By Diane Pineiro-Zucker
KINGSTON, N.Y. — Providing emergency medical services to the city using existing fire department personnel and ambulances is “not sustainable long term” and the Common Council will meet later this month to discuss “a plan for hiring,” Mayor Steve Noble said Thursday.
Ambulance services will also be on the agenda Wednesday, Jan. 10, when the Finance Committee meets, he said.
“The first phase of this program will be detailed to the Common Council at the Finance Committee next week. As I have mentioned, this program was launched out of immediate need to ensure there is no interruption of EMS service for our residents. Currently we are running ambulance service with existing staff but that is not sustainable long term. When we meet with the Common Council later this month, we will discuss a plan for hiring,” Noble said in an email.
“In the long term, we hope this program will bring in revenue through insurance billing that will meet the additional costs necessary but that will not be able to be determined until we have completed the Request for Proposals for an insurance billing company and they provide revenue estimates based on current call volumes,” the mayor continued.
Until a contract is signed with a billing company, however, it remains unclear “how/if to bill the insurance companies for the transports to date, as we will need to discuss that with the actual company we choose,” Noble said.
As of Wednesday, Kingston’s municipal ambulance service, which launched full-time operations using Fire Department ambulances and staff at midnight Jan. 1, had taken 24 patients to HealthAlliance Hospital, Noble said.
Patients without insurance will not be billed “directly,” the mayor said. “For us, this is an important public service and so billing for these services is not a focus of our efforts at this time and we will be serving everyone regardless of their ability to pay.”
Until a medical billing company is onboard, Noble said, he could not anticipate whether patients with insurance will be billed for services that are in or out of their insurance companies’ networks. “We won’t have answers to those questions until we have the medical billing company onboard, however, I have stated that we are going to serve everyone regardless of their ability to pay,” he said.
Until more staff is on board, Noble has said the current fire department budget “will handle any overtime costs that might arise and so no additional funding is needed until more staffing is hired.”
On Jan. 1, the city’s Fire Department replaced Empress EMS, which took over in June when it purchased Mobile Life Support Services, the company that had serviced the city until then.
The city has “three paramedics and over 50 EMTs in the fire department, all with extensive training,” he said last week. He said that most calls “require a BLS (basic life support) unit and so that was generally what we saw used here in Kingston. We believe two ambulances will meet most needs here.”
The move was a response to Empress’ requirement for the city to enter into a paid contract where city taxpayers would have been required to contribute between $500,000 and $1 million annually beginning Jan. 1 depending on whether it chose to contract for Basic Life Support (BLS) or Advanced Life Support (ALS) services, Empress EMS’ executive director Robert Stuck said.
For the most part, Stuck said, the city’s plan should meet its needs. He said Empress will continue its Cornell Street operations and, “Obviously, we had a lot more units in the area and we’re still going to have the same amount of units in the area.”
Kingston has one ALS unit and one BLS operating in the city of Kingston out of Central Station. The city’s Mobile Mental Health ambulance will serve as a backup BLS unit, officials said. The Mobile Mental Health Program will continue to run Mondays through Fridays from 10 a.m. to 6 p.m., officials said.
A letter sent Tuesday, Jan. 2, to the Freeman by Alanna Badgley, of New Paltz, president of the International Association of EMTs and Paramedics (IAEP) Local R2-20, which represents EMTs and paramedics who work for Empress, said the city was asked by Empress “to subsidize the cost of the high-quality healthcare and services we provide.”
According to Badgley, “Insurance reimbursements do not cover the cost of ambulance readiness. Every community must therefore invest in this service if they expect it to be provided.”
Badgley said communities “are unlikely to beat the costs quoted by Empress without either lowering the standard of care provided or lowering the wages of the practitioners providing it, which are already low to begin with.”
The letter from Alanna Badgley that is referenced in the above article can be found in full below.
January 2, 2024
To The Editor:
For too long, our governments— local, state and federal—have shirked their responsibility of providing people high quality, out-of-hospital health care. Emergency Medical Services (EMS) are not deemed to be an essential service or critical infrastructure by New York, and most towns and counties in the state spend $0 annually to fund EMS. At the same time, they invest millions in fire and police services. Yet, there is a public expectation that all three services will be equally available when you call 911.
This disparity in public resources has led to inequalities in the viable career paths available to first responders. Nationwide, there is an average annual EMS turnover rate of 30%, with most of our personnel leaving for other careers in healthcare or first response.
At Empress EMS, we have a strong union— IAEP Local 20— which has made incredible strides in the last few years to negotiate for the long-term wages, benefits and professional support needed to create a viable career within this field. This enables us to focus on providing high-quality medicine to our communities. Our members have decades of combined experience as medical practitioners and are the experts in pre-hospital medicine in this region.
Empress asked the city of Kingston to subsidize the cost of the high-quality healthcare and services we provide, which supports the livelihood of those who work here. Insurance reimbursements do not cover the cost of ambulance readiness. Every community must therefore invest in this service if they expect it to be provided. And communities are unlikely to beat the costs quoted by Empress without either lowering the standard of care provided or lowering the wages of the practitioners providing it, which are already low to begin with. It is in the best interest of our communities to have those specialized in medicine responding to medical calls.
The members of our union live in these communities and want to continue to use our decades of experience to serve you well. It is up to our local governments to support us in doing so by properly funding the essential service that we alone can provide at the quality the residents deserve.
Alanna Badgley, IAEP Local R2-20 President