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Ambulance Study for Town of North Hempstead Concludes: “In Spite of Complexities, the System Works”

An independent study of ambulance services in the Town of North Hempstead that was funded through a $180,000 grant from New York State in 2007 has concluded that “the current system works.” In fact, local ambulance providers, affiliated with volunteer fire departments, beat the average response time in New York State by two minutes.

Further, local providers have major resources, such as well-trained committed volunteers and up-to-date equipment, because revenues for fire and ambulance services go directly toward enhancing those services.Great Neck’s local ambulance services, provided by the Vigilants, Manhasset-Lakeville and the Alerts, also have the advantage of knowing the community intimately. They are aware of the idiosyncrasies of local traffic patterns, one-way streets, poorly marked street numbers and the like; they know the shortcuts to take if traffic is blocked. Drivers know that even GPS devices can lead one astray and in life threatening emergencies, minutes lost can make a difference in outcomes.

There is no question that the current system is complex and is best understood by the responders themselves. There are 13 separate agencies that provide ambulance services to residents of the Town of North Hempstead. Eleven are volunteer fire departments, one is a volunteer ambulance corps, and one is based within the Nassau County Police Department.

There is also consensus among the service providers that there are challenges that are stressing the volunteer system, namely recruiting volunteers and responding to non-emergency calls.

Dispatching in Great Neck

In an emergency, the number you dial can make a difference. If 911 is dialed, the number is routed to the emergency system under the police department and if one is served by the Vigilants, the call is “handed off” to them. If one dials 742-3300, those calls go to Nassau County Fire Commission (FireCom) which also “hands off” the call to the Vigilants. It saves time in a real emergency if the call is made directly to the Vigilants at 482-5000. Vigilant serves as the primary EMS and ambulance service for the peninsula. (Great Neck Alert is certified to provide basic-level emergency medical services.)

If served by the Manhasset-Lakeville Fire & Water District, the situation is different. It services a huge area, some 10 square miles. It is not part of the County 911 system from 6 a.m. to 6 p.m. on Monday through Friday. While MLFW has two ambulances and reports that 30 people are involved with ambulance services, it pulled out of the 911 system during the daytime hours because of the high volume of non-emergency calls it was receiving. Residents calling 911 for an ambulance during the week will have a response from the Nassau County Police Department’s ambulance service.

Still, MLFW is one of the busiest departments in the community. In 2007, it logged 570 ambulance calls in the hours it covers.

Money Matters

Volunteer fire and ambulance services are funded by villages and the town. Great Neck households pay, through their village or town taxes, $40 a year on average for ambulance services. Negotiations for the services are under way among the various parties right now. It is no secret that villages and the town are trying to hold the reins on raising their taxes and that they are looking to pare every expense, every dollar possible from budgets. There has been a long-standing push by some officials to “encourage” ambulance providers to try to recoup money for ambulance runs from insurance companies.

The snags are many.

First, under state law, volunteer fire departments may not charge for their services. But, as the study points out, there are ways around the laws. One option is a “spin-off” whereby, ambulance services could, “on paper only” divorce themselves from the fire companies. They would still share space, equipment and volunteers (some ambulance volunteers are also fire fighters), but they would be a separate legal entity and could attempt to collect insurance money for their services.

The Nassau County Police Department ambulance service collects about $20 million a year from insurance claims. At the public meeting, Joel Bearman, a director of the Association of Fire Districts of Nassau County, noted that the money collected goes back into the general coffers of the county and is not spent to add personnel or equipment. He stated that if the county spent some of that money for increasing personnel and equipment, it would alleviate many of the pressures on the volunteer systems that handle the county’s overflow of calls.

The study states that revenues from “cost recovery” from insurance collection could amount to some $2.8 to 3.2 million a year. These were gross figures, however, and did not account for administrative costs.

Even if state laws associated with this matter were repealed or “spin-offs” could be accomplished, there has been a serious push back from fire departments on this matter. Volunteers for fire and ambulance services go through extensive training and dash from home and work to save lives and property. In discussions over the years with the Record, they have made it clear that they do not want to get involved in the paperwork and hassles associated with filing insurance claims.

Although initially the study was greeted with skepticism by the local providers, the people working in most of the fire companies and ambulance services cooperated with the researchers so that they would have correct information about what exists currently.

Supervisor Jon Kaiman applauded the findings of the study and explained that he hoped that the Project Independence program run by the town and its provision of taxi services for seniors could be part of the solution for reducing the volume of non-emergency calls received by the fire departments. Both the supervisor and the fire/ambulance representatives believe that public education on the topic of “what constitutes an emergency?” would be advantageous. For example, a free ride to a doctor’s appointment does not require an ambulance or emergency personnel.

The study was conducted by the Center for Governmental Research led by Joseph Stefko, Ph.D. in partnership with Hofstra University led by vice-president for business development Richard Guardino, Jr. The baseline review was presented at a public meeting on July 29 to a roomful of mostly representatives from fire departments in the town and local officials.

The study did not make recommendations; rather it presented various options that the town, local officials and fire companies might take while presenting the pros and cons of each option. The Town of North Hempstead and the Village of Great Neck Plaza applied for the $180,000 grant.