The Montauk Fire District is considering a pilot program to enlist paid emergency medical service workers as early as this summer, a move that comes on the heels of new talk in East Hampton Town to introduce paid first responders town-wide by summer 2014.
"We haven't made a committment," to the pilot program, Joseph Dryer, the chairman of the Montauk board of fire commissioners, said. "We recognize the need and we're exploring the possibility." Funding has not been discussed, yet, he said.
The program would put one paid Advanced Life Support provider on duty 24 hours a day, 7 days a week, from June 15 to Sept 15.
Meanwhile, all of the agencies in the Town of East Hampton, which for a century has depended solely on volunteers to give emergency medical treatment and transport to the sick and injured, is looking at a proposal from the East End Ambulance Coalition to introduce paid first responders.
About 15 Montauk EMTs and three ALS providers run 700 calls annually. While the call volume throughout East Hampton increases when the population swells in the summer months, Montauk takes a particular hit, with a jump from 3,000 residents to 40,000, according to Alan Burke, the captain of the ambulance company.
Typically, Burke said, the district receives one call per day from Jan. 1 to St. Patrick's Day. From then to Memorial Day, they run up to two per day on average. But, when the summer hits, they run 5 to 10 calls per day — a big jump, he said. "We have three ambulances. It's not uncommon for all three to be out of town at the same time," he said.
Burke said the proposal for Montauk initially came from Kenneth Alversa, an East Hampton Town police officer who is also a lieutenant in the ambulance company, who knows first hand how long officers are waiting for ambulances to arrive at an EMS call.
In recent years, it has become more difficult to form full crews for every ambulance call — a problem that each agency on the South Fork battles, particularly during the day when most volunteers are working their regular jobs. Just in January, a complaint was lodged about a 20-minute response time for one call outside the East Hampton Post Office.
Montauk EMS workers answer calls 96 percent of the time without mutual aid from other East Hampton Town agencies, Burke said, but 20-to 45-minute waits have become common.
The town-wide issue is why the East End Ambulance Coalition formed a subcommittee to look for solutions, and it met for the first time in January.
"Montauk is going to be the canary in the coal mine. We don't know how it's going to go," Burke said. For 75 years, the Montauk Fire Department has provided EMS services, and introducing paid providers is not done so lightly. "It's killing us. It's killing me — I'm a 40 year member. But I just can't stand by any more while people wait for care," he said.
The East End Ambulance Coalition has been shopping a similar proposal — a town-wide first responder program — to all the agencies that serve East Hampton Town residents from Montauk to Bridgehampton, including Sag Harbor, as well as those who have fiduciary responsibilities.
Philip Cammann, a Bridgehampton paramedic leading the subcommittee with Ed Downes, said they are proposing the creation of a new town-wide district in which paid staff would respond directly to call locations, similar to how agencies have first responder vehicles already driven by volunteers. It would be, he said, "the biggest advancement in the EMS system on the East End" in his three decades of volunteering.
The idea now includes having five paid first responders — a mix of ALS and BLS providers — on the road for 12 hours per day during the summer and three on during the rest of the year, Cammann said. They would not be responsible for transporting the patient to the hospital and would still need the help of volunteer EMTs and ambulance drivers.
If one of the paid first responders answers a call, for instance, in Springs, the other paid responders on duty would shift from their "sectors" to help cover the other areas. Cammann said it's similar to the way police officers cover each other when one responds to a call.
Funding has been discussed, though figures are rough at this point. Cammann proposes that the capital expenditure for the five vehicles at the beginning be amortized over five years. Each vehicle equipped with radios and basic life support equipment costs about $50,000 to $60,000, he said. With advanced life support equipment, it costs up to $100,000.
An annual budget to run the program could be about $600,000 per year, including a supervisor at $35 per hour and ALS providers at $25 per hour, all of whom who work per diem, Cammann said. It's comparable to Southampton Town Volunteer Ambulance, which employs paramedics for its 43-square-mile district year-round at a cost of $550,000 per year.
Taxpayers from all six districts would share the cost — similar to the way they share the cost of the firefighter training facility in Wainscott.
Cammann estimates the cost at an extra $24 per year for the average household. "It's really no comparison to what you get out of it," he said of the figure, though, he added, "Until you get all six fire districts' assessments, it's hard to budget."
There are still plenty of questions to be explored. Just to name a few: Where would the home base be? Who would pay for insurance? Fuel? The coalition is going to meet with representatives from the county to discuss particulars, such as a certificate of need that would be required from the state's health department.
So far, the coalition is finding support, both from volunteers and at the county level, Cammann and Downes said.
While they continue to do more research, they do have a plan for summer 2013: To better educate the public on what makes up true emergencies. Minor calls often draw on resources, Cammann said. They are planning media campaigns, literature to leave in hotels and in storefronts, and more.
They also plan to work with EMTs on how to streamline the process of answer mutual aid calls.
"We want to do the best we can do for our community — that's why we joined in the first place," said Mary Ellen McGuire, the chairwoman of the East Hampton Village Ambulance Association. She has made recent changes within her own department, such as instituting day squads this winter as a way to better respond to calls.
Village Deputy Mayor Barbara Borsack, an EMT for over 20 years, also sits on the coalition subcommittee and said she thinks the group is moving in the right direction. "Whatever we can do to make a better product is always important," she said.
"We know there's a lot of hurdles to cross," Cammann said. "The hurdles, we can deal with, as long as everyone is proactive and wants to do this." A key element of the concept is that the volunteer members are supportive.
"We still need them to continue doing what they're doing. To hire somebody is not going to just solve the problem," said Downes, who is the president of the Sag Harbor Volunteer Ambulance Corps.
There is a law that prohibits volunteers from taking a paid job within their own department. However, since the proposal is for a separate district, the hope is that members who volunteer as EMTs may be eligible to work in a different area of town, Cammann said.
"They already know the roads. They already have a rapport with the members," he said. "It also keeps the money in the local economy, providing jobs for locals," he said.
Downes agreed. "A lot of people are working two, three jobs to survive. Maybe if one of their jobs can be working as a first responder, we kill two birds with one stone so to speak, and you keep them as a volunteer, too."