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N.Y. county EMS officials worry over impact of departing ambulance service

EMS officials in Cayuga County are looking at how to deal with increased calls as AMR prepares to leave at year’s end



By David Wilcox
The Citizen

CAYUGA COUNTY, N.Y. — Providers of emergency medical services in Cayuga County aren’t entirely sure how those services will look beginning in 2024.

Since American Medical Response announced last month that it will end ambulance operations in the area on Dec. 31, the county and its remaining EMS providers have been working on a solution. Riley Shurtleff, the county’s director of emergency services, told The Citizen that data is being reviewed to predict the biggest gaps in coverage, as AMR’s two rigs are dispatched to 3,000 calls a year.

No decisions have been made, Shurtleff continued, but the county’s discussions with EMS providers are ongoing.

Still, some of those providers told The Citizen there’s only so much they can predict over the next two months.

“Some things won’t be known until this happens,” said Kezia Sullivan, director of operations for Auburn City Ambulance. “There’s a lot of factors at play. We don’t know exactly what’s going to happen.”

Matt Smokoski, director of Four Town First Aid Squad in Moravia, is also uncertain, if a little more pessimistic, about AMR’s exit.

“I think it’s going to be bad,” he said. “How bad? We’ll see. There are many wheels that will need to turn to help everyone.”

AMR informed the county in an Oct. 20 letter that it will cease ambulance services in the area due to “stagnant reimbursement rates, rising costs of apparatus and medical supplies and the cost of a qualified workforce in a post-pandemic society.” Shurtleff said the private ambulance company has since told county officials and EMS providers that its decision to close its Auburn station is final.

[PREVIOUSLY: N.Y. county officials look at AMR data in search for replacement ambulance service]

A major area of discussion between the county and EMS providers has been their capacity to handle additional calls, Shurtleff continued.

“It is clear that many agencies are struggling with the same situations that AMR has in deciding to close,” he said in an email. “With the cost of employees, supplies and apparatus.”

But some EMS providers in Cayuga County say they’re more prepared to pick up the slack left by AMR than others.

The Throop Fire Department, for instance, posted on Facebook last month that it has “serious need” for firefighters, medics and drivers. The department has formed a task force to address the need.

The department relies on AMR for “a lot of our calls,” Throop Fire Chief Brian Dahl said.

“I think this is going to be a hit to all the volunteers around the city,” he said. “We’ll just have to manage our resources.”

With one advanced life support ambulance and two medics who can’t always be available, the department may have to buy another rig and start billing patients, Dahl said, in addition to hiring more staff.

Southern Cayuga Instant Aid, meanwhile, has “a little bit of excess capacity,” Executive Director Jackie Dickinson said. The provider’s new advanced life support ambulance responds to about a call a day in the towns of Genoa, Scipio and Venice, as well as parts of Ledyard. Occasionally, the ambulance responds to calls in the villages of Union Springs or Aurora when AMR can’t.

“If our crew is sitting there all day and they can take one more call once in awhile, that’s income for us,” Dickinson said. “Plus it would help the wider community. So we’re open to filling the gap.”

Dickinson said Southern Cayuga Instant Aid might be less open if it begins receiving too many calls. But the service has a second, older rig it could staff with volunteers if demand surges.

Like its neighbor on the southern end of the county, Four Town First Aid Squad will be less directly affected by AMR’s exit than what Smokoski called the “doughnut towns” that surround Auburn. But the Moravia provider — whose three ambulances and 18 staff members cover that town along with Locke, Sempronious, Niles and Summerhill — could see ripple effects beginning Jan. 1, he said.

“It’ll affect everyone in the county one way or another,” he said. “Either we have to do calls somewhere else or we have to cover a neighboring agency because they’re doing someone else’s calls.”

Similarly, Auburn City Ambulance expects it will be asked to respond to calls outside the city more frequently, Sullivan said. Last quarter, 2.9% of the city-run EMS provider’s calls were mutual aid to other municipalities. Another 3.2% of its calls required mutual aid into Auburn from providers like AMR, which Sullivan called “a really good neighbor to us.” Still, she’d like to lower the latter number.

One way she hopes to do that is reducing wait times at hospitals. Auburn City Ambulance staff is tied up accompanying patients as they wait for a room at the emergency department for an average of 46 minutes, Sullivan said. Smokoski also cited hospital wait times as a challenge for EMS providers, and added that he would like to see more public education on the subject from the county.

“You don’t need an ambulance because your finger hurts,” he said. “People are abusing ambulances and emergency rooms.”

Though she anticipates more of a need for mutual aid, Sullivan said the city ambulance service has no plans of adding staff or rigs in response to AMR leaving the area. She hopes to fill an open paramedic position, and plans to shift to hiring full-time medics to fill existing shifts instead of relying on part-time medics or overtime. But she’s also prepared for the unknown beginning in 2024.

“We’re certainly going to do our best to continue improving coverage of the city and continue helping the municipalities surrounding us,” she said.

“We’re in a pretty good position to do that, but we’re going to continue preparing and making sure our schedule’s covered.”

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