Irvington Volunteer Ambulance Corps in trouble?

[Westchester 49]

Personally, i would argue thats probably already happened. It will probably only get spoken of after there is some large scale incident that occurs on a weekday during normal business hours, you know...the one we don't have six month notice for and is not on a weekend. It's all laughable really.

Yes. But here is the problem. If there was to be a large scale incident or MCI every volunteer member that hasn't been around or hasn't had a call on there shift for months would come out of the wood work, same goes for the fire service. If EMS (River Towns) merged not only would members or paid see more incidents for real life training but there would be no delay response. Again I hear 60 Control page out multiple times for crews short and can't get out. But instead of REMSCO having meetings not pertaining to this serious situation it's going to be the Department Of Health to pull rigs off the road and fine VACS. Example IVAC has been warned once and I know Dobbs was suspended awhile ago for a month. Again Board Members of VACs or Captains of Vacs have together and sit down with Dept of EMS or 60 Control and repair or rebuild this problem.

[Bnechis 3,961]

1) Yes. But here is the problem. If there was to be a large scale incident or MCI every volunteer member that hasn't been around or hasn't had a call on there shift for months would come out of the wood work, same goes for the fire service.

2) Again I hear 60 Control page out multiple times for crews short and can't get out. But instead of REMSCO having meetings not pertaining to this serious situation it's going to be the Department Of Health to pull rigs off the road and fine VACS.

3) Example IVAC has been warned once and I know Dobbs was suspended awhile ago for a month.

1)That use to be true, but no longer. On the FD side they are not coming out of the woodworks for big fires and need multiple mutual aid units to cover.

2) And the agencies do not seam to be concerned about the multiple pages. The REMSCO has a number of legaly mandated items that it must do and it has no legal authority to do anything about this situation. The REMSCO has made attempts, but only the DOH has the legal authority to do anything and they have made it very clear that they will not. DOH says if they did anything about it most of the VAC's/VFD's in the state would be closed, as the situation in Westchester is not bad compared to "upstate".

3) Warned by whom? And why was Dobbs suspended? I believe it was not for delay/no response.

[jmrmedic 1]

@ Goose, It's a statewide problem. The state DOH is a governing body that should do something. I believe all they require them to do is answer 1 call a month to maintain there CON. That's what I was told by REMAC. This morning, one of my guys sat in a village waiting 45 minutes for an ambulance. It comes down to the State DOH breaking some balls, and unfortunately, the word needs to get out to local officials because its a violation of their contract (24hr svc for free). We all have solutions, but they cost $$$$. I can solve the local problem. It's a matter of the local volunteers understanding there is a problem, and forgetting about their rank!!!

[jmrmedic 1]

@Westchester....I know for a fact Dobbs was never suspended by any state or local agencies.....not sure why your talking out of your ASS!!! but your WRONG. When there was a problem with Dobbs Ferry, I assisted the FIX. There was no violations or suspensions. I'm not sure Who and What you do, but the solution comes down to money. Donate some and I will fix it!!!

[Westchester 49]

@Westchester....I know for a fact Dobbs was never suspended by any state or local agencies.....not sure why your talking out of your a**!!! but your WRONG. When there was a problem with Dobbs Ferry, I assisted the FIX. There was no violations or suspensions. I'm not sure Who and What you do, but the solution comes down to money. Donate some and I will fix it!!!

I believe and I may be wrong.Sorry.I think during one of the audits the state does several years ago Dobbs VAC had some problems either with records or something else, and I was informed they they were out of service for a period of time to correct it and IVAC covered them for awhile. I apoligize if I was mistaken, but if you remember not to long ago when new officers came into Dobbs VAC they cleaned house and a lot of old timers left and Dobbs VAC had very little coverage infact IVAC covered them through mutual aide. Thank God for the Greenburgh Police and Dobbs Police for making it easy for IVAC, Hastings, Ardsley for helping. Buy the way I'm not talking out of my a**. You know what happened when the State came for the audit, infact I believe they have 1 cabinet fully stocked and locked just in case of inspections at Hospitals or Headquarters. Tell me I'm wrong. The whole conversation was about problems IVAC now has and is getting worse. P.S I've donated alot of hours and years. I've been in this field for 40 years.I remember when IVAC had a Cadillac for a Ambulance and it was only Red Cross First Aid

Edited July 19, 2013 by Westchester

[Westchester 49]

@ Goose, It's a statewide problem. The state DOH is a governing body that should do something. I believe all they require them to do is answer 1 call a month to maintain there CON. That's what I was told by REMAC. This morning, one of my guys sat in a village waiting 45 minutes for an ambulance. It comes down to the State DOH breaking some balls, and unfortunately, the word needs to get out to local officials because its a violation of their contract (24hr svc for free). We all have solutions, but they cost $$$$. I can solve the local problem. It's a matter of the local volunteers understanding there is a problem, and forgetting about their rank!!!

The scary part is that "your guy sat in the village for 45 minutes for an ambulance" after 10 minutes did he call for mutual aide, Christine Quinn's aide I faster service in the city( 30 Minutes ) I hope you you questioned your fellow medic why did the police on scene or the medic call for another resource. How do you tell family members the ambulance will be here soon, have a cup of coffee while you loved one is circling the drain. Thats why we all have to stand together and think of a way to fix this. Since the State or Local Goverment maybe it's time for VACs and FDs to come together and merge or minds and resourses

[Goose 188]

The scary part is that "your guy sat in the village for 45 minutes for an ambulance" after 10 minutes did he call for mutual aide, Christine Quinn's aide I faster service in the city( 30 Minutes ) I hope you you questioned your fellow medic why did the police on scene or the medic call for another resource. How do you tell family members the ambulance will be here soon, have a cup of coffee while you loved one is circling the drain. Thats why we all have to stand together and think of a way to fix this. Since the State or Local Goverment maybe it's time for VACs and FDs to come together and merge or minds and resourses

Every agency develops its own M/A policy and more often than not those policies don't put patient care first. Besides, just because the medic requests mutual aid doesn't mean your getting an ambulance any faster. I can recall many an overnight as a flycar medic and 60 dispatchers putting tones out essentially begging people to sign on. I think it went something like " 60 to xyz VAC is anyone going to sign on or out there to answer this call?" It got so bad I would have them send me however could drive and I would ride BLS jobs in because it was quicker for me to get back in service and quicker for the patient. That's the sort of thing we are dealing with here.

[Westchester 49]

Every agency develops its own M/A policy and more often than not those policies don't put patient care first. Besides, just because the medic requests mutual aid doesn't mean your getting an ambulance any faster. I can recall many an overnight as a flycar medic and 60 dispatchers putting tones out essentially begging people to sign on. I think it went something like " 60 to xyz VAC is anyone going to sign on or out there to answer this call?" It got so bad I would have them send me however could drive and I would ride BLS jobs in because it was quicker for me to get back in service and quicker for the patient. That's the sort of thing we are dealing with here.

Goose you are 100% right, but again we all know it, and at sometime within our roles as a Captain, Chief, etc. we all tried to fix these problems, but when does it stop. If it's not getting Ambulances out or Fire Trucks out when does it stop. My whole discussion started with IVAC Captain Lewit pleading to the Village Board for some help or guidance. IVAC has no budjet from the Village. There fund rasing has dropped, and now village residents see the problem and they are scared. IVAC is now requesting mutual aide from other villages which inturn takes a ambulance away from that town.

[mllax14 18]

Why didn't anything come from the 2008 study?

Edited July 23, 2013 by mllax14

[helicopper 1,050]

That video simply highlights the fact that we have no EMS system in Westchester. We have a patchwork of different agencies doing different things with different resources hoping for a positive outcome and despite the best intentions of the people involved, we are nowhere near a solution.

A comprehensive approach is needed to address the problem and institute a true system.

If the six villages in Greenburgh, as an example, continue operating on their own little islands, they will fail. The notion that Irvington will put on per diem personnel for 451 calls a year at a cost of $288 per shift is just not sustainable.

If the six villages all do that the cost is prohibitive. But a town-wide solution would be much more cost effective based on the call volume.

There was also a lot of misinformation in that presentation. "Private services do not do emergency care, they do transport only". Really? Other assertions about the law were questionable and hopefully someone reviews them for IVAC and the village board.

It also baffles me that anyone is still proposing that DPW or other municipal agencies provide drivers during the day instead of fixing the broken EMS system.

[chazEMT 5]

I'd like to see the underlying cause of the problem individually in the various agencies throughout the county. With respect to volunteer coverage waning, well, there are two reasons volunteers stop volunteering-they CAN'T, or they WON'T! Take a look at the rosters of many of these agencies, you'll see a long list of names...then take a look at the coverage rosters, and you'll see a significantly different number of names!

Why is that?! I believe in the volunteer system, and I believe it could work, if managed properly! Unfortunately, in many cases, it isn't the volunteer system that's flawed...it's the management of it.

[Goose 188]

I'd like to see the underlying cause of the problem individually in the various agencies throughout the county. With respect to volunteer coverage waning, well, there are two reasons volunteers stop volunteering-they CAN'T, or they WON'T! Take a look at the rosters of many of these agencies, you'll see a long list of names...then take a look at the coverage rosters, and you'll see a significantly different number of names!

Why is that?! I believe in the volunteer system, and I believe it could work, if managed properly! Unfortunately, in many cases, it isn't the volunteer system that's flawed...it's the management of it.

Volunteerism is a honorable thing, i think few would argue that. However, the volunteer EMS system simply doesn't work here - it cannot guarantee a timely and appropriate response to requests for service. Its 2013, enough is enough already.

That video simply highlights the fact that we have no EMS system in Westchester. We have a patchwork of different agencies doing different things with different resources hoping for a positive outcome and despite the best intentions of the people involved, we are nowhere near a solution.

A comprehensive approach is needed to address the problem and institute a true system.

If the six villages in Greenburgh, as an example, continue operating on their own little islands, they will fail. The notion that Irvington will put on per diem personnel for 451 calls a year at a cost of $288 per shift is just not sustainable.

If the six villages all do that the cost is prohibitive. But a town-wide solution would be much more cost effective based on the call volume.

There was also a lot of misinformation in that presentation. "Private services do not do emergency care, they do transport only". Really? Other assertions about the law were questionable and hopefully someone reviews them for IVAC and the village board.

It also baffles me that anyone is still proposing that DPW or other municipal agencies provide drivers during the day instead of fixing the broken EMS system.

Have to say that i "face-palmed" quiet a few times watching this video. I think it's honorable that leadership met with the town and was honest about the situation - but i just feel it was a bit too "off the cuff." That said, correct me if i'm wrong, but there currently exists no legal requirement that a municipality in NY State provide EMS service (i remember this being an issue many years ago up in Pawling).

[Westchester 49]

I'd like to see the underlying cause of the problem individually in the various agencies throughout the county. With respect to volunteer coverage waning, well, there are two reasons volunteers stop volunteering-they CAN'T, or they WON'T! Take a look at the rosters of many of these agencies, you'll see a long list of names...then take a look at the coverage rosters, and you'll see a significantly different number of names!

Why is that?! I believe in the volunteer system, and I believe it could work, if managed properly! Unfortunately, in many cases, it isn't the volunteer system that's flawed...it's the management of it.

In IVACs case it's past mangement and loss of volunteers due to it. Clicks began to form and groups started to turn against each other.

[Bnechis 3,961]

That said, correct me if i'm wrong, but there currently exists no legal requirement that a municipality in NY State provide EMS service (i remember this being an issue many years ago up in Pawling).

Correct. the only requirement is IF you provide EMS, you must meet the minimum standards. But you do not have to provide EMS.

[mllax14 18]

How does the system in Nassau County work? I know the Nassau County PD has a number of ambulances. Not really sure how its set up with the large number of volunteer ambulances corps in LI.

Edited July 24, 2013 by mllax14

[helicopper 1,050]

Correct. the only requirement is IF you provide EMS, you must meet the minimum standards. But you do not have to provide EMS.

The Statute (General Municipal Law 122-:

§ 122-b. General ambulance services. 1. Any county, city, town or

village, acting individually or jointly, may provide an emergency

medical service, a general ambulance service or a combination of such

services for the purpose of providing prehospital emergency medical

treatment or transporting sick or injured persons found within the

boundaries of the municipality or the municipalities acting jointly to a

hospital, clinic, sanatorium or other place for treatment of such

illness or injury, and for that purpose may:

(a) Acquire by gift or purchase one or more motor vehicles suitable

for such purpose and supply and equip the same with such materials and

facilities as it may consider necessary for prehospital emergency

treatment, and may operate, maintain, repair and replace such vehicles

and such supplies and equipment;

( Contract with one or more individuals, municipal corporations,

associations, or other organizations, having sufficient trained and

experienced personnel, for operation, maintenance and repair of such

emergency medical service or ambulance vehicles and for the furnishing

of prehospital emergency treatment;

© Contract with one or more individuals, municipal corporations,

associations, or other organizations to supply, staff and equip

emergency medical service or ambulance vehicles suitable for such

purposes and operate such vehicles for the furnishing of prehospital

emergency treatment;

(d) Employ any combination of the methods authorized in paragraph (a),

( or ©;

(e) No contract shall be entered into pursuant to the provisions of

this section for the services of an emergency rescue and first aid squad

of a fire department or fire company which is subject to the provisions

of section two hundred nine-b of the general municipal law;

(f) Consider prehospital emergency treatment as that care provided by

certified emergency medical technicians or certified advanced emergency

medical technicians certified pursuant to the provisions of article

thirty of the public health law.

1-a. As used in this section:

(a) "Emergency medical technician" means an individual who meets the

minimum requirements established by regulations pursuant to section

three thousand two of the public health law and who is responsible for

administration or supervision of initial emergency medical assistance

and handling and transportation of sick, disabled or injured persons.

( "Advanced emergency medical technician" means an emergency medical

technician who has satisfactorily completed an advanced course of

training approved by the state council under regulations pursuant to

section three thousand two of the public health law.

2. Such municipality shall formulate rules and regulations relating to

the use of such apparatus and equipment in the provision of emergency

medical services or ambulance service and may fix a schedule of fees or

charges to be paid by persons requesting the use of such facilities.

Such municipalities may provide for the collection of such fees and

charges or may formulate rules and regulations for the collection

thereof by the individuals, municipal corporations, associations, or

other organizations furnishing service under contract as provided in

paragraph © of subdivision one of this section.

3. Such municipality may purchase or provide insurance indemnifying

against liability for the negligent operation of such emergency medical

service or ambulance service and the negligent use of other equipment or

supplies incidental to the furnishing of such emergency medical service

or ambulance service.

    4.  Such  municipality  may  provide  for   the   administration   and  coordination  of  such  emergency  medical  service or ambulance service  including  but  not  limited  to  operation  of  an  emergency   medical  communications system and medical control.    5.  Fire  districts, which, as part of a fire protection contract, may  provide general ambulance and/or emergency ambulance service pursuant to  section two hundred nine-b of this chapter and  article  thirty  of  the  public  health  law where a town or village has not designated itself as  the primary  provider  of  or  otherwise  contracted  for  an  emergency  ambulance, a general ambulance service, or a combination of such service  acting   individually   or  jointly,  may  contract  with  one  or  more  individuals,  municipal  corporations,  or  other  organizations  having  sufficient  trained  personnel, vehicles or combination of personnel and  vehicles suitable to provide prehospital emergency  treatment,  for  the  furnishing  of  supplemental  personnel,  equipment  or service to cover  instances or periods of  time  when  its  service  may  not  be  readily  available.

[Goose 188]

How does the system in Nassau County work? I know the Nassau County PD has a number of ambulances. Not really sure how its set up with the large number of volunteer ambulances corps in LI.

Nassau isn't much better off. Read this article:

http://resqrev.blogspot.com/2013/06/volunteers-vs-patients.html

[velcroMedic1987 330]

That's an hour of my life I'll never get back. I just finished watching the video of that village board meeting and am stunned by how poorly presented that information was and how many times she said "me, me, me, me" or "I, I, I, I, I, I".

If it wouldn't make me want to gouge out my own eyeballs I would watch it again and count her references to herself as saviour of IVAC but nobody should have to see that twice.

My sympathies to IVAC - and to the Village Board - you are in a bad spot!

[Westchester 49]

That's an hour of my life I'll never get back. I just finished watching the video of that village board meeting and am stunned by how poorly presented that information was and how many times she said "me, me, me, me" or "I, I, I, I, I, I".

If it wouldn't make me want to gouge out my own eyeballs I would watch it again and count her references to herself as saviour of IVAC but nobody should have to see that twice.

My sympathies to IVAC - and to the Village Board - you are in a bad spot!

That's is way I started this topic. The Captain of IVAC does this. She also stated that she has been a member of Ivac for 39 +/- years. Not true. After she retired. She joined IVAC. Her mother ( God Rest her soul ) was one of the original charters members that formed IVAC. Betty Lewit rode till the day she passed. If she saw what has happened to this Corps, she would roll in her grave. There are so many members that have been with this organization for years and years and to see this happen is a total disgrace. Your right about the video I watched it a work again and again the one thing she metions is that the board of IVAC sucks. And that she walks around town asking to become a member, or she signed 16 new members. If I not mistaken one member was arrested for having illegal lights in his SUV and a FDNY plate and some other things. I also believed the Police went to his home and arrested. Nice back ground check IVAC why don't you give a application to George Zimmerman, he's a hero know saving those people in the roll over.

[Westchester 49]

Several residents in Irvington are seeing what's happening with Irvington Volunteer Ambulance Corps. Dobbs Ferry has covered them with their paid per-diems. And their election is coming up for new officers and it seems nobody wants to run. Also I found out 2 Board members resigned. This is the begining of the end. Get the Shovel Out and Broom it's clean up time

[ems-buff 81]

So here's the question? How do you get paid personal in there, or how do you dissolve IVAC into the other EMS/VAC's districts

[antiquefirelt 994]

Volunteerism is a honorable thing, i think few would argue that. However, the volunteer EMS system simply doesn't work here - it cannot guarantee a timely and appropriate response to requests for service. Its 2013, enough is enough already.

Have to say that i "face-palmed" quiet a few times watching this video. I think it's honorable that leadership met with the town and was honest about the situation - but i just feel it was a bit too "off the cuff." That said, correct me if i'm wrong, but there currently exists no legal requirement that a municipality in NY State provide EMS service (i remember this being an issue many years ago up in Pawling).

It's not just Westchester or NY, it's in a lot of places, maybe everywhere. I just sat in a meeting last week with local service chiefs and members of our regional medical control and the State EMS Board (Maine) and can tell you first hand the problem is wherever we used to have volunteers. Between dwindling volunteers, increased time constraints, increased mandates and the increase in the standard of care, volunteers are burning out and new ones are harder to hook then ever.

Our State EMS took over EMS dispatching and require all dispatch centers to use EMD. Just recently they mandated the centers use the determinant codes, but provided no instruction or notification to any services as to what they meant or how they were to be responded to. Most of the volunteer services lack paramedics unless they hire them per diem, so the services are forced to pay mutual aid services to provide ALS for significant number of calls. This of course benefits the patients and is the right thing to do, but the push back is becoming immense as services chew through their budgets paying for out of town ALS. They want to modify the protocols to wait and see if they really really need a medic or not, instead of embracing the EMD system. The State's final word is that they are under no obligation to call out of town ALS, that protocols state ALS must be called when and where available, but this means the services own ALS not any ALS available! So the State in their fear to not push an unfunded mandate is allowing these services to respond to calls as they see fit if they do not have their own medics, but they do require a signed mutual aid agreement that ensures every patient gets an ambulance, just not one that can be as effective as the system was designed for. Overall our State EMS is long been known for being totally spineless when push comes to shove. They wield tons of power if your license fees check crosses in the mail with your new license, but if you want to handle a cardiac arrest with BLS providers, they aren't going to tell you not to.

Anyway, things aren't better everywhere else, just different names, same issue. Good luck, if you find a solution post it, we'll put you up for a Nobel Prize, they've been awarded for less!

[Westchester 49]

So here's the question? How do you get paid personal in there, or how do you dissolve IVAC into the other EMS/VAC's districts

Ok let's take it step by step! IVAC has a contract with the Village of Irvington to provide service.And IVAC has a service award program through the village. The Building, Rigs, equip,etc. ae owned by IVAC. From my understanding they already have per-diems or in the process of getting them. IVAC in 3 years has lost about 70% of its membership due to moving out of the village, injurys, and in house problems.The Board of Directors has to go to the Village and say it's over, contact REMSCO, DOH, and 60 Control. After that they can either sell off everything or keep IVAC as a fully paid dept with no more volunteers. The Captain is trying to keep everything bandaged but it keeps pulling off. IVAC has lost alot of great members, this is a sad event, I knew alot of members back in the day.IVAC will just have to pay the per-diems out of their pocket. It's not fair for my Dobbs Taxes to pay for our paid staff to cover Irvington. In fact Dobbs is hiring more because Dobbs is covering Irvington almost all the time!

[Westchester 49]

It's not just Westchester or NY, it's in a lot of places, maybe everywhere. I just sat in a meeting last week with local service chiefs and members of our regional medical control and the State EMS Board (Maine) and can tell you first hand the problem is wherever we used to have volunteers. Between dwindling volunteers, increased time constraints, increased mandates and the increase in the standard of care, volunteers are burning out and new ones are harder to hook then ever.

Our State EMS took over EMS dispatching and require all dispatch centers to use EMD. Just recently they mandated the centers use the determinant codes, but provided no instruction or notification to any services as to what they meant or how they were to be responded to. Most of the volunteer services lack paramedics unless they hire them per diem, so the services are forced to pay mutual aid services to provide ALS for significant number of calls. This of course benefits the patients and is the right thing to do, but the push back is becoming immense as services chew through their budgets paying for out of town ALS. They want to modify the protocols to wait and see if they really really need a medic or not, instead of embracing the EMD system. The State's final word is that they are under no obligation to call out of town ALS, that protocols state ALS must be called when and where available, but this means the services own ALS not any ALS available! So the State in their fear to not push an unfunded mandate is allowing these services to respond to calls as they see fit if they do not have their own medics, but they do require a signed mutual aid agreement that ensures every patient gets an ambulance, just not one that can be as effective as the system was designed for. Overall our State EMS is long been known for being totally spineless when push comes to shove. They wield tons of power if your license fees check crosses in the mail with your new license, but if you want to handle a cardiac arrest with BLS providers, they aren't going to tell you not to.

Anyway, things aren't better everywhere else, just different names, same issue. Good luck, if you find a solution post it, we'll put you up for a Nobel Prize, they've been awarded for less!

Your 100% correct. Trying to recruit and keep volunteers in and Emergency Services is almost impossible. So with that said what is Towns, Villages, State going to do. In the Rivertown Area Volunteer's are leaving left and right when will a local or sate officilal get involved and do something before someone dies.

[Bnechis 3,961]

Your 100% correct. Trying to recruit and keep volunteers in and Emergency Services is almost impossible. So with that said what is Towns, Villages, State going to do. In the Rivertown Area Volunteer's are leaving left and right when will a local or sate officilal get involved and do something before someone dies.

It is unlikely they will. There is no requirement in NYS to provide EMS and very few communities are willing to jump in with funding to tackle the problem. The State has made it clear they will not get involved.

The costs for a small village make it unlikely that they can afford to properly staff it, particularly based on the total call volume. And since the surrounding communities are in the same boat....they need to work together to have a chance.

Benjamin Franklin - "We must all hang together, or assuredly we shall all hang separately". (At the signing of the Declaration of Independence, July 4, 1776)

[Westchester 49]

It is unlikely they will. There is no requirement in NYS to provide EMS and very few communities are willing to jump in with funding to tackle the problem. The State has made it clear they will not get involved.

The costs for a small village make it unlikely that they can afford to properly staff it, particularly based on the total call volume. And since the surrounding communities are in the same boat....they need to work together to have a chance.

Benjamin Franklin - "We must all hang together, or assuredly we shall all hang separately". (At the signing of the Declaration of Independence, July 4, 1776)

The Village of Irvington has a contract with The Irvington Volunteer Ambulance Corps. If they can not hold up to the agreement and they have no one on the schedule and a 911 call comes in and 60 Control knows nothing, there will be lawsuits. If the Village can't afford to contract out EMS service then a deal or partnership must be done. I'm a volunteer and career, and I'm burnt out. There's nothing worse then sitting on the apron waiting for more crew members and you know theres not a damn thing you can do. Which is more important the cost to the Village to hire EMS or the cost of a life? I understand it happens in NYC, Yonkers, etc. But the small communities must tackle this increasing problem before it gets out of control.

[Bnechis 3,961]

1) Which is more important the cost to the Village to hire EMS or the cost of a life?

2) I understand it happens in NYC, Yonkers, etc. But the small communities must tackle this increasing problem before it gets out of control.

1) Since EMS is underfunded in most communities, clearly what is more important is $$$$$

2) It happens in the larger communities mostly do to volume of calls vs. resources (again $$$), but it happens much more in small communities (particularly as a total percentage of the call volume).

[Westchester 49]

1) Since EMS is underfunded in most communities, clearly what is more important is $$$$$

2) It happens in the larger communities mostly do to volume of calls vs. resources (again $$$), but it happens much more in small communities (particularly as a total percentage of the call volume).

EMS in the volunteer world has third party billing, unless they have a budjet fron there villages in Irvington's situation they have third party billing + fund drives + EMT and CME courses. IVAC owns there building and every thing inside. Most communities are set up like IVAC.

My main concern is response time and eventually loss of life due to shortage on duty shifts.

The important question you should ask is Who are paying the per-diems from Dobbs Ferry to cover Irvington. IVAC isn't. Is it Dobbs Ferry residents through their taxes or is it DFVAC paying it through thier funds? Maybe their using their fund drive money to pay per-diems to protect Dobbs but are instead covering Irvington. Thats the real question, that no one has a answer for.

[huzzie59 75]

So, Westchester, you've been a member here for a month or so , welcome.

How many years have you been around Irvington?

What about the 15 years prior to Dobbs Ferry hiring paid personnel when Irvington covered more calls in Dobbs than they did in Irvington?

Maybe Irvington can back charge Dobbs for all of the calls and they would have enough money to hire paid personnel?

[Bnechis 3,961]

1) EMS in the volunteer world has third party billing, unless they have a budjet fron there villages in Irvington's situation they have third party billing + fund drives + EMT and CME courses. IVAC owns there building and every thing inside. Most communities are set up like IVAC.

2) The important question you should ask is Who are paying the per-diems from Dobbs Ferry to cover Irvington. IVAC isn't. Is it Dobbs Ferry residents through their taxes or is it DFVAC paying it through thier funds? Maybe their using their fund drive money to pay per-diems to protect Dobbs but are instead covering Irvington. Thats the real question, that no one has a answer for.

1) Just because they are doing 3rd party billing, and have the other sources, does not mean they are well funded. 3rd party billing generally only covers a percentage of the call. Once agencies start providing perdiem staff, if they pay them for 24 hours but only do 1 or 2 calls a day, they may be into negative numbers quickly.Thats the reason its better to cover a larger area,

2) maybe they are using the 3rd party billing of Irvington patients, just like Irvington does.