East End Ambulance Coalition Proposing Paid First Responders Program For Region In 2014

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Ambulance companies from Montauk to Bridgehampton are considering hiring a team of paid first responders, acknowledging an increase in both call volumes and personal responsibilities that keep volunteers from being able to keep up with the need.

Members of the East End Ambulance Coalition, made up of representatives from six volunteer ambulance companies—Bridgehampton, Sag Harbor, East Hampton, Springs, Amagansett and Montauk—say a paid first responder program, beginning in the summer of 2014, would help cut response times.

While the coalition members weigh their options and flesh out a plan, members of the Montauk Fire District are considering a pilot program to bring in a paid responder as early as this summer.

And while the planning continues, the agencies want to better educate the public about what constitutes an emergency and when to call an ambulance, hoping to reduce the number of unnecessary calls.

Under the coalition’s plan, a team made up of three to five paid responders, hired by the coalition, would be dispatched at the same time as one of the six ambulance companies, as a dual response, and render care until the ambulance crew arrives. The plan is to have at least three paid first responders on duty at all times, and as many as five during the busier summer season, providing around-the-clock coverage for the entire region from Bridgehampton to Montauk.

According to coalition member Philip Cammann, a Bridgehampton paramedic and Southampton Volunteer Ambulance EMS manager, members of the coalition recently have been pitching the idea to their respective ambulance companies, but the coalition has been researching and forming a plan since the summer of 2012.

The number of emergency calls the volunteer departments respond to has increased dramatically in recent years. Last year, 14 Bridgehampton Fire Department ambulance crew members responded to 150 calls, 30 active members of the East Hampton Village Ambulance Association responded to 1,300 calls, 30 volunteers from the Sag Harbor Volunteer Ambulance Corps responded to 750 calls, and 15 Montauk EMTs responded to 700 calls.

While the concept of the paid first responder team has been pretty well received by most of the ambulance companies, Mr. Cammann said, the next phase is to work out the financial and operational details. The coalition, which was formed about 25 years ago as a means for the different companies to improve services, likely would pay the crew members, with financial support coming from all six volunteer departments.

Under the plan, each paid first responder would have his or her own fully equipped vehicle, which could cost up to $100,000 each. Mr. Cammann said in the summer, there would be about five cars on the road, and at least two or three of them would be equipped with Advanced Life Support equipment; in the winter, when there would be three cars on the road, at least one or two of them would be ALS equipped. The cost of these vehicles would be amortized over a five-year period.

The responders would work on a per diem basis, at least in the beginning, he said. Current rates for ALS, and Basic Life Support responders is about $20 to $25 per hour, according to Mr. Cammann. He said they would work 12-hour shifts, from 6 a.m. to 6 p.m., so 12 to 15 people would need to be hired.

Mr. Cammann said that the average household would probably pay about $24 per year to help support the first responder program, although much work still needs to be done to work out specifics. He compared it to the Southampton Town Volunteer Ambulance, whose budget is about $550,000 per year. He said the average household in Southampton Town pays about $26 per year.

The six agencies also would recommend candidates for paid first responders. If the coalition fails to find enough candidates from East Hampton Town, Sag Harbor and Bridgehampton, it would then look farther west for help. And because there is a law that prevents volunteers from taking paid jobs within their own departments, the hope is that local volunteers can be assigned to work in a different community as paid first responders.

Mr. Cammann said the move is a way to supplement and improve the quality of medical care. “It’s not the end of volunteerism—this is another asset for the volunteers,” he said. “A perfect example is Southampton Town and to the west—all these agencies in the western Southampton Township and others farther out all do dual response. They have paid and volunteer responders, and everybody works together really, really well. This is a major improvement and advancement for this end of the island.

“Everybody knows we have to make some changes and improve on things. The fact that we’re all working together toward a common goal is the thing that is the driving force.”

While the coalition plugs away this year, forming its plan for the paid responders program, the Montauk Fire District is planning to take matters into its own hands this summer with its pilot program.

All eyes will be on the Montauk Ambulance Company, said its captain, Alan Burke. “We are really the canary in the coal mine,” he said. “The coalition said, ‘Please get it right, because we’re all watching.’ We’ll either have mud or get a gold watch when the summer’s over.”

Montauk’s program, if given the green light by its commissioners, would put one paid Advanced Life Support provider on duty at any time, 24 hours a day, 7 days a week, from June 15 to September 15. The paid responders would work rotating 12-hour shifts.

Mr. Burke said that the pilot program this summer would cost less than $100,000 to run and would not be any cost to taxpayers because the commissioners would likely reallocate capital funds. Those details still need to be worked out, he said, and if the program were to continue in the coming years, it would need to be funded by taxpayers.

According to Mr. Burke, the Montauk Ambulance needs a paid first responder program more than the others because of its small, busy membership and its distance from Southampton Hospital. “When a call goes off, trying to get a crew together takes way too much time,” he said. “It can go up to 20, 30 and sometimes 40 minutes before a call gets answered.”

East Hampton Town Police Officer and Montauk Ambulance Company Lieutenant Kenneth Alversa, who first proposed hiring a paid responder, told Mr. Burke that he watched a man struggle with signs of a heart attack for nearly 30 minutes while waiting for the ambulance to arrive last year. Mr. Alversa responded to the call as a police officer. “He came to me with almost tears in his eyes,” Mr. Burke said. “He thought this guy was going to die right there.”

In the same breath, Mr. Burke said the idea of having to hire a first responder is a bitter pill to swallow within the department. “The Montauk Fire Department is almost 75 years old—we take care of ourselves out here, we’ve taken care of the town. We’ve been strictly volunteer people for almost 75 years, and so when we bring this up, people’s eyes go sad,” he said. “We need it, but it’s killing us to do it. It’s a necessity. Why wait until somebody dies waiting 40 minutes for the Montauk Ambulance?”

And with another summer ahead of them, the Montauk Ambulance and the East End Ambulance Coalition plan to work with local media to get the word out about what constitutes an emergency in hopes of cutting down the number of less serious ambulance calls.

“Sixty-five percent of our calls are nonsense calls,” Mr. Burke said. “Some people actually quit over it.”

It’s not just a Montauk problem—crew members throughout the region say many calls that come in are for non-emergencies, like a bloody nose, or situations that do not require an ambulance and a trip to the hospital emergency room.

“Taking three people in an ambulance company out of service to take your 10-year-old with a broken finger to the emergency room, meanwhile Granny’s having a heart attack—the consumer needs to understand the resources and know how to use them to their best advantage,” Mr. Cammann said. “The point is, you have walk-in clinics for a broken finger, or two or three stitches, or a bad cough that you’ve had for three days. Using a walk-in clinic is good for business and takes a little pressure off the emergency room for real emergencies.”

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