That was a fantastic article.......and if Mr. Huston reads this and is interested I'm sure DVAC could arrange a nice stress free weekly 6 hour shift with fun people any time he would like....... In fact we would welcome 2 or 3 hours. Hope to hear from you Mr. Huston
SCHENECTADY Taking risks not an option Towns cope with ambulance corps growing pains BY JUSTIN MASON Gazette Reporter
John Tobiassen fears the day he calls for an ambulance and one never arrives. The Plotterkill fire chief had a foreboding sense of this bleak future recently, when his department was called to Princetown to treat an elderly man having trouble breathing. Rotterdam Emergency Medical Services was initially dispatched, but couldn’t respond because the one ambulance staffed had broken down at Ellis Hospital in Schenectady. And before a mutual aid company could be dispatched to Princetown, four more emergency calls came in throughout western Schenectady County. Both Mohawk Ambulance in Schenectady and an ambulance company from Guilderland were tied up on calls when Plotterkill’s first responders arrived on the scene. Had the call had been for a serious trauma the situation could have been more dire. “We’re fortunate right now we haven’t gotten caught,” he explained. Tobiassen used the scenario to ask the Princetown Town Board to support REMS with a subsidy or risk the possible loss of ambulance service altogether. Absent the Rotterdam-based company and the Duanesburg Volunteer Ambulance Corps., the three towns of western Schenectady County are largely reliant on the 10 city-based Mohawk ambulances that also service Scotia, Glenville and parts of Niskayuna, or on ambulances dispatched from Altamont and Guilderland in Albany County, or from the Greater Amsterdam Volunteer Ambulance Corps in the Montgomery County town of Florida. Many emergency officials and first responders fear the ongoing problems facing the Rotterdam and Duanesburg companies could one day leave residents in a large swath of the county with long waits for ambulance service. Or, under extreme circumstances, no ambulance service at all. PRECARIOUS SITUATION REMS, a nonprofit, paid ambulance service not subsidized by many towns, is near insolvency. Board president Joe Vanderwerker said the ambulance company struggles to make its payroll every other week. The ambulance service’s problems partially stem from the 2003 merger between the White Eagle and Rotterdam ambulance volunteer companies. The merger was done under the assumption that Rotterdam would eventually fund the service through either an annual town contribution or a taxing district. Neither happened, and the ambulance company, which relies on insurance reimbursements, began to fall into debt. Between 2007 and 2008, it accrued more than $250,000 in debt to the Internal Revenue Service in unpaid payroll taxes. The company is now trying to work out a settlement with the IRS to avoid some federal tax liability. Vanderweker said REMS is trying to pay off some of its local debts that accumulated during the years the company awaited town funding. Even the small debts have hampered the company from remaining solvent. An unpaid bill to a local printing company prevented them from sending out this year’s fundraising mailer, which generates them about $30,000 of revenue. A 2007 proposal to merge REMS with the town-operated paramedic program never got off the ground. Proposed by Holdsworth Pelton, an EMS and fire department consulting firm, the proposed merger never gained support among town officials or the paramedics, a unionized force. Combining them with the non-union ambulance company was an obstacle the planners couldn’t overcome, and the idea was ultimately scrapped this fall. PROBLEM SOLVING REMS is now trying to set up a taxing district in Rotterdam that would fund two ambulances on the road, 24 hours a day and all week. Vanderwerker said the district could be established through permissive referendum and would cost residents about 10 cents per $1,000 of assessed property value — an average of $30 per home. Rotterdam board members are waiting for the results of an audit of REMS before proceeding. Meanwhile, REMS is also asking for a $32,000 contribution from Princetown, which has three fi re districts that rely on the ambulance service. “If they confirm a contract, there will be another ambulance on the road in 24 hours,” Vanderwerker said. The Duanesburg Volunteer Ambulance Company also came precariously close to insolvency recently. In January, turmoil left the town-subsidized company with few volunteers to staff their four ambulances. The result was a marked increase missed calls. The situation was highlighted when a student fell through a plate glass window at Duanesburg High School in February. Though volunteer fi refighters from Delanson were able to slow the boy’s bleeding, it took more than 20 minutes for an ambulance crew to arrive to take him to the Albany Medical Center Hospital. In response to an outpouring of community criticism, members of the Duanesburg Town Board decided to withhold the town’s subsidy until leaders of the ambulance company could provide duty rosters showing an adequate staff for an ambulance. During times the company couldn’t field a staff, the board asked the state police dispatchers in Princetown to rely on REMS as the town’s primary ambulance service. The Duanesburg company reorganized in May and pledged to solidify membership; Duanesburg granted them a monthly $10,000 subsidy, which they pledged to renew as long as the ambulance company continues to make strides in the right direction. SOLUTIONS TAKE TIME Despite an influx of volunteers DVAC still lacks enough emergency medical technicians to fully staff its ambulances. In August, Chairman Charles Leoni informed Princetown the ambulance company didn’t have the crews to cover the areas of the town it had historically served. “We’re definitely are on the mend,” he said. “But it’s going to be an uphill climb.” Leoni said DVAC is in the process of working out a mutual aid agreement with the Plotterkill and Mariaville Fire companies. The agreement would allow them to dispatch crews without an EMT, provided one from a fire company was already at the scene of call and willing to ride in the ambulance. “Before the driver rolls, he has to know the EMT is there,” he said. POSSIBLE ALTERNATIVE Turmoil in the two communitybased ambulance companies has drawn the attention of the for-profi t Mohawk Ambulance, which has approached Rotterdam as a cheaper alternative to REMS. Company officials offered a $430,000 contract with the town, which would ensure two advanced-life-support ambulances stationed in Rotterdam; the company even offered to hire some of the REMS personnel they would displace. “We’re still very much interested in working with town officials,” said Richard Brandt, Mohawk’s vice president of operations. Mohawk now covers both Albany and Schenectady, in addition to Watervliet, Glenville, Brunswick and Scotia. The company has a base of operations off Route 5 in Schenectady and has a fleet of 30 ambulances with a staff of about 220. Brandt said his company could easily cover all of western Schenectady County with either basic or advance life-support ambulances. He said all of Mohawk’s ambulances are dispatched using GPS systems, meaning they have a real-time idea of where the fleet is deployed. In the event of a glut of calls in one area, Bradt said ambulances can be diverted from other locations. “Our ambulances are all throughout the Capital Region,” he said. “It’s a very mobile, fluid and dynamic operation.” ANOTHER VIEWPOINT As attractive as Mohawk may appear on paper, the ambulance company is no replacement for an adequately-funded, well-staffed community-based program, according to Terence Hannigan, an Albany attorney and volunteer fi reman who has advised both REMS and DVAC in the past. Hannigan said the advantage of community-based ambulance design is that they almost always draw their staff from the municipalities they serve, staffing ambulances with first responders who know the local roads and understand the community. “When the system works well, there’s nothing better to define that community or the American spirt,” he said. In Rotterdam, Hannigan said, the problems facing REMS have been compounded by the town’s inaction in funding the service. Had the company been funded after its merger, he said the financial problems they’re now experiencing wouldn’t be as pronounced. “Right now they’re at the mercy of a Town Board that doesn’t want to keep up their end of the deal.” Hannigan said Duanesburg’s problems aren’t as easily solved. Like REMS, he said, DVAC is taking an evolutionary step from a loose-knit company of volunteers to a complicated business, absent a paid management structure. “It’s a problem we’re seeing across the state,” he said of the issues now facing the Rotterdam and Duanesburg companies. One solution would be to combine the community-based companies under the auspices of a municipality, as the Albany County town of Colonie did with its ambulance services in 1989. The town-supported merger joined five volunteer squads operating in the area, and led to the dissolution of a sixth. The new service became funded through the Colonie budget and began recouping costs by billing insurance companies. The service initially used volunteer fire departments as their base, but eventually was given a base of operations when the town’s public safety facility was built off Wolf Road. Today, the Colonie Emergency Medical Services Department covers 62 square miles and serves a population of roughly 90,000.
There are reasons folks move the 'country'....it's quiet, no one 'bothers' you, you can make your own way,hunting, farming etc....the chance folks take is that breathing issue, or uncontrolled breathing, farm accident etc....the best investment with immediate impact would be to use their community center to teach locals BLS---aka basic life support and advanced first aide.....be prepared and responsible.....
as for Rotterdam/Princetown $30 give or take would be fine....
however this will all be moot when national healthcare/emergency service state.....takes over.....and the lucrative contracts emerge
shuffle along......
...you are a product of your environment, your environment is a product of your priorities, your priorities are a product of you......
The replacement of morality and conscience with law produces a deadly paradox.
STOP BEING GOOD DEMOCRATS---STOP BEING GOOD REPUBLICANS--START BEING GOOD AMERICANS
....but remember, Senders, when we have a car accident it is usually at 50mph or higher. Slightly more intensive training is needed then learning cpr at the community center. Most farm accidents are equally traumatic. To be qualified to work on someone with those kinds of injuries requiress a great deal of formal training by certified experts. There are 4 or 5 DVAC members attending SCCC for emt training right now. Check out their website (SCCC) to see what it entails, it starts in Sept. and they graduate in December. It's quite a comitment for volunteerism. Paramedic training would be the next step and even more intense. I agree we need to take responsibility but there are times (when one is unconcious or bleeding to death) when you can not. My husband cut the pad of his finger off with a sawsall and I drove him in but that isn't always an option.
REMS, a nonprofit, paid ambulance service not subsidized by many towns, is near insolvency. Board president Joe Vanderwerker said the ambulance company struggles to make its payroll every other week.
I bet this issue could be taken care of in one way...make them volunteer again. I bet the payroll issue disappears. If it doesn't, I guess you're looking at the accountant again.
The payroll problem will disappear but you will be left with the volunteerism problem. There are only a rare few who volunteer for this type of community service. I speak from experience on this issue.
....but remember, Senders, when we have a car accident it is usually at 50mph or higher. Slightly more intensive training is needed then learning cpr at the community center. Most farm accidents are equally traumatic. To be qualified to work on someone with those kinds of injuries requiress a great deal of formal training by certified experts. There are 4 or 5 DVAC members attending SCCC for emt training right now. Check out their website (SCCC) to see what it entails, it starts in Sept. and they graduate in December. It's quite a comitment for volunteerism. Paramedic training would be the next step and even more intense. I agree we need to take responsibility but there are times (when one is unconcious or bleeding to death) when you can not. My husband cut the pad of his finger off with a sawsall and I drove him in but that isn't always an option.
I'm not saying just use that....but to 'plug a hole' is better than doing nothing and waiting.....the time a person continues to bleed not breathe etc is time lost......but, to have someone there to start the emergency help needed is overall better than---paying and sitting and waiting......JMHO
folks know what they get into(or we like to think) whether it be the person who gets mugged in the city while walking alone at nite or the farmer that gets cut on equipment working alone...........
...you are a product of your environment, your environment is a product of your priorities, your priorities are a product of you......
The replacement of morality and conscience with law produces a deadly paradox.
STOP BEING GOOD DEMOCRATS---STOP BEING GOOD REPUBLICANS--START BEING GOOD AMERICANS
Over the past 20 years, ambulance service for the town of Rotterdam has transitioned from three volunteer squads to a single nonprofit entity, Rotterdam Emergency Medical Service (REMS), with all paid personnel. Donations, fundraisers and sporadic insurance reimbursement are not capable of providing the revenue stream necessary to support REMS’ critical emergency operations. Given proper financial support, REMS can provide basic life support that is at least as good as the service that any outside company can give. In fact, since REMS employees come primarily from Rotterdam, they know the town and its residents better than any outsider. That is a distinct advantage to the citizens of Rotterdam. In the long run, financial support of nonprofit REMS should prove to be substantially more economical than contracting with any for-profit company. In order to stay in business, a for-profit company must charge substantially more than its costs in order to pay necessary real estate and income taxes and provide a return to the owner. Non-profit REMS is not subject to any of those requirements. An outside, for-profit, company may low-ball a short-term contract price in order to get the business. However, in the long run, its price must be higher. The Rotterdam Town Board should opt to give appropriate financial support to local nonprofit REMS rather than contract for service with any forprofit ambulance company. GARY BONK Rotterdam The writer is chairman of the Rotterdam Fire District No. 3 board of commissioners.
Seeeeeee your repub idea to get rid of the ambulance drivers and have the people rely on big bussiness is dead so forget it over here repubs the people have rejected you all
Ok, that's a good answer ... Medicaid? Social Security? Why do they not bill those without insurance - just like a doctors office or ER ?
I can't specifically to REMS, but I do know that other such services can and do bill directly. Of course the problem is still collecting on those bills. If a person doesn't have insurance, and is not covered by Medicaid or SS or what not, they probably don;t have the cash for the ambulence ride.
I'm really not trying to beat them up ... but if you don't pay a credit card bill, credit bureaus know about it. Don't pay your Satellite bill for couple months - zing, it's on your report. Maybe they need to work on billing procedures to get what they're entitled to. Not paying for the service is "theft of services" isn't it?
From what I remember hearing, and this was years ago, when my sister was on the squad (and give me a little room on this, this is years-old hearsay), I think somebody said that they would bill the person's insurance, then turn around and bill the person for a set period of time (2-3 months). If there was no reply in that time, they would write it off. Is there a way that the Corps could actually be a bit more solvent getting a collection agency to collect some of the money? As I understand, those types of things usually work on a percentage of the amount that is collected. Also, I realize that some insurance companies will pay only a set amount for trips. Is it possible that Rotterdam EMS could negotiate with local insurance carriers to get a little higher rate? Or have they tried raising the price to the patient/customer?
I want Rotterdam to still have it's own ambulance service, and I would personally be happier if it were not a paid staffing, but that is just me personally. The thing is, they now have a payroll that they did not have before they changed from volunteer to paid. They are now working less as a "community organization" and more like a business. They need to start looking at the billing more as a company and not as a group of people that are doing things to help out. I know that they are doing their best to help the community, they just need to find different ways to look at things.
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