EMS Subcommittee

Monday, March 29, 2021 - 9:00 am

HELD VIRTUALLY

 

Robin DeLoria - Chairman

 

Chairman DeLoria called this subcommittee to order at 9:00 am with the following in attendance, Clayton Barber, Robin DeLoria, Archie Depo, Shaun Gillilland, Charlie Harrington, Roy Holzer, Ken Hughes, Steve McNally, Noel Merrihew, Jim Monty, Jay Rand, Tom Scozzafava, Jeff Subra, Ike Tyler, and Davina Winemiller.

 

Also present: Dina Garvey, Rob Wick, Matt Watts, and Darren Dickerson.

 

News Media present: Tim Rowland.

 

DELORIA: Patty, if youíve got an introduction here thatís youíd like to start with, we can. Iím sure that Rob will joining, oh that might be him.

 

WICK: Iím on now.

 

DELORIA: Okay, Robert, very good. Why donít you kick us off here and weíll move into the agenda items.

 

WICK: Okay, did everyone get the agenda that was sent out last week?

 

DELORIA: I did, everybody got the agenda?

WICK: Okay, if everybodyís got that, we can just kind of thumb through it.

So, changing this up just a little bit. Something that we wanted to get through early on are some of the high points that we wanted to adjust for today, because the first thing thatís kind of important here is we need a resolution for the CON application, thereís a fee associated with that for $7,500.00.

 

DELORIA: Okay, Iíll move that resolution, if I can get a second and then weíll move for discussion. Jeff Subra, thank you, Jeff.

 

RESOLUTION AUTHORIZING THE EMERGENCY MEDICIAL SERVICES DEPARTMENT TO SUBMIT A CERTIFICATE OF NEED (CON) APPLICATION AT A COST OF $7,500.00, FUNDS TO COME OUT OF GRANT FUNDS

DeLoria, Subra

DELORIA: Okay, Rob the resolutionís for spending the money, but isnít the CON after our, somewhat probationary, doesnít the just automatically roll over for approval?

 

WICK: I believe thatís correct, but Patty can you confirm?

 

BASHAW: I donít understand the question.

 

DELORIA: Well, initially we had a CON that was subject to review, so they can determine that we were, actually, you know, qualified for that and weíd have to carry that for a certain number of months and then that would roll into automatic approval.

 

BASHAW: No, that is what weíre working on right now that is a huge undertaking. We have to get approval for a permanent CON and thatís what weíre working on.

 

DELORIA: Thatís what this applicationís for?

 

BASHAW: Correct and what the $7,500.00 is for, is it has to be a public hearing. So, there has to be a stenographer, there has to a lawyer that does the mediation and finds need, so, itís impartial. And Mountain Lakes organizes all of that, then whatever doesnít get used, as far as funding comes back to the County.

 

DELORIA: Okay, so this application fee would fall under the grant, would it not?

 

BASHAW: Correct

 

DELORIA: Okay

 

BASHAW: In the past, you guys approved to go after the permanent CON, we just, like anything else we do in the County, we need a resolution to spend that money, which is in the budget. So, we were told we needed a resolution for that.

 

DELORIA: Okay, any questions from anyone on this? Okay, all in favor of this resolution to submit the application for the permanent CON in an amount of $7,500.00? Any opposed? Okay that will carry.

Okay, Robert, next item.

 

BASHAW: Do we bring it that to the floor this morning?

 

MASCARENAS: Thatís what I was going to ask the same question Patty did. Would you like to run it at Ways and Means this morning or wait until the next Public Safety?

 

DELORIA: Oh, absolutely, it would have to be from the floor, correct?

 

MASCARENAS: Yes

 

DELORIA: Well, letís add that then. Okay, weĎll add it from the floor at the end of Ways and Means.

 

BASHAW: Thank you

 

WICK: Okay, the next item that we had was a bit of a carryover, the billing consultant that we have here at the County, EMR, a couple of months ago we brought that contract up for renewal, and then the conversation of, you know, what is construed as centralized billing kind of, prevented that contract getting renewed. So, EMRís contract expired at the end of 2020, so for the last couple of months theyíve not been active, and theyíve not had an executed agreement with the County. So, we would like to move that forward and get that contract renewed. I donít know if thereís still some lingering questions as to, you know, how weíre defining the centralized billing and scope of work specifically for what EMR is doing now versus what they do for some of their other EMS agency clients in the county.

 

DELORIA: Patty, when Newcomb decides to opt into this program and I know the rescue squad in the fire department approached me most recently, and they want to establish some discussion so that everybody understands exactly what itís about. Newcomb is going to need to participate with this, correct?

 

BASHAW: Um, yes, because they have to do the PCR. The beauty of Newcomb is, they already have the software program, and they already know the program, so it wonít be a big lift.

 

DELORIA: Correct and currently we cannot bill, because weíre a protection district.

 

BASHAW: Correct

 

DELORIA: Okay, so what are we looking at Rob? Do you want to extend this contract, or where are we going with this?

 

WICK: Yeah, it was just to extend the option here, again, because it was set up with a base year plus two option years.

 

DELORIA: Okay

 

WICK: So, if we can just renew it until the end of 2021 that would be fine for now.

 

DELORIA: Okay, Jim, question or are you going to move that resolution?

 

MONTY: No, a question, because it wasnít, thereís some question, because some agencies did not want to participate, they want to do all the billing themselves, did that get rectified?

 

MASCARENAS: I can help answer that a little bit Jim. Right now, this is really to be able to, to bill on behalf of the County and the service that weíre providing. County agencies that are currently billing and doing that will not be required right now, to come in under, what weíre hoping to do is get that low hanging fruit and offer billing to those agencies that canít. So, that we can inject more revenue into the system. But, anybody whoís billing right now and successfully doing so, weíre not necessarily going to take that on until we can evaluate it further and know what the impact is, community to community. Itís also important to know that this CON (LOST AUDIO).

 

PALMER: We lost you Mike.

 

HOLZER: Robin, while weíre waiting for Mike, can I just ask a quick question?

 

DELORIA: Absolutely Roy, jump in.

 

HOLZER: It was my understanding with the billing, though, that this would be insurance billing for County provided services, like, for example, Wilmington, we already bill, but when the County provides assistance to us, that gives you the ability to bill, am I correct in saying that?

 

DELORIA: I believe you are. Patty is he correct in saying that?

 

BASHAW: He is correct.

 

HOLZER: Okay

 

DELORIA: Mike Mascarenas did you get your microphone restored there or what?

 

MONTY: So, there will be only one bill given; right? It will be from the County or from the agency, patient wonít receive two?

 

BASHAW: Correct

 

MONTY: So, if itís a County EMS that responds, the agency still will get it or the County will get it?

 

BASHAW: If the agency, if the County responds and does a link up with, letís say Etown/Lewis, Etown/Lewis gets the money and then the County bills, the billing agency bills Etown/Lewis, the agency a flat fee. Thereís only one bill.

 

WINEMILLER: I have a question Robin.

 

DELORIA: Yes, Davina.

 

WINEMILLER: So, Iíve heard that thereís been some issues with this billing, for example, with the chase cars. So, Iím really not exactly sure whatís happening, but just things that have been told to me is, for example, an ambulance gets called in, say, Wilmington, whoís participating and the chase car shows up, and so now thereís a question; they werenít called specifically, they were just sent because itís a chase car, you know, so, now the question is theyíre billing and Wilmingtonís billing?

 

BASHAW: No

 

DELORIA: No, but, Patty you want to tell us how that works out?

 

BASHAW: Again, itís a link up. If they donít even go, if they just help with lifting and getting them in the ambulance, thereís no bill at all to the agency and if they do go, ride in, at the agencyís request, which is whatís happening on occasion with Wilmington, for an example, then Wilmington will receive a bill and then Wilmington can bill at the higher paramedic rate, because they have a paramedic onboard, now.

 

DELORIA: Oh, interesting. Okay, Davina, did that resolve your question?

 

WINEMILLER: No, not really Robin. I think Iím a little bit confused, because what Iíve been questioned about is the chase car going when theyíre not requested and then billing even though they havenít been requested, theyíve just been sent. Do you know what Iím trying to say Robin?

 

DELORIA: I donít know if that would be the case. Patty, when these cars respond, theyíre responding to, what in my head is a mutual aid or responding to the scene of a rescue call.

 

BASHAW: Right, they do self-dispatch and respond to the area for assistance and then itís up to the agency to decide whether or not they need that, that individual.

 

DELORIA: Okay, so the agency, as in Wilmington, or wherever they make that call, whether or not do we need this paramedic that just showed up?

 

BASHAW: Correct, itís a plus, because this has happened a couple of times now in the Jay area. They may respond and hold, for an example and then stay in that area for the second calls and thatís what Corey has asked us to do over there.

 

DELORIA: Okay, thatís interesting, okay. So, perhaps at some point in time, you can just kind of lay out what this policy looks like, whatís being billed out as self-dispatching. I see it from a different level of perspective, just, you know, the ability to have mutual aid on site and things of that nature. So, I think it makes sense to me. Davina, are you good with that?

 

WINEMILLER: Well, yeah, I mean, I guess it kind of answers my question. But, the person that talked to me was concerned, because the chase car was showing up without being needed and then and then doing the billing. So, I guess thatís, you know, thatís what we need to clarify. You know, so, so, Patty, I guess my question is the chase car goes automatically, regardless of whether theyíre needed?

 

BASHAW: Correct, because you donít ever know whatís at the scene until you get there.

 

WINEMILLER: Okay, okay, I understand that part of it.

 

BASHAW: We do not bill, we do not bill just for response.

 

WINEMILLER: Okay, thatís not what I was told.

 

BASHAW: Thatís incorrect then.

 

DELORIA: Yeah, thatís not surprising Davina. Weíre going to get a lot of what they call Ďmidnight quarterbacksĒ, trying to, you know?

 

WINEMILLER: Okay, I think we need to clarify exactly, you know, what is billed and what isnít billed, etc., in the future.

 

GILLILLAND: Robin?

 

DELORIA: Yes, sir.

 

GILLILLAND: So, Patty, we donít have cars driving around the County willy-nilly looking for calls. We have cars and medics assigned to various, assisting various agencies, would you say thatís correct?

 

BASHAW: Yes

 

GILLILLAND: So, in that case, like this, so if, if itís Wilmington, if the Wilmington is asked to go somewhere, then the paramedic or ALS that has the car thatís assigned to help Wilmington would go, show up, just as if you had a volunteer leave his house and run to the scene; correct?

 

BASHAW: Yes

 

GILLILLAND: Thank you.

 

DELORIA: And thatís that whole mutual aid response that I see and Iíve mentioned this in the past about Minerva, even though their services are better provided by their neighbor in the southern county, but the ability to have those people come to Newcomb when we need them. Thatís what this coverage is all about, so that everybodyís in it together and everybodyís helping everybody.

So, letís get a resolution out to extend this EMR contract into December 31, of 2021. Do I have a motion? Roy, thank you. Do I have a second? Jeff, do you want to second that?

 

RESOLUTION AUTHORIZING A CONTRACT EXTENSION WITH EMR FOR EMERGENCY MEDICAL SERVICES BILLING THROUGH DECEMBER 31, 2021

Holzer, Subra

 

DELORIA: All in favor? Any opposed? Okay, weíll carry.

Go ahead Robert, item number 3.

 

WICK: Yes, so the full scale phased budget, we brought this before the Committee last fall, whenever we were also trying to square away this yearís program budget. I donít know if the folks here on the committee have copies of that, I can forward that back out, but I bring this up as an agenda item today, because we need to revisit that and get it approved here very quickly, because the process to get access to those full-scale funds is basically that the budget modification with EOS, but as all things with EOS, thatís going to take some time to get approved. So, we had planned the small scale funds to carry us as far through this calendar year as possible, but we really need to be able to get access to the full-scale funds soon so that we can start making claims against not just those grant funds, but also any additional items that weíre going to incorporate into this yearís program that we had set in the full-scale. So, in a nutshell, what we have is there are some tack items that are grant funded, right, that are associated with small scale and some that are associated with full-scale that kind of overlap forming the actual expense budget for this year. So, what I would like to do, unless thereís any objections, is Iíd like to send that budget sheet back out to the Committee today and if we can establish a time to go over that specifically, perhaps at the next committee meeting and see if thereís any questions or anything that we need to address on that and kind of get that moving. And I will say this, too, if thereís anything that we need to change for the full scale grant budget, we can do more budget modifications like perhaps later on this year, if there are lingering questions or if there are other communities that kind of respond in a latent fashion to get onboard, into the program, so to speak, but there has been some set aside items that you will see in this budget when it goes out to you, where, because there are so many unknowns and there have been so many agencies that havenít, kind of, laagered up that they want to join the program. We have set aside some generic line items in that budget for both staffing per diems and, like equipment resourcing, that sort of thing, each year in that budget. So, that will be a three-year program.

 

DELORIA: Okay, so Robert, send that out to the group, and Mike Mascarenas, if you can hear me, we had discussed one time about possibly not meeting prior to Ways and Means and then dropping in earlier in the month, if we needed to, so Iím opened to establishing this committee earlier than Ways and Means, next month. So, you can get together and if you want to call that meeting earlier on, just let me know.

 

MASCARENAS: Okay, Iíll talk to you. Can you hear me?

 

DELORIA: I can how, Mike, yeah.

 

MASCARENAS: Thank you

 

SUBRA: Robin, we donít need to do that now, but I seriously need to sit down with probably, Patty and Rob and maybe even Mike and I donít know whatís going on with Schroon Lake and I donít understand their additional requests for the full scale, but we need to have a full on meeting with the EMS and figure out what theyíre doing, okay? Because Iím, I am not in agreement with what this, this roller coaster is doing here, as far as Schroon Lake and as far as our funding. So, maybe we need to establish a meeting amongst ourselves, whether Zoom or whatever to figure out what Schroon is doing. Iíve been, they finally got a contract signed, I think, a little over last, a little over a week ago from this year and I told them no more funding until we figure this out. But, Iím requesting at this point a serious meeting with Schroon Lake EMS and the County to figure out whatís going on here; okay? because I think weíre, this rollercoaster is going way too high. So, thank you.

 

BASHAW: I have already reached out to the new president.

 

SUBRA: Okay

 

DELORIA: Okay, please include me in this Zoom meeting, and Mike and Rob, for sure and then we can report back to the committee with whatever weíve picked up and learn from that. Jeff, youíre good with that? Okay, very good.

 

HOLZER: Quick question for Rob, have we received any additional reimbursement from the State, yet, speaking of budgets?

 

WICK: No, none, yet.

 

HOLZER: Okay, so, whatís our total amount so far? Ball park., it doesnít have to be, I just want to refresh my memory.

 

WICK:Itís going to be, gosh, probably between $1.5 and $1 million, somewhere around there or last couple of years, aggregate expenses.

 

HOLZER: That weíve gotten reimbursed?

 

WICK: No

 

HOLZER: Thatís what Iím asking, how much weíve gotten back so far?

 

WICK: Right, weíve received nothing from DOS, so far.

 

HOLZER: All right, thank you.

 

WICK: Thatís kind of why I want to try and get the budget mod approved for getting the full scale funds, because it does take so long. I really donít want to kind of have us behind the eight ball, too much and all. Itís up to the County how far we want to lean into this at risk for a lot of this, but Iíd be not doing my job, if I did bang on the table and get the grant agreements approved, and you know, get things moving for us.

 

DELORIA: And Mike your office is on top of that, Iím sure.

 

MASCARENAS: Well, Robís is, my old office.

 

DELORIA: Wells, we want the State of New York to pass the buck, not you.

 

MASCARENAS: No, I agree. DOS and I know a lot of you have had experience with Department of State for a lot of years, and they are, try and be politically correct here, so just very slow at getting dollars to people, and if we can get those grant agreements approved, and start getting quarterly claiming in, youíll start seeing, at least, some money roll and I think thatís why Rob is trying to encourage us to get our full scale project and as soon as possible, so, so that money can start turning over.

 

WICK: And just for everybodyís awareness, as part of the first budget modification process, with just trying to get some, you know, some inclusion that we have to make, some changes that we had to make for the small scale phase, get those included and being able to be reimbursed, and draw against those. You know, a couple of additional staff members and some other materials, EMS supplies that we had to purchase here and there that were not, you know, specific budget line items to get those included and get that budget mod approved, has like taken four months. So, I really want to get that ball rolling sooner rather than later.

 

SCOZZAFAVA: The Department of State is the absolute worst funding agency on the planet. I donít have to be politically correct, because Iíve dealt with them for 30 years. They are. The Village of Port Henry dissolved in April of 2017, Iím still waiting on disillusion. I finally brought it to the attention of Dan Stec, Betty Little when she was in and Iíve just got a returned phone call a couple of weeks ago. But, we really need, I donít know how you do it, other than through our elected state representatives, put some pressure on Department of State and one of the big issues that we all are aware of is the fact that thereís no state agencies in their offices, yet, which makes it extremely frustrating, and difficult to deal with. But, you know, eventually, as Mike said, youíll get the money, but I mean, it can take years, and thatís, thatís the whole issue with the Department of State. You know, itís a department thatís overwhelmed. They have way too much under their umbrella and quite frankly, since they have not been working in their offices, things move, they always move at a turtleís pace, now itís a snailís pace, horrendous and thatís all I got to say about that.

 

DELORIA: Okay, Rob, where are we here on the agenda?

 

WICK: Yeah, so another item I sent out here to the committee last week, at the past meeting, going through the minutes, there was a discussion about trying to have some type of visual of like all the different services that were available here in the small scale phase and kind of what we were anticipating for the full scale phase, specifically by participating agencies and then having an idea of, okay, what does everybody get just by the County having this EMS program, some of the core services? So, this was the other word document that we sent out last week, itís got those three columns to it. I donít know if everyone has had a chance to review that, but this kind of showcases the current proposed and what everyoneís getting throughout with a specific contract and services and those that are kind of just generally available to the entire county.

 

WINEMILLER: Rob, is there any way that you could put that on the screen? Maybe Ken can have you present? So, we can see. Is that even possible, Ken and Rob?

 

HUGHES: Itís possible if Robís on a computer, connected to the meeting.

 

SUBRA: That was attached to our meeting minutes or meeting notes.

 

WICK: So, okay, Iíve got that pulled up now. I can share that Ken, if you can send me over control to it.

 

HUGHES: I only see you calling me from the phone. I donít see you connected on the computer.

 

WICK: Is there like some generic login that you see? Thatís probably me, Iím using our conference room computer, as well as my phone.

 

HUGHES: Okay, itís not letting me, itís saying youíre only on audio, not video.

 

WICK: Okay, thatís weird, um, well then. Do you have this is your email? Can I send it over to you real quick?

 

HUGHESL I can share my screen, if you want. I donít have it on email, though.

 

WICK: Alright, if you have the handout, perhaps that will work. If not, let me just see if I can just email it over to you, real quick.

 

WINEMILLER: I never get the emails, Iím not on the committee, so I think Robin, thatís probably why I donít get the handouts, is that why?

 

DELORIA: I would, I would say yes, but we can certainly include you Davina.

 

WINEMILLER: Thank you, Iím not trying to beÖ

 

HUGHES: Or if somebody has it on their computer screen, right now, I can just give them access to share. Robin, do you have it?

 

DELORIA: Youíre asking a lot of me this morning.

 

BASHAW: Max said that he has it and heís muted, can you share his screen?

HUGHES: I got Max right here, so Max is being made the presenter.

 

DELORIA: Thank you Max.

 

WICK: Okay, there it is. As I mentioned, see those three columns there? On the left there is whatís relevant, just a small scale phase. The one in the middle shows the increase in services and a full scale and the one to the right is everything the is generally available to everyone in the County. So, it helps kind of illustrate the specific contracted services where the medic cars are staged and what the EMS team is doing outside of specific contracted services, where the medic cars are staged and what the EMS team is doing outside of specific contracted services.

 

DELORIA: So, Rob, let me just throw this out here. So, training is something available on a countywide basis here, irregardless if a municipality and agency opt in to the program? Would that be correct Patty?

 

BASHAW: Yes, that is correct.

 

DELORIA: Okay, good, good.

 

WICK: Did anybody have any questions on this?

 

DELORIA: Specific questions, Davina, on that for us?

 

WINEMILLER: Um, sure, So I guess one thing, I am curious about and you know, this is, thank you for sharing this, I appreciate it. So, I just want to go back for a minute and please forgive me for, Iím not quite following this, so, Patty, the cars self-dispatch. So, I am just going to use Wilmington as an example, so a call comes into the Wilmington ambulance, the cars here it on their scanners or whatever, they go there; okay? Wilmington, the ambulance is already there, theyíre not needed, so the car goes back to wherever itís hanging out for the day?

 

BASHAW: No, they stay in that area.

 

WINEMILLER: Okay, so my question is, are we keeping track, say, say the cars and I donít know what the numbers are, so, just as an example, thereís 200 calls in the month and the cars respond to 200 of those calls and how many of those calls were they actually needed and did billing for? So, for example, they were, you know, there were 200 times they self-dispatched and then there was only 3 times that they were needed, are we keeping track of that information?

 

BASHAW: Yes, Matt, you have that; correct?

 

WATTS: Yes, I do.

 

WINEMILLER: Okay, I would like to see that information, as well. Thank you Patty.

 

GILLILLAND: Patty

 

BASHAW: Yes

 

GILLILLAND: If this car responds and doesnít do anything, no PCR is filled out by them; right?

 

BASHAW: Yes, there is a PCR filled out, but not, it says canceled. It doesnít give any patient information. Thatís why itís not billed to the patient.

 

GILLILLAND: Davina, we have got to move on with business here. I mean, if you have these issues on a specific issue, I recommend you talk to Patty offline, but we know we have got to move on with the agenda.

 

WINEMILLER: Sure, yeah.

 

DELORIA: Okay, Max, you can lose the screen, weíll go back.

 

MONTY: Robin

 

DELORIA: Yes

 

MONTY: I just got a question here, I see we have one medic car thatís, thatís located in, in Crown Point and dispatches to Moriah and Ti; right Patty?

 

BASHAW: Yes

 

MONTY: Do we have a medic car thatís stationed someplace central that goes to a couple of other communities?

 

BASHAW: Yes

 

MONTY: Because I believe early on we were talking about having 4 zones, areas where they would be stationed.So, do we have those established now?

 

BASHAW: Yes, there is. The one that goes over on the Wilmington side.

 

MONTY: That doesnít say that on that form that we were just looking at.

 

BASHAW: Yes, it does. It says, Keene/Keene Valley, Medic Two covering Monday through Thursday; Jay/AuSable, Medic Two covering second calls Monday through Thursday. Thatís all the same car.

 

MONTY: Okay, I didnít know, okay, I thought that might be, someone, an EMT or AEMT going to the Keene/Keene Valley area. Medic Car Three, obviously, there. Who covers Schroon Lake area and that area?

 

BASHAW: We are using, right now, Medic Two, but we have a fourth car that can be staffed. We havenít taken that step yet, because I think, Rob, is it in this budget or the full scale?

 

WICK: Medic Car Four is in the full scale budget.

 

BASHAW: Thatís once we get that approved.

 

DELORIA: Okay

 

MONTY: Okay

 

BASHAW: And actually, initially, weíve had them cover Etown/Lewis station a couple of times, because of the staff being out sick, because we need more per diems.

 

DELORIA: okay, Rob Wick, next item?

 

WICK: Okay, so those were the items that we really wanted to kind of get addressed first, before we walk through, more or less, kind of like a report for the rest of the agenda. Everything else that we have in the remaining format of this document is more or less just kind of updates, normal business, so to speak.

We talked a little bit about the grant agreement, weíve got the first budget mod pushed in, then we get claim number two that is off and away and so the next thing would be to, you know, just as we already discussed, square away access to the full scale funds and as we get closer to being able to pull the trigger on that and execute that grant agreement, weíll have to just look at whatís remaining, so to speak and dial in those numbers. So, everything thatís residual from small scale gets lumped into the full scale piece, so weíre not losing anything.

 

DELORIA: So, get that budget up, everybody and you and Mike Mascarenas can set up a meeting sometime early in the month before Ways and Means and everybody work on that and certainly weíre going to do the Jeff Subra meeting, that needs to be set up.

Did we have anything else relevant for today, Rob?

 

BASHAW: I have one more item, and its permission to hire a few more per diems. We have people that are maxed out, now, on their time, because theyíve been here for like two, at least two years and are starting to take time and we need a few more per diems to cover those slots.

 

DELORIA: Okay, would that be for vacation time, Patty? When you say theyíre maxed out on their time?

 

BASHAW: Theyíre getting to that point, yes. Theyíre already asking for vacations and the medic cars are covering those slots, but we canít always, we only had one, Matt, correct me if Iím wrong, weíve only had one issue, so far. We werenít able to cover Moriah, one day.††

 

DELORIA: What areas would they be covering, Patty?

 

BASHAW: The whole county.

 

DELORIA: Okay, all right, so not necessarily one area. They may have to travel and sit in the station and wait for the call, okay. Alright, is that something that something you need today?

 

SUBRA: How does this fit into our budget, the per diems?

 

WICK: That should be incorporated into the grant.

 

SUBRA: Iím preaching, Iím preaching this all the time, the grant does, it doesnít last very long, so just, Iím saying buyer beware, people. All we do is keep adding more and more jobs. Iím just concerned whatís happened after the grant, say it again, but we keep hiring and hiring, hiring. Iím sorry, but weíve destroyed our volunteer program, at least down in Schroon Lake, but, Iím still worried, after all this is done, whoís paying for it, because now youíre adding more jobs. So, I would and I know, Dan, you can speak in, but this thing is just exploding in my, in my opinion.

 

DELORIA: But, the per diems is something that we discuss right from day one, Jeff and how important per diems are, because theyíre not full time employees. Theyíre those people that can step up to the plate when we, when we really need that.

 

SUBRA: But, where are those per diems coming from?

 

SCOZZAFAVA: I understand that this, you know, is going to cost Essex County money, but, when you look at the statistics about how many calls we are now responding to, versus what, when we couldnít respond and you had to wait the timeframe, people, you know, weíre, weíre dying, quite frankly, you know, this is the whole reason why we decided, well we havenít decided, we discussed having a countywide district and I think the cost was minimal. You know, we have a fire in our communities and five fire departments show up, you know, under mutual aid, we donít have any discussion about what those fire districts are costing the taxpayers, but Iíve never had a taxpayer come and complain to me about fire departments responding to a call. So, you know, I think that we have found that we are losing volunteers and thereís somethings that we need to for our constituentsí safety.

 

DELORIA: Yeah, yeah

 

SCOZZAFAVA: I hear about the money. Money, money and believe me, I am very conservation when it comes to money, but this is something that our constituents need, itís like public health. I mean certain services that, that we provide that absolutely need to be provided by local government be it town or county. So, I think we need to take a look at both sides of the spectrum here and realize, you know, this crucial, critical service that our constituency depends upon the population. So, I think we need to look at both sides of the spectrum here and realize, you know, this critical service that our constituency depends upon, the population, our age population is getting older, as we all are aware of. So, we gotta weight both sides of the equation here.

 

DELORIA: Yeah, we can, Jeff, when we have this meeting about Schroon Lake with your squad, we can discuss that in depth, okay?

 

SUBRA: Sure, thanks.

 

PALMER: Robin, can I just weight in?

 

DELORIA: Yes, Dan, please.

 

PALMER: But, you know, and again, Jeff, I know that you werenít here at the beginning of all of this, when we started this study, and we started the discussion, but what drove this was the lack of volunteers. Each community, I donít know whether itís true in Schroon, but there were so many rescue squads that were losing volunteers that we were running into response time. We were not getting out, calls were going unanswered. We had to call another agency to respond, so, thatís what drove the start of this program. The fact that we are hiring people is not because weíre trying to take away volunteers, weíre hiring people because the volunteers werenít there to start with. The fly cars are what represent that first response that we used to get out of volunteers, but weíre now getting out of fly cars. If a fly car heads out for a call, it would be no different than if somebody got a call, actually jumped into their car and put their blue light on and headed out to that location. How that billing plays out depends upon the agency itself. The other thing that I keep hearing is this opt out, there is no opt out in the program that we designed. We had originally asked for a countywide district, EMS district and you could have drawn the lines around towns that wanted out, if that district had been approved, it was not. We are a countywide program, any leftover funding will go on the county budget. I know that doesnít sound great, but I mean, the alternative is that we donít respond to calls. So, this had been frustrating. We feel like, you know, people seem to think weíre doing a poor job at this, when in fact, I think if you look around, thereís been a lot of success in this program over the last year and half, or two years and the bottom line is, people are getting coverage, because people, thereís people hired to respond. Thatís the wave of the future, I donít know, again, I donít know how, we didnít create a situation where people are not volunteering, itís just what weíre dealing with. So, I donít know, in terms of the per diems that weíre hiring right now, we allocated $275,000.00, I think, out of the first phase to pay for these positions, thatís why weíre asking for them. Itís a, itís not an easy, but, you know, I think, like I said to you people before, you know, we can absorb a certain amount on the County levy as we move forward into this thing. In 2024 and 2025, both the bond payments for the jail project and bond payments for the radio project come off the levy. That leaves us some room to pay for some of this stuff. Weíre not going into this blindly. We know where weíre headed down the road. Do we know the full extent? We do not, because not every agency has come forward and said they need help yet. So, as we play down this grant, which weíre trying to leverage, we will have a better handle on what the levy will look like, but we canít give you exact numbers until we get to that point.

 

DELORIA: Okay, I donít see any hands, but letís conclude this meeting. We have Ways and Means in about 15 minutes and Jeff, set this meeting up. I want to be part of it. So, just let us know.

 

BASHAW: So, can I ask that you allow me to put some per diems on?

 

PALMER: Patty, we can do a resolution to hire the per diems.

 

DELORIA: Iíve got that written down for Ways and Means. Do you want to push it from there or from here?

 

PALMER: Well, with the other ones we did a resolution from here to move to Ways and Means.

 

DELORIA: Okay, alright, Iíll move it, so we can get some per diems on place.

 

HOLZER: Iíll second it.

 

RESOLUTION AUTHORIZING THE HIRING OF PER DIEM STAFF FOR THE EMERGENCY MEDICAL SERVICES DEPARTMENT

DeLoria, Holzer

 

DELORIA:All in favor of that? Any opposed? Okay, so weíll move that at Ways and Means.; correct, also? Okay, very good.

Anything further?

 

BARBER: Patty, I know you reached out to Dave Winters to set up a meeting. I would just like to make sure that Iím included in that, by all means.

 

BASHAW: Absolutely, absolutely.

 

BARBER: Thank you

 

BASHAW: Youíre welcome.

 

MASCARENAS: Iím happy to participate in any of those that you want to, Patty, just let me know.

 

BASHAW: Okay, thanks Mike.

 

DELORIA: Okay, letís adjourn this committee meeting and weíll see everybody at Ways and Means. Thank you.

 

AS THERE WAS NO FURTHER BUSINESS TO COME BEFORE THIS TASK FORCE IT WAS ADJOURNED AT 9:45 AM.

 

Respectively Submitted,

 

Dina Garvey, Deputy Clerk

Board of Supervisors