consolidation 3

8/9/2019 Consolidation 3

1/22

Consolidation ofEmergency Medical Services

Our people, our communities

A collaborative effort with the

Towns and Villages of Macedonand Palmyra.


2/22

Goal of the Committee

The goal of the committee is to determineif patient care and cost effectiveness canbe improved through the sharing of 24hour/7 day a week ambulance servicebetween the municipalities of Macedonand Palmyra.


3/22

How did we get here?

Dr. Robert Ike holds meeting for consolidation ofservices between the school district and areatowns and villages.

Committees were formed to review specificareas. e.g.: Purchasing, Human Resources,Ambulance, Highway Equipment, etc.

The ambulance committee currently consists of: Charlie Ziegler, Dave Maul, Vicky Daly,

Ken Miller, David Husk, Chief Dalton,Ron DeMena, and Todd Pipitone


4/22

How did we get here? (continued)

The committee recognized a need forimproved service in areas, and anopportunity to improve in cost-effectiveways.

The Town and Village Boards were askedif they would support a fact-finding study to

evaluate a combined regional ambulance. No commitment or obligation was necessary

at that point in time.


5/22

Committee Work

Review of Call Statistics

Discussion: Agency heads, existing volunteerrepresentatives, WC EMS Coordinator, WC 911

Coordinator Inventory of significant non-consumable assets.

Met with NYSDOH Representative Ross

Zastrow Discussed options available per NYS Health Law

Discuss political and personal impacts of change


6/22

Considerations

Four possible options: Choose one existing entity, to receive the

transfer of otherexistingCONs to it.

Surrender all existing CONs. Form a newagency which would apply for a new CONcovering the larger area. (up to fourmunicipalities)

Two villages merge their CONs to one thatcovers both towns. (Town of Macedon CONremains unchanged.)

Do nothing; leave things as they are.


7/22

Examination of Options

Choose one existing entity, to receive thetransfer of otherexistingCONs to it.

The Town of Macedons CON cannot betransferred to any other entity. (NYS Department of Health Policy 09-01)

Therefore under this option, the Town of

Macedon could only be the recipient oftransferred CONs.


8/22


1. Surrender all existing CONs. Form anew agency which would apply for a newCON covering the larger area. (up to four

municipalities) This process would be much more time-

consuming and expensive than #1.

The Town of Macedon CON just became

permanent after a lengthy process, and itsoperating model is successful at this time.


9/22


1. The two villages merge their CONs toone that covers both towns.

The existing operating models (callcoverage, financing, ALS coverage, ) donot seem to offer a much improved resultover existing conditions.


10/22

Examination of options

4. Separation from fire department and hiring onone BLS employee. would still require the Department to rely on the

County ALS to both provide advanced life support,and provide a medic when the agency could notsecure a driver. (county ALS cars are not dedicated

just to one area)

If there is just one staff member hired the agencywould need to get a volunteer driver. If no driver isavailable the paid staff member would be driving forthe County Fly car; if this happens the agency cannotbill (except for mileage.)


11/22


5. Leave things as they are. The existing operating models (call

coverage, financing, ALS coverage, ) do

not seem to offer a much improved resultover existing conditions.

This sacrifices an opportunity to vastlyimprove patient care, while realizing

economies of scale associated withcombining equipment and personnel towarda common goal.


12/22

Recommendation

Option 1 to have the two villages transfer their CON to the

Macedon Town Ambulance.

Why? Currently have a full 24x7 coverage.

Minimum of 1 EMT and 1 Paramedic on at all times.

Enhanced by solid volunteer framework.

Ready to extend coverage to the other geographicareas without interruption of service.

All aspects of operation are in place: billing, staffing,and oversight.


13/22

Area to be covered

If one of the municipalities decides not to participate, wewould either exclude that region from the CON, or wewould abandon the idea altogether.


14/22

How it could work

Villages of Macedon and Palmyra wouldtransfer their CONs to the Town ofMacedon. Completed through paper work provided by

the NYS Department of Health.

The Finger Lakes Regional Council votes to

approve or disapprove the transfer. The process takes approximately 3-4 months.


15/22

How it could work

Needs of the agency (capital assets, etc.)would be studied and those needed assetswould be transferred to or purchased by

the Town of Macedon

Crews would be formed with both paid andvolunteer staff

A study will be completed to determinelocation and number of crews needed


16/22

Possible Organization Layout

Crews of EMTs and Paramedics formedutilizing both paid and volunteer staff.

Daily operations would continue to be

handled by the Director of EMS anemployee of the Town of Macedon.

Revenue generated from billing would go

into line item account managed by theTown of Macedon.


17/22

Cost of Start up

There is a cost to start up the expansion ofEMS Where can this funding come from?

Grants are available for this type of consolidation

Contribution payments in cash or in-kind fromparticipating municipalities

With 3rd

party billing the goal would be tohave operation at little or no cost to thetaxpayers.


18/22

What are the costs?

Estimated start up cost $ 127,000 for the first year.

This number is an estimate and a final number

would be determined by the municipal boards.

Cost includes staffing and day to dayoperations.

Review of the system will be conducted todetermine cost vs. revenues and the need forongoing contributions.


19/22

What are the cost for staffing?

The cost for the Town of Macedon to staff one24hr/7 ALS ambulance is $250,000 per year

The cost to hire your own staff

One BLS technician five days a week 8hs/day $10.50/hr X 2080 hours total=$21,840.00

X 35% benefits = $29,484.00

This is just one person eight hours a day five

days a week. Excludes all other costs associated with

operation of the services.


20/22

Benefits

Reduction in ambulance response times

24hr/7 day a week coverage

Paid staff ensures consistency throughout the

agency Economies of scale; lower cost and more

reliable service for all municipalities involved.

3rd

party billing puts us on a path towardreducing tax burden for ambulance service.


21/22

Recommendation

Provide 24/7 professional ambulance service to ourcommunities

Have Village of Palmyra and Village of Macedon transfertheir CON to the Town of Macedon

MTA is only ambulance service that provides 24/7coverage staffed at all times in our two communities

Minimum of 1 EMT and 1 Paramedic 24/7

Enhanced by solid volunteer framework Ready to extend coverage to the other geographic areaswithout interruption of services

All aspects of operation in place:billing,staffing,oversight


22/22

Our people, our communities

consolidation 3

Documents