North Shore-LIJ EMS Chief Speaks to Nassau County Mayors About Reengineering Emergency, Ambulance Services

More than 75 Nassau County mayors and village administrators this week heard Alan Schwalberg, vice president of the North Shore-LIJ Health System’s Center for Emergency Medical Services (CEMS), discuss the groundbreaking public-private partnerships now operating in seven communities.

“The shortage of volunteer fire, emergency and medical personnel, especially during daytime hours, and the skyrocketing costs of hiring EMS professionals have become difficult problems for local governments and fire districts throughout Long Island,” Mr. Schwalberg said at the April 8th meeting of the Nassau County Village Officials Association at La Marmite restaurant in Williston Park, NY.

As a result, many communities are now partnering with North Shore-LIJ to provide life-saving emergency ambulance and medical services. Founded more than 20 years ago, CEMS is the largest hospital-based ambulance service in the New York metropolitan area. With more than 600 employees and 110 ambulances and emergency support vehicles, CEMS responded to more than 135,000 emergency calls during 2013.

Mr. Schwalberg explained that the center utilizes an innovative global positioning system (GPS) that instantly directs its ambulances to the right location in the shortest time. This GPS system also allows dispatchers to track ambulance locations and speed in real-time.

Partially fueled by the growth of Long Island’s elderly population, the demand for emergency medical services has been increasing significantly.  At the same time, the number of residents who volunteer to serve as firefighters and as emergency medical technicians has been on the decline.  In addition, labor costs, pension benefits and municipal expenses are all adding higher costs to already overburdened local government budgets.
“Several years ago, at the request of the Rockville Centre Fire Department and the Village of Rockville Centre, we agreed to launch the first-of-its-kind public private partnership in Nassau County to provide 911 emergency response services,” said Mr. Schwalberg. “The program has been hugely successful for the village and has been hailed as a national model for the delivery of emergency and ambulance services.”
Under the terms of the original agreement, North Shore LIJ provided ambulance and emergency medical services for the village weekdays from 6:30 a.m. to 6:30 p.m. when local volunteers are in especially short supply. The village’s costs were based on the number of calls answered by North Shore LIJ. The more calls, the lower the cost. And to protect its taxpayers, Rockville Centre’s bottom-line costs were capped, regardless of the amount of calls. The agreement was recently extended to provide for additional secondary coverage for the remainder of the week.

 Following the success of Rockville Centre, the North Shore-LIJ CEMS developed a new partnership with the Village of Hempstead, which was dependent for years on the Nassau County Ambulance Bureau for the majority of its 911 emergency calls. Under the old system, when Nassau County ambulance services were needed, a Hempstead Village police officer had to be assigned to drive the ambulance to the hospital while the accompanying Nassau County AEMT cared for the patient. That system strained staffing resources within Hempstead Police Department and drove up police overtime costs for responding to nearly 6,000 emergency calls every year.

“There had to be a better way of providing life-saving emergency medical services without taking our police officers off our streets,” reasoned Hempstead Mayor Wayne J. Hall. “We needed to keep Hempstead cops patrolling Hempstead streets. Having police officers become ambulance drivers made no sense at all to us.”

 In June 2012, the Hempstead Village Board of Trustees signed an agreement with North Shore-LIJ CEMS to deliver 24-hour, seven-day-a-week ambulance and emergency medical coverage to the village at no cost to Hempstead’s local government. “We are thrilled with the results,” Mayor Hall said. “We have received more than 100 letters and emails from local residents complimenting us on the emergency services they received. And, we have saved a great deal of taxpayer money as well. We estimate that we have saved between one and one-half hours of police time for each and every call, resulting in a total of more than 7,000 police-hours saved.”
Over the past two years, the North Shore-LIJ CEMS has developed five more innovative partnerships for delivering emergency ambulance services with the Nassau villages of Lake Success and Old Westbury, LaGuardia Airport, the State University of New York at Old Westbury and New York City’s Central Park Medical Unit.

Mr. Schwalberg explained the different service models available to local governments and fire departments. “Ambulances can be dedicated to a specific community, provide backup coverage, provide all services in a ‘turnkey’ operation or just enter into a mutual aid agreement where we share and partner with the community,” he said. “CEMS works with all existing service providers in order to maximize the value each brings to the table.”

“These partnership plans are designed to perpetuate the traditions of the volunteer fire service and respect the practice of home rule,” Mr. Schwalberg said. “It is an added benefit that the partnership can also result in substantial savings for local property-taxpayers.”  Every community is different. There is no ‘one size fits all’ model when it comes to these partnerships. We can fashion an agreement that makes sense for every individual community.”

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