|NYSVARA 2012 Officers|
Michael J. Mastrianni, Jr.
Henry A. Ehrhardt
Executive Vice President
Chris Bitner Vice President
Teresa A. Hamilton
If you are not a member, please join NYSVARA today and help increase the voice of the community / volunteer / non-profit EMS / First Responder Sector in New York State.
For information on NYSVARA membership go to our web site at www.nysvara.org.
Message from our President
As always, I want to thank all those who work to make our Association a valued and recognized one.
As you read through this issue you will see many are contributing to our cause and actively defining our future.
I am committed to continue to make NYSVARA the voice of volunteer and not for profit EMS in New York State and I thank you for your continued support.
If you or anyone you know is interested in helping us with our mission, please do not hesitate to call me.
We hope to see you at Pulse Check!
Michael J. Mastrianni, Jr. President
Pulse Check 2012
Educational Conference and Trade Show
Join the NYSVARA Board, members and EMS providers from throughout New York October 11th - 14th
at the Crowne Plaza in Suffern, New York for the
2012 Pulse Check Educational Conference & Trade Show.
Register Today Here
REGISTRATION: Conference fees and payment policies are detailed on the conference portion of our Web site. Please read the information carefully before registering. Register and pay early to lock in the best rates for what is already one of the most affordable EMS education experiences.
LODGING/MEALS: Registration fees do not include lodging or meals.
Conference attendees are strongly encouraged to stay at the host facility, Crowne Plaza, Suffern, in order to gain the most from the conference experience. On site meal plans are available. However, many other nearby facilities (lodging and meals) are available.
VENDORS: A Complete Vendor package is also available on our website
More information about the conference schedule, seminars, fees, special awards, scholarships, BLS skills challenge, etc. is available online.
Registration - Lodging/Meals - Vendors
CELL PHONE BUYBACK PROGRAM
We are pleased to announce that NYSVARA and SPRINT have joined together to develop a program that will keep old unused cell phones out of our landfills which pollute our environment, as well as, generating addition income to support NYSVARA's mission. It costs you nothing. SPRINT evens pays for postage.
Here is all you do:
- Search your home, office, and basement or anywhere you may have an old unused cell phone.
- Place it in a box along with any accessories you may have;
- Print the attached mailing label and place it on the box;
- Drop the box in the mail.
- THAT IS IT.
NYS DOH TOPS LIST OF LATE PAYING STATE AGENCIES
New York State relies heavily on the not-for-profit sector as a partner in the delivery of services. The state's Prompt Contracting Law, enacted in 1991 as Article XI-B of the State Finance Law, recognizes the importance of not-for-profit organizations (NFPs), including EMT course sponsors and EMS Regional Program Agencies, that provide critical services and support to residents throughout the State.
NYS Comptroller Thomas DiNapoli has released Prompt Contracting Annual Report, an accounting for the timeliness of contracting and payment processes to nonprofits during fiscal year 2011. It reports that NYS agencies were late more than 80 percent of the time in approving contracts subject to the Prompt Contracting Law with nonprofit providers last year, prompting interest payments that cost taxpayers nearly $200,000. NYS agencies report that 1,996 contracts were eligible for interest, but interest was paid on just 37% of those.
The NYS Department of Health had the greatest number of NFP contracts in 2011 at 944 and was late in paying 928 or 98% of them.
The report is at www.osc.state.ny.us/agencies/pcl_reports/pcl_2011.pdf.
PHYSICIAN CERTIFICATION STATEMENT FOR
AMBULANCE SERVICE CONTROVERSY
The law firm of Page, Wolfberg & Wirth, LLC (PWW), which specializes in issues related to ambulance services, advises that the US government's Centers for Medicare Services (CMS) published on 7/30/12 a Proposed Rule revising 42 CFR Section 410.40(d)(2) that would that would significantly change the regulation regarding Physician Certification Statement (PCS) of medical necessity for ambulance level transportation vs. an ambulette or private vehicle for scheduled, repetitive non-emergency transports. The proposed change would make clear that a PCS signed by a patient's attending physician would carry no conclusive weight in establishing medical necessity. Billing for these non-emergency transports can be a significant source of revenue for the larger non-profit services and commercial providers. Such transports include visits to dialysis centers. In New York City dozens of severely handicapped students are transported to and from schools each day.
PWW indicates CMS is reacting to recent Federal District Court decisions holding that a completed PCS from the patient's attending physician for a scheduled, repetitive transport conclusively established medical necessity. These Court holdings are only binding in one jurisdiction, the Middle District of Tennessee. But, they are a strong indication that the current repetitive PCS regulation gives more weight to a PCS signed by an attending physician before a transport. CMS asserts that the regulation does not give such weight to repetitive PCS forms. This Proposed Rule would revise the repetitive PCS regulation to state that a PCS alone doesn't establish medical necessity. CMS also states in the Proposed Rule that ambulance providers bear the ultimate responsibility for determining, and establishing, medical necessity. CMS places the burden on ambulance providers to educate physicians and other healthcare professionals about Medicare's medical necessity and PCS requirements. And, CMS states that in all cases, ambulance providers are responsible to have the appropriate documentation on file, and provide it to a Medicare administrative contractor upon request.
This is a call to action to the entire EMS industry according to PWW and the firm is asking everyone in the EMS industry to comment on this Proposed Rule and by asking CMS to either give a PCS signed by a physician the same weight as any other physician's order; or, eliminate the PCS requirement because it is meaningless if it doesn't conclusively establish anything. PWW submitted its own comments to CMS and prepared a model comment letter for ambulance services to customize in submitting their own comments.
MEDTEC AMBULANCE CEASES PRODUCTION
Oskosh Corporation issued notices to dealers and suppliers on 7/26/12 advising that its Medtec Ambulance brand was ceasing production on or before January 2013. No new orders are being taken but existing orders will be completed. In a filing with the Securities & Exchange Commission, Oskosh indicated lower municipal spending was a major factor in the decision to exit the ambulance business in that slowing sales and customers spending less on new emergency vehicles made the Medtec ambulance line unprofitable. Not cited in the filing is the pending implementation in January 2013 of new NFPA 1917 Automotive Ambulance standards which are expected to increase the cost of ambulances and other emergency service vehicles by thousands of dollars for agencies that adhere to NFPA standards. Oskosh produces heavy vehicles for the military, sanitation and other industries is also the parent of Pierce Manufacturing, a major manufacturer of fire and rescue trucks.
Medtec was founded as an independent company in 1974 and was acquired by Oskosh in 2000. In 2011 the company's plants in White Pigeon, Michigan, and Goshen, Indiana were closed and production was consolidated at the 300,000 square foot Pierce fire truck manufacturing plant in Bradenton, Florida and management had been working to improve efficiencies of production. The relocations and pledges to invest $5 million in capital improvements in Florida helped Oskosh qualify for up to $1.44 million in economic development incentives from the state and two of its counties. At the time, 100 to 150 new manufacturing and office jobs were expected to be created in Bradenton. First layoffs of 325 employees of a 610 production staff at the Pierce plant are expected in the November-December period with a separation package being offered that includes bonuses if employees stay on until pending orders are completed. The Bradenton plant is not shutting down and will continue to manufacture Pierce fire trucks.
Medtec dealers that have been serving NY are Tyler Fire Equipment in Elmira and Specialty Hearse & Ambulance which recently moved from Plainview to a larger facility in East Farmingdale. Medtec deliveries this year in the state include two units to Lutheran Medical Center in Brooklyn, three units to NY Presbyterian in Manhattan plus single units to Hammondsport VAC, Meadowmere Park VFD and Richmond University Medical Center on Staten Island.
Bob O'Neil of Specialty, a Medtec dealer for 15 years, issued a statement to the NYSVA&RA indicating that it had been blindsided by the announcement but that all Medtec ambulances on order would be completed, all Medtec ambulances in the field that are still under warranty will continue to have their warranties honored and Medtec ambulance parts will still be available. Specialty will continue to be a dealer for PL Custom Emergency Vehicles.
MEDICAL DIRECTOR HANDBOOK
AND ONLINE PROGRAM
The Department of Homeland Security's (DHS) US Fire Administration (USFA), in partnership with the DHS Office of Health Affairs (OHA) and the International Association of Fire Chiefs (IAFC), has developed an innovative online educational outreach program and focused website for physician medical directors of local departments and agencies who are involved in emergency medical services (EMS) response. This initiative is designed to assist EMS medical directors in their role of providing medical oversight and direction, training, protocol development, and resource deployment advice.
"This web-based program for current and prospective EMS medical directors will provide information in a conveniently accessible format to support key roles in the provision of EMS to communities," said U.S. Fire Administrator Ernest Mitchell. The online program, developed by the IAFC as part of a cooperative agreement with the DHS OHA and USFA, complements the recently released Handbook for EMS Medical Directors and covers a wide variety of topics for the EMS medical director ranging from occupational health and safety to liability issues.
The handbook is at http://www.usfa.fema.gov/downloads/pdf/publications/handbook_for_ems_medical_directors.pdf
and the online education program is at http://content.learnshare.com/courses/73/406418/player.html
NASAL NARCAN (NALOXONE)
DEMONSTRATION PILOT PROJECT
NYS Emergency Medical Advisory Committee (SEMAC) has approved a demonstration project involving BLS providers at the CFR and EMT level administering nasal Narcan. Regional EMS Councils/Medical Advisory Committees in the following regions have signed on to participate: Adirondack-Appalachian, Hudson-Mohawk (REMO), Monroe-Livingston, Mountain Lakes, Nassau and Suffolk. The goal of the project is to place lifesaving Narcan in the hands of as many first responders as possible in effort to combat the emerging public health emergency caused by opioid overuse/overdose. FDNY EMS proposed a similar demonstrate project for its personnel in 2007 but it was never implemented.
Information from Suffolk County in early July indicated that 24 ambulance services have volunteered to participate in the program and each is either in-serviced and operational, or conducting final training and will be operational shortly. Enrollment of agencies in the pilot program is now closed. 242 providers from 21 agencies have been trained and medical supplies have been placed on 52 ambulances. Per recently enacted local legislation, the Suffolk County Police Department is also in the program, using police officers with EMT certification in select sector cars in the 4th, 6th and 7th precincts, as well as the Marine Bureau. It is expected that 300 police officers will be trained and 60 sector cars equipped with nasal Narcan supplies. There were 5 cases of nasal Narcan being administered BLS providers.
Separate from EMS involvement, there has been an officially sanctioned program available for a number of years to train and equip friends and family of addicts with nasal Narcan syringes as these would normally be the first to observe someone in need of medical assistance. The 2/17/12 Morbidity and Mortality Weekly Report (MMWR) published by the US Center for Disease Control (CDC) discusses the community based opioid overdose prevention programs that exist in the USA, most of which pass out naloxone as either intranasal or intramuscular forms of delivery. This report states that over 53,000 laypersons have been trained with a reported successful reversal of over 10,000 patients who have overdosed. At least 15 states including New York have existing programs. This report was featured in a recent Time magazine article where the authors suggest this should be made an over the counter therapy and suggest that the FDA will be considering this in 2012.
CITY DATA AVAILABLE ON FEDERAL
A new open data portal on data.gov creates a shared platform where American cities can make all of their streams available in one place. Four cities - New York, Chicago, San Francisco and Seattle - have already done so. The new clearinghouse features thousands of openly accessible data streams, including information on building permits filed in these cities, a regularly updated feed of Seattle Fire Department 911 dispatches, budget documents and tons of maps of things like parks, film locations and building footprints. Chicago has 1,826 data feeds on the site, New York has 1,087, Seattle has 711, and San Francisco has 310. The federal government has made 6,560 of their own available.
For more information go to http://www.data.gov/communities/cities There are some apps available for download to smart phones that make use of the data and these can be accessed at http://www.data.gov/communities/node/42391/tools-apps
YOU CAN'T MAKE THIS UP
NY Post Item 8/2/12 from Saratoga Race Track - "Training was shut down early at 9 a.m. on Tuesday, sources say, so the track ambulance drivers could be shown the route to Saratoga Hospital. When a valet was injured saddling a horse on Sunday, he had to give his ambulance driver directions on how to get there."
NEW YORK STATE BUREAU OF EMS NEWS
NYS DOH BUREAU OF EMS STAFF CHANGES
Lee Burns - formally appointed as Director after serving for 2½ years as Acting Director.
Thomas Behanna - appointed Deputy Director, responsible for administration and contracts.
Andrew Johnson - will serve as Associate Director of Education & Certification.
Michael Tayler - will serve as Associate Director of Operations and Information Technologies.
Jim Soto - formerly Associate Director for Pre-Hospital Preparedness assumed a new position with the NYS Office of Emergency Management as the Director of the Hudson Valley Field Office.
BLS FIRST RESPONDER AGENCY RECERTIFICATION COMPLETED
Basic Life Support First Responder (BLSFR) agencies were notified in 2011 that the NYS DOH Bureau of EMS was conducting a recertification process. The Bureau states that an interest in getting "a grip on who is doing EMS in our communities" and "how are we to prioritize our training" if the state's EMS budget is slashed were the reasons for the review. In actuality, Lee Burns is quoted from the February SEMSCO meeting saying "We scared the volunteer fire constituency half to death with the packet" and apologized to the REMSCO for all the phone calls they got.
Agencies interested in renewing their DOH Agency Code, which made them eligible for state funded EMT and CFR training for their members, had until 12/31/11 to submit the required paperwork. Most of the agencies are volunteer fire departments. 491 BLS agencies renewed their certification and retained their Agency Codes. 187 agencies were deactivated either because paperwork was not submitted or the agency did not meet requirements for continuation. Lack of an Agency Code does not preclude an agency from continuing its BLSFR service and services that were deactivated can reapply at any time.
Information gained from the renewal process is that excluding FDNY, which is an ambulance agency, EMT at just under 5,000 rather than CFR at 1,085 is the predominate level of BLSFR personnel. The top 16 BLSFR agencies have almost 2,000 EMTs and 587 CFRs. FDNY adds 8,635 firefighter CFRs to the statewide total. Also, 99% of BLSFR agencies have an AED under the Public Access Defibrillation program and most have physician medical directors.
NATIONAL STANDARD CURRICULA FOR EMS TRAINING IMPLEMENTED IN NYS
The 12/20/12 NYS written exam will be based on the new National Standards education model adopted by the NYS DOH Bureau of EMS. The EMT training course will be longer by up to 30 hours or more with no changes in state funding for courses. Instructors will be called educators. The EMT-I and EMT-CC levels specific to NYS will be preserved with the EMT-I level being brought up to the National Standard AEMT level. Certified First Responders (CFRs) will be called Emergency Medical Responders (EMRs).
PCR SHORTAGE IN NYS - DÉJÀ VU ALL OVER AGAIN
On 8/22/12 notice was received from Lee Burns, Director, BEMS that the NYS DOH Bureau of EMS (BEMS) was again shipping PCR Versions 5 supplies to Regional Program Agencies.
Supplies of PCR Version 5 began to run out in June. Hudson Valley REMSCO notified agencies on 6/26/12 that it had no more copies to give out. The office that handles distribution to agencies in New York City advised in July that it had no supplies of PCRs to give out. NYS DOH had advised they are encountering continued delays in printing PCR Version 5 and did not anticipate printing and shipping PCRs until late fall. Two years ago the problem was NYS DOH funding for a printing contract with a vendor. This year it may be the delay is getting final approval for the format of PCR Version 6. We have been hearing that the new PCR will be increasing from one (1) page to four (4) or more pages.
In the interim, Bureau of EMS provided a link to camera ready proofs of the PCR Version 5. Agencies were advised they may use these proofs to have 3 part PCRs printed locally, at their own expense. Notice of permission to reproduce the copyrighted form was given at the website. Alternatively, NY State DOH advised that is acceptable to use the PDF of the full PCR to make photocopies to be used as a last resort. A photocopy could be left at the hospital as the Hospital Patient Record copy and the Research copy filled out later for submission to keypunch. Agencies were cautioned that if they decided to photocopy PCR forms, to be certain the copies do not include a PCR number.
Two organizations stepped up to help agencies with obtaining PCRs. Proforma Corporate Systems, a printing company associated with Steve Kaye of Spring Hill VAC, offered commercially printed copies of PCRs. Cooperstown Medical Transport had 22,000 PCR Version 5 sets printed and offered packs of 250 while supplies last.
NYS COMPTROLLER AUDITS OF LOCAL
Audit results serve as guidance to ambulance and fire districts and independent non-profit organizations as to what is considered good and/or problematic financial practices. The following audit findings have been recently released by the Comptroller's office: This information is provided to help make agencies aware of concerns and issues that government agencies and oversight offices (like the Comptroller's Office) are focusing on and provide them with an opportunity to consider the situation in their agency.
ARLINGTON FIRE DISTRICT, TOWN OF POUGHKEEPSIE, DUTCHESS COUNTY
District provides EMS ambulance service at the paramedic level
NYS Comptroller report issued 5/4/12 covering 1/1/09 through 12/22/10
Internal Controls Over Selected Financial Activities and Information Technology
http://www.osc.state.ny.us/localgov/audits/firedists/2012/arlington.pdf. Report Finding as follows:
Board did not exercise sufficient oversight to ensure that the District was receiving quality services from an IT contractor to whom it paid $147,480.
Board did not do a needs assessment prior to buying three sport utility vehicles, costing a total of $108,060, that the District had not yet put in service nearly two years after they were purchased.
Board and District officials did not establish sufficient controls over the District's Length of Service Awards Program to ensure that qualified service award credit was being accurately reported for its volunteer members. We found that six of 12 volunteer members reviewed were improperly reported to the program administrator as having attained the points necessary to receive service award credit for the 2010 plan year. Not all service award points given were supported by electronic records or source documents, and the service award point system did not include clear guidance for the calculation of service award points for some categories of activities.
District officials also have not established procedures for the backup of critical electronic data and the verification of the data's integrity, and have not developed a disaster recovery plan. Controls over electronic data were not sufficient to protect sensitive and confidential data stored on District servers, and the District does not have policies and procedures for the transmission of sensitive data on portable drives. Non-technology District personnel have domain and computer operating system administrative rights, and user permissions for the District's financial software were not assigned to restrict access to necessary routines and to adequately segregate incompatible duties. Finally, District computers were used in violation of District policy.
THIELLS-ROSEVILLE FIRE DISTRICT, TOWN OF HAVERSTRAW, ROCKLAND COUNTY
District through the fire company provides rescue services and assists EMS crews at emergency scenes.
NYS Comptroller report issued 5/17/12 covering 1/1/10 through 5/13/11 Report Findings as follows:
Board Oversight and Recordkeeping
David B. Roche Volunteer Fire Company (Fire Company)
David B. Roche Exempt Volunteer Fireman's Benevolent Association (Association)
Board did not provide adequate oversight of the District and its financial activities, exposing District assets to the risk of loss, misuse, and/or theft. Our audit identified over $60,000 in questionable payments and other financial transactions that were a misuse of public funds. For example, a Board member assigned over $36,000 in foreign fire insurance to the Association on his own, in violation of State law. In addition, the District provided about $2,000 in cell phone service to the Fire Company and a cash gift of $10,000 split between the Fire Company and the Association. Also, the District gave gifts of cell phone service, buyer club memberships, a diamond ring ($1,874 for retiring Chief and $384 for watch for retiring Commissioner) and other items to various individuals in the District and Company. All of these examples are inappropriate use of public funds. We also found that the Board authorized payment for over $9,285 for purchases that may not be actual and necessary expenses of the District.
Board did not provide adequate oversight of the Treasurer's online banking activities that included 22 electronic transfers totaling $1,049,900 made during our audit period. Furthermore, the Board did not ensure that the Treasurer recorded and maintained accurate and complete financial records. As a result, the 2010 budget the Board prepared and filed with the Town did not include estimated fund balance of $524,000. The Treasurer reported the District's $40,864 liability insurance as employee benefits and the Board could not provide a resolution establishing a truck or equipment reserve. In addition, The Board minutes did not identify specific claims audited and approved, and the aggregate amount paid. Therefore, the Board could not be sure that they audited all claims. The failure to maintain adequate accounting records precludes the Board from having necessary financial information and increases the risk that errors and irregularities may occur and not be detected and corrected in a timely manner.
DOWNLOADABLE APPs FOR NYS AND
If you have an Android, iPhone, iPad or iPod Touch handy on calls you can also have access to NYS and regional protocols at your fingertips. A number of entrepreneurs have converted field treatment protocols into programs or "apps" that can be downloaded onto smart phones for easy reference at emergency scenes. These are available free or at a nominal cost such as $2.99. Protocols available include:
- Central NY EMS (2/07/2011)
- Collaborative New York Protocols (AAREMS, Mountain Lakes, REMO) (9/23/2011)
- Finger Lakes REMSCO (5/24/2012)
- Hudson Valley REMSCO (11/20/2010)
- Midstate EMS (12/08/2010)
- Monroe-Livingston REMSCO (5/15/2012)
- Nassau REMSCO (11/29/2011)
- New York City REMAC (3/01/2012)
- New York Statewide BLS (8/23/2011)
- North Country EMS (5/02/2012)
- North Shore LIJ EMS (4/24/2011)
- Suffolk REMSCO (4/30/2012)
- Susquehanna Regional EMS (5/24/2012)
- Westchester REMAC (3/31/2012)
- Western REMAC (7/08/2011)
For further information go to: http://www.acidremap.com/ or
RED CROSS UPDATES RESPONDING
TO EMERGENCIES COURSE
The American Red Cross is pleased to announce the new Responding to Emergencies: Comprehensive First Aid/CPR/AED (RTE) program.
RTE is a semester-long first aid/CPR/AED course for high schools and colleges, which features an integrated teaching approach that includes classroom lecture, extensive video assets, simulated emergency situations, discussion and hands-on skills practice. Core content includes recognizing and responding appropriately to cardiac, breathing and first aid emergencies involving adults, children and infants; preventing disease transmission; injury management; healthy lifestyle tips and much more.
The new course includes comprehensive, easy-to-use instructor resources, including instructor's manual with in-depth lesson plans, multimedia presentation, electronic test bank, extensive video library (DVD or streaming) and a web-based training management system for course records and certificates.
BLUE GRILL LIGHTS PROPOSED FOR FIRE
NY Senate Bill S5021A was introduced by Joseph P. Addabbo on 5/2/11 to amend Section 375(41) of the Vehicle and Traffic law, to incorporate a red/blue grille light configuration for fire police vehicles excluding the fire chief's vehicle. The last action on the bill was to refer it back to the Committee on Transportation on 1/4/12 and to date there are no Senate co-sponsors and no corresponding bill has been introduced in the NY Assembly. Senator Addabbo represents the 15th Senate District in Queens County.
The justification given for the change states "Since fire police need to report as quickly as possible to the scene of an emergency in order to secure an area for emergency vehicles, a blue grill light shall be placed on the passenger side of a fire police vehicle with a red grill light on the driver's side in order to permit fire police the right away in traffic. This will also allow fire police to set up a perimeter at the scene of an emergency. By changing the lights on fire police vehicles, this will ease fire police response to emergencies. With the exception of the fire chief's vehicle, all fire police vehicles will have to utilize an alternate red light/blue light system".
A front facing blue light is currently permitted by law only as a courtesy light on the personal vehicle of a volunteer firefighter responding to an emergency. The legislative history of blue lights for the rear of emergency vehicles was fragmented with separate legislation over period of years to add the lights to police, fire and then EMS vehicles. US government agency law enforcement vehicles can have both front and rear facing blue lights..
BOUND TREE MEDICAL OPENS NEW
DISTRIBUTION CENTER IN ALBANY, NY
Bound Tree Medical, a major supplier of EMS equipment, supplies and medications has opened a new distribution center in the Albany area at 620 Pierce Road, Clifton Park, NY 12065.
According to the company's news release, Bound Tree will be able to service customers more efficiently from this new location, which replaces the distribution center located in Henniker, New Hampshire. The Albany Distribution Center has 50% more capacity than Henniker. The full-service Albany facility will distribute prescription drugs/devices along with the full line of Bound Tree's EMS supplies, facilitating more complete and less expensive shipments. "Bound Tree Medical customers will benefit from this expanded Distribution Center," said Mike Underwood, senior vice president of operations of Bound Tree's parent company, Sarnova, Inc. "The Albany facility will help Bound Tree fulfill orders quickly and completely for our Northeast customers."
NYS SHERIFFS' ASSOCIATION YELLOW
Yellow Dot is a free program from the NYS Sheriffs' Association designed to help first responders provide live-saving medical attention during that first "golden hour" after a crash or other emergency. A Yellow Dot in the driver's-side rear window of vehicle alerts first responders that vital medical information is stored in the glove compartment.
How Yellow Dot Works - The kit contains a personal information card and a Yellow Dot decal.
Complete both sides of the personal information card as fully as possible, in pencil. Attach a recent photo of yourself and place it in a visible location in your car's glove compartment.
Complete one card for each person who regularly occupies the vehicle. See below to print additional medical information forms.
Place the Yellow Dot decal on the rear driver's side window to alert first responders to look in the glove compartment for your medical information.
Update the card annually yourself or bring it to your annual check-up. If you sell your car, remove the Yellow Dot sticker.
Use Yellow Dot at Home
A Yellow Dot kit can also be used to alert those who respond to an emergency in your home. Simply place a Yellow Dot decal on or beside your front door and place a completed card for each occupant in a clear plastic freezer bag and place in a visible location in the freezer compartment of your refrigerator.
Print Additional Medical Forms
Copy additional forms if you need to add medical information on family members to your Yellow Dot folder.
How to Get a Yellow Dot Kit
Yellow Dot kits are available for free. To request a kit, Click Here! You can request kits for your friends and family, too!
DRUG SHORTAGES & USE OF EXPIRED
MEDICATIONS - STATE ACTIONS VARY
Minutes from the 5/16/12 NYS EMS Council (SEMSCO) meeting indicate the Director of the Bureau of EMS saying "It was made abundantly clear that expired medications are considered by the F.D.A. to be adulterated and that the F.D.A. is not going to approve the use of expired medications". This seems to preclude NYS DOH taking any action to approve use of medications past their expiration date.
The Oregon Health Authority, Public Health Division, according to the National Association of State EMS Officials, has temporarily adopted OAR 333-250-0051 relating to drug shortages and the use of expired pharmacological and medical supplies in ambulance services. Emergency medical services (EMS) providers in Oregon may periodically be unable to obtain necessary and sometimes life-saving pharmacological and medical supplies due to national or regional shortages. Currently, ambulance services are prohibited from carrying expired pharmacological and medical supplies. The intent of this temporary rule is to provide that an ambulance service will not be subject to discipline for retaining expired pharmacological or medical supplies when certain standards are met. By adopting this temporary rule an ambulance service may carry expired pharmacological and medical supplies and use them, at the direction of a medical director, if not providing the drug would adversely affect patient care or if necessary to potentially save a patient's life.
NEWS FROM NATIONAL ASSOCIATION
OF STATE EMS OFFICIALS
EMERGENCY RESPONSE GUIDEBOOK 2012 EDITION RELEASED
The new 2012 Emergency Response Guidebook (ERG2012) has been released by the Department of Transportation (DOT) for use by fire fighters, police, and other emergency services personnel who may be the first to arrive at the scene of a transportation incident involving dangerous goods. The ERG2012 is primarily a guide to aid first responders in quickly identifying the specific or generic hazards of the material(s) involved in the incident, and protecting themselves and the general public during the initial response phase of the incident.
EMTS AT WILDLAND FIRES - STATE PROCESSES FOR LEGAL RECOGNITION
The Rural EMS Committee has compiled information on twelve Western States regarding state EMT credentialing requirements for wildland fires incidents. The guide is to be used as reference material only, and is intended to assist Medical Unit Leaders at wildland fires. Go to https://www.nasemso.org/Projects/RuralEMS/StateProcesses.asp
NEW YORKERS AMONG NEW APPOINTEES TO NEMSAC
U.S. Transportation Secretary Ray LaHood appointed 25 leaders in the EMS field to serve on the National Emergency Medical Services Advisory Council (NEMSAC), which advises the National Highway Traffic Safety Administration (NHTSA) on all EMS matters and related issues. Among the appointees are two current New Yorkers as well as a former one:
Arthur Cooper, MD, FACS, FAAP - At Large - Dr. Cooper is a Professor of Surgery and Director of Trauma & Pediatric Surgical Services at Columbia University Medical Center Affiliation at Harlem Hospital. A pediatric trauma surgeon who has worked at an urban Level I Trauma Center for more than 25 years, his academic career has been focused on emergency medical services for children.
James McPartlon - Private EMS - Mr. McPartlon is the General Manager of Mohawk Ambulance Service in Schenectady, New York, and has leadership experience at the local, state and national levels. He is the Past President of the American Ambulance Association.
Raphael Barishansky, MPH - Emergency Managers - Mr. Barishansky is Chief of Public Health Emergency Preparedness and Response for Prince George's County, Maryland and leads the Health Department's emergency management responsibilities. He previously was the Executive Director of the Regional EMS Council in Hudson Valley, New York and a Senior Fellow at the George Washington University's Homeland Security Policy Institute.
Administered by NHTSA, NEMSAC provides expert advice and recommendations to the safety agency and its federal partners on key issues, including recruitment and retention of EMS personnel, quality assurance, data collection and EMS education over the course of a two-year term. For more information go to Press Release
NIOSH SEEKS COMMENTS ON SCBA REMAINING SERVICE LIFE INDICATORS
National Institute for Occupational Safety and Health (NIOSH) is seeking comment (Docket 2012-0009) on a proposed revision to the requirements for remaining service life indicators on self-contained breathing apparatus. The proposed revision sets a default service-life at 25% of the rated service-time and allows the indicator to be adjusted higher by the manufacturer, at the request of the purchaser. Comments must be received by August 24, 2012. The entire Federal Register Notice can be viewed at https://www.federalregister.gov/articles/2012/06/25/2012-14764/open-circuit-self-contained-breathing-apparatus-remaining-service-life-indicator-performance
WISER FOR IOS 3.0 NOW AVAILABLE IN THE APPLE APP STORE
Wireless Information System for Emergency Responders (WISER) for iOS 3.0, a universal app for Apple iOS devices, is now available. This new release adds native support for the iPad. Search WISER's full set of known substances, employ WISER's popular Help Identify Chemical capability, and leverage WISER's protective distance mapping feature with an interface customized for your iPad, iPhone, or iPod touch. To check out what's new in the release go to http://wiser.nlm.nih.gov/whats_new_iOS_3_0.html
WISER for iOS 3.0 can be downloaded and installed directly from the Apple App Store at http://itunes.apple.com/us/app/wiser-for-ios/id375185381?mt=8
VOLUNTEER FIRE FIGHTER KILLED WHILE DIRECTING TRAFFIC AT AN INTERSTATE HIGHWAY INCIDENT
The factors that contributed to the death of a 41 year old volunteer fire fighter in Iowa included insufficient training, staffing, equipment and standard operating procedures to adequately establish a traffic incident management area; the victim working a highway travel lane; and an inattentive passing motorist.
The victim had responded to the scene in the department's rescue truck to establish a traffic incident management area (TIMA) while an ambulance crew from his department checked on vehicle occupants involved in the collision. After establishing and repositioning the TIMA, the victim positioned himself in the left lane ahead of the TIMA to direct oncoming motorists to the right lane.
The victim was struck while standing on the left shoulder/left lane when a motorist swerved to the left from the right lane of travel to avoid hitting a vehicle in the right lane. The victim was pronounced dead on the scene.
Several of the "lessons learned" can be used to help educate EMS personnel avoid a similar tragedy. The investigative report is online at
NEWS ITEMS FROM THE NONPROFIT
COORDINATING COMMITTEE OF NY
VALUE OF VOLUNTEER TIME - Independent Sector organization has released the 2011 estimate for the value of a volunteer hour at $21.79. Charities can use this estimate to quantify the value volunteers provide. For more about the value of volunteer time, including new state-by-state figures, go to www.independentsector.org/volunteer_time.
CHARITABLE CONTRIBUTIONS - The IRS has released a revised edition of Publication 1771, Charitable Contributions - Substantiation and Disclosure Requirements, which explains the rules for documenting charitable deductions and explains new guidelines that allow charities to electronically mail documentation to donors. It's at www.irs.gov/pub/irs-pdf/p1771.pdf.
BOARD QUESTIONNAIRE - Accounting firm Fried & Kowgios, LLP, has made available to NPCC members a sample questionnaire that each board member, officer and key employee should complete relative to questions that need to be answered on the organization's IRS Form 990. The latest version of IRS Form 990 asks more questions than the old versions on related party transactions such as loans or grants, and family and business relationships. How can you complete these answers if you don't ask the person who actually knows? The IRS instructions read: "The organization is not required to provide information ... if it is unable to secure the information after making a reasonable effort to obtain it. An example of a reasonable effort would be for the organization to distribute a questionnaire annually to each such person that includes the name and title of each person reporting information, blank lines for those persons' signatures and signature dates..." The sample questionnaire is at www.npccny.org/members_only/Form_990_Board_Questionnaire.doc.
NON-PROFIT ORGANIZATION INVESTMENT SAMPLE POLICY - The New York Prudent Management of Institutional Funds Act (NYPMIFA) enacted in September 2010 requires the adoption of an investment policy by all corporations subject to its provisions, regardless of whether they have endowment funds. Members of NPCC's Government Relations Committee have created draft sample policies that can be used by nonprofits that do not have endowment funds. The first draft sample policy is intended for consideration by a nonprofit that holds cash equivalents (such as bank deposits) as well as some longer-term investments but does not have endowment funds, and delegates or permits delegation of authority to invest or manage its assets to committees, officers, employees or external agents. The second is for a nonprofit that holds cash equivalents (such as bank deposits) as well as some longer-term investments, does not have endowment funds, but has not delegated and does not wish to allow delegation of authority to manage or invest its assets to any external agents, such as an investment manager. The draft sample policies are at www.npccny.org/databank.htm#3
VEHICLE DESIGN CONTRIBUTES TO
DECLINE IN ROAD DEATHS & INJURIES
A national Highway Transportation Safety Administration (NHTSA) technical report issued in June finds "remarkable improvement" to vehicle safety and a marked decline in the likelihood of crashing and increased likelihood of escaping a crash without injuries in a comparison of model year 2000 to model year 2008 cars. NHTSA's analysis of police reported crash data estimates that design improvements over the eight years helped save 2,000 lives, prevented 700,000 crashes and prevented 1 million occupant injuries in 2008 alone.
NHTSA estimates the likelihood of crashing in 100,000 miles of driving decreased from 30% in a model year 2000 car to 25% in a model year 2008 one, when both vehicles are driven "as new". The likelihood of escaping a crash uninjured improved from 79% to 82% as a result of improvements between the 2000 and 2008 car fleets. Improvements are also found for light trucks and vans, and for the chances of surviving a crash and avoiding incapacitation.
The impact for EMS is fewer calls, more RMAs, less severe injuries and fewer transports.
The full report is at http://www-nrd.nhtsa.dot.gov/Pubs/811572.pdf
TEMPERATURE'S RISING - REHABILITATION
By Bill Tricarico, Senior Risk Management Consultant, Emergency Services Insurance Program
Incident Commanders must be concerned with many issues and as the seasons change to summer, heat must be one of the most important. The chances of winning a lottery are 1 in 135,145,920, but according to the National Safety Council, the chance of dying as a result of exposure to excessive natural heat is 1 in 6,174. Throw into that turnout gear, SCBA, hard work, climbing, chopping, advancing heavy hose lines, lifting patients, and all of the other areas of the emergency ser-vices field and that number is reduced even further. According to the U.S. Fire Administration, other factors which relate to how an individual reacts to heat are physical condition, age, chronic disease, recent alcohol use, prior heat injuries, genetics, and current medications. For instance, antihistamines impair sweating and diuretics may increase the rate of dehydration.
All of this means personnel on the scene should be more aware of the heat as well as the symptoms of heat exhaustion which include profuse sweating, headache, tingling sensations in the extremities, pallor or ashen color of the face, shortness of breath, nausea, and vomiting. Of more concern is that according to a NIOSH study, heat exhaustion may cause impairment of judgment even before the other symptoms are noted. Imagine how devastating this could be on the fire ground.
As a result of all this, establishing Rehab Operations is extremely important. Policies and procedures for the how, when, and where for rehab should be established and followed closely. Rehab cannot be an afterthought, it must be there and ready for use when it is needed. It also must be capable of changing in size accordingly based on the size of the incident. If an incident grows, the rehab operations must be able to accommodate additional needs.
Rehab Operations are not limited to rehydration and cooling in hot weather. There should also be some method of medical evaluation of the members. For instance, recovery from heat exhaustion is usually fairly quick, but immediate return to duty is not advisable since heat exhaustion can develop rapidly into heat stroke and monitoring must be maintained.
For more information on Incident Rehab, the U.S. Fire Administration publication, "Emergency Incident Rehabilitation" may be downloaded at no cost from: http://www.usfa.fema.gov/downloads/pdf/publications/fa_314.pdf. And the NFPA provides Standard 1584, "Standard on the Rehabilitation Process for Members During Emergency Operations and Training," which actually provides a sample policy for rehab.
The many tasks associated with the fire service provide for hard and stressful work which is difficult even under the best of conditions. Add in the hot and humid summer temperatures and we know we are expecting a great deal from our members. Rehab could very well be a lifesaving necessity.
NORTH COUNTRY COUNTIES LOOK TO JOIN
5-COUNTY COMMUNICATION CONSORTIUM
Jefferson, Lewis and St. Lawrence counties are reported by the Watertown Daily Times to be looking to join an emergency radio consortium to which five other counties already belong in order to improve communications and gain access to grant funding for radio upgrades.
Lewis County legislators voted June 5 to join the Central New York Interoperable Communication Consortium, formed in 2007 by Cayuga, Cortland, Oswego, Onondaga and Madison counties.
A week later a Jefferson County legislators' committee gave preliminary approval to join the consortium. A proposal to join the consortium should come before the St. Lawrence County Board of Legislators in July.
All five counties in the existing consortium have done or are completing radio upgrade projects designed to improve communication within their borders and with surrounding counties. Officials from the three counties attended a meeting of the consortium in late May, and members were helpful in sharing information.
According to the news article, that expertise and increased potential for federal Homeland Security grant funding will be particularly useful for Lewis County as it continues to work on an expensive emergency radio upgrade project. Federal Engineering Inc., Fairfax, Va., in December completed a $53,000 study of the radio system that identified many deficiencies, including spotty coverage in many areas and little interoperability between emergency agencies. It recommended an upgrade, estimated at $6.4 million to $11.6 million, that could be done in phases. Lewis County in April retained the Wladis Law Firm, Syracuse, to help apply for radio funding and recently contracted with C&S Companies, Syracuse, to do pre-design work on the project for up to $40,000. The current dispatch center at the Lewis County Public Safety Building on outer Stowe Street in Lowville will probably not be adequate to house a new radio system, so county officials also will need to further discuss that issue.
The Department of Homeland Security has a few more funding rounds scheduled this year, with the deadline for applications in the next one coming on July 16.
BITS FROM AROUND THE STATE
DISTRICT 1 - ROCKAND COUNTY
NEW SQUARE VILLAGE EMS, Rockland County, has joined the Town of Ramapo Ambulance District No. 1 which also includes Chevra Hatzalah of Rockland County, Sloatsburg Community Ambulance Corps, Spring Hill Community Ambulance Corps, Ramapo Valley Ambulance Corps and William Paul Faist Volunteer Ambulance Corps. New Square EMS was established under a two year municipal CON process to serve the village population of about 7,000 and recently received its permanent Ambulance Operating Certificate from the NYS DOH. Lohud.com reports Ramapo Ambulance District #1 will take over collecting insurance reimbursements from village residents who receive emergency medical services from the New Square agency. New Square will receive $350,450 - the remainder of its 2012 budget - from Ramapo's ambulance fund to provide services for the rest of the year, retroactive to June 1. The village plans to continue the agreement in 2013. Previously, the corps was funded with the help of donations and insurance reimbursements from people who receive services. New Square operates 4 ambulances with about 40 volunteers. It's service area is also covered by Rockland Hatzalah.
DISTRICT 5 - ORANGE COUNTY
NEW WINDSOR VOLUNTEER AMBULANCE CORPS, Orange County, completed a new public information film. It was made utilizing Good Samaritan Hospital cardiac surgeons and squad members. It was shown for the first time at the hospital's Cardiac Symposium at the Officers' Club at West Point. Plans are to distribute copies of the film to local movie theatres and TV stations.
DISTRICT 6 - SULLIVAN COUNTY
CATSKILLS HATZALAH, Sullivan County, opened its new $600,000 garage, dispatch and command center at 205 Brickman Road (County Road 52) in South Fallsburg in June. The 6,000 square foot facility on 1.72 acres has three ambulance bays as well as heated driveways. The land was donated to the squad in 2010 by Chut Hameshulash, Inc. of Fallsburg which owned the property since 1998. During the summer the Catskills Hatzalah operates 13 ambulances covering 300 bungalow colonies and summer camps in Sullivan and Ulster Counties. Just two of those ambulances remain in the Catskills during the winter months. Previously those two ambulances were kept outdoors and during severe weather ice and snow had to be scraped off before responding to an emergency. Dedication ceremonies were attended by county legislators, town supervisors, local officials and Jerome H. Hauer, Commissioner of NYS Department of Homeland Security. Catskills Hatzalah ambulances are also stationed in Liberty, Monticello and Woodridge.
DISTRICT 7 - SUFFOLK COUNTY
COMMUNITY AMBULANCE COMPANY OF SAYVILLE, Suffolk County, received Town of Islip Planning Board approval for its new headquarters. The squad is moving from its current location on Railroad Avenue to a more central location at Lakeland Avenue and Chester Road. Local residents had expressed concerns about the current and potential for increased traffic in the area as well as noise and "quality of life" issues. As a result, the squad is being required to install a traffic signal on Lakeland Avenue near the entrance to the new station, to be used only during emergency calls, as well as some landscaping changes. The new 10,000 square foot structure will hold the company's five ambulances, a mass casualty truck and trailer and two first responder vehicles. Sayville covers about 40,000 residents in a 23-square-mile area in Islip including Bayport, Bohemia, Oakdale, Sayville and West Sayville and answers over 4,000 calls annually.
SELDEN FIRE DEPARTMENT EMS, Suffolk County, is one of the three recipients of the Congressional Fire Service/MedicAlert Foundation 2012 Excellence in Fire Service Based EMS Award. Selden, a volunteer department, which indicates it is among the top 10 in the state in terms of 911 call volume, was recognized for "a number of new initiatives and expanded training that have reduced reliance on mutual aid support," according to a release from MedicAlert. The department was praised for assigning all newer members to shifts on the ambulance squad, which has resulted in covering all calls without needing mutual aid, and providing 24/7 paramedic coverage. The department was also honored for training its volunteers on dealing with the specialized needs of the growing elderly population in Selden. The other two winners were the Mesa Fire and Medical Department in Arizona (Career) for introduction of Transitional Response Vehicles (TRVs) and innovative methods to manage significant increases in call volume for emergency medical services and reduce overcrowding in emergency departments and the Center Point Fire District in Alabama (Combination) for innovations in training in emergency medical services, and participation in research and development programs.
SHELTER ISLAND TOWN EMS, Suffolk County, volunteers will be getting a Length of Service Award Program (LOSAP) approved by voters by a margin of 180-13 at a special referendum in August. Under the proposal, volunteers age 65 and older would get $360 a year for each year after 2011 they accumulate enough service reward credits for their work, and $240 a year for up to five years of similar volunteer work before that time. To qualify, they would have to earn at least 50 points a year, based on a system which awards points for various ambulance work activities. Town officials say the cost of the program would be about $100,000 a year, or about $5,000 per volunteer, and would drop to about $3,000 per volunteer after five years when the prior service costs before 2011 are fully funded.
SUFFOLK COUNTY Advanced Life Support (ALS) REMAC identification cards that expired on June 30, 2012 have been extended to December 31, 2012. This means that all currently authorized Suffolk County ALS providers will remain in active status as long as his/her New York State certification is current. The plan is to issue updated Suffolk County ALS REMAC identification cards during the ALS protocol update sometime late fall or early winter of 2012 when new ALS protocols for adult and pediatric patients will be introduced.
SUFFOLK SERVES retention program expands VAC member free tuition. The county has a program called the Suffolk Educational Program for Retention in Voluntary Emergency Services (SERVES). This program pays college tuition for eligible volunteers attending Suffolk County Community College (SCCC). The county's Fire, Rescue & Emergency Services Commission (FRES) manages the fire and emergency medical services recruitment & retention program, of which SERVES is a major component. FRES's request for a grant amendment to include members of volunteer ambulance corps in the county's SAFER funding has been approved by FEMA. Until this amendment was approved, only volunteers from fire departments were eligible for grant funding to cover college tuition with county funds used to subsidize those few members of volunteer ambulance corps. This will result in additional seats being made available to independent VAC based EMS volunteers/students attending SCCC as the program moves forward. The next application deadline is May 1, 2013.
Applications are available at www.suffolksbravest.com or by pasting www.suffolkcountyny.gov/Portals/0/fres/Forms/SERVES/Current%20SERVES%20Administrative%20Guide.pdf into your browser. For further information, contact Ryan J. Murphy, Volunteer Programs Coordinator at 631.852.4885.
SUFFOLK COUNTY SPECIAL NEEDS REGISTRY AND JOINT EMERGENCY EVACUATION PROGRAM has been transferred from paper records to a web based application maintained bt the county's Office of Emergency Management. The information will be pushed into the County's Computer Aided Dispatch System, so that information about residents with special health needs will be provided to first responders or used during disaster situations to coordinate shelter and transportation assistance to eligible individuals who have no other way to evacuate their homes. . Participation in the program is voluntary and residents can go to a secure website to sign up.
DISTRICT 12 - NASSAU COUNTY
GLEN COVE EMS, Nassau County, has hired three full time advanced EMTs (EMT-CC or EMT-P) to supplement the one full time advanced EMT it currently employs for the weekday 9:00 AM to 5:00 PM shifts. This allows the agency to have one paid EMS responder on duty 24 hours a day, seven days a week to help fill in the gaps when volunteer members cannot respond. Glen Cove EMS has four ambulances, a mass casualty trailer and truck, first responder truck, utility van, mountain bikes and a 6x6 Gator along with support vehicles. Its 64 volunteers and paid staff respond to over 2,400 calls a year in a seven square mile district that includes waterfront and coastline on Long Island Sound and Hempstead Harbor.
MALVERNE VOLUNTEER AMBULANCE CORPS, Nassau County, has moved into a new 2,500 square foot headquarters in mid July at 11 Hempstead Avenue, next to the village Department of Public Works. The $800,000 cost of the building was paid for a by a village bond and $150,000 raised by the squad. The structure has two ambulance bays, two offices, a meeting room, kitchen and basement. Malverne VAC has about 40 volunteer members and handles about 450 calls a year, often with less than a three minute response time, in the Village of Malverne plus Malverne Park Oaks, North Lynbrook and North Valley Stream, which are unincorporated areas of the Town of Hempstead. The squad's web site indicates "For years, the MVAC was the only Corps in New York State without its own headquarters. MVAC supplies, paperwork, meetings and the ambulances themselves were kept and maintained at numerous places, including member homes, the Malverne Library, the Malverne Police Department and a garage near the Department of Public Works. As the years progressed and volunteer membership decreased, it became necessary to look for members residing outside of the Village, and to build a headquarters to house them while on duty. We have had people interested in joining the MVAC who we always had to turn away because they live too far from the Village and could not respond quickly enough to an emergency call. We now have the capability to consider so many candidates because of the building".
NASSAU COUNTY Executive has proposed a new $7,500 fee for "any case where medical evacuation and transportation is accomplished by helicopter". The proposal is one of a number in an effort to balance this year's $2.7 billion budget. The county, considered one of the richest in the country, is facing a $45 million deficit without further belt-tightening. The Nassau County Police Department Aviation Unit and its 4 helicopters provide police and medevac services for Nassau County residents, visitors and tourists. The unit is located at 8NY9 (Nassau County Police Heliport, Bethpage NY) in one of the hangars of the former Grumman Corp's "Iron Works." The unit and its 13 personnel are under the command of a Deputy Inspector, who is also a fully designated pilot-in-command. Unit members consist of a Chief Pilot, 5 line pilots, 4 New York State certified paramedic/EMT-CC technicians and 3 A&P mechanics.