Villages penny wise with Vigilant contract

Karen Rubin

Some years ago, I remember riding my bicycle into the Plaza. One minute I was on the bike and the next thing I remember is waking up at North Shore Hospital, in a panic that I had missed my son’s Bar Mitzvah entirely.

I had no idea how long I had been unconscious. I had no memory of the Vigilant EMTs – for the most part volunteers like the firefighters, people who live or work in the community – who came to my aid, scraped me off the pavement and brought me to the hospital. I never saw their faces or a bill.

The reason I never saw a bill is that the villages contract with the Vigilants to provide ambulance service, and it is paid for through their operating budgets.

For many years, the villages have balked at paying this charge, and now, with latest obsession among governments to slash budgets any way they can, they are looking for a means to have patients pay their own way – either through their insurance, or from their pocket.

Before examining whether his proposal would actually save taxpayers money, the problem is that it is not legal for a volunteer fire ambulance to charge. To implement this pay-go policy, the Vigilants would have to set up some kind of sister corporation, which the Vigilants claim would lead to several adverse consequences.

The Vigilants are saying that they cannot function in the same way as now, with a volunteer, community-based organization, if they are forced to set up such a pay-go corporation.

In the end it would cost the residents in two ways, says Robert Lincoln, Vigilant trustee and ex-chief: first they would be charged for use of the ambulance; second, they would lose the free labor provided by the volunteer EMTs (who meet the same training and testing standards as paid people do.) So, a system with paid personnel would have to cost more. Also lost would be the mutual-aid system where fire departments help each other.

Remember the microburst disaster last June? That was a clear example of volunteer companies coming to our aid from all around Nassau County.

But for those who are obsessed with a pure bottom-line analysis, just how much more would it wind up costing and would there really be a savings?

Lincoln has done the calculation: currently a middle income home with a market value of $700,000 (paying approximately $11,000 per year in total property taxes) pays approximately $42 per year for the Vigilant EMS service, now, operating with three ambulances stationed in the Vigilant firehouse on Cuttermill Road and the Alert firehouse on Steamboat Road. The dispute over the budget allocation amounts to less than $10 per household, he says.

On the other hand, if you actually needed an ambulance, the cost of a typical ambulance call would be about $400. And if you didn’t have health insurance or if your health insurance didn’t cover the whole amount, you would be on the hook until the bill was paid.

A village official argued that while the cost of an ambulance call is 10 times more than the tax amount, most village residents are paying for a service that they wouldn’t use. But one way to look at it is that the $42 per household cost a year is like paying for health insurance – you pay a small amount to cover the possibility of a large amount.

For some time the villages have been in disagreement over how the Vigilant ambulance budget is allocated to each village.

“We leave this decision to them,” says Lincoln. “Our budget is broken into two sections: fire protection and ambulance service because we provide EMS only to the villages protected for fire by the Alerts (they do not run an ambulance).”

But some villages (apparently the Village of Great Neck is leading the way) have threatened to withdraw from the Vigilant service, and hire another service, which would be based outside of Great Neck. Also, all the villages have been very slow to renew their contracts with Vigilant because of this dispute, Lincoln says.

But If even one village pulls out of this cooperative arrangement, Lincoln says, the cost would skyrocket to the rest, and be unaffordable – in effect, Great Neck would lose its locally-based ambulance service.

Currently the EMS system is based in Great Neck. Members are sent directly to the scene from home or wherever they are, while others bring the ambulance. This makes response time fast, and certainly faster than a provider responding from off the peninsula.

Indeed, by 10 a.m. on Monday, the Vigilants had already responded to four ambulance calls.

In situations where minutes can mean the difference between life and death, and considering the geography of Great Neck, that could be a tragic mistake. It would seem that the overarching issue over whether a decision is made to change the payment system would be whether we would lose the Vigilant service we have or how the service would be changed.

“The changes are being proposed by local villages, not by the county or the state,” Lincoln notes. “To the best of our knowledge, it is not part of a consolidation plan; however the result could be the same. We now have a community-based service which is staffed and funded locally. The system works and we believe that the cost is reasonable, if not a bargain for what our residents get. And it could be dismantled by our very own local elected officials who have been silent with their constituents.”

While consolidation of the fire services is not the essence of this proposal, the effect of the proposal could be comparable.

The Vigilant Fire Company has provided a volunteer ambulance service to the residents of Great Neck north of the train tracks since the late 1930s. At that time, the residents of Great Neck decided they needed their own volunteer ambulance service for several reasons, including faster and dependable response times. 

Today, with the volunteers living in the community, they often arrive at scenes and begin treating a patient in advance of the ambulance – making response times even quicker than the national standard.

“Having people with an intimate knowledge of Great Neck’s streets helps speed up our response times, which is paramount in a situation where every second counts,” said Chief Scott MacDonald.

The EMS mission of the Vigilant Fire Company has continued to grow with an increasingly large number of calls and greater training demands being placed on EMTs. Utilization of the ambulance service has risen from once or twice a week when it started in 1937. Today, the Vigilants see about 2,000 EMS calls a year – averaging more than five each day.

“The Great Neck peninsula has always benefited from the highly-trained volunteer EMS providers who staff the Vigilant ambulances,” says David Weiss, chairman of the board of trustees. “The volunteers are proud of what they do and are happy to be volunteers. They receive the same training as paid EMTs and they volunteer because of their dedication and passion to help the community.”

Their professionalism is truly extraordinary – but there is another benefit of having a volunteer firefighting force -and that is the sense of community that it forges. The firefighters and EMTs have a camaraderie – a kind of society- of their own, it is true, but they have a fierce loyalty to the community. And they have a superb way of cooperating with each other – our volunteers assisted during 9/11 and companies from all over Nassau County came to Great Neck after the June microburst.

But I would question whether there is a cost savings to shifting this way, and whether residents are that anxious to save the $42.

This dispute over how the villages are assessed for ambulance service has simmered for years, and now has reached a kind of a head or a stalemate, depending on who you talk to. Town of North Hempstead Supervisor Jon Kaiman has apparently taken up the issue, seeing it as another way to examine the way governments offer services, more efficiently, and was reportedly seeking a grant to study a proposal for the pay-go system.

What is upsetting to many is that these discussions are happening among the village officials and the town, and not in a general forum, where people could express their view on whether it is worth it to pay $42 in tax a year, versus a pay-go system that could result in the loss of our local ambulance service.

The Vigilants are not standing by but are taking the matter to the people,

The Vigilant Fire Company, which opposes these proposed changes to Great Neck’s ambulance service, will hold a community meeting on Tuesday, April 5, at 7:30 p.m. at Great Neck North Middle School to inform residents of all of the facts regarding this important issue and how it could affect them.

“The Vigilants want to inform the community of the proposed changes that are being discussed,” says Lincoln. “We welcome all residents to come out on April 5th for an important community meeting regarding the future of their ambulance service and what it means for them.”

He adds, if the people decide they want to change from a tax-based system to a pay-go system, then so be it.

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