LEGISLATURE STUFF - Financial Nuts and Bolts

CATSKILL  - Getting down to the fiscal nitty gritty of forming a unified ambulance system is continuing for the Greene County Legislature.

Lawmakers are hosting a series of meetings focused on the possible creation of a countywide organization, eliminating municipal units.

Two sessions have taken place following an appeal from mountaintop town and village officials, in the late fall of 2023, to help facilitate what was seen as an inevitable shift in emergency medical services.

An outside consultant was brought in to assist in the effort and a general consensus has been reached to move toward a single network.

Many financial and operational details need to be ironed out prior to then, a process that may call upon the same consultant, Fitch and Associates.

In the meantime, and in synch with the consultant’s study, an intense in-house gathering of facts and figures is underway by local ambulance administrators and EMS experts.

Their information is slated to be shared at the next sitdown of county and municipal leaders, March 12, following postponement of a scheduled February 12 assembling.

“This is going to boil down to how much money it will take to get this done,” legislature chairman Patrick Linger says. “Whatever that number ends up being, we need to find a way to make it work.”

As an example, Linger explained, “the Fitch group has determined we will need nine-and-a-half equivalent ambulance crews” to properly cover the entire county during any 24-hour period.

“Our local providers think that isn’t enough, that we will need as many as  twelve,” Linger said, taking into account on-the-ground realities such as busy ski weekends, mutual aid and unforeseen major incidents.

“So what does that mean in terms of the number of ambulances that will be required?” Linger said. “And where will those ambulances be located? What will be the hourly schedules for workers?”

It is widely acknowledged the countywide system must include significant changes in employee wages and benefits, along with what will be essentially a buyout of existing municipal rigs, equipment, etc.

Another key issue is the total hours employees will be allowed to work. Current workers bundle nearly two 40-hour weeks into one.

While they say it is necessary to make household ends meet, it is also widely acknowledged not to be an ideal or desirable situation.

And due to industry-wide shortages of paramedics and EMTS, it is not uncommon for someone to be on-duty 24 hours straight.

“I don’t want to be the guy having a heart attack and the medic who shows up is in their 24th hour,” county administrator Shaun Groden says, emphasizing it is not a matter of inability but rather, fatigue.

Linger and Groden have emerged as the visible and vocal momentum behind the movement toward the countywide system.

They both remember a similar initiative that unfolded seven years ago, coming to the precipice of being put in place before fizzing out.

“I believe, based on many conversations, that people are willing to pay for good ambulance service,” Linger says.

“Ultimately this will be a vote of the legislature,” Linger says, not leaving it up to town and village officials as in the previous thwarted initiative.

“We have set an aggressive schedule,” Linger says, tentatively shooting to have the transition completed as early as the beginning of next year.

“If we took a vote now, I believe it would pass but we feel it is better to have an absolute consensus before we move ahead. We want to do this once and do it right,” Linger says.
Groden says the in-house committee of fact-finders includes longtime paramedics, EMT’s and ambulance administrators, the folks in the emergency medical systems trenches.

The plan is to huddle with them at the county emergency operations center in Cairo leading up to the March 12 gathering of government officials.

“My hope is to hammer out these details and present them to the larger group at the March meeting,” Groden says.

“Right now we operate with the [Greene County Emergency Medical Systems] flycars and a basic life support system,” Groden says.

The flycars deliver paramedics to the scene of a call but do not provide patient transport to a hospital, handled by municipal squads.

Both systems are ultimately financed by taxpayers, whether through county or town tax payments, and those costs will be impacted by any changes.

“There are many questions right now,” Groden says. “Do we stick with the flycars, having the [transport] rigs coming [to the scene] afterwards?

“Or do we drop the flycars and combine everything? If we keep the flycars, who owns that system” (currently operating as a non-profit entity)?

“Then we need to discuss shifts,” Groden says. “Do we do 8-hour shifts or 12-hour shifts, like our sheriff’s deputies and county dispatchers?

“And we need to decide an acceptable response time [getting to the scene], and how that response time, within X number of minutes, impacts the total number of ambulances we need which impacts the cost,” Groden says.

“When we started this process, we set a 6-month goal to have a plan,” says Groden. “Implementing that plan is a whole other discussion so we don’t want to waste any time.”