Revival of rural NY ambulance squad called a "miracle"
Town leaders and community members bolstered a grassroots effort to revive the squad, which nearly closed down last year
Watertown Daily Times, N.Y.
CAPE VINCENT, N.Y. — The Cape Vincent Ambulance Squad nearly closed a year ago. On its deathbed as volunteers dwindled, new leaders and members performed a miraculous revival within months.
The turnaround of this small squad, which once had too few people to answer any calls for help itself, bucks a national trend of ailing rural crews shutting down.
“It’s a miracle,” said Town Supervisor Edward P. Bender. “From what those guys did in March to now, it’s a frickin’ miracle.”
Thirteen part-time paramedics and emergency medical technicians and two part-time ambulance drivers have joined since March. The fire district has also recruited eight certified first responders and three EMTs to assist. The ambulance service now provides 24/7 ambulance coverage. It only missed two calls out of about 300 since March, leaving other providers to answer them. It has also given aid to Thousand Islands Emergency Medical Service, or TIERS, and Three Mile Bay Ambulance.
“I think we’re right on target to where we anticipated we would be, maybe a little better,” said squad Chief Jeffrey Call. “This is, to me, one of the proudest things we’ve accomplished in EMS is to keep this thing from falling down.”
The grassroots effort to rejuvenate the squad, directed by town leaders and bolstered by the community, ignited at the end of a long road for the Cape Vincent squad.
The squad attempted to grow its numbers for years but failed. Its leaders tried to recruit new paramedics and EMTs from outside of the town after separating from the fire district, but the effort yielded no results.
Volunteer participation dwindled to only two active medical professionals to answer as many calls as possible, said Tracie Mason, a paramedic. Whenever the squad gained new paramedics or EMTS, it lost them not long after to burnout. Ms. Mason said the work exhausted them. They had to leave their homes, because they did not wait at the fire station; venture to the station and respond to a call on another side of town consistently, all while working full-time jobs.
“It was a vicious cycle,” she said.
The squad responded to virtually no calls for emergency medical service around the time its dissolution was announced in November of 2018. It answered zero calls in October and December and only one in November of that year. Cape Vincent residents relied primarily on TIERS, Clayton, to aid them.
Residents took issue with the squad’s inability to respond to calls, worried they would continue waiting longer for ambulances from TIERS, headquartered 20 minutes away. Despite lacking coverage, they still feared losing the squad when its former leaders planned to cut its life support in November of 2018. If the service ended, the community with more than 500 residents older than 65 would have no nearby ambulance coverage.
Tim White, who serves as vice president of the squad’s board of directors, said if nothing was done, the certificate of need, which allows the local squad to provide ambulance coverage to Cape Vincent, would be revoked by the state Department of Health. Residents would have automatically been provided coverage by Guilfoyle Ambulance Services, located 40 minutes away.
“It wasn’t so much even a question,” Mr. White said, “in the simplest sense, it was either start from the center of the village or start from Watertown.”
ROAD TO RECOVERY
The town council wanted residents to have an ambulance service that rapidly responded to emergencies. With the ambulance squad on the verge of dissolution, it created a committee of residents, including Mr. White, to find solutions.
The committee and town decided they needed to revive the existing squad to keep an ambulance service in town. Many committee members accepted appointments to the squad’s board of directors to steer it away from termination.
Determination from new leaders to resurrect the ambulance service, and compassion for the small community at the edge of the county, attracted experienced emergency responders like Mr. Call, Watertown, now chief, and Nicholas Pickett, now deputy chief, to join the cause.
Despite working full-time with Guilfoyle, Mr. Call said he was adamant about Cape Vincent not losing its squad. Cape Vincent is his hometown, where he volunteered as a firefighter and took his first EMT class. Mr. Pickett, who also works full-time at Guilfoyle, said news of the ailing squad prompted him to help.
Mrs. Mason stayed with the squad after years of hardship. As a native, Mrs. Mason said she cares deeply for her community, has family who live in it and didn’t want to let anybody down by leaving the squad. Guy Sweet, an ambulance driver, said he joined after seeing an ad in the Thousand Islands Sun. His aunt, Marley Barduhn, who has served as a paramedic, told Mr. Sweet he could help as a driver, he said.
“I’ve met the greatest people,” Mr. Sweet said. “Every now and then, I feel really appreciated” by the public.
The struggling squad only recruited volunteers and did not charge residents beforehand, but its new leaders believed both were unsustainable, Mr. White said. They incorporated a method for billing residents, aided by a third-party billing service. The money from bills would generate revenue for payroll and attract enough members to provide an improved ambulance service for residents.
The squad now has a working budget of $267,000, Mr. White said.
Even if they have passion, Mr. Call said emergency medical professionals like him have little time and energy to volunteer. Paramedics and EMTs work 60 to 80 hours a week not only at full-time positions with some emergency medical services, but part-time jobs as well, Mr. Call said.
Training requirements to become a basic EMT are also extensive, which Mr. Call said can turn away people from volunteer-only positions. Becoming a basic EMT requires 160 hours of training, plus 10 hours of clinical work in a hospital or ambulance.
“It’s not something you do because you want to help your community. It’s a job choice,” Mr. Call said.
The squad began billing residents on March 19, and squad members began receiving payments in April, Mr. White said, meaning they worked for 45 days as volunteers. The squad also has an agreement with Guilfoyle to lease emergency medical service providers when needed, although Mr. Call said the squad has not yet required their assistance.
Paramedics and EMTs work 12-hour shifts. Paramedics earn $15-per-hour, or $180-per-shift, while emergency medical technicians earn $12-per-hour, or $144 per shift, Mr. Call said. The drivers are paid for any time they serve. The squad, however, needs more drivers.
The fire district created a first responders program to aid the ambulance and purchased a Ford Explorer and filled it with medical supplies for its first responders, said Fire Chief William Gould. While recruiting volunteer first responders has been a challenge, Mr. Gould said they have managed with help from village employees. Sometimes new firefighters also switched over to becoming first responders.
“It’s worked out good,” Mr. Gould said. I’m really impressed with the way the ambulance turned around.”
With enough manpower to answer virtually all calls, and money to pay squad members, Mrs. Mason said she has found relief after years of hardship.
“It’s been a struggle for so many years,” she said.
A LOOK OUTWARD
Volunteer squads across rural America and New York have been terminated over the years, particularly due to a lack of members.
The Russell and Redwood fire department ambulance services lack enough members to continue, so they disbanded this year. The Croghan and Edwards fire departments ended their ambulance services in 2015.
Ann M. Smith, program director for the North Country Regional EMS Agency, said local volunteer squads lack the means to offer incentives or promote themselves to attract new members. Training availability has also decreased, with Jefferson County losing its only paramedic class this year after Jefferson Community College could no longer offer it. While EMTs receive extensive training to handle medical crises, they are typically not prepped to run business, but ambulance squads demand financial management to maintain their operations, Ms. Smith said. Not all ambulance squads need to have paid staffers, or at least all of its members to receive income, but Mrs. Smith said having people to manage the business aspects of them.
“I don’t feel they necessarily need to be paid, but without having someone manage the business end ... they would struggle,” Ms. Smith said.
Inaction from local government officials on all levels, exacerbated by a lack of awareness, also leaves small ambulance squads with little support to survive, Ms. Smith said.
“Everybody has to come to the table, including municipal leaders, to solve the problem,” she said.
Unlike other the small emergency medical service providers, the Cape Vincent’s leaders and community involved themselves in keeping its ambulance squad alive, Ms. Smith said. New members on the squad’s board of directors were crucial for reinvigorating the squad, particularly when they incorporated billing and payroll, she said.
The revival of the Cape Vincent Ambulance Squad harkens back to an effort nine years ago to ensure Antwerp, Philadelphia and Theresa kept their emergency medical service coverage.
The three communities struggled to retain volunteers for their separate ambulance services, which also resulted in them failing to answer calls left, Ms. Smith said. In order to remedy the issues, an Oxbow resident, Lance T. Ronas, led the effort to consolidate their squads, which lead to forming the Indian River Ambulance Service in 2010. The nonprofit squad retains both paid and volunteer members.
Ms. Smith said the effort would have faltered if not for Mr. Ronas engaging with municipal leaders and fire departments that housed the ambulance services to encourage consolidation.
“It was not an easy venture,” she said.
While the Cape Vincent Ambulance Squad has turned around, it still needs additional support, according to its members.
Mr. White said the squad remains on track to respond to 240 to 280 billable calls, but a typical squad must respond to 400 or 500 to remain in the black. The ambulance service has answered 147 billable calls, or when it provides transportation to hospitals or medical service, as of the end of October, averaging 21 billable calls a month, Mr. White said.
The town has helped finance the squad with 90,000 in its 2019 budget, which proved essential for its sustainability, Mr. White. Officials from the squad have also been squad exploring grant funding opportunities.
The town board, however, has yet to determine how much money to grant the squad in its 2020 budget, Mr. Bender said. He said he would like to reduce the town’s contribution to the ambulance if possible.
“We run a pretty tight budget,” Mr. Bender said.
The squad also needs to replace its 13-year-old ambulance. Mr. Call said the battery has died at times, fuel has leaked and the engine is unreliable.
The vehicle has experienced operational issues three times that squad leaders have considered troublesome, Mr. White said Thursday. The squad began actively searching for a replacement ambulance to purchase, which Mr. White said it might be able to accomplish in two to four weeks. The issues, however, have not inhibited the squad’s ability to treat and transport patients, Mr. White said.
“This ambulance is still in service,” he said.
The town board is not the sole entity backing the ambulance squad. The local Lions Club joined the squad in kick starting a fundraising campaign for a new ambulance. They aim to raise $200,000 to replace the ambulance. Mr. Bender, a member of the club, said they have raised $100,000. They to host another fundraising event Dec. 12 at Ray’s Pub & Grub.
The squad also has long-term goals, such as growing its membership and moving out of the fire hall into its own facility, Mr. Call said.
Despite the hurdles that still lay ahead, members and leaders of the Cape Vincent Ambulance Squad took great strides toward its rejuvenation. Virtually no calls have been left unanswered, more people have signed up and now receive payment, all within less than a year.
“They have really turned it around. It’s not been an easy road, but they’ve done a really good job,” Ms. Smith said.
©2019 Watertown Daily Times (Watertown, N.Y.)