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Post by firstamendment on Jun 30, 2011 21:25:09 GMT -5
Anybody have email addresses for City Council members? I think it would be a good idea to forward Larry's link above to them.
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Post by bobbbiez on Jun 30, 2011 22:48:40 GMT -5
Anybody have email addresses for City Council members? I think it would be a good idea to forward Larry's link above to them.  Huh, Larry might be in jail after he and the Mayor went at it today. The last thing I saw on the news tonight was the Mayor asking where the police officer was when he was arguing with Larry.  |
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Post by bobbbiez on Jun 30, 2011 23:03:46 GMT -5
I don't have a dog in this fight but I will try. The state of New York has determined that in order for a health care provider to provide a new service or service in a new area that provider must demonstrate that there is a need for another provider of that service. This doesn't apply just to ambulance services. Faxton-St.Luke's cannot offer heart surgery because the program at St. E's is sufficient for the area. Each hospital and nursing home has a fixed number of beds that are licensed. The same applies to ambulances. In order to get a certificate of need Utica would need to show that the area needed additional ambulance service. Unless there were a lot of calls which were not answered in a timely manner, it's difficult to show this. From everything I've read, the city did not even attempt to show that three more ambulances were needed in the city. So far their response seems to be to thumb their nose at the law and in effect say "bite me." I don't think this is a winning legal argument. CB, I understand that part, but setting that aside, why do some think it's a bad idea since as I explained the UFD is the first responders at a scene anyways. They can treat the people but without their own ambulance they can not transport the injured or the sick person. Just seems ridiculous to me since the UFD is there anyways then why not have their own ambulance?  |
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larry
French Fry
Posts: 169
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Post by larry on Jul 1, 2011 0:01:00 GMT -5
Anybody have email addresses for City Council members? I think it would be a good idea to forward Larry's link above to them. Huh, Larry might be in jail after he and the Mayor went at it today. The last thing I saw on the news tonight was the Mayor asking where the police officer was when he was arguing with Larry. BZ, not a chance. If anyone should be in jail, it's the mayor. Ask Jim what happened. These guys are literally out-of-control. They think they can act as Gestapos whenever someone dares disagree with them. The guy from Syracuse couldn't believe what he saw. He said he felt like he was in a twilight zone. |
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Post by bobbbiez on Jul 1, 2011 0:54:56 GMT -5
Huh, Larry might be in jail after he and the Mayor went at it today. The last thing I saw on the news tonight was the Mayor asking where the police officer was when he was arguing with Larry. BZ, not a chance. If anyone should be in jail, it's the mayor. Ask Jim what happened. These guys are literally out-of-control. They think they can act as Gestapos whenever someone dares disagree with them. The guy from Syracuse couldn't believe what he saw. He said he felt like he was in a twilight zone. What the hell happened?  ? The news only showed it briefly. Did ya come to near-blows? It looked that way. Boy, did he look pi**ed and cried like a baby for an officer.  |
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Post by longtimer on Jul 1, 2011 4:29:25 GMT -5
bobbbiez, there is absolutely no advantage to having the UFD transport the patient over Kunkel. If an engine company responds and are the first to arrive and start treatment they have to hand the patient off to the UFD ambulance personnel to be transported. The same thing happens with Kunkel. The whole continuity of care issue is a bunch of bull concocted by Brooks and company. A report is given and care is transferred. This is the same thing that happens with every volunteer fire company outside the city and there is no problem with that process.
I think I read that you were a nurse so you are familiar with reporting off, it happens every shift in every hospital and nursing home in the country.
It would be nice if the OD would actually do some investigation to find out exactly what happens at the scene of most calls and compare what happens in the city and outside the city. I believe they would find those outside the services of UFD do just as well as those in the city with the only difference being the actual transport time to the hospital. That of course can be a major factor in critical cases but has nothing to do wit the care givers or the fact that the care was handed from the fire department to the ambulance.
Of course that would take some actual reporting so we will never see that but I can dream..
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Post by firstamendment on Jul 1, 2011 8:51:42 GMT -5
Typically during shift changes they call it giving report, or similar. Police do it, nursing staff does it, possibly fire staff. It is a very important part of continuity between shifts to communicate what has transpired to the incoming staff.
The City's contention with regard to continuity of care is that their personnel is on scene already and will continue care during their transport to the hospital. Their notion that by them having their ambulance at every call there is no hand off to a different ambulance staff for transport. While this additional transfer may be avoided, it is a scare tactic that a patient is under a lower level of care whether it is UFD or Kunkel mananging the patient on the way to the hospital. And as I've said on the OD, if continuity of care is such an issue, why not have the City start its own hospital that way each patient stays in the care of the same provider?
By intentionally or unintentionally giving the appearance that they provide better care is impossible to quantify. It is also highly misleading. EMT's, paramedics, etc all have to meet the EXACT same state standards for their applicable roles. I used to hold an EMT Basic certification. My reason for doing so was that it is a requirement to have it in order to be on the UFD. That was my goal, some 15+ years ago. Having that certification allowed me to work for Kunkel or any other ambulance service had I wanted to, but that was not my intent.
And again, I'm not knocking the professional staff of the UFD and I certainly have no axe to grind with them. It is just a matter of fact, they, just like Kunkel staff have to pass the same State requirements so the question of quality of care is not an issue. It is puffery if you ask me.
The City's justifications are not founded on the applicable provisions of law. And that is what matters.
Also, if you take a look at the pdf document of the DOH letter, they outline nicely the timeline of events. Notice how the City applied for a CON with the Regional Council but at the same time filed suit in court that they felt they were exempt from being required to get a CON. Interesting. That tells me they knew there was no public need and knew their application would be denied. The suit claiming they were exept was a hail Mary and it failed because the law seems pretty clear.
I can't wait to see someone finally approach them about how they CAN'T profit from the service. Sounds like the beginning of a Class Action lawsuit against the City for INTENTIONALLY ripping people off.
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Post by Clipper on Jul 1, 2011 9:14:36 GMT -5
One thing I don't understand about the Certificate of Need thing is this. If Kunkel doesn't want any competition, is it as simple as insuring that he has enough ambulances and personnel to virtually monopolize the "market" for service? If so, the process is very flawed, and should be looked at. I read it as saying that unless there are calls that go unanswered because there is not an ambulance available, there is no basis for another ambulance service to be allowed to enter the "market". ( I use the word market for lack of another word)
Regardless of whether the city's prices are higher right now, it seems that if there is only one service available, they would be able to demand whatever price they want aside from limits paid for by insurance etc.
One should remember, Kunkel was never "chosen" to be the city's only ambulance. They became such by default when other commercial ambulance services ceased to operate.
A fair process would allow for at least TWO ambulances to be available to be chosen by the person needing the service, or to be dispatched on a rotation.
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Post by longtimer on Jul 1, 2011 9:28:51 GMT -5
I have never seen any of the engine company staff go in the ambulance and ride to the hospital. Now I have only witnessed about a dozen incidents in over the last several years so I admit it is a small sampling and I am would not be shocked to find that in a very few extreme case it has happened. I did work at at the hospital it was not the norm for the engine staff to arrive with the ambulance so a hand off from those first responding to the ambulance staff is taking place anyway. The whole thing is just a false argument.
To be clear about my earlier statement, I do not want to imply that anyone is superior to the UFD EMT's, just that I have seen nothing to indicate they are better than Kunkel, Edwards or volunteers who have achieved the same level. The UFD guys are very competent, as are all the others.
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Post by bobbbiez on Jul 1, 2011 14:02:27 GMT -5
bobbbiez, there is absolutely no advantage to having the UFD transport the patient over Kunkel. If an engine company responds and are the first to arrive and start treatment they have to hand the patient off to the UFD ambulance personnel to be transported. The same thing happens with Kunkel. The whole continuity of care issue is a bunch of bull concocted by Brooks and company. A report is given and care is transferred. This is the same thing that happens with every volunteer fire company outside the city and there is no problem with that process. I think I read that you were a nurse so you are familiar with reporting off, it happens every shift in every hospital and nursing home in the country. I just don't see the benefit why there has to be a "hand-over" when the UFD is the first responders on the scene anyways. BIG difference in taking a report in a shift change in a hospital, nursing home or whatever to an emergency situation. Time is essential and precious in saving a person's life.  |
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Post by stoney on Jul 1, 2011 14:13:16 GMT -5
I think the fire dept. or police, as typically are the "first responders", should continue to perform whatever life-saving technique is necessary until an ambulance shows up. The latter should take it from there & let the fire dept./police carry on with their respective business. I have spoken.  |
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Post by Swimmy on Jul 2, 2011 11:44:10 GMT -5
After reading longtimer's post, and learning what the disgrace of a paper and Utica Daily News could not offer, I have to agree with you stoney.
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Post by firstamendment on Jul 3, 2011 21:19:53 GMT -5
I think the fire dept. or police, as typically are the "first responders", should continue to perform whatever life-saving technique is necessary until an ambulance shows up. The latter should take it from there & let the fire dept./police carry on with their respective business. I have spoken. Actually I believe they have to continue until other emergency personnel arrive. BZ, I don't think anyone was implying giving report for shift changes was comparable to the transfer of patients from one EMS to another. I made mention of it in regards to who does it and why. I was trying to put into context ''continuity''. Even when patients are handed off from one EMS to another, there is brief communication as to the situation as there needs to be. I believe the City's ''continuity of care'' to be simply a strawman I emailed Larry's linked document to Dan Miner at the OD, Joleen Ferris at WKTV, as well as the State AG's office to see what they think of it. I'm having a hard time believing it is actually legal for a City, a non-profit by nature, to be able to turn a profit like they claim. Hoping someone's feet are held to the proverbial fire. |
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Post by bobbbiez on Jul 3, 2011 21:55:38 GMT -5
I think the fire dept. or police, as typically are the "first responders", should continue to perform whatever life-saving technique is necessary until an ambulance shows up. The latter should take it from there & let the fire dept./police carry on with their respective business. I have spoken. Actually I believe they have to continue until other emergency personnel arrive. BZ, I don't think anyone was implying giving report for shift changes was comparable to the transfer of patients from one EMS to another. I made mention of it in regards to who does it and why. I was trying to put into context ''continuity''. Even when patients are handed off from one EMS to another, there is brief communication as to the situation as there needs to be. I believe the City's ''continuity of care'' to be simply a strawman I emailed Larry's linked document to Dan Miner at the OD, Joleen Ferris at WKTV, as well as the State AG's office to see what they think of it. I'm having a hard time believing it is actually legal for a City, a non-profit by nature, to be able to turn a profit like they claim. Hoping someone's feet are held to the proverbial fire. Well maybe I read longtimer's and your previous posts wrong, but I did see it as comparing shift reports in hospitals, nursing homes, police and fire staff to emergency calls. I am also confused in what you mean by "having a hard time believing it is actually legal for a City,a non-profit by nature, to be able to turn a profit like they claim." Isn't that what churches and many non-profit organizations do and claim? |
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Post by Swimmy on Jul 5, 2011 18:50:59 GMT -5
Not really. Churches, at least the ones I have attended try to break even with their costs and income. A non-profit, by definition, cannot "turn a profit" or else they lose their tax exempt status.
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Huh, Larry might be in jail after he and the Mayor went at it today. The last thing I saw on the news tonight was the Mayor asking where the police officer was when he was arguing with Larry. 
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