a " duty to act". Such as if I was walking around in my XYZ Dept Job Shirt with an EMT patch on it I'm identifying myself as an EMT and therefore I have a duty to act god forbid something happens that I come across.

[RNMedic08 0]

I heard county dispatching the ALS unit to Greenhaven. I think county said ALS assist to Greenhaven for a possible heart attack Hudson Valley Paramedics will be sending a BLS unit.......In the last 3 weeks this has been happening more and more frequently. Why accept the contract when you can't commit the resources and then have to rely on other agencies to cover your a** on ALS calls when they have their own fire districts to cover, I can understand an ALS assist every once i awhile but this is getting ridiculous now, I hope people in the right places are hearing this and think twice about giving them any more contracts in Dutchess County....

I said it before they should not be going by the name Hudson Valley Paramedics but maybe something more truthful like Hudson Valley EMS.

[helicopper 1,050]

I'm less concerned about the name they're using than the fact that they're tying up two units for calls that they're contracted to cover themselves (theirs and an ALS unit to assist).

Hopefully the affected agencies are monitoring this and will take appropriate action before their own calls start going uncovered.

[NWFDMedic 58]

I'm less concerned about the name they're using than the fact that they're tying up two units for calls that they're contracted to cover themselves (theirs and an ALS unit to assist).

Hopefully the affected agencies are monitoring this and will take appropriate action before their own calls start going uncovered.

In fact Chris, this very thing has happened. It didn't happen on Sunday night, but it has happened. All of the other agencies in the county (Alamo, Mobile Life, NDP, and Transcare) have times when their resources are limited and they have to rely on mutual aid. When units have to cover HVP/Regional, the aid is far from mutual. The Regional territories are starting to feel the strain of HVP as well ... when Regional is sending an ALS unit code 3 from New Windsor to a facility in Peekskill and then attempting to cover an ALS call in New Windsor from Chester or Middletown.

[Medic442 15]

NWFDMedic,

Please, tell me when this has happened. I really need to hear this one. Come on. I can tell you as well as you know yourself. MLSS has called in service and responding to calls in Dutches from Newburgh. I have been next to a MLSS bus at St Lukes when they did just that.

With that being said. Everyone of these companies have been short staff (Right Seth). And why isnt Beekman not covering the calls in there area? Hmmm a heart attack or cardiac. Hmm can we all say closest unit. We all have seen it every place we have worked. The company or better yet ALL THE COMPANIES & I am not just taking HVP & Regional. I am saying everyone Alamo, Transcare, NDP, MLSS & any other companies out there that I have missed or is in hidding (lol), has gone threw hard times with staff. I can say that with 1st hand knowledge. The companies meet the demand or challenge. I can also say that the company in this bashing is changing and getting better. I will also be glad to get back to work by the end of this month (I hope). Okay I m done, just my 2 cents.

"WHY CAN'T WE ALL JUST GET ALONG, & SUPPORT EACH OTHER TO DO OUR JOBS" There is enough work out there for all of us.

Edited December 10, 2008 by Medic442

[SageVigiles 1,194]

I have a quick question about laws. This could have been answered a bunch of times before but I've never seen it asked. As an EMT or a marked ambulance you have a " duty to act". Such as if I was walking around in my XYZ Dept Job Shirt with an EMT patch on it I'm identifying myself as an EMT and therefore I have a duty to act god forbid something happens that I come across. So getting to my point how does the Identifying yourself thing go for instance this is not a shot whatsoever, but if a Hudson Valley Paramedics ambulance ( a BLS unit) came across a MVA with heavy trauma, assuming they did all they could on a BLS level. Could that Company or EMT-B's be Liable because it says "Paramedics" on their ambulance and on the shirts they wear but however cannot perform ALS functions, in any case not just an MVA?

As some others have mentioned, I don't think having the word "Paramedic" on the side of the rig constitutes a duty to act as an ALS provider. I drive NF Medic 1's car to the hospital behind the ambulance, does that mean that I would have to provide ALS service to anything I came across on the way? Absolutely not. You don't have to be an EMT to drive that truck to the hospital. Good point though, it does kind of come off as false advertising.

[RNMedic08 0]

Medic442

"I can also say that the company in this bashing is changing and getting better." I will also be glad to get back to work by the end of this month (I hope). Okay I m done, just my 2 cents.

Really ya think so Medic 442???????????????? Cause this is happening in the last month with this particular agency.......what is that phrase "a leopard can't change his spots." The company may have changed it's name but it still appears to be doing the same thing it did as before....

Hey but that is just my 2 cents what do I know.....apparently not much

[Medic442 15]

RNMedic08,

You are funny & your few words at the end do say exactly that.

You should know the samething has happened with the other companies. Hmm I not sure I can count how many times it has happened at the other company I also work for. No company is perfect & Empire has had a bad start, but they have stuck it out. Now there are people that really know how the system works and they are doing what needs to be done. It will not be done overnight. After all look at Alamo.

The company has not just changed its name. It has gone to a complete overhaul and is continuing. The several people at the top know more about EMS than you or I ever will. I hope that they continue to improve the company. I will be glad to be a part of it.

Tom O

Edited December 10, 2008 by Medic442

[Guest alsfirefighter]

From NYSDOH EMS Policy # 98-05 "Certified persons have NO authority or responsibility to respond independently. In NY there is no duty to act as an individual citizen, regardless of certification or licensure. Individuals may respond only as a part of an authorized agency's response system and within an EMS system."

You have no Duty To Act unless you are "on duty".

If you are a volunteer and consider yourself always "on duty" you would only have Duty To Act in your department's area, though I would suppose there is room for interpretation as to what it means to be "on duty" as a volunteer if your department does not have duty schedules.

Thank you medibart for clearing that up. I really don't know how people get some the info they spit out or believe when it comes to thing in ems. Is it that the info comes out wrong or are there people out there teaching wrong I don't know.

"WHY CAN'T WE ALL JUST GET ALONG, & SUPPORT EACH OTHER TO DO OUR JOBS" There is enough work out there for all of us.

Exactly. There is enough work out there for me to handle just in my response area alone. I should not have to add "intercepts" for private companies to my load. Which maybe then you can explain to me how being dispatched to a facility for an "ALS intercept" because an agency has a bls crew there they sent, when the nursing home clearly gave them information sufficient to deem it als from the get go or even said we need ALS. How is that my problem. I don't need to..nor do I feel that I should have to support anyone in doing "their job." Particularly private companies doing transports. I have no problem assisting my surrounding ALS agencies in 911 mutual aid. They can't control that. But those agencies we are discussion can certainly control who they are sending to transports. I get sent to play XYZ Ambulance or ABC paramedics...paramedic and my community loses a 911 responder...not just for EMS calls, but being dual role also fire.

Know your role. I don't work for any of you, so the whole can we get along and support each other? I shouldn't have to. I can only think of 1 intercept that the patient needed active ALS intervention and not profalactic care that tied me up on BS to cover a private agency call as their medic. Sorry but that is BS and always will be.

I should also not see units flying code 3 to facilities for interfacility transports either. I bring in patients with no lights and sirens in worse looking conditions then most of the tranports being wheeled in at the same time that not 30 to 45 mins. prior to that I saw the unit blazing through my city code 3 and sadly often mach 3.

[RNMedic08 0]

Medic 442,

Glad to hear that your back to your old self again and will be returning to the road.

I hope your right....although only time will tell.............I am just putting in my 2 cents from what I personally hear and what I have seen...don't kill the messenger!

Just because I haven't been in EMS and a Medic as long as you doesn't necessarily mean I don't know what I'm talking about.

Best wishes for a safe an Happy Holiday Oppie

[smwells 7]

I used to work for Empire State (Now HVP), as an EMT. The dispatcher relies on the facility to give valid information about the patient's condition, so the proper assistance can be provided. I am sure this is the case in all dispatch locations, 911 or private.

(Example - dispatch tells me "pt has dificulty moving" {ok, BLS job}, when I arrive at the facilty I find patient in bed with hip fracture/dislocation from fall onto tile floor 4+ hrs prior, and someone at the facility put them back in bed for the "day shift to handle", now it is ALS job, the patient is in shock and cant move anything below the waist. - yes, this a true story from a local nursing home)

You can't fully blame the agency for poor information obtained, nor can I say the issues raised about "pulling" ALS don't occur.

I have been sent to many jobs, that not only should have had ALS, but should have been a 911 job, not a transport.

Facilities need to contact the best agency for the problem, not just the one that is under contract.

- My 2 Cents-

[Medic442 15]

alsfirefighter,

So if I am understanding this right, you have direct knowledge of what a NH or other facility told a dispatcher at a private company. You also know that bls transports never goes bad. You also know or knew that for this bad call the bls was the closest unit available and no other private agency would have a unit available for hours. I dont, but I have been at both ends to see that things do happen. I have responded to calls from other companies that I have and do work for. Where I have been told by the staff we asked for als and then contacted the sup to find out why and listen to the call recording that was not the case. Also the call for a person sleeping to find in arrest. Some facilities should have a better grip when to call 911 or the private. I can say this for sure after being in a local Westchester NH for rehab a short period ago. I can also say this from first had knowledge from the past 20 plus years. Also I just want to understand, that a bls crew that found themselfs over there heads and need help for there Pt not themselfs but there Pt took up your time. I am very sorry for the Pt that they only asked for your help in the first place. At least they knew to ask for help. For the record I dont know and was not where you where at the time. Yes the are also som winners out there that think this is a game.

As for running code 3 to a transport. You knew that for sure too. Then report it so the it can be stopped. I agree that it is so much better for everyone on a job to run code 1 when it can be done.

Just for to clarify. The comment I made about "There is enough work for all of us" was ment for the transport side of the comments. I am sorry nor do I or did I mean that I wish anyone harm. I am happy with a no call day on the 911 side, but I am happy to help anyone when they call.

Tom O

[Medic442 15]

RNMedic08,

Yes & thanks. I twisted the Drs arm for a possible return to work on the 29th of Dec. Still alot of rebab to go but its going.

Yes there is a lot of talk out there and everyone is and has there sides as well as there fav teams. Alamo & HVP has done for me as well as others Ihave vollied & worked for. Alot of people love to bash the underdog. It is very few that want to make a positive change work. At least thats what I have read

[helicopper 1,050]

This thread is now closed. The fact that HVP has their ALS authority back has been reported and commented. Since that time, the thread has gone off on negative tangents.

If anyone wants to start a generic, non agency specific discussion about the problems associated with the transport side of EMS or long-distance responses to fulfill contracts, feel free to do so. Agency bashing will not be permitted there either.

RNMedic08/Medic442, will we EMTBravo'ers be invited to the wedding?