By Shane M. Liebler, Senior Editor
At South Lockport, the side of the rig promises the fire company is “Fully Staffed by Professional Volunteers.” While recruitment difficulties common to all of the volunteer fire service these days challenge the “fully staffed” portion of that mantra, the statement is emphatically true. And on the EMS side of the South Lockport operation, those professionals are in trouble.
“South Lockport Fire Company is funded primarily by donations and taxes. The Town of Lockport is only paying us for fire protection, so our emergency medical services are outside the budget,” AEMT Kenny Allore says. “My biggest concern is that in order to provide EMS, it’s deficit spending on our part. Eventually it’s going to become extremely difficult for us to maintain our standard level of care.”
Volunteer fire departments have a unique distinction in that they are not required to provide emergency medical services. In most if not all cases, it’s simply a historical obligation.
“It’s the right thing to do,” Allore says. “We are in the business of protecting our community in whatever capacity that may be.”
But a law that dates back to 1957 (eight years before Medicaid and nine years prior to Medicare) prohibits those volunteer fire departments from billing for emergency medical services. A new law recently passed by the State Senate and currently before the Assembly would change that. Volunteer fire departments have said for decades that it’s long overdue in the only state that still does not allow EMS billing by these entities.
FASNY has long argued that state-mandated training requirements and costs have continuously increased while insurance coverage has just as dramatically improved. On the surface, the “Fair Play” Cost Recovery Bill makes perfect sense, but there are other lobbies at work in Albany.
Commercial ambulance organizations say allowing volunteer fire departments, which make up nearly half of all EMS in the State, to bill would affect their ability to provide services. Under current statutes, they can bill for all services on a call that involves both commercial and volunteer ambulances. The Fair Play bill would simply allow volunteer fire departments to bill for their portion of the services in these cases, which are common. Volunteer fire departments that answer some 297,000 calls annually are missing out on more than $100 million each year, according to a 2018 study.
“If this bill passes, we could stop raising taxes and maybe even lower taxes because the offset of costs would be from billing the insurance companies instead of always asking the taxpayers to foot the bill,” says Chief Johnathan Eck of the Selden Fire Department on Long Island. In his jurisdiction alone where they answer 3,000-plus calls billing would amount to more than $1 million.
That’s money that could be used to finance the $275,000-plus rigs that need replacement every other year, not to mention the costs of training that amount to tens of thousands of dollars each year.
“These commercial agencies that are making the argument that we’re basically going to be cutting into their bottom line – quite the inverse is true,” Allore says. “The commercial companies are overextended as it is, so by allowing us to bill and maintain our current standard of care or even improve it, it’s only going to be helpful for the community as a whole.
“We’re not trying to turn a profit, we’re just trying to cover our costs,” he says. “A commercial agency only has so many resources. If the call volume is as such where you have to wait 15, 25, 45 minutes for response, a matter of minutes can make all the difference.”
The COVID-19 pandemic has only made the already fragile financial status worse, especially in the Selden community just outside of New York City.
“The stress it puts on our staff is probably the hardest it’s ever been,” Eck says. “When COVID hit, it was determined we need PPE to protect ourselves, so not just the gloves and the face shields, but we had to wear masks, had to wear gowns, had to wear Tyvek suits, which we did have, but in limited supply.
“When we tried purchasing more of it, we saw that the prices went up,” he says. “It’s such a big cost for this pandemic and how are we going to pay for it?”
It’s hard enough to maintain the basic life support level of service, according to Allore. Companies like South Lockport have already had to drop from advanced to basic life support units. For some others, the outcome has been far worse, as they’ve discontinued service.
“Eventually we’re not going to be able to sustain it, we’re not going to be able to maintain our equipment, we’re not going to be able to maintain our ambulances, which is going to result in a decreased response time and the level of care for the community as a whole,” Allore says. “Resources are already stretched thin. I’m concerned if this bill is not passed, that’s only going to get worse.”
It’s certainly a possibility with more than 75 EMS operators closing up shop between 2006 and 2017.
“All we do is raise taxes. People can’t keep covering that,” Eck says. “All we’re going to do is keep losing people and if people keep leaving the State and we’ve got no one to tax, then we’re not going to be able to supply a service.
“Help the volunteer system. The volunteer system needs help,” he says. “Not only does it help us as volunteers, but it also helps the public.”