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There are people, perhaps some politicians that would argue on behalf of private/for profit 9-1-1 EMS in Nassau County.
There is NO question that the current EMS system in Nassau County - from dispatch/assignment right through to disposition can use some work. Some would say that there is a problem, possibly even a crisis, while others will argue that the pre-hospital care providers of this County and the system itself are leading the nation in cutting edge emergency care.
No matter where you stand on this issue, what is the overall opinion about private/for profit ambulances; answering 9-1-1 calls in Nassau County?
Between North Shore/LIJ and whatever buses are run out of the Medical Center - it is possible that augmenting the current system with MORE trucks might benefit everyone. Let's take an area like the Village of Freeport. Let's take for example the Village of Freeport - Freeport keops things as is with both the NCPD EAB units, and the FFD ambulance. But they also contract a private ambulance from NUMC or NS/LIJ.
The Village assigns this ambulance to park at the intersection of Sunrise Highway and Guy Lombardo and instructs them to monitor both the PD and FD frequencies and respond to any call for an ambulance within the Village that they hear. Who's going to stop them?
Now, if the private ambulance is available/in service and they hear a call dispatched within the Village, they go. The FD and/or the PD will respond also, and for the times that private bus is unavailable - the Village still has the resources of the NCPD and the FFD.
As far as a "win/win" - the Village politicians get MORE assurance about the one thing that they really care about when it comes to fire & emergency services ... that when one of their registered voters picks up the phone and dials either 911 or 742-3300, that SOMEONE shows up PROMPTLY. Then, since patient steering is no stranger to EMS in Nassau County ("No, your going to this hospital because that is the hospital that this our fire department transports to."), these for profit units would probably do their best to get the patient's back to the hospitals that are in cahoots, excuse me ... in "cooperation" with these ambulances.
The municipal government continues to provide and most definitly enhances the ambulance service that it is RESPONSIBLE to provide, the hospitals earn more MONEY and the taxpayers don't have to be assessed for more police or fire department ambulances.
"It can't happen." "There's a charter"
There's plenty of true believers out there who think that this could not happen.
If it could be done in a Village like Freeport, why can't it be done in a Town like North Hempstead? Positioning said ambulance at an intersection like Middle Neck Road and Northern Boulevard.
My only problem is that these hospitals are going to get in the buisness of chasing calls to drum up buisness for themselves. However it's worth a shot to help out a system that is overburdened.
Every one keeps using the term private/for profit when using the example of NS/LIJ. NS/LIJ is what is known as a voluntary non-profit hospital.They are non-profit just as the fire service. Why are we so eager to have them supplement our service or even take it away from us If the Nassau County fire service got wise and began to bill for what they have been giving away for free ,the fire departments would have more than sufficient money to hire day-time Paramedics. The argument that we are "double dipping " just isn't true. If it was true for us it would be true for NS/LIJ. Do you think your Federal, State and Local tax dollars don't already go to NS/LIJ. Start billing for all your runs where all the patients have private insurance , Medicaid,and Medicare.When the taxpayers understand the system they will thank you for reducing their tax liability!
There are many billing services that can help with what is called 3rd party billing. Thus allowing departments to charge for ambulance services. I was a member of an upstate department that did 3rd party billing. MVAs were great because no fault always paid. We would then bill the pt's insurance company for regular calls. If after 2 submissions/bills and it wasn't paid the bill was dropped. We never went after people for their money, just the insurance companies. It worked well and the ambulance corp was finally solvent, since we survived on donations only. We weren't even part of a fire district.
I've been hearing people say that for almost 20 years, yet I've never once seen anyone show me a law or point me to a specific opinion from the state saying that.
I'm starting to believe it's like the old urban legend of "you can do that because our insurance company says you can't".
Why would downstare be any different than upstate? Does upstate NY have different laws than we do (at a state level)? I can't see the counties having any laws or jurisdiction over whether a district or fire protection district, both governed by state law, prohibiting this.
I'm not saying you're wrong, I'm just saying that I've never seen anything in writing to back it up.
Quote:
Originally Posted by Keep Back 500 Ft.
In this region of NY Volunteer FD's can not bill for ambulance services. That's the law. Call your politician.
Give me a day or two and I will get what you need. One of the reasons that upstae can bill is because they went to their politicians and showed the loss they were taking. Their donations/taxes do not even touch ours here on the island.
The plain answer is that there's no $$ in 911.... For all the headaches and drama it's hard to get a 'for profit' entity to provide and stay providing services to a public who they 'have no ties' too. That's why (you were there once Signal 12) NYC EMS/FDNY EMS or whatever they are now are having volly hospital EMS units drop like flies from the system.
WHY? Because why should XYZ health care system pay for its units to do 911 calls and x-port them to their hospital when the count/city/volly FD unit would have don it for free!
NS/LIJ has NO interest in 911 in this county and why should they. To deal with all the union crap the PD would give them (since they control the 911 as the only primary PSAP), and they deal with all the voll-iticts (that's politics volly style) out here? All this so that the aided would go to a NS hospital 85% of the time by default anyway?
Any smart guy with half a brain would leave the bickering to the PD & Volly's and just laugh as aided after aided is carted though the ED doors of one of you health systems hospital's with NO $$ invested or spent to get them there.....
There’s no $$ in 911 EMS guys that's why the taxpayers have to ensure funds to keep it a float by billing etc..By taxes or per-transport.
Why don't WE poll our gov't reps to get more 14a's and get more of our volly brothers/sisters GOOD PAYING JOBS near home...the system is already here make it better and benefit the guys/gals who are doing it for free! By getting more PD buses on the road we would need more tech's and 95% of the new NCPD techs are taken from our Nassau county volly FD's...
wake up brothers/sisters and be part of the solution not creating more of a problem!!
There is no prohibition for Fire Depts. billing. the only catch used to be that you had to be NYS certified, which many depts in LI were not,, now that this is no longer an issue, I dont know why all depts dont bill if only to recoup the cost of fuel and supplies....
Fire Districts, on the other hand may be a different story because of the whole Tax thing.....
Now, if the private ambulance is available/in service and they hear a call dispatched within the Village, they go. The FD and/or the PD will respond also
This is dual response, something we're trying hard to limit.
Private for-profit systems are difficult to operate because, as stated, profit margins are slim-to-none if the pt. is not transported back to their own hospital. Several city hospital-based 911 units have been publically accused of patient "steering" over the years.
Although Signal12 has excellent ideas and in theory it's the ideal solution, the real solution lies in fixing what we have now, not totally re-inventing the wheel. Allocate the funds to add another 10 EAB units with 2 techs on board. Have EAB run a fly-car system. Have the FD's put on more paid staff or better yet, go to a squad-based approach where residents that want to do EMS but not be a FF are able to (i.e. Elmont, Port Wash, etc). There are many departments in Nassau that still require all members of the ambulance company to be full Class "A" FF's, something that perplexes me to this day.
There is an untapped resource in every community (homemakers, work-from-home types, retirees, etc)of people that want to volunteer on an ambulance but don't want to go to fire school. Yet we, as a whole and with few exceptions, still have the mindset that EMS is the red-headed stepchild of the fire service. Open it up to the community and I bet you'll see people actually come out and want to be involved. If memory serves me correct, Elmont had a waiting list of people when they first opened it up to the community that you didn't need to be a FF to join. Can you imagine any dept that has a waiting list to get in?
Then once we get them in, we can't break their balls when they can't make every meeting, detail, clean-up, etc. Take what you can get and be happy w/ it. When you join a dept and after telling them you wouldn't be around much for a certain 30 day window when you first join and then they break your balls that, as promised you weren't around much during that 30 day period and missed two company meetings, a dept meeting, a clean-up, and suggest that you resign, blah blah, it makes people say WTF, and bam...they quit.
Until we take EMS seriously from top to bottom, it'll stay this way. Suozzi doesn't take it seriously. And although the Commission is behind us, we need the FD's to start to think outside the box.
Like I mentioned to one of the more senior EMS members on this forum via a private message ... the purpose of this thread is not to advocate and/or promote the privates or voluntary hospitals to get trucks on the road in Nassau. But rather shed some light on the idea that it is possible and that the current system is broken and needs to be fixed.
There is nothing stopping a municipality from contracting out with a private provider and telling them to take jobs off the scanner in a pre-designated response area/district.
The reality is that the NCPD EAB is not as organized as it could be and a good amount of the volunteer fire departments have bitten off more than they can chew when it comes to EMS. Everything from the providers themselves to the ambulances and their maintaince, to the worst problem of them all (on both sides of the fence) ... response times.
Yes, a municipality can contract with a private EMS service as long as that service has a state DOH certificate to operate in that area. The problem is the profit margin as previously mentioned. Its not just the ambulance and crew, its the fuel, supplies, logistics train, liability etc...
Also, federal law mandates hospital based EMS providers to transport their patients back to their hospitals unless directed otherwise by local protocol.
As far as billing, yes volunteer based agencies cannot bill, BUT if they are a municipal based agency (village, town, city etc..) then the municipality can bill for the services...
Private "For Profit" 9-1-1 EMS
If the Nassau County fire service got wise and began to bill for what they have been giving away for free ,the fire departments would have more than sufficient money to hire day-time Paramedics. The argument that we are "double dipping " just isn't true. If it was true for us it would be true for NS/LIJ. Do you think your Federal, State and Local tax dollars don't already go to NS/LIJ. Start billing for all your runs where all the patients have private insurance , Medicaid,and Medicare.When the taxpayers understand the system they will thank you for reducing their tax liability!
