Hornell Mayor John Buckley addresses shortage of services
BATH – There is little worse for a Steuben County 9-1-1 dispatcher than hearing a terrified person gasping out their urgent need for emergency services. Unless it’s trying to reach one of the many short-staffed volunteer ambulance companies throughout the 1,391-square-mile county unable to respond because everyone from the agency is at work.
According to protocols, the dispatcher tones out for service every three minutes for 9 long minutes or calls for mutual aid from another nearby short-staffed volunteer group. Under dire circumstances, the dispatcher then sends a paid unit, funded by the host municipality or a private company with limited ability to recoup the cost.
That worsening situation, fed by the retirement of older trained volunteers who in turn require more emergency responses, and potential volunteers’ jobs and family needs, is now under review by the county Legislature. “We’ve got to do something,” said county Legislature Chairman Scott Van Etten, R-Caton during a recent special legislative Public Safety and Corrections Committee. “It’s only getting worse.”
For municipalities who rely on their paid ambulance and fire services the problem has an added – and expensive – cost. “We’re not going to say we’re not coming,” Hornell Mayor John Buckley told the committee. “We can’t do that.” Hornell’s units respond to calls from as far away as Canisteo, Greenwood or Jasper – adding precious time to the response, an unexpected cost for the patient, and potentially removing a service in the city. Paid corps from Bath, Cohocton Valley and AMR in Corning also respond to calls outside their areas when volunteers are unavailable.
Yet paid assistance outside is too often not reimbursed. Patients don’t expect to be charged since they think they’re calling for unpaid volunteers, Medicare and Medicaid reimbursement is meager and many people in the outlying regions are uninsured or underinsured. “They don’t know they’re going to be charged until they get the bill,” said county Legislator Fred Potter, R-Troupsburg. “It’s getting so their question is ‘When do I call an ambulance? When do I not?’”
Volunteer ambulance services also are hampered by state requirements for training, an essential element in providing care yet poorly compensated by the state, according to Michael Pirozzolo, head of the Regional Emergency Medical Services Program agency EMSTAR.
The issue is being faced across the state, he said. One answer may be contracts between municipalities providing paid response, and the municipalities benefiting from the paid medical staff. Hornell has a contract with the Town of Hornellsville, which also includes the villages of Arkport and North Hornell, Buckley said. Yet other municipalities across Steuben are reluctant to budget for paid services, in part due to their need to train and buy costly equipment for their volunteers. Pirozzolo told the committee the time it takes for an emergency medical responder to the scene is critical to the recovery. He said county Sheriff Jim Allard’s program of training deputies to be certified Emergency Medical Technologists has been a literal life-saver — but that’s not their primary mission. “They’re on duty, they’re often first on the scene,” he said. “They have saved lives.”
But more needs to be done to facilitate rapid response and the inequity of costs, Van Etten said. “You’re paying $2 million a year, and the other areas are getting it for free,” he told Buckley. “That’s not right.” Paid emergency organizations are facing a line they do not want to cross, Buckley told county legislators. “We have the staff, the equipment, we’re happy to do it,” he said. “But other municipalities need to do something to offset the cost as City taxpayers cannot continue to subsidize neighboring towns and villages.”