The decision by New York Community Hospital to pull its ambulances from responding to any of the city’s 911 emergencies has prompted the de Blasio administration to fund additional FDNY EMT ambulances to pick up the slack, according to a report from the Independent Budget Office.
A spokesman for the FDNY said the purchase of new rolling stock would also mean additional personnel. “To staff New York Community Hospital’s three tours, we’re going to increase staffing (an additional 15 EMT’s) and purchase two ambulances,” said Deputy Commissioner Francis Gribbon. The hospital, located in southern Brooklyn near Marine Park, is privately-run.
Union Knocks Privates
“The fact that another private ambulance company has gone out demonstrates how unreliable the private 911 ambulance providers are,” said Vincent Variale, president of DC 37 EMS Officers Local 3621. “It's great the Mayor has decided to increase the amount of FDNY ambulances. This will improve response times, and since FDNY EMS members receive more and better training, this will improve medical care to the public.”
The latest exit of a private ambulance provider from the city’s 911 system comes as the share of emergency calls handled by the private sector appears to be on the decline. In 2012, DNAinfo reported that the private operators were performing 40 percent of the 911 runs. According to the FDNY, they are now handling 33 percent of those calls.
It was back during the Giuliani administration that the city opened the door for the private carriers. Mayor Rudy Giuliani also took the Emergency Medical Service function away from the City’s Health + Hospitals and merged it with the FDNY. At the time, the New York Times reported it was part of the then-Mayor’s plan to shrink the municipal system and sell off three hospitals.
In the years since Mr. Giuliani opened the door to the city relying on private carriers for 911 emergency medical calls, the leadership of DC 37's Local 2507 and Local 3621, which represent the FDNY EMS workforce, has warned the City Council that such a reliance could create a sudden gap in coverage if a private carrier in the 911 network went bankrupt.
And that’s exactly what happened in February 2016. TransCare, a private provider with contracts with several private hospitals to run 27 ambulances in the Bronx and Manhattan, filed for bankruptcy. According to a City Council research paper, the FDNY “implemented additional ambulance units staffed on overtime to fill the vacancies” created by TransCare's collapse. City Council researchers wrote that while the FDNY had come up with a workable remedy that required overtime, the “situation highlights the risk in the Department’s reliance on private-ambulance tours.”
TransCare was a national firm owned by Patriarch, a private-equity firm. In 2016, a New York Times investigation found that after the 2008 financial collapse, private-equity firms were buying up ambulance services around the country. “The business of driving ambulances and operating fire brigades represents just one facet of a profound shift on Wall Street and Main Street alike,” the newspaper reported.
The Times found that three of the 12 ambulance companies owned by private-equity firms had filed for bankruptcy between 2013 and 2016.
New York City was able to fill the gap left by TransCare’s overnight exit by spending overtime dollars. But the demise of the company created problems for the city of Mount Vernon. “Private equity has, in this case, threatened public safety,” Richard Thomas, the city's Mayor, told the Times. “It’s not the way to treat the public.”
While some private carriers may have dropped out of the 911 system, the Independent Budget Office reported that New York City continues to see a major growth in the amount of work out there. And the IBO found that the total number of private and public ambulances working 911 calls has grown.
“Last year, there were on average 1,167 eight-hour ambulance tours on city streets each day—or 217 (23 percent) more than the comparable number in 2010,” according to the IBO. “Most of this growth has come with an increase in the number of ambulances run by the New York City Fire Department.”
IBO noted that the city subsidizes its ambulance fleet operation with hundreds of millions of dollars annually. “The city spent about $567 million last year staffing and operating FDNY ambulances,” according to the IBO. “That cost is more than three times the $184 million in revenue generated for the city from a combination of private insurance, Medicare, Medicaid and individuals paying out of pocket.”
Last year the FDNY EMS responded to 1.75 million calls, up from 1.7 million in 2016 and 1.46 million in 2013. According to the latest FDNY response time data available on line for January response to a Level 1 cardiac arrest or choking call, Manhattan was the fastest at 5 minutes and 20 seconds, followed by Staten Island with 5:53, Queens with 6:02, The Bronx with 6:16 and Brooklyn with 6:23.
Mr. Variale said his members welcomed the de Blasio Administration’s spending additional money to backfill the latest private operator to leave the 911 network. But he said in light of the city’s growing reliance on FDNY EMS, additional new money was needed to ensure the right ratio of supervisors to rank-and-file EMS workers.
Need More Bosses
Mr. Variale said his members want to see additional money spent “to increase the amount of EMS Lieutenants or Captains who are the most experienced medical professionals and on the front lines working on the streets with EMTs and Paramedics.”
“The span of control for Fire, Police and EMS according to Federal, New York State and New York City standard and guidelines is a ratio of 1 officer for every 7 individuals,” he said in an email. “Fire follows a 1-to-5 ratio, police is 1-to-7, and EMS has a ratio of 1 officer for every 20 individuals, which violates the standard.”
He continued, “FDNY statistics have shown an increase in the survival rate for cardiac-arrest patients whenever an EMS Lieutenant is on the scene of a cardiac arrest. A small investment would provide better medical care and save many lives.”
Both Local 2501 and Local 3621 have maintained for years that pay for EMS first-responders lags tens of thousands of dollars behind that of other uniformed workers at the FDNY, NYPD and Department of Sanitation.