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Montauk Plans To Hire Paid EMS First Responders by Summer

East End Ambulance Coalition also discussing a town-wide paid first responder program for the following summer, and better public education in 2013.

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."

Taylor K. Vecsey (Editor) March 18, 2013 at 06:14 PM
Via Eat Hampton Patch's Facebook page, Jack Connors wrote, "That is wonderful news overdue. We really have dedicated volunteers in our east end hamlets, lots of lives have been saved because these hardworking folks."
Sophie7 March 18, 2013 at 06:22 PM
IT's a great start...but lets do this paid thing YEAR ROUND! Can;t imagine why summer only....that dear man by the post office didn't fall in July...and he waited a long time...this was an issue.
Taylor K. Vecsey (Editor) March 18, 2013 at 06:32 PM
Sophie, are you referring to Montauk's pilot program or the town-wide program? Because here's what it says above about town-wide: 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.
ViralGrain March 18, 2013 at 11:58 PM
Where does the money go that is charged for the transport? Is the money to transport going to be totally upon the backs of tax payers or is this service going to charge those who they transport to subsidize or pay for this service. I think it is well over due that we have a more comprehensive first responder program inplace given the fact the population has grown, and the rumors of S.H. Hospital moving to the old South Hampton college campus as part of the merger with Stoney Brook. Guess my concern is that this can become a money pit for tax payers quickly if not planed rite. These numbers are just hypothetical but, if there is one call a day and a minimum charge of lets say $500.00 to transport is collected, that is a minimum of $180,000 a year in revenue. Will that income lessen the burden on the tax payers in paying for this service?
Taylor K. Vecsey (Editor) March 19, 2013 at 01:50 AM
There is no "charge" to transport (whether you have insurance or not). EMS services currently provided are paid for through taxes, the same way you support your fire rescue services. That won't change.
ViralGrain March 19, 2013 at 04:20 AM
That should change. Some people already use the EMS because they don't have a ride to the ER. They hope to be seen quicker by arriving in ambulance and for non-life or death emergencies that don't really need a ride to the ER but a ride to a primary health physician. Also those who only have emergence health care coverage understand that the only way their insurance will pick up the cost is to go to the ER. This is going to be a disaster for the tax payers. Especially since we have so many houses that are packed with people in the summer, and transit workers that add to the percentage of calls who do not pay taxes. Drunken tourists in Hotels and weekend worriers drinking and acting stupid and getting them selves hurt. I think its a great idea that we add on ready a 24/7 unit ready to go, but I think this is just another half wit plan thrown together to address the tragic thing that happened at the post office, and is going to be into motion when it has not been given much thought as to the long term ramifications and the escalating burden to the tax payers in the future. If we are going to do something like this then lets do it correctly with the minimum adverse effect to the tax payes as possible.
ViralGrain March 19, 2013 at 04:38 AM
There are medical transport provisions included in most health care coverage plans. Charge them. They charge us. Its a law supposedly that everyone is suposed to carry some sort of health care. Also if they don't pay nail their credit report. We who live here and own property have enough bills. Unless the hotels and bars want to start paying my bills, I do not want to be responsible for when their patrons fall on their face drunk, or pull out of their parking lot when not looking or don't know where they are going and cause an accident. Bad enough we have to deal with their traffic and arrogance, now you want me to pay for their medical care? Screw that! Same goes for the people renting their homes out for insane prices. Why do I have to pick up the costs for their rental guest who are partying it up in the Hamptons that they are making a killing off of? I would bet that more then half of the calls are from non residents in the summer especially. Why should residents bare the burden when there are successful ways to recoup at least a good majority of the operational costs for such an endever with a little organized planning other then just banging tax payers?. Please think this over. Hasn't the Town learned yet from other half cocked ideas and endeavors that dispit all the good intentions of them, they have put us in the hole that we are still not out of? Come on! Good idea but there is allot more work that needs to go into this plan to make it a successful one.
Shrinkgirl March 19, 2013 at 01:11 PM
What a great idea. I am very happy to pay a few dollars more to ensure the safety of my family and my community.
Yearounder March 19, 2013 at 01:58 PM
I think ViralGrain has a point. If some citidiot knows its going to cost them $1,000 for a bus ride to SH hosiptal for their broken toe, they're going to think twice about it. Anyone would for that matter. Again, its charging the masses to provide resources to the few. This program sounds great, and is needed, but lets make sure it's paid for correctly. There is no such thing as a pilot program funded by taxpayer money. Once funded, it will be impossible to take way.
Taylor K. Vecsey (Editor) March 19, 2013 at 02:05 PM
The first responder and pilot program has nothing to do with transport, though. Transport remains as it is now. I don't believe the ambulance agencies have ever charged for the ride, so to speak, and that may be because the agencies are supported with taxpayer dollars.
ViralGrain March 19, 2013 at 05:04 PM
They never charged because aside for the vehicle and equipment there was no other burden upon the tax payer. Now aside from the vehicle there's going to be insurance, payroll, benefits, fuel, possible overtime, dispatching fees, bandages, and more tact on to the taxpayers? Their is a way for us to be compensated monetarily for providing such a service through insurance and billing those who use the ambulance for transport. Their are other communities that do charge for medical transport. Maybe someone needs to get on the phone with them and find out the ins and outs and how they do it and apply it to what we are trying to do here. So first responder and the pilot program has nothing to do with transport? I don't understand? We are going to be taxed for someone to run out to calls to do triage, but this will not put another vehicle and crew on the road to provide transport to the hospital, nor provide life-support in a situation that may a defibrillator, and other life saving equipment? The problem we need to fix is transport. The wait times for transport can use improvement. If this program is not even going to fill the gap of transport and not provide life support capabilities and provide a person to sit their and hold someones hand till an ambulance show up, why not pay for police to be certified for emergency first responder and give them a bump in pay for being certified to provide such care since they are generally the first on the scene anyway.
Taylor K. Vecsey (Editor) March 19, 2013 at 05:20 PM
A few things: Dispatching, fuel for the ambulances and first responder vehicles that are already on the road and driven by volunteers is already paid for by tax dollars. The first responder program is to get someone to the scene quickly. The ambulance that responds now is still going to have to respond and transport the person. BUT, the first responder DOES provide life support in the field (I have to speak from personal experience here — they do a lot more than just hold your hand). All first responders carry Automatic External Defibrillators, which are life saving pieces of equipment. A-EMTs can intubate for ventilation. They can start IV lines. Some can carry life saving and pain easing narcotics to administer in the field. This is often just as important as fast transport to the hospital (which I'm not saying isn't important, but when you are as far away from the hospital as some of us are, you need this advanced life support in the field and minutes count). Just wanted to clear those things up. Hope that helps.
Steve March 19, 2013 at 05:38 PM
I've watched these EMS (and FD in general) people work hard, at all hours of the day and night, giving their own time and effort with sick or injured people. I've sat through lengthy classes with them so they can be certified to help someone who needs it, and I laud their tireless efforts. However, they are indeed abused (particularly "in season") by people who don't really need an ambulance... it's just more convenient for them. (Viralgrain is on point with the example of a broken toe) I've seen ambulances roll for less, and it's a shame, but where do you draw the line for fear of litigation?! Certainly putting paid personnel into those positions would take some of the pressure off the volunteers... a wonderful thing. I see no reason a volunteer couldn't become a paid employee. It used to be that way in MFD with the "house man". As far as "transport costs" why not charge all non-resident non-tax-payer patients? Resident tax-payers need not pay twice. I just want to thank all the volunteers on the East End, and in particular, a guy who I am proud to call a friend, Alan Burke, who has been "elbows deep" into it for a helluva long time. Good luck with formatting this program. It has promise if done correctly.
Denise gentile March 19, 2013 at 07:09 PM
Forward thinking! Hope this is up and running by June 2013. Our shoreline is quite changed ( ie. watermill beach reveals erosion helping cars from 1960's) . The element of "the unexpected" is upon us and it is wise to be prepared.
ViralGrain March 19, 2013 at 09:23 PM
Well is it posible that we take advantage of the fact that most health care insurance will cover medical transport costs and start charging for rides to the hospital first, and collection agencies take payments from people who may not have coverage? The revenue that is generated can help fund a program like this, maintain and buy needed equipment and would alleviate some of the stress to the taxpayers. Police in many other parts of the country carry external defibrillators and life saving narcotics such at the ones used when someone is O.D.-ing. By giving a slight pay increase to officers that become certified as first responders and equipping them with the gear needed I bet would be way cheaper and achieve the same thing as the proposed program. In the meantime we can figure a way to recoup some revenue by starting to charge for medical transport that we can use to expand our abilities to provide the best medical response possible. Maybe expand our fleets, or equipe them with more cutting edge technology or put paid ambulance transport squad on the road to help pick up any slack. Much is possible, but it all costs money. The money that is needed should not be thrown solely on the backs of the tax payers. Look at this as if it was a nonprofit and try to get it as close to self sufficient as possible. The resources are there to generate revenue and pay for the service and improve the current one. They just got to be tapped.
Taylor K. Vecsey (Editor) March 19, 2013 at 09:36 PM
Police do carry AEDs (and you do not need to be a first responder to use one). Check out this one story from a while back: http://patch.com/A-cxSs You made a reference to Narcan. Suffolk County police officers are carrying it as part of pilot program and they are having great success. It's the decision of the county medical director which narcotics can be carried and administered. Due to the success of the Narcan pilot program, I bet we'll see this in use county wide soon. I will explore some other points you bring up. Stay tuned.
ViralGrain March 19, 2013 at 11:45 PM
Wow. I did not know. Good story and glad to see those guys were the two officers who pulled it off. Must of made their day and the guy they saved also. Good for them!
pat March 20, 2013 at 12:38 PM
There are limits as to what police should be expected to do; they didn't become police to do more than they do now. You should be aware that Narcan has a short "shelf-life" in the body of some people, and if they don't get to a hospital really quickly after they receive the drug they can be in some real trouble: back to overdose status.
mtkmiss March 22, 2013 at 12:53 AM
In Australia, we pay a "membership" fee, which is very affordable, to our local St John's Ambulance. This means that, IF we need them, they will come, no extra charges. If you haven't paid the membership, you WILL get a bill for the ride. I can't see why EH can't institute a similar policy here. It was a nominal fee $100 or so per person per year, the best part, it was a community saying we acknowledge & will help with the costs. For the frequent flyers, it was in thier best interests to remain members, or be billed "big bucks" I see nothing wrong in the Ambulance squads charging for their services, "Thank You's" are not going to keep them on the road. Perhaps Eh needs to look into this & I wish that they had the power to saying NO to that person who needs to be transported just because he has a hangnail & it hurts. I hope that the person waiting for them to get back from a wasted trip, is not hanging on for life & death..........just saying.
ViralGrain March 22, 2013 at 02:26 PM
Any news on how we can start collecting revenue for medical transport? The volunteer program is awesome. I think it is the best thing we have that unites our community in a healthy productive way. But if we want to be the head of the pack of providing cutting edge Emergency Medical Services, we have to start collecting money and not from just taxes! Our ambulance squads and dive teams should have the state of the art life saving equipment consider the distance and time it takes to get to a hospital. A paid 24/7 Paramedic squad (not EMT) ready at a moments notice is important. When they are dispatched out, a volunteer crew can be notified to report to cover any calls that may come in or for additional support. When the fulltime paramedic squad is back and ready for another call the volunteer squad could be relieved. Val- The police would not have to do anything more then they do now which is to protect and save lives. The only difference is that they would be better equipped to be more effective in preforming their duty and add strength to the EMS. They are usually always the first to respond. An officer on duty per hamlet with EMT training could be compensated for completed certifications and for taking on the added responsibility. If I was a cop I would want to know what to do and have what it takes to save a life. They would only be part of the puzzel in a multilateral approach to save lives. It takes money. The free ride needs to end and insurance companies need to pay up

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