Care 1 ALS services suspended

[EMT111 149]

Apparently, as of today, the Hudson Valley REMSCO has suspended all Care 1 ALS services in the Hudson Valley region based on complaints from the NYS DOH. I don't know if this is also occuring in the other regions that Care 1 services. In Orange County it appears that Mobile Life will be covering the Care 1 coverage area until further notice.

[watercanmonkey87 1]

It was only a matter of time....don't worry; they are only another name change away from resuming business as usual.

[Ga-Lin 86]

Anyone know the particulars of why. Not that it really matters, I agree with watercan they'll just change the name and start over or sell it off.

[50-65 205]

My guess is it is related to narcotics issues. This is not the first time for them. When they were Empire State Ambulance they were shut down (for ALS) because of issues with this. They fixed whatever the problem was and had ALS privileges reinstated.

[87D124 37]

The information I got today is that both the BLS & ALS got shut down by DOH. This came from a very reliable source.

[helicopper 1,050]

The information I got (also from a reliable source) Friday was that ALS operations were suspended. I saw a couple of Care 1 ambulances on the road over the weekend so my guess is that BLS is still operating.

[v85 212]

Who actually suspended them? NYS DOH or HVREMSCO? If its HVREMSCO, it is very well possible that their BLS operations are not affected in Westchester, which is considered a different region.

[helicopper 1,050]

 

Who actually suspended them? NYS DOH or HVREMSCO? If its HVREMSCO, it is very well possible that their BLS operations are not affected in Westchester, which is considered a different region.

 

As it was explained to me, their ALS privileges and Part 80 approval were suspended by the State DOH and each region they operate in notified.

[EMT111 149]

From, what I heard is that their medical director quit

[sympathomedic 383]

Well, since we are all tossing in grist for the rumor mill: My understanding was that NYS DOH contacted the medical director about a narcotics policy issue. It was during that conversation that the director elected to resign. Still having the original question unanswered and now with no medical director, the Powers That Be (I don't know from REMAC SEMAC Regional council or NYS DOH BEMS) has issued a 6 month suspension. I do NOT know if that is a punishment suspension or a 'Hold on while we figure out what is going on here' suspension. Either way there is an appeals process. I have heard they have a new medical director. The Email I saw from HVR said that HVR medics whose primary affiliation in the HVR was Care 1 had 30 days to find a new primary or lose their MAC's. God I love the HVREMAC! I got the same cheery little note back when Westchester divorced them- affiliate in what remaines of our Region or we will deny that you exist. Kind of like the Palestinians and Isreal. But I digress.

I fully get that other companies will need to pickup Care 1 work and those companies will need the medics to do it. So the HVR is nudging them over to other companies rather then having them idle while other providers need them. But that move will only make it harder for C1 to restart as an ALS provider if they get through this.

Speaking as a long-time medic, I feel for the Care 1 medics. They did nothing wrong, and now their jobs are gone, and they are left to find work at the bottom of the pay scale and seniority list elsewhere.

[x635 4,066]

Most importantly, what is going to happen to the Care 1 employees and the effect this is going to have on them and their families?

[v85 212]

So is it confirmed only ALS is affected, not BLS. I just saw a Care 1 rig yesterday in Wallkill headed towards ORMC, with only one person in the front.

[sympathomedic 383]

More grist from the ED doc at Phelps: Per him, the BLS cannot do RX, like epi-pen, albuterol and ASA. But they can do plain BLS work. Which is what we all did before the damn medics with their tubes and needles and wires came along.

[x635 4,066]

Doesn't BLS also have to have a Medical Director?

And, again, even if BLS is still running, what is going on with all the Paramedics that were emplyed there?

[vtach39680 23]

As a past officer in a VAC. BLS does need a medical director. And how could they still operate a BLS service and not be able to give or vary the part 800 mandatory drugs which also includes oxygen.

My guess is. They have a medical director for BLS as any Dr fits that requirement. They must be lacking a Medical Control Dr for the ALS portion of medical Direction

[v85 212]

I would assume that the paramedics are operating as EMT-B's, with extra knowledge and assessment skills until/if they get ALS back

[JM15 386]

How can you even operate at the BLS level without oxygen, albuterol, epi etc?

[sympathomedic 383]

NY State does not require the "add-on" drugs in order for a squad to be BLS certified. Yes oxygen is a drug. It IS part of minimum required gear. I can assure you NYS will not allow an ambulance to be in service without oxygen. Without epi, asa and albuteral yes. Oxygen no.

If the state were to demand that every squad carry those life-sustaining drugs, then some squad that is more interested in existing rather than functioning, would c/o to thier political friends and convince them that the state should not make such a demand. The political friends. who are more interested in getting re-elected than functioning, would pander to them. Hence: A we have a state with low pt care standards, and a legislature with like a 95% incumbant re-election rate. The other 5% get locked up annually. Oh, and a state whose trusting, but clueless citizens are getting shorted.

But I digress. Sorry.

[WAS967 97]

Actually, per NYS DOH policy statement 10-01, epinepherine and defbrillators (both of which require a medical director to carry) are REQUIRED by part 800.

http://www.health.ny.gov/professionals/ems/policy/10-01.htm

[Ga-Lin 86]

Just spoke with one of the medics the other day. They were all downgraded in pay to EMTrate until issue is resolved. Most are starting to look elsewhere.

[sympathomedic 383]

OK WAS, I stand corrected. ASA and albuterol (i think) are add-ons. If I see that ED doc at Phelps again, I will have to take this up with him.

[jamesbdown 1]

Policy Statement 10-01 says "During the regulatory approval process, the SEMSCO and SEMAC are strongly encouraging all ambulance agencies to comply with the following:..."<br /><br />NYS Part 800 Regulations were never changed to require either defib or epi on BLS ambulances.<br /><br />Operating a BLS ambulance without a defib or epi is another issue as community expectations on standard of care come into play.

[JM15 386]

So your saying that BLS ambulances aren't required to have a defib? Do you have a link?

[sympathomedic 383]

I know that for a while lots of places HAD to have defibs, but not BLS ambulances- places like schools. They operate under a different set of laws. As patient advocates, we should all hang our heads in shame over that. Here I am digressing again.

So according to James, they voted to set a date to require it. They advised places to ramp up in prep for the requirment, but never acatually institued it. Probably like I said- some semi-functional agency with friends held the population of the State of NY hostage so they would not have to be burdened with the expense of buying a $2000 defib or the few hours needed to learn how to operate it.

[JM15 386]

While it is disgraceful I guess it is better than suddenly having no job... Hope there are other agencies out there to pick them up

[v85 212]

Actually, per NYS DOH policy statement 10-01, epinepherine and defbrillators (both of which require a medical director to carry) are REQUIRED by part 800.

http://www.health.ny.gov/professionals/ems/policy/10-01.htm

Maybe it has to do with what kind of medical director is needed? I was told that a civilian could carry a defib under the PAD program as long as they had a "medical director" to sign off on it, and that it could be any doctor willing to sign the prescription and review AED usage reports. But it didn't have to be an actual medical control doctor

[EMT348 12]

First, I'll start by saying that the fact that it is sad that very skilled and experienced paramedics are losing money because of someone else's mistake. There's no way to officially know who is at fault. I use the word officially because unless you're an administrator at Care1 or an official with the Regional EMS Council(s) or the State DOH BEMS all you can do is speculate and even if you were in one of those three catagories, I doubt seriously that you would be on here discussing this. That brings me to my second point. The rumor mill. I noticed a few 'speculative' posts before mine here and I just want to say that those who know nothing should say nothing.

Instead of gossiping and talking trash about another company, how about we work to correct the completely screwed up method in which things are done by the EMS system in place in this state? EMTs being limited due to the fact they can't carry certain equipment because it's too expensive or because people are too concerned with their own agencies losing business. We do what's right for patients, not what's right for business. Period.

[ndpemt519 10]

First, I'll start by saying that the fact that it is sad that very skilled and experienced paramedics are losing money because of someone else's mistake. There's no way to officially know who is at fault. I use the word officially because unless you're an administrator at Care1 or an official with the Regional EMS Council(s) or the State DOH BEMS all you can do is speculate and even if you were in one of those three catagories, I doubt seriously that you would be on here discussing this. That brings me to my second point. The rumor mill. I noticed a few 'speculative' posts before mine here and I just want to say that those who know nothing should say nothing.

Instead of gossiping and talking trash about another company, how about we work to correct the completely screwed up method in which things are done by the EMS system in place in this state? EMTs being limited due to the fact they can't carry certain equipment because it's too expensive or because people are too concerned with their own agencies losing business. We do what's right for patients, not what's right for business. Period.

While I agree with the majority of your post, without doing what's right for business we can't treat patients. At the end of the day, if an agency has to choose between buying an epi pen or paying the insurance on their ambulance, we all know what the choice is going to be. It is sad that it comes down to this, but due to the current economy and crap insurance reimbursement rates, EMS (and more specifically our patients) are having to pay the price. Some agencies have more money than others, but I highly doubt many EMS bosses would say that they're 100% comfortable with the current financial state of their company.

I also need to say that there always seems to be gossip in the EMS community about Care1. I'm not going to pretend I know all the details of the current situation. I have yet to see any memo from the company, region, or state regarding the circumstances, so anything said about it on here is purely speculation. What we do know though, is the suspension of ALS services took place almost two weeks ago, and the company is still running and doing calls. That in itself is something to be said for them. I also saw several posts on here about how the company is allegedly only paying paramedics at the EMT rate. If anyone has a memo or a pay stub from the company proving this, please feel free to post it. I have spoken to several employees regarding this and found out it is in fact not true at all. The company has cut a few trucks day to day, however they ONLY cut shifts from part timers. All the full time employees are still bringing home their regular pay check and benefits, which I'm sure they are very grateful of. I fail to see how the company has done wrong by their employees in this current situation.

Edited April 16, 2013 by ndpemt519

[EMT348 12]

While I agree with the majority of your post, without doing what's right for business we can't treat patients. At the end of the day, if an agency has to choose between buying an epi pen or paying the insurance on their ambulance, we all know what the choice is going to be. It is sad that it comes down to this, but due to the current economy and crap insurance reimbursement rates, EMS (and more specifically our patients) are having to pay the price. Some agencies have more money than others, but I highly doubt many EMS bosses would say that they're 100% comfortable with the current financial state of their company.

I also need to say that there always seems to be gossip in the EMS community about Care1. I'm not going to pretend I know all the details of the current situation. I have yet to see any memo from the company, region, or state regarding the circumstances, so anything said about it on here is purely speculation. What we do know though, is the suspension of ALS services took place almost two weeks ago, and the company is still running and doing calls. That in itself is something to be said for them. I also saw several posts on here about how the company is allegedly only paying paramedics at the EMT rate. If anyone has a memo or a pay stub from the company proving this, please feel free to post it. I have spoken to several employees regarding this and found out it is in fact not true at all. The company has cut a few trucks day to day, however they ONLY cut shifts from part timers. All the full time employees are still bringing home their regular pay check and benefits, which I'm sure they are very grateful of. I fail to see how the company has done wrong by their employees in this current situation.

I am pretty aware of what's going on and it seems that people have a hardon for that company either because they're wearing a different colored shirt or because they worked there.

[ndpemt519 10]

Ok, and what have they done wrong? For the last 13 days they've ensured their employees still had jobs and paychecks. I fail to see how this is wrong.