NYC Voluntary Hospital Employment

[46Young]

An article I read about NYC planning to charge up to a million per 911 provider hospitals in 2012 prompted me to call my cousin, who is married to a FDNY EMS Capt, and also works per diem at North Shore LIJ. The thread:

http://www.emtlife.com/showthread.php?t=22035

She said it's true, and that NSLIJ isn't going to pay them anything. They're expanding their IFT, they have 911 contracts in Nassau County, and they also get a lot of emergent calls on their private line, instead of these pts calling 911. She said the're expanding, and need to hire. I would apply now. It certainly pays better than the pprivates, better benefits, wirking conditions, etc.

 

[looker]

An article I read about NYC planning to charge up to a million per 911 provider hospitals in 2012 prompted me to call my cousin, who is married to a FDNY EMS Capt, and also works per diem at North Shore LIJ. The thread:

http://www.emtlife.com/showthread.php?t=22035

She said it's true, and that NSLIJ isn't going to pay them anything. They're expanding their IFT, they have 911 contracts in Nassau County, and they also get a lot of emergent calls on their private line, instead of these pts calling 911. She said the're expanding, and need to hire. I would apply now. It certainly pays better than the pprivates, better benefits, wirking conditions, etc.

I am always surprise when I read that an ambulance company are able to do code 3 respond to a phone call without being contracted with the city for 911.

 

[Minnick27]

Why is that surprising? They are still an ambulance and they were called for an emergency. That being said, my company isn't allowed to run lights and sirens in Philly

 

[looker]

Why is that surprising? They are still an ambulance and they were called for an emergency. That being said, my company isn't allowed to run lights and sirens in Philly

It is surprising because 911 is no longer under centralized control. Regarding your company not going code 3, is that city rule/law or your company decision?

 

[46Young]

My understanding is that in NYS, a private ambulance company must have an EMS permit. This permit allows them to run L/S. Just because you're not a 911 service, that doesn't mean thart you won't get private emergency calls. Dispatch at NS-LIJ would dispatch their own bus only if their ETA was reasonable, or they would call 911 for them instead. Some residents prefered us to the local vollies, or FDNY EMS in the city as the case may be. Emergent STEMI cath lab jobs need to be L/S. Same for a balloon pump job, a critical NICU or PICU txp, perinatal txp, etc. The privates in NYC, such as Hunter Ambulance-Ambulette, Transcare, Citywide, Seniorcare, AMR, First Response, etc. all have nursing home contracts, and get first shot at any NH emergent call, so long as they can be there within a certain time interval. I didn't know that running L/S as a private was not allowed in other areas until I moved out of NYC.

 

[Minnick27]

Regarding your company not going code 3, is that city rule/law or your company decision?

Nobody has ever given me a straight answer. I can't see how the city can say "ok the state has certified you as an ambulance, but we don't want you operating as one." it's basically like going to a nursing home for a call and having a nurse offer to call a "real" ambulance

 

[firecoins]

So if a patient in a private amnulance begins to code, we should wait at red lights?

 

[JPINFV]

I sorta of agree with Looker with this. Outside of critical hospital to hospital transfers (e.g. traumas not at trauma centers, MI patients not at cath lab hospitals, etc), if the patient is in such dire condition that they need to be treated and transported ASAP, then they need to get the closest paramedic level ambulance. In the vast majority of places, the closest paramedic level ambulance is going to be obtained through the 911 system.

Now, if the non-911 crew arrives and finds out that the patient is critical and that the facility should have accessed the 911 system, then fine. They should be allowed to trasport emergently if they are a paramedic level ambulance, or transport emergently based on the ETA of the closest paramedics (regardless of if paramedics from that company or through the 911 system) and the estimated transport time.

Afterall, this is about the patient, not the company or the crew.

 

[looker]

So if a patient in a private amnulance begins to code, we should wait at red lights?

No go you code that is what you have lights for unless intercept is closer(if you're bls) in which case you call for one and meet up at designated place. On the other hand what is being described is calling private company instead of 911.

 

[looker]

Nobody has ever given me a straight answer. I can't see how the city can say "ok the state has certified you as an ambulance, but we don't want you operating as one." it's basically like going to a nursing home for a call and having a nurse offer to call a "real" ambulance

When someone have an emergency they should be calling an emergency centralized number which have the resources to get first available unit to that person. For ex if city own ambulance is not available the city calls back up contracted service if they are not available they either check another contracted service or back up service calls their own back up service etc. This way all calls go in to the same place. If something big go down first responders will have all the available info instead of getting it through second hands.

 

[looker]

Nobody has ever given me a straight answer. I can't see how the city can say "ok the state has certified you as an ambulance, but we don't want you operating as one." it's basically like going to a nursing home for a call and having a nurse offer to call a "real" ambulance

Here is the language for Los Angeles regarding this

"Owner's Responsibility- No Ambulance Service permittee or other person directing an ambulance shall:
a. Respond to any emergency call that would normally be considered an emergency 9-1-1- call for authorized emergency transportation unless the call is either from public entity or an authorized emergency transportation 9-1-1- operator requesting backup service"

 

[DrParasite]

When someone have an emergency they should be calling an emergency centralized number which have the resources to get first available unit to that person. For ex if city own ambulance is not available the city calls back up contracted service if they are not available they either check another contracted service or back up service calls their own back up service etc. This way all calls go in to the same place. If something big go down first responders will have all the available info instead of getting it through second hands.

that is how is works. when someone calls 911, it goes to the 911 center and the closest ambulance is dispatched (in theory anyway)

in the case a a nursing home, if 911 is called, then the nearest ambulance is sent. if 911 is not called (for various reasons usually have nothing to do with patient care) and the doctor still wants the patient to go to the hospital, a private service is called (which is contracted to provide services in a contract between the facility and the private service), and they are usually there within the hour.

 

[looker]

that is how is works. when someone calls 911, it goes to the 911 center and the closest ambulance is dispatched (in theory anyway)

in the case a a nursing home, if 911 is called, then the nearest ambulance is sent. if 911 is not called (for various reasons usually have nothing to do with patient care) and the doctor still wants the patient to go to the hospital, a private service is called (which is contracted to provide services in a contract between the facility and the private service), and they are usually there within the hour.

I understand that but article says they get a lot of calls on their private number for emergency respond. Which to me means code 3 lights and siren respond. If the nursing home have an emergency they should not be able to call their contracted provider to respond as emergency unless they are contracted as one with the city.

 

[DrParasite]

hence the term nursing home 911. believe it or not, nursing homes will call private companies for residents with chest pains, diff breathing, seizures, etc. it's not right but it happens. and yes, i have taken ALS requests from private companies who have BLS ambulances responding to ALS criteria emergencies.

 

[looker]

hence the term nursing home 911. believe it or not, nursing homes will call private companies for residents with chest pains, diff breathing, seizures, etc. it's not right but it happens. and yes, i have taken ALS requests from private companies who have BLS ambulances responding to ALS criteria emergencies.

Can you explain why no protocol existed that would require operator to transfer the call to 911? Just seems like company putting profit above patient care but that is just my opinion.

 

[DrParasite]

Can you explain why no protocol existed that would require operator to transfer the call to 911?

and the answer is:

Just seems like company putting profit above patient care but that is just my opinion.

 

[94H]

Back on topic, NS-LIJ is hiring

Is a CDL standard for companies in NYC/LI?

 

[46Young]

Back on topic, NS-LIJ is hiring

Is a CDL standard for companies in NYC/LI?

I was hired by NS-LIJ back in 2003. At that time, they still ran an ambulette. As a condition of employment, we were supposed to obtain a CDL BP within six months of hire. The ambulette program was discontinued later that year. The CDL requirement was also scrapped. I worked for Hunter Ambulance-Ambulette in 2002. Their ambulette service was seperate from their ambulance service. I don't know of any places that make you have a CDL to be an EMT. The places that have ambulettes were paying those drivers less than their EMT's, typically 7-9 bucks an hour.

 

[looker]

I was hired by NS-LIJ back in 2003. At that time, they still ran an ambulette. As a condition of employment, we were supposed to obtain a CDL BP within six months of hire. The ambulette program was discontinued later that year. The CDL requirement was also scrapped. I worked for Hunter Ambulance-Ambulette in 2002. Their ambulette service was seperate from their ambulance service. I don't know of any places that make you have a CDL to be an EMT. The places that have ambulettes were paying those drivers less than their EMT's, typically 7-9 bucks an hour.

Never seen ambulette term used till today. We just call it non emergency medical transportation(nemt). Learn something new everyday

 

[46Young]

Never seen ambulette term used till today. We just call it non emergency medical transportation(nemt). Learn something new everyday

http://www.hunterambulance.com/

Skip past the cheesy intro, and go to employment. It states the qualifications for ambulette driver. When I worked there, the 'lettes worked during the day, and the ambulances would take 'lette jobs at night - no PCR required, and we would be required to take $40 cash (2002) if payment was not pre-arranged. Looking back, I'm not sure if that was legal or not. The fact that you need a CDL to txp these customers, would suggest that using an ambulance to txp them instead is shady.