The Elephant in the Ambulance
Back in mid-October, shortly after General Manager and Senior Editor Darla M. Youngs was hired—and just as staff writer Ted Mebust came on board—our offices received a call from a volunteer EMS worker in northern Otsego County. This person spoke at length with Mebust, laying out concerns about lack of coordination and cooperation between Otsego County’s paid EMS service and its volunteer squads, general discontent among the rank and file, and real worries that these issues would result in someone being seriously injured or, worse, dying. Mebust took extensive notes and a decision was made by staff to do nothing for the time being, but to pursue the storyline.
In the weeks that followed, we began to receive more calls and e-mails echoing the first caller’s concerns. EMS volunteers voiced similar thoughts in passing to our contributing writers. People involved in other ways with the fire departments and their EMS crews stopped by the office, again referencing lack of coordination and cooperation. One went so far as to herald the “collapse of the county ambulance service” as imminent.
Mebust had continued to follow these leads since October, eventually reaching out to Otsego County Representative Dan Wilber, chair of the Public Safety and Legal Affairs Committee, and Robert O’Brien, the county’s 9-1-1 Center director, both via e-mail and telephone. Neither responded. Youngs then caught the attention of Otsego County Administrator Steve Wilson with the e-mail subject line, “potential collapse of county ambulance service?”, asking Wilson for “help connecting Ted with someone who is responsive to his inquiries.” A meeting with Mebust followed not long after.
Mebust sat down with O’Brien, Wilber and other county officials in February, after which he wrote the first in what was to be a three-part series: “Otsego County EMS Reaches Crossroads Part I: The County Service.” That first article focused on the 24-hour, county-based advanced life support paid ambulance service instituted in December of 2021 in response to the number of squad captains, according to Wilber, who told him they “couldn’t handle the load anymore.”
Previously, Mebust wrote, prehospital emergency medical services in Otsego County had been largely carried out by the 17 volunteer-based EMS agencies serving the county, most associated with local fire departments. “These first responders had reached a breaking point and were the first to sound an alarm,” according to Wilber. “With both county and volunteer crews responding to calls, we’re starting care sooner,” O’Brien told Mebust.
In his discussions with county officials, Mebust was directed to two recently released reports: the New York State Emergency Services Council’s “2023 EMS Agenda for Future” (EMS Sustainability Technical Advisory Group NYS 2023 Evidence Based EMS Agenda for Future) and the Center for Public Safety Management’s “EMS Services Delivery Report,” (https://www.cpsm.us/wp-content/uploads/2023/03/Otsego-County-EMS-Report-Final.pdf). Article two of Mebust’s series, “Otsego County EMS Reaches Crossroads Part II: Recent Reports,” disclosed that both reports highlighted concerns about uncertain funding systems and the declining rate of volunteerism in communities statewide. The CPSM report further revealed that Otsego County’s ALS ambulance division — originally funded through the American Rescue Plan Act — is projected to “run an average deficit of $639,847.00 over the next four years.”
Matt Zavadsky, an EMS subject-matter expert hired with grant funds to analyze the county service’s effect and determine sustainability options, also spoke to volunteer agencies around the county, who said they were struggling but remain committed to the communities they serve. Following a year-long observation period, Zavadsky concluded that the county service was “working as designed.” Average response times and activation times, he reported, had both decreased. Despite this, Mebust went on to point out, the county’s paid service had, at times, caused friction with existing EMS services.
Which brings us full circle to Part III of the series, intended to examine the perspective of volunteer EMS providers in relation to the current state of services—an article that cannot now be written because suddenly no one will talk. Mebust has since left Iron String Press, having accepted a job overseas (congratulations and good luck, Ted; you will be missed). With one notable exception, sources who seemed interested in sharing their perspectives at the start of the series of articles have since dried up.
When questioned about possible conflict with the county paid service, one EMS volunteer replied, “I can’t talk about that. I’m not allowed to.” Another source, wishing to remain anonymous, wrote in an e-mail, “I prefer to keep my identity…confidential. I fear retaliation from those in EMS opposed to paid EMS providers/paid emergency services,” and referred to an aggressive social media campaign underway to “squash the county’s paid EMS program.”
Other volunteers said they could not go on record for fear they would lose their jobs—many are employed by Otsego County in roles not related to emergency services, or by the Bassett Healthcare Network, for instance. Reports have also surfaced, and been confirmed, that things got a little heated recently between the county’s paid EMS providers and EMS volunteers from Fly Creek as they responded to the same call.
Volunteers have closed ranks and refuse now to speak on this issue—whether for fear of reprisal or under some sort of unofficial “gag” order, real or imagined—where once they seemed eager to do so. And, last Friday, a county official rescheduled a meeting with one of our reporters in order to ensure that County Administrator Wilson could also be in attendance. Needless to say, the third and final article in the EMS crossroads series may not be written any time soon.
That third article may never run. But the bigger issue here—the elephant in the ambulance which really must be addressed—is that regardless of what is happening behind the scenes, there needs to be a day of reckoning and reconciliation between the county’s paid EMS service and its volunteers, all of whom are delivering essential services to the residents of Otsego County, and all of whom deserve to be praised for their long hours, selflessness, and dedication.
Those providers, coming face to face at a call, must put aside their differences for the greater good. They must learn to work together, respect each other and turn their combined attention to the job at hand. They must stop sniping at each other via social media, where name-calling and finger-pointing have become the order of the day.
And, regardless of what the coming months hold for the future of EMS both in Otsego County and statewide, our paid and unpaid EMS workers must resolve to come together as one in service, before someone in their care suffers further as a result of the divide or the unthinkable happens, and someone dies.
In the oft-quoted words of “Project Runway” mentor Tim Gunn, “Make it work, people.” Otsego County’s residents are trusting you with their lives.
Thank you for your information. However, as a former County employee, I can assure you that there continues to be a story here that needs to come out.
Planning in a Vacuum
While I am certain that members of the Otsego County Public Safety Committee gave careful consideration to the long-term expenses of funding salaries for the l6 FT and 10 PT EMT’s assigned to the new grant-funded ambulances (were there two or four?)—not to mention the long-term maintenance costs for such complex emergency equipment–the initial funding for the personnel will run out at the end of this county’s fiscal year. Are we, the taxpayers, expected to bear the burden for these wages once the county’s fiscal year ends? In your March 30 editorial on the matter, it is stated that the CPSM report revealed that Otsego County’s ALS ambulance division, originally funded through the American Rescue Plan Act, is projected to run an average deficit of more than $639,000 over the next four years.
What came to mind regarding this new ambulance system was a conversation I’d had in recent years with one of the heads of a well-known charitable organization in a neighboring county, when I advised them of an opportunity to acquire at no cost a large former sorority house for use as a domestic violence shelter. The response I received was this: “Oh, Maureen, a bricks and mortar acquisition is always the easy part, but where will the long-term operating dollars come from?” Needless to say, they passed on the opportunity for a free, beautiful 20 bedroom facility adjacent to their downtown community!
For some time now, there had been discussions concerning improving incentives for EMS volunteers. For some time, these dedicated volunteers had continued to sacrifice their personal time to keep up with the State’s demands—NYS’s growing certification requirements for EMS volunteers. For some time, EMS volunteers, many of whom were NOT homeowners, were expressing concerns that the tax incentives offered by NYS were geared toward homeowners, and not at the dollar levels offered in other states. As regards the reported “aging” out of our county’s EMS volunteers, the county’s current overall demographics reveal residents’ average age of 42, with 29% of the population identified as “renters.”
All of the above matters, for me, smack of “planning in a vacuum,” whether at the county or state level. The three R’s of volunteerism are Recruitment, Retention and Recognition. What’s being done here at home? I’ve met a number of our area’s EMS volunteers and, given their level of dedication and personal sacrifice, I’m not at all surprised to learn of their dismay when they rush from their homes,families and businesses to respond to an emergency call only to find the county ambulance had arrived just a few minutes earlier. Talk about a disincentive!