EMS
Subcommittee
Monday, February 9, 2026
Matthew Stanley - Chairman
Supervisor Stanley called this EMS
Subcommittee to order at 9:30 am with the following in attendance: Clayton
Barber, Matt Brassard, Ken Hughes, Clayton Menser, Jim O’Bryan, Tim Pierce, Cathy
Reusser, Matt Stanley, Davina Thurston, Ike Tyler, Meg Wood, Mike Mascarenas, Josh
Favro, and Jody Whitney.
Deputies Present: Bill Tansey, Dina
Garvey, and Michael LaVallie.
Also Present: Randi Swires
STANLEY: It’s 9:00, we’ll go ahead and
call this meeting to order. Jody, do you want to start.
WHITNEY: We have one resolution request
which is authorizing the Director of Emergency Services execute agreements with
EMS agencies for the temporary use of the County ambulance.
STANLEY: Can I have a motion? Motion by
Clayton, seconded by Ike.
RECOMMENDATION TO THE PUBLIC SAFETY
COMMITTEE AUTHORIZING THE DIRECTOR OF EMERGENCY SERVICES EXECUTE AGREEMENTS
WITH EMS AGENCIES FOR THE TEMPORARY USE OF THE COUNTY AMBULANCE
Barber, Tyler
STANLEY: All in favor?
MASCARENAS: Do we need to bring that to
Full Board?
TANSEY: Yeah, probably should because
we’re delegating authority.
MASCARENAS: We’re changing authority.
STANLEY: I will bring it up during
Public Safety.
TANSEY: We drafted a contract, so that
the ambulance can be loaned out for 24-36 hours and the Director of Emergency
Services, probably should be able to do that because it happens fairly
frequently.
MASCARENAS: That’s it
TANSEY: It’s not a long term loam, it’s
not a long term lease, it’s a borrow.
WHITNEY: Trying to make the process
easier.
Staffing updates; I believe we’re done
with the layoffs. The first round of layoffs.
MASCARENAS: Yeah
WHITNEY: From agencies that didn’t take
the waiver.
We’re looking at reducing pre-diem pool,
the people that have not been active and we also conducted three paramedic job
interviews for the fly cars.
Contracts updates; Newcomb, has signed
their renew for this year. Etown-Lewis, Willsboro-Essex and Ticonderoga, are
pending. We don’t have any amendments and the new contracts are being worked on
with Mr. Tansey and we have a draft one here, for the stabilization plan. Along
with that, we’ve made up the payment request cover sheet, that will go to each
town when they receive the payment.
MASCARENAS: So, how close are we, Bill,
with that? I have a number of Supervisors, asking me about payment.
TANSEY: The contract is drafted very
similar, I mirrored a grant project that came out with subrecipient agreements,
so, essentially the County giving money to the towns. There is some violation
of the contract provisions at the end. I am not sure how in forceful those are,
because once the money is given, how are we going to crawl it back from the
towns. But it certainly can be used for following years, based on bad behavior,
not giving money to the certain towns.
MASCARENAS: Right, so if you remember
some of the guideline, rules we adopted in terms of program. There’s some
benchmarks that have to be hit in order to maintain the funding levels for all
the different agencies that are receiving EMS funding. Most of it is terms of
performance response rates, those types of things. They don’t loose the money
instantly. We prefer they work with our individuals, Jody, Josh, Michael, in
terms of figuring out ways of getting that response rate better. So, it would
only be through repeat failure that we would consider pulling the funding in
terms of individual agencies. Just so you know, in those contracts, that money
is tied to specific benchmarks.
STANLEY: Would it better to base it on
the previous year’s track record?
MASCARENAS: We could, what I really want
to encourage is that the service is getting on the street. So, if somebody’s
failing, it’s not really about the money as much as it’s about the service,
right? And making sure that when you call 911 that you get an ambulance and I
think that’s our primary concern. So, to have somebody fail for 6-8 months in
getting people out there, I think before we even reach out to people and start
working on a better response or change, would probably not be a great idea.
STANLEY: Like, do we have a benchmark of
what we want? Just because I know, looking at last month, AuSable Forks
Ambulance, utilized the fly car, once. Yet, we’re actually getting the funding
for, so is there a number of how many?
MASCARENAS: There is. Why don’t we send
that out? We’ve got some many new members, what we’re looking at, so it’s about
3 straight months of failure rates. I think, it’s 90%?
WHITNEY: 95%
MASCARENAS: 95% response rate, so you
have to fail that 3 straight months to kind of be on the hey, we want to come
and help you, it’s not meant to be disciplinary, I guess is the big thing. It’s
meant to be helpful and how can we assist you with scheduling? Are you
struggling getting people? We have a pool of individuals that we can send you,
those types of things.
WHITNEY: So, it’s all going to be listed
in the appendix, along with a contract. It’s got everybody’s responsibilities,
the town, EMS agency and this office.
STANLEY: And I know we filled out a form
last year, based on how much we spend.
MASCARENAS: Yes
STANLEY: Is that something that’s going
to be, like I say, the contract to get the money is very short, should there be
what the town has paid towards EMS service as part of that contract right
there?
WHITNEY: That’s basically, it’s got a
one liner that tells you how much the town funded the EMS agency with, but I
believe that’s also going to be listed in the contract. That is just a
coversheet for us to track the money.
MASCARENAS: And it’s not always just the
town, again the struggle with this is town, districts, which could be, there
are about 3-4 different formats, it’s about the same constituency paying for
the service. So, some towns directly fund EMS, some have districts, some are
protection districts, some are under fire exclusively. So, when you look at all
those different things, what we basically said was, how much are your residents
paying for this service? Whether it’s coming directly out of the town coffers
or not is irreverent. It’s coming from them same people in your community and
that’s where we kind of draw the line, because it’s difficult to make everybody
play the same when they’re so different. So, you’ll hear me loosely say town,
agency, all those things somethings mean the same, and it’s hard, because 18
different people, 18 different rules.
STANLEY: I just want to make sure that
we all get in the information that you guys need to be able to pay that money.
MASCARENAS: Yeah, so around September -
October, we will come back to you and say what are you spending now and next
year’s allocation will be based on what you spent in the prior year.
STANLEY: And then it goes back to, not
to be punitive, but you’re response rate was this, next year is going to be
based on this, based on that previous year’s.
MASCARENAS: Yeah and if people are
working with you in good faith efforts to improve the service to get to those
benchmarks, those are all things that we can consider and probably should.
STANLEY: Because I know that’s how we
work on our contract with the ambulances, based on previous year’s call volume,
since we share with Blackbrook.
MASCARENAS: Right, right, you have a
whole different setup with multiple counties. Steve, has something similar in
the south.
BARBER: That would be like the Town of
Chesterfield, where we rely on CVPH or we’re paying a 3rd party
through them for calls. So, again, we don’t depend a lot on your guys, but as I
said, I don’t want any dropped calls in my area either.
MASCARENAS: Right and that was the point
of the funding was those towns weren’t over relying on using our staffing still
had a significant cost. So, to even the playing field and making sure that all
of our constituents in every town, regardless if you were using our staffing,
received the benefit of the added dollars to support that service was critical.
I think that was our goal. Towns that have spent a lot should get a reprieve.
Towns that haven’t spent a lot, it gives them an incentive to spend a little
more to take advantage of the incentive dollars, right and I think so far, so
good. Is what I would say.
STANLEY: Well, I think it’s a great
program, I just want to make sure that we don’t shortchange one side or the
other or create hard feelings or somebody somewhere in the County, make sure
all of our I’s are dotted and Ts are crossed.
MASCARENAS: So, we’ll get that out,
Bill, I think.
TANSEY: Very soon, the contract is
drafted, really to push the money to the Towns and let the Towns do what they
need to do and if we have pushed it too far, we will know for next year and we
will have some data of how this program works and we can adjust the contract
for next year if we need to.
MASCARENAS: Right, so any
recommendations on that contract, we’re all ears.
STANLEY: Awesome.
HUGHES: I am not on the committee, but
Mike, you just mentioned the timeline of September/October, I might encourage
you to back that up one month to August/September, because that’s when Town
budgets are really starting to come to play in August. I know Willsboro/Essex
EMS, had our conversation with our people in mid-august, just a preliminary
conversation, so I would back it back one month.
MASCARENAS: Yup, that works for me.
REUSSER: I am not on this committee,
either, but vested interest, to stabilize workforce in all the different
agencies in the county, have we ever looked at what we’re paying the different
titles? Has there ever been a wage study done, so that we’re not experiencing
people moving from one agency to the other because they’re making $2 more an
hour, but they’re driving 100 miles for instance?
MASCARENSAS: We have, we originally
based our wages off those wages. Where we had some benefit rates there to
consider. The hard part is, they’re private. So, I don’t know how much say we
have or control over what E5 pays versus Etown-Lewis versus Newcomb. If I were
to look at your highways, you’re going to see a big discrepancy between what
everybody in the room pays a HEO and that’s why you’re seeing a certain amount
of jumping. So, I know what it is, but I can’t control it.
REUSSER: Understood.
MASCARENAS: Short of regionalizing all
those services, the wage is going to vary based upon region, what people can
afford to pay, revenues coming in, how many calls they are getting which
enhances your revenues. Those agencies are a little wealthier and can probably
pay a little higher wage.
STANLEY: Anything else on this topic?
FAVRO: One thing, if you don’t mind,
with the fly cars, when you’re looking at the monthly runs for your towns. The
fly cars are out patrolling, now it’s 24/7, so when you see Schroon Lake, say 5
calls or they ran to 5 calls in January. That doesn’t mean that Schroon Lake
dropped 5 calls. They are there to help. So, they may go and do a lift assist,
or a BLS call or help package the patient and help send them off. So, every
time a fly car responds somewhere, we document this response by town. So, I
didn’t want that to get confused with them completing a crew or your agency
dropping that call.
MASCARENAS: Right and the fly cars
really are there for that support and to act as a second level of service when their
ambulances are not available. So, if an ambulance is on a run, hopefully we’ve
got a fly car coming into that area, if they’re not needed, to act as mutual
aid, essentially to make sure that we have service.
WHITNEY: And it just happened this last
week. We completed a crew for a second call in Willsboro.
HUGHES: Josh, are these dispatched?
FAVRO: These are the numbers that the
fly car called into route to a scene or that we dispatched. If they responded,
we put them down.
STANLEY: Can we also get, as part of
this report, the number of calls by agency? Just so we can see the percentage,
essentially, or we can figure out the percentage.
WHITNEY: It’s on here, I can transpose
over.
STANLEY: And I saw AuSable one, Jay one,
is that the Town of AuSable or AuSable Forks going to the Town of Jay?
WHITNEY: I believe it’s because of the
program that is used and it draws it out of that.
MENSER: I am not on the committee, but
we don’t have an ambulance service for Crown Point, itself, because several
years ago when they changed the regulations, you had to have a doctor that was
approving everything that the EMT was doing and we didn’t have a doctor and we
lost that capability. So, we primarily rely on Ticonderoga and Moriah’s
ambulance services to take care of Crown Point, and we just call 911 and the
dispatcher assigns where it’s going to go, which ambulance service is closer or
available. So, I don’t know if we pay any additional fee as a town for that or
if it’s all covered by the insurance of the person that gets taken away.
O’BRYAN: We have a contract.
MASCARENAS: There’s a lot to talk about
there, but I do believe you have a contract with the Town of Ticonderoga for a
certain amount. So, if you have that contract with the Town of Ticonderoga, you
can then give that contract to me and I can give you back ½ of those dollars or
you can increase what you are paying. There’s a lot of things that I think
you’re going to want to consider in terms of that. We can certainly sit down
and have that discussion, but yeah, that’s a lot.
WOOD: Clayton, we do that with North
Hudson, they contract with us and they got some money that way.
BRASSARD: Clayton, I guess we got to get
a contract together.
MASCARENAS: Yeah, I don’t believe we
have gotten a response from Crown Point in terms of what they’re spending, I
don’t know.
MENSER: And because I was not involved
in the budget process, last year, at all, I have looked through the budget, but
I have been looking at what I considered more important things than ambulance
service, but I will definitely be looking at this week.
STANLEY: Any other questions about this
topic?
O’BRYAN: Well, I am a hybrid, I think in
Ticonderoga. Where we sit on the border, we have not only Crown Point on
contract, but we have Putnum, across the county line. Our ambulance, you might
find our ambulance in Grandville, responding, because of dropped calls. I see
it every month. There aren’t a lot of them, last month there was one to
Grandville, Fort Ann, different spots in Washington County and they will call
us and we will respond, which is, I am trying to get my hands around that to
understand. I mean we want to help our neighbors, but in the meantime, we’ve
got to make sure that we’re not putting ourselves in a position.
MASCARENAS: Right, especially when your
mutual aid to the north is likely Moriah, because Crown Point, doesn’t have it.
Yeah, that can be a challenge.
O’BRYAN: It is, so that’s something
we’ve got to keep our eyes on. We have Hague, we respond to Hague, we’ve got
Washington County, Warren County, Essex County, just by where we sit
geographically.
WHITNEY: Training and events; we did a
CRP class for BOCES. The EMT basic class in Keene is almost complete. They
should be testing out, I think this month. ECH paramedic class started on 01/15
and then there is going to be another EMT original refresher starting the 19th
of March at the Public Safety Building.
Recruitment and retention;
HUGHES: Can I ask a question, real
quick? What’s the possibility of getting an EVOC course scheduled for any new
individuals that want to drive?
WHITNEY: I’ll look into that.
HUGHES: I am just curious, thank you.
WHITNEY: Recruitment, retention; I already
mentioned about the 3 paramedic job interviews, and we have two of our county
employees started the paramedic program.
Community outreach; we didn’t have
anything.
Grant status; Randi or Bill, do you want
to?
TANSEY: We’re a lot further along than
we were in December, but we’ve got another email, as Matt knows, kind of got my
blood pressure up on Friday. But, we’re working through it and if I don’t get a
response, I will let you all know, but we have contact and we don’t have the
money, yet essentially.
STANLEY: Well, I may reach back out to
them, as well, because as you know, dollar signs aren’t changing. It’s their
way they want us to report. Well, when you tell us what it’s supposed to be to
report and then change what we’re supposed to report and the dollars haven’t
changed, that’s on you. Get us our money and then…
MASCARENAS: 20 years I have been dealing
with Department of State, at this point, in some capacity and I can tell you
that not much has changed in terms of them getting money out in a timely
fashion. Their reporting forms are relatively straightforward, if you were to
look at them, but the person receiving them seems to have changed their mind
and varies over time. So, when it takes so long to get out a payment, you might
be dealing with person number three or four at this point, that all has a
different way in understanding of how to complete their own forms. The problem
is you can’t move on until first payments made. So, you’ve incurred millions of
dollars in expenses on the back end, but until that first one’s correct, you
can’t claim the other ones because it all changes the prior and the further you
get away from it, the harder it is.
STANLEY: I mean we’re closing in on
6-years for a payment from 2020. I’ll reach out again.
MASCARENAS: And your contact was a good
contact. They were all over it and then again, it just dies and goes away.
WHITNEY: The rest of it is just the
stats on the calls, if you have any questions on that and the next meeting is
scheduled for March 9th.
STANLEY: Alright, does anybody have any
questions?
MENSER: You mentioned CPR training for
BOCES, is there any minimum requirements for town employees that are CPR
qualified?
WHITNEY: What do you mean the minimum?
MENSER: In other words, do I have to
have at least one in ten employees trained in CPR or do I have to have one
period or none at all?
MASCARENAS: No, it depends on what
you’re doing. So, if you’re running a youth program, you have to have a certain
amount of individuals trained per Department of Health rules and regulations,
we typically train them all, but that’s the number that has to happen. So, like
your summer day camps, those types of things, within your highway, no. Some
towns have incentives that will pay town employees stipends that are trained on
some level, on an annual basis. It has helped response rates in different towns
when, if an highway is an EMT or something a little more significant than CPR
trained, they might pay them a little extra, they might allow them to go to calls
and those types of things during their normal work day, but again, that various, so no, there’s no
requirement with the majority of your staff, but it depends on what you’re
doing.
STANLEY: I think Lewis, actually tried
to get a First Responders course, last year. for all their highway guys.
MASCARENAS: You have a handful that are
trained.
PIERCE: Right
STANLEY: Jim, was pushing that.
Any other questions? If not, it is 9:25
and we are adjourned.
AS THERE WAS NO FURTHER BUSINESS
TO COME BEFORE THIS SUBCOMMITTEE, IT WAS ADJOURNED AT 9:25 AM.
Respectively Submitted,
Dina Garvey, Deputy Clerk
Board of Supervisors