Paid E.M.S. in Springs, at Last
On Monday, just three hours into the very first shift on the first day of the Springs Fire District’s new paid emergency medical service provider program, it had its first success when the department received a call for an elderly woman with chest pains. The paid paramedic on duty arrived on scene with an ambulance within six minutes.
By comparison, just 24 hours earlier, an ambulance staffed only with a basic life support crew arrived 12 minutes after a cardiac arrest call. Six minutes into that call, when an advanced life support provider failed to sign on, the East Hampton Village Ambulance Association sent its paid first responder to its neighbor, on what is known as a mutual aid.
“Our goal is to provide a fast, professional response with the ambulance. Today the driver was here very quickly, and we got out very quickly, and that’s the goal,” David Baumrind, a paramedic who was hired to lead the program, said after he got back to the firehouse on Monday afternoon.
The Springs Fire District, the last holdout on the South Fork, agreed in October to put aside $100,000 in its 2016 budget to fund a paid E.M.S. program to supplement its volunteer department. The district was resistant due to the department’s low call volume — only about 430 a year — and concern about increasing taxes in an area that already struggles with the highest school taxes in East Hampton Town. While all other districts made the shift over the past three years, Springs was struggling to answer alarms and officials in neighboring districts raised concerns over the number of E.M.S. calls Springs needed help with over the last year, a reported 26 percent.
“We really had no choice. . . . We don’t have enough providers,” said Pat Glennon, chairman of the board of fire commissioners. Mr. Glennon is one of two advanced life support providers who shouldered the responsibility of responding to critical calls like heart attacks or strokes. There are also severn volunteer emergency medical technicians. “At first I was resistant,” Mr. Glennon admitted, but he is content with the type of system being implemented.
The program is laid out differently than in most neighboring districts. In Springs, the paid provider may be an E.M.T. or advanced life support provider — a paramedic or a critical care technician who has more advanced training than basic E.M.T.s. The sole provider on duty will respond in the ambulance — with someone else, a volunteer in most cases, behind the wheel — and volunteer E.M.T.s will respond as additional help. The paid personnel will be on duty every day from 6 a.m. to 8 p.m., with the day split into two shifts; 6 a.m. to 1 p.m. and 1 p.m. to 8 p.m. All-volunteer squads currently in place will handle calls on their own between 8 p.m. and 6 a.m.
In Montauk, East Hampton, Amagansett, and Bridgehampton, paid providers certified in advanced life support are on duty 24 hours a day, seven days a week and act as first responders, going to calls in a vehicle equipped with a cardiac monitor, drugs, and other medical tools to begin patient care before the ambulance arrives. Providers work in 12-hour or 24-hour shifts, depending on the district.
The $100,000 Springs put into its 2016 budget for the program only covers salary for the providers. Mr. Baumrind will be paid $50,000 a year. In the coming weeks, the district will hire four to five other providers, who will make $18 an hour — a bit less than in surrounding districts, which pay $22 to $25 an hour. Buying a first-responder vehicle and outfitting it with all the necessary equipment would cost about $110,000, Mr. Glennon said, and the district decided not to do that at this point.
“I think different is okay,” Mr. Baumrind said. “Every community out here is not the same. So to me, it doesn’t seem like every program should be the same. It’s designed to fit the needs of the Springs community, and I think that’s how it should be,” he said. He does not see the lack of a first-responder vehicle as “any sort of handicap.”
“You’ve got to remember, we’re very centralized right here where we are. That’s one of the reasons why we really didn’t bother to look for another site for our tower,” he said, referring to district’s ongoing legal battle over the communications tower it erected behind the firehouse last year. “Where we’re located here,” on Fort Pond Boulevard, “we can get to almost any part of our district in four or five minutes.” The department’s coverage area is only 4.5 square miles.
If an E.M.S. call is time sensitive, for example when a patient is in cardiac arrest or experiencing chest pains or having a stroke, the paid provider can have the houseman drive him or her to the call in the ambulance. The houseman only works from 8 a.m. to 4:30 p.m. Mr. Glennon said he is not worried about the gap because the department has “a good handful of retired or close to retired” volunteers who show up to drive.
Mr. Baumrind will work seven of the 14 shifts each week. However, if there is a call when he is off duty and only an E.M.T. is working or it is the district’s second call and the A.L.S. provider is out on the first, Mr. Baumrind may respond and will be paid for his time. He lives in Springs. In fact, he was a volunteer with the department for about a year, but had to resign to take the position due to a federal law, the Fair Labor Standards Act, that prohibits an individual from being paid and volunteering in the same agency in the same capacity.
While the commissioners had planned to seek the advice of a consultant who specializes in setting up such programs, Mr. Glennon said that never panned out. With the company being located upstate, it became clear to the district, he said, that it was not going to be financially beneficial. At about the same time, Mr. Baumrind expressed an interest in running the program.
“I’m invested in making this work,” Mr. Baumrind said. “I’m passionate about taking care of the community and providing the best care we can . . . grow[ing] a system to provide the type of patient care I would want my family to receive, which is sincere, because my family lives in Springs.”