EMS team fights for sustainability
DUNDEE--After a two hour meeting at the Dundee fire department, it seems Yates County's EMS may need life support to survive. With concerns about funding, the lack of new volunteers and the widespread area of coverage, it will take time to see how the EMS team tackles the obstacles.
The meeting was held on Thursday, Sept. 28 at the Dundee fire department. The Yates County EMS team invited representatives from around the region to go over the issues they have been facing and the best ways of dealing with them in the future.
Sandy Smith, chief dispatcher of Yates County sheriff's office spoke on the concerns over patients who call 911. Smith said, "Typically in our center, when the 911 phone rings at least two people pick up the line. What people don't realize is that when they call 911, one dispatcher asks them questions and keeps them on the phone while the other gets the necessary services on the way."
Smith delivered statistics on the call volume of 911 calls to date: Penn Yan (1,262 calls), Dundee (416 calls), Middlesex (210 calls). Smith went on to describe the "NextGen" system that would be implemented in the future. Features of this system would include: text messaging, video streaming on all deputies, voice identification, faster location information on cell phone calls and "smart" clothes for the elderly (shirts that dial 911 in the case of medical emergencies).
Ross Zastrow, Senior EMS representative for the New York State Department of Health, spoke at length about the challenges faced by rural communities who are experiencing similar problems through the issues of funding, staffing and vehicle upkeep. He has recently facilitated mergers in several rural counties to manage their ability to handle the increase in demands on their EMS teams.
Zastrow continued, "Nobody bats an eyelash to pay for trash pickup or police protection but the minute the EMS needs money to operate, residents complain, 'Oh? That should be free! We don't pay for that.' In what kind of world would that work?"
Zastrow said, "The key is to start thinking now. What are we going to do when there are no more people to cover these shifts? What are we going to do when the money starts to run out from the sources we have? We have to make this a priority. Right now it seems to be holding its own, but I can tell you that here and everywhere else, it's a tightrope walk. The slightest little breeze and we'll be in a hole with no way out. I did a study in 1998 of costs of one paramedic unit (staff, ambulance upkeep and equipment) for the year and it was $307,000. It's been 19 years since then so things are a lot different, a lot more expensive."
David Dowdle, chief advanced life support (ALS) paramedic for Yates County, described the challenges in operating Medic 55, one of the few fly cars left in the state. A fly car is an emergency medical service vehicle that responds to emergencies but is not equipped to transport patients.
Dowdle said, "It's really difficult in this day and age to run an advanced life support fly car service and make any kind of money. Where other outfits are subsidized by the county, my outfit is subsidized by the hospital."
Dowdle added, "I'm trying to recruit people into Yates County to work. The biggest problem is that of wages and that the hospital is smaller than they'd like but those are just the things we face out here in the rural areas. As far as an ALS unit, we run about 900 calls per year. I always like to say, 'It's not so much volume as it is acuity.' The calls we do run are farm-related accidents, we have a high elderly population, traffic is horrendous in the summers so we have a lot of accidents. These are the things we're up against. It's difficult to recruit and maintain good paid people to handle these sorts of things."
Several members of the audience asked questions of Zastrow regarding his previous experiences with other similar situations. Wayne County EMS coordinator Bill Liddle and chief paramedic Jim Lee were there to attest to how challenging these issues could seem but reiterated that there was "light at the end of the tunnel."
The overall consensus was that even though it may be a fight to maintain and fund the EMS team--the staff in Yates County was ready, willing and able to continue the fight.
Dundee Fire Chief Doug Miller summarized the feelings by saying, "It's always been peaks and valleys over the years but the peaks are getting taller and the valleys are getting deeper. Two steps forward and one backward until sometimes it seems hard to remain standing."
Chris Warriner, EMS coordinator for Yates County, closed out the meeting by asking a series of thought-provoking questions.
Warriner asked, "Think about what can we do to help? What changes would we have to make? Combining agencies--is that something we'd want to do down the road? Are there things we'd want to do with the inability to bill with our Dundee ambulance, does that need to change? Those are all things that we will continue to talk about and discuss."