Dutchess County Emergency Medical Services (EMS) Task Force Releases Report on Countywide EMS Delivery

Poughkeepsie, NY…The Dutchess County Emergency Medical Services (EMS) Task Force has released a data-intensive report outlining the current state of Emergency Medical Services (EMS) in Dutchess County.  The report outlines the patchwork system of EMS throughout the county, with local municipalities and fire districts opting for differing approaches resulting in fragmented, inconsistent, and non-standardized service delivery.   Additionally, the extensive data reveals a wide range of cost structures, coverage ability and response times.   The report includes the task force’s immediate, short-term and long-term recommendations to improve and enhance EMS service in Dutchess County.

In 2016, Dutchess County Executive Marc Molinaro convened the 28-member EMS Task Force, comprised of representatives from government, emergency, fire, and education sectors, to identify, develop, and recommend county coordinated solutions for an EMS system that is “patient-centered, consistent, reliable, affordable, and sustainable.”   The Task Force worked closely with Marist College to analyze multiple data points provided by the Dutchess County Department of Emergency Response to identify trends in emergency service requests including population density and geographic location; distance and travel time to area hospitals; inability to respond and use of other agency’s resources.    The compilation of data is unlike any report assembled to date by Dutchess County, and the New York State Department of Health’s Bureau of EMS has expressed interest in replicating this effort in other areas of the state, as EMS service delivery has become a statewide, as well as national, concern.

County Executive Marc Molinaro said, “I thank the members of our Dutchess County EMS Task Force for their commitment and dedication over the past year having compiled a thorough and complete understanding of our county’s emergency medical services. Their recommendations for improvements to service operations will be evaluated carefully and we will move to implement the lifesaving changes we need.”

The task force looked at EMS history and current challenges at the national, state and local level.   There are no federal or state mandates to provide EMS service and there are no dedicated federal and state funding streams, as generally found with other emergency services including law enforcement, fire service and emergency management.    Yet, EMS has become an expected and relied upon public service.  Additionally, there is little to no state or federal oversight and there is a lack of standards or benchmarks for service and care.    In New York, as a home rule state, local agencies and municipalities set their own service standards, creating wide variation in service delivery between jurisdictions, with little to no collaboration or shared service.

The task force assessed local EMS provision by municipality and agency, revealing that EMS is provided by a multitude of agencies including volunteer and career fire departments, volunteer ambulance corps and commercial providers.     Generally, fire districts direct most EMS activity in the county, however local municipal governments are also engaged in contractual relationships with EMS providers.    EMS service agreements range from informal “handshake” agreements (no contract in place) to subsidized and unsubsidized contract relationships that may include partial coverage or 24/7 coverage.   Level of care varies from Basic Life Support Services to Advanced Life Support Services.  The result is the response time to a call and the level of care a patient receives within Dutchess County can vary greatly based on several factors including location, time of day, and day of the week.

Other challenges include increased call volume, diminishing volunteer capacity and rising costs for commercial and career agencies as well as a general lack of public knowledge about EMS.

New York State Assemblymember Didi Barrett (D-Columbia, Dutchess) said, “All of our towns must be able to count on dependable and affordable emergency services which is why our office both urged the launch of and partnered in the Dutchess County EMS Task Force.  The report outlines short term and long term solutions to our county-wide problem and I look forward to continuing to work with County Executive Molinaro, the Task Force, and other stakeholders to engage the public in an open dialogue to implement solutions that work for all our communities."

Based on their findings, the Task Force developed the following immediate, short-term, and long-term recommendations:

Immediate

• Coordination of EMS Provider Education and Training.  Hudson Valley Regional EMS Council has implemented a regional EMS training calendar to provide a coordinated and single source for educational and training opportunities.
   
• Conduct Public Forums and Emergency Service Forums.   Beginning this month, Dutchess County Department of Emergency Response officials will be meeting with members of the Fire and EMS communities to discuss findings and review recommendations.    This spring, DCDER will begin hosting public forums at various locations throughout the county to gather input from the users of EMS, the general public and educate the public on the findings and recommendations of the report.
   

Short-Term
 

• Political and Public Safety Education.   Over the next year, the task force recommends DCDER develop a comprehensive, standardized EMS leadership educational program for local leaders responsible for and/or involved in the guidance, delivery and decision-making of providing EMS.
   
• Establishment of a Citizens Advisory Committee.  Following the public forums and educational efforts, an advisory committee should be established.    The committee’s role would be to:
   
• Identify community and provider expectations for the delivery of EMS
• Provide ongoing education and guidance for local leaders
• Identify models and opportunities for improvement of the provision of EMS
• Explore the need and potential establishment of an EMS Authority in Dutchess County

Long-Term
 

• Consideration of an Emergency Services Authority.  The task force recommends  consideration of an Emergency Services Authority to provide a coordinated solution for the delivery of EMS among its members.  The authority could be created as an autonomous governmental agency, under an act of New York and Dutchess County Legislature, that municipalities and agencies could participate in. The task force recommends a professional consultant to develop a strategy for creating such an authority, including identifying legal requirements, gaining necessary public, political and emergency services community support as well as define powers and organizational structure.

The Task Force members, including the Steering Committee, have committed to continuing to serve throughout 2017 to assist in the implementation of the recommendations and transition responsibility to the Citizens Advisory Committee.

Dutchess County Legislator and EMS Task Force-member Jerry Landisi said, “The Task Force spent many hours carefully evaluating and reviewing EMS operations throughout Dutchess County in order to develop a solid plan moving forward. We believe the report issued represents a thorough examination of services, areas that need to be addressed in order to provide improved and quality service for our residents, as well as sound recommendations to improve service delivery countywide.”

Learn more about the Dutchess County EMS Task Force and view their full report and additional findings.

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The Dutchess County EMS Task Force members, including steering committee members noted with asterisk:

Dutchess County Government
Carol Bogle, Chief Assistant County Attorney
*Cathi Tegtmeier, Director of Health Planning, Education & Emergency Preparedness
*John Mahoney, EMS Coordinator, Department of Emergency Response
*Dana Smith, Commissioner, Department of Emergency Response
 
Citizens
Chris Rohrbach, (LaGrange)
Bruce Cutler, (Red Hook)
 
Municipalities
Dave Kelly, Supervisor, Town of Pawling
*Anthony Ruggiero, City Manager, City of Beacon
Mark Johnson, Fire Chief, City of Poughkeepsie
Dave Shultz, Town of North East
 
EMS
Cheryl Hilbrandt, Captain, Tivoli-Rescue Squad
Patricia Fusco, East Fishkill Rescue Squad
*David Violante, Director of EMS, Arlington Fire District
*Tim Murphy, Union Vale Fire District; President, Dutchess County EMS Council
 
Dutchess Community College
Bernadette Cekuta, Program Coordinator, Dutchess Community College Emergency Services

Fire
Chris Howard, Fire Chief, Amenia
Dewitt Sagendorph, Commissioner, Staatsburg Fire District
*Chris Maeder, Chief, Fairview Fire District
Dan Nichols, Chief, Roosevelt Fire District
 
County Legislature
Kari Rieser
Jerry Landisi
 
New York State Department of Health Bureau of Emergency Medical Services
Richard Robinson, Regional EMS Program Administrator
Kevin Gage, Senior Emergency Medical Care Representative
 
New York State Elected Officials
Senator Terrence Murphy (represented by Ian Miller)
Senator Sue Serino (represented by Anil Beephan)
Assembly Member Didi Barrett (represented by Bill Gustafson)
Assembly Member Kevin Cahill
Assembly Member Frank Skartados

Subject Matter Expert Presenters
Tim Scannell, Vice President and CFO, Mobile Life Support Services, Inc.
Stephen Brucato, Chief of Operations, Greene County EMS Paramedics
PJ Keeler, EMS Coordinator, Columbia County EMS
Dr. David Gavin, Assistant Professor, School of Management, Marist College
William Yellin, Project Leader, Dutchess County Office of Central and Information Services