ambulance

Monday evening’s city budget talks took a step back in time, slightly dé·jà vu in reverse when it came to the city fire and police departments.

City Councilman Paul Viele suggested the possibility of having one ambulance on reserve just in city limits.

“For police and fire reserves, I want to see some research on response times for the (Mercy EMS) ambulance. If they're not good, I’d like to maybe see if we can get one ambulance for the city, that just takes care of the city limits. Its response time isn't that good,” Viele said during the workshop at City Hall. “There's one incident, the kid got bitten by a bee. And there was no ambulance, and they throw the kid in the police car to bring him to the hospital.”

“We’ve got to have a backup pickup truck thing for the hospital. You know, I don't want to spend $250,000 on an ambulance. But just something to keep someone alive at the hospital. If your wife is having a heart attack, and there’s not an ambulance, you’re going to be pissed off.”

City Manager Rachael Tabelski said that she could check with Mercy EMS to see if some type of arrangement could be made to house an ambulance within city limits. Mercy has a current contract with Genesee County to provide ambulance service countywide, which means that wherever an emergency occurs, the ambulance responds to that municipality within the county.

“There is the option for the city to contract for one soul ambulance from Mercy to be staged in the city at all times. What that costs, what negotiations are, I don't know. And opening negotiations in this manner probably isn't the best way to get a good price, because now it's public,” she said. “But I think we have a lot more to explore. I don't disagree with you, that if an ambulance isn't available for our families in the city of Batavia, that's a severe issue, or if our kids were out in sports fields. And that poor kid, I can't even imagine.”

The service throughout the county is strapped as it is, Council President Eugene Jankowski Jr. said.

“I mean, the county is struggling with staffing and ambulance and shortages. They're struggling now. So I don't think it's by design, I think it's just manpower, we'd have to find out,” Jankowski said. “But I knew they were struggling. They couldn't even get in the volunteers.”

The dé·jà vu factor here is that the city at one time operated its own ambulance service within the fire department. As a cost-saving measure in 2008, a prior City Council and city management agreed to shut down city ambulance operations in lieu of a private company taking over the service.

Councilman Bob Bialkowski recalled how “complicated” the process was at the time, and it involved fire department staff and public protests and concern. The city cannot simply operate its own ambulance due to health certifications, he and city management said, but perhaps an ambulance could be housed inside city limits if Mercy agreed to such an agreement.

Tabelski said that both the police and fire chief can talk more about this topic at a future meeting, as, per a related report, there is a “critical lack of services from ambulance not only here but across the state,” she said.

Top Photo: City Councilman Paul Viele, and Council President Eugene Jankowski Jr. talk about the 2023-24 budget during a workshop Monday at City Hall, and above, City Manager Rachael Tabelski, left, Assistant Manager Erik Fix, far right, city staff and council members work through the proposed budget line by line. Photos by Joanne Beck.

It doesn't happen often, but late this afternoon there was a shortage of in-service ambulances serving Genesee County.

All Mercy EMS units were tied up on accidents and medical calls, Le Roy, Byron and Oakfield were tied up, too, and crews in Bethany, Darien and Alexander were requested to respond to their respective fire halls to stand by in case needed.

At the time, there were no in-service ambulances within Batavia city limits. There were also no pending calls in the city at the time.

Within 30 minutes of the Bethany, Darien and Alexander crews being put on standby, three Mercy EMS units came in service.

"It doesn't happen a lot, but there is a system in place to protect the public," said Tim Yaeger, director of emergency management for Genesee County.

Yaeger explained that there is a tiered-response system with Mercy EMS, the respective Volunteer Fire departments' units and the medics with volunteer departments. The county also has mutual aide agreements with neighboring counties.

The volunteer departments can respond to other jurisdictions when the primary ambulance services are tied up.

There's been some talk, Yaeger said, of volunteer departments getting out of ambulance service because of the expense and the difficulty in keeping the services staffed with qualified volunteers.

"This is why we've got to do everything we can to keep those units in business, because they fill in during busy times," Yaeger said.

(UPDATED 12:48 p.m.)

It's been a year since Mercy EMS was established in Genesee County, and during that time Mercy has responded to 4,767 calls in the county.

During the same period, Mercy Flight has been put in the air for medical missions 92 times. There were 166 requests for the helicopter.

In the prior 12 months in Genesee County there were 151 requests and 83 flights.

"As you can see there was no significant change in air transports," said Mercy VP Margaret Ferrentino in an e-mail response to a question about comparable data. "This data along with results of our internal system wide utilization reviews supports appropriate use of resources."

In a statement, Ferrentino said: "We are extremely proud of the men and women at Mercy EMS; their commitment to the community and their dedication to our mission has been outstanding.

“We value the partnerships that have developed with the hospital and agencies throughout the county. The resulting teamwork allows us to effectively provide critical service to those who live, work or play in Genesee County.”

Mercy employs 51 people and has seven ambulances and three paramedic cars in service in Genesee County. 

When Mercy EMS launched on Sept. 1, 2009, the organization hired 57 people. Of those, 43 are still with Mercy.

From the press release:

“To support our patient care focus, we continue to add equipment assets and strive to provide the best work environment possible for our employees,” said Douglas H. Baker, Mercy Flight’s CEO and founding president.

An interesting situation arose tonight that's just kind of worth noting for the record: Mercy EMS ran out of ambulances.

When a girl fell from a scooter on Summit Street at about 10:45 p.m., just a block from UMMC, a dispatcher asked Batavia City Fire who should respond. The city asked for Oakfield.

Seconds later, a Mercy EMS ambulance noted they were in service (meaning free to take a call). The dispatcher asked city fire if Mercy EMS should respond. City fire responded that it was only a "BLS call" (basic life support).

Dispatch informed the Mercy EMS unit that Oakfield was responding. The unit, with a siren blaring in the background, informed dispatch it was only three minutes out. The dispatcher responded that the agency with jurisdiction had already requested Oakfield.

Oakfield's ambulance was on scene within minutes and had the patient quickly transported to UMMC.

I can't think of another time in which I've personally heard a volunteer ambulance service responding to a call in the city since Mercy took over ambulance service.

What if you were having a heart attack or some other serious medical emergency and it was one of those rare times when all Mercy EMS ambulances were tied up on calls outside of the city?

Wouldn't it be a good thing if a paramedic from the city's fire department -- the emergency responder most likely to get to your house first in such a situation -- was certified to provide Advanced Life Support service?

On an 8-0 vote Monday, the Batavia City Council decided to deny city residents that extra level of protection, even though it wouldn't cost taxpayers a single dime.

"I think we had to decide whether we wanted our fire department chasing ambulances, or do we want our fire department used for the function it's best suited for," said City Council President Marianne Clattenburg.

She characterized the vote as a policy decision that extends from the city's decision to get out of the ambulance business.

She said the council wants the fire department to concentrate on fire prevention, code enforcement, public safety, fire suppression and education.

Fire Chief Ralph Hyde requested the council approve a program that would have allowed the department to become ALS certified, allowing its firefighters that are trained as paramedics -- 16 of them are, and all future hires will be, by state law -- to provide a higher level of life-saving services. Paramedic-trained firefighters can only provide Basic Life Support services without ALS certification for the department.

Because of state reimbursement programs and the ability to recoup training fees from other jurisdictions, city taxpayers would not have been required to foot any portion of the bill for ALS certification.

Among the critical life-saving procedures that ALS-certified medics can provide that BLS paramedics cannot is cardiac defibrillation.

"The Basic Life Support will still be there," Clattenburg said. "Once we divested of the ambulance, and the (new service) ambulance seems to be running fine, they seem to be getting where they're going and they've even added personnel and vehicles to respond to the call volume, so it really is a change in focus, because when you have a whole fire department that's geared toward to ALS but yet there is someone else doing that now doesn't make sense, just to keep that mindset and that training level there when that's not their primary job."

For more on the difference between BLS and ALS, read the following Wikipedia entries:

• Basic Life Support
• Advanced Life Support

The retired ambulances of the discontinued service of the Batavia Fire Department are up for auction today.

The ambulances and related items are being sold through the Teitsworth auction site.

A 2008 Ford F350 XLT w/McCoy Miller body and a 6.4-liter diesel engine is bringing in the highest bid so far -- $10,000. The next highest bid is $3,500 for a 2005 Ford F350. The auction closes in a little more than 5 hours.

Fire Chief Ralph Hyde will get his light-rescue vehicle, and it's the one he's requested during at least three City Council meetings now.

After a 20-minute discussion at last night's council meeting, the council sort of collectively shrugged and said, "go ahead."

At the end of the discussion, after saying Hyde has "our blessing," Council President Charlie Mallow motioned his hands like a priest, which drew a laugh.

Hyde has sought permission to convert one of the former ambulances -- the newest one, bought within the past year with a state grant -- into a vehicle that could carry additional rescue equipment that doesn't fit on either Ladder 15 or Engine 12.

Council members dithered, asking him to justify the need for the ambulance as a rescue vehicle. Then they asked him to research the option of selling the ambulance and purchasing a new truck, since the ambulance already has 50,000 miles on it.

Hyde's report Monday night put the cost at a new vehicle at between $65,000 and $189,000.

"It would take a $1,000 to convert it, so it’s far cheaper than going out and getting a new vehicle," Hyde said. "And It’s something that we’ve needed for many years."

Previously, Hyde's argument for the ambulance didn't include using some space inside the vehicle to give people displaced from their homes by fire a place to stay warm.

"In the past, we've had people have to wait outside for 30 minutes to an hour, and had to send firefighters in to retrieve shoes and jackets," Hyde said.

The table and benches inside could also serve as a convenient place to interview fire witnesses.

Councilman Bob Bialkowski complained that he thought the purpose of getting rid of the ambulance service was to save money and he expected all six of the city's ambulances to be sold. Mallow pointed out that previously, the council resolution only authorized the sale of the five older ambulances.

A vote was not required on the decision to convert the ambulance into a light-rescue vehicle since the city owns it and it's already assigned to the Fire Department.

Interim Fire Chief Ralph Hyde has a simple request: Let him use the newest of the retired city ambulances as an additional emergency response vehicle.

It would carry specialized rescue equipment that doesn't currently fit on the fire trucks and provide an air-conditioned space for overheated firefighters to rest when on scene of fires.

Hyde said with all the equipment stored in one mobile vehicle, instead of lockers in the fire station, the equipment could be deployed to emergency scenes when needed much more rapidly.

Councilman Bill Cox questioned, however, the wisdom of not selling the most valuable of the old ambulances at a time when the city still has $1.3 million in debt.

His suggestion set off a discussion last night that revealed that four of the council members present favored letting Hyde repurpose the ambulance, and four favoring selling it.

Councilman Bob Bialkowski suggested that the city look at selling the ambulance -- which has 50,000 miles on it -- and using that money to buy a new, potentially more suitable, all-wheel-drive vehicle for the fire department.

All members agreed the city should at least explore that idea.

I happened across this scene this afternoon -- four of the city ambulances sitting next to the fire hall on Evans -- out of service.

Terming it an "exit interview," Lori Ann Santini, an eleven-year veteran of the Batavia Fire Department's EMS service, told City Council members Monday night that the council had "no idea the distress the employees of the medic division went through" in the months following the decision to discontinue the service.

Santani told the council that EMS personnel felt they were not treated with the dignity and respect they deserved.

"We were never given the dignity of a human being notifying us of our impending job loss," Santini said. "We only found out through the Web. Then we spent months listening to angry words from you again through the Internet and radio. Not one of you took time out of your lives to address us. We definitely deserved that courtesy."

It was an emotional statement from Santini, punctuated by her stern attempt to hold back tears.

"As I stand here today, in front of you, there is no statement, no thank you that would be enough to compensate for how you dismissed us," Santini said. "If you want the City of Batavia to grow you, need to remember these few thoughts. You have to make it a place that people want to live and work. You have to show you that your employees are equally valued and respected."

The council's unanimous decision to accept a settlement negotiated by City Manager Jason Molino ends the fire union's unfair labor practices claims. It also and gives 36 union firefighters raises and bonuses while ensuring Santini and her EMS colleagues will no longer be part of the Batavia Fire Department. City Council President Charlie Mallow said there was no other way of handling the personnel situation.

"You’ve got to understand the laws of this state and how they revolve around union employees," Mallow said. "It’s laid down very precisely how we can do these things. It’s bit cold. That’s how the system works."

Molino echoed Mallow's remarks, saying the city followed civil-service law in how it handled relations with the EMS employees and had no other course of action.

During the press conference, Mallow praised his council colleagues and Molino for making tough decisions and sticking together.

"Change is a pretty difficult thing especially being a municipality, especially with unionized employees," Mallow said. "This city had to make a very, very tough decisions. The people on the council who made (those decisions) took one for the city, for the long-term health of the city. There is no point at which this was an enjoyable experience for the last two years.

"This was always hanging over our heads, especially during tough times when you’re letting people go. I mean, Ms. Santini, it’s pretty heart wrenching. Someone lost her job. I’m very happy that the circumstances were that they were able to retain their jobs with another company, but there is no way this wasn’t a very traumatic experience for everyone on council as well."

Many city managers, Mallow said, would have looked for an easier path, but Molino saw what needed to be done and made the right recommendation.

"Maybe it would have been easy for him to recommend another 20-percent or 30-percent tax increase," Mallow said. "To keep going with the status quo over and and over again and just wait for those post-retirement hits that keep coming, but he didn’t take the easy way."

As for the future, Mallow, who's council term ends in three months, said somebody on the City Council needs to step up, be a leader and deal with the expense, for a small city, of an all-professional fire department.

"I know there is support on the council for that (going to at least partial volunteer), Mallow said. "That's where the next council has to go. We have to be proactive. We have to lower costs, we have to right size this small little city. If the new council is not willing to step up, there will be another tax increase. But that’s me speaking. I‘ve seen the numbers. I’ve seen where we’re heading."

Both Mallow and Molino hesitated to call the settlement with the union a "win-win situation."  Both sides protected their interests and both sides gave up something.

"I think what happened here is you got both parties understanding that there is an increasing amount of risk in either direction and in order to resolve the issue, this is the conclusion that was come to," Molino said.

With Mallow adding, "You have a situation where the union leadership gave up 20 of their people. They also gave up a good percentage of their overtime. When you figure in adding back the four people, maybe half of their overtime. You have the city who gave, but the rank-and-file also gave. They gave dearly. So it’s hard to say that one side came out on top in this."

Press Conference Audio:

• Part 1
• Part 2
• Part 3

Dispatcher at midnight: "Good luck Batavia EMS. Welcome Mercy EMS."

Mercy EMS: "Genesee, Mercy EMS in service, and thank you for the welcome to the county."

Mercy Flight held an open house this evening at its headquarters at the county airport.  Above is a picture of its new ground ambulance fleet. Mercy EMS takes over as primary provider for ground ambulance service in Genesee County at midnight.

The City of Batavia has just released a memo detailing the settlement agreement between the City and the firefighters union.

It will be the subject of a meeting in about 5 minutes at City Hall.

The City Council will hold a closed-door executive session before the standard public comment opportunity. This is always provided prior to council business and public comments are not allowed afterward.

Under terms of the settlement, according to City Manager Jason Molino's memo, the city would:

• Be out of the ambulance business, "a long-term losing operation."
• Eliminate 24 medic positions, saving an estimated $1.8 million in wages and benefits annually. This includes those entitled to retiree health care until age 65, a $1.5 million to $2 million annual savings.
• Avoid litigation and risk, including subsequent applications for injunctive relief, PERB hearings, etc. The case, according to Molino, could drag on for two years at a cost of at least $200,000. If the city lost, a judgment of more than $2.5 million could be imposed.
• Decrease workers comp and liability expenses by $35,000 to $45,000.
• No longer manage 23 intermunicipale ambulance agreements.
• Receive revenue from disposal of ambulances of $50,000 to $100,000.

The proposed settlement will:

• Maintain staffing at 36 firefighters, with each platoon receiving one additional firefighter (the four firefighter/paramedics previously slated for dismissal), and a significant reduction in overtime (according to Molino). The additional revenue available in next year's general fund could be $175,000 to $275,000.
• Extend the existing contract two years, expiring in March 2013, with a salary increase in each of the additional years of 2.5 percent. This is an estimated cost of $50,000 per year.
• Provide severance for the 17 medics being laid off, including 50-percent of sick leave and 30 days additional health benefits. A one-time cost of $70,000.
• Give each retained firefighter a $1,000 bonus, a cost of $36,000.

The one-time costs of the last two items above, a total of $106,000, will be paid out of the ambulance fund.

"In closing," Molino writes, "it should be noted that regardless of the City's confidence with respect to defending the City's unilateral right to eliminate the ambulance service, there is a financial risk. Should this issue progress further to litigation, it must be understood that there is always an element of risk with regard to litigation. ... Should these decisions be adverse to the City, our responsibility for reinstatement and back wages and benefits could exceed $2.5 million, in addition to having no resolution to the current issue and no alternative but to continue to provide ambulance service or negotiate the service away.

"Both parties, the City and the union, have a vested interest to not take this issue to litigation as the financial risk is high."

An application by the firefighters union to prevent the city from disbanding its ambulance service at midnight has been rejected by New York's Public Employment Relations Board.

Both the city and the union received a copy of the decision (PDF) this morning.

David P. Quinn, director of litigation for PERB, ruled that should the city lose the unfair labor practices claim filed by IAFF Local 1896, there are ways that union members can be compensated even if the ambulance unit can't be immediately reinstated.

Union President Greg Ireland was unsurprised by the decision.

"We knew that these applications in New York are rarely very successful," Ireland said. "But if she (a hearing officer at PERB hearing on the matter in Buffalo earlier this month who recommended the union apply) thought it was was worth a try, we thought it was a good idea to give it a shot."

It could also be moot.

As The Batavian first reported last week, the city and union have reached a settlement in the Taylor Law violation dispute that will result in four firefighters keeping their jobs, raises and bonuses for the 36 member department.

The City Council is scheduled to meet on the proposed settlement at 6 p.m.

City Manager Jason Molino was not immediately available for comment.

Mercy Flight will begin preparations at 6 p.m. to take over ground ambulance service by midnight, Tim Yaeger told WBTA today (mp3).

That's when the Batavia Fire Department shuts down its ambulance service and Mercy EMS officially becomes the lead provider in Batavia and Genesee County.

The new service will be staffed with 15 of the former Batavia EMS members and have six emergency vehicles based in Batavia.

Mercy Flight officials have assured people that they will respond to calls in Batavia, even though the City of Batavia has yet to sign a contract with Mercy Flight.

The main point of the contract is that it guarantees response times. City residents will not be without ambulance service in the absence of a contract.

The city is apparently blocked from signing a contract with Mercy Flight because of provisions in the Taylor Law that prevent governments from replacing union workers with contract workers.

The firefighters union has accused the city of an unfair labor practice, an accusation it is apparently agreed to drop in return for some concessions by the city.

City Manager Jason Molino and Union President Greg Ireland have reportedly reached an agreement that will: extend the fire union contract two years; provide a 5-percent pay raise over the additional years; retain four firefighters cross trained as paramedics; give all 36 members of the department a $1,000 bonus; and promise not to eliminate any of the 36 positions during the term of the contract.

The City Council meets at 6 p.m. today to publicly discuss, and possibly vote on, the proposed settlement.

A city unit was unable to respond, for unknown reasons, to an ambulance call in Indian Falls.

The dispatcher reported this to a person on scene and he said, "What else is new?"

The call was routed to Darien's ambulance, which agreed to respond.

The person on scene then said, "Just think, we've only got two more days of this."

On Sept. 1, Mercy Flight takes over primary ground ambulance service in the county.

Greg Ireland, fire union president, and Batavia City Manager Jason Molino have cut a deal after a marathon negotiation session Tuesday that will save some Fire Department jobs and put more money in the pockets of firefighters.

In exchange for several concessions by the city, the firefighters' union has agreed to drop its unfair labor practices claim against the city.

The Batavian has confirmed with two sources that the city has agreed to retain four positions that were slated for termination Monday, and to extend the current union contract -- originally ending in 2011 -- by two years, provide a 5-percent pay raise over the next two years and pay each member of the department a $1,000 bonus.

Additionally, the Sept. 1 staffing of 36 paid personnel will be retained throughout the term of the contract and not be reduced by either layoff or attrition.

Neither Molino nor Ireland would comment on specifics of the agreement (Molino spoke with WBTA this afternoon and would not confirm the settlement).

The City Council is meeting in closed session at this hour to hear for the first time details of the proposed settlement.  When reached this afternoon, City Council President Charlie Mallow said he had no insights into the agreement.

Both the union and the council would need to approve the settlement.

The need for a settlement arises from the city's decision to eliminate the city ambulance service. The union maintained that the decision to eliminate the union jobs and inevitably replace them with contract workers violated the Taylor Law.  The union filed its claim immediately after a county task force announced Mercy Flight as the preferred contractor for ground ambulance service in the county starting Sept. 1.

"The best solution for everyone involved, every one involved, including the city, the fire department and the community is to have a settlement in place before Sept. 1," said Ireland in a phone interview this evening.

Some people think Mercy Flight won't respond to calls in the city unless the city signs a contract with Mercy Flight, but Mercy Flight will be based in the city and Mercy Flight executives have said the ground ambulance service will respond to any calls sent to it by Genesee County dispatchers. But with a settlement, the city can sign a contract with Mercy Flight that will guarantee response times.

Ireland said the main reason to reach a settlement before Sept. 1 is just to ensure everybody can work together well.

"As we move forward, if there is a different ambulance service, then we need to continue to work with them as well because we're going to be on scenes together," Ireland said. "We need to be able to work amicably with everyone."

Many of the Mercy Flight employees will be former members of the city ambulance service. Fifteen city employees were hired by the Buffalo-based non-profit organization.

Under terms of the settlement, the EMS members who had their jobs eliminated will retain their unused vacation and comp time, holiday pay and earned longevity. Those stipulations appear to be items the laid-off workers would have received anyway. They will also get half of their sick time and one-month additional health care coverage.

AUDIO: Interview with Greg Ireland

UPDATE 7:50 p.m.: Council members came out of their closed session smiling and laughing but wouldn't comment on the settlement proposal. When asked what he thought of the settlement or if council would support it, a jovial Frank Ferrando said both times, "We'll have more for you on Monday."

Mallow said the council will meet in public session Monday, but stopped short of saying there would be a vote that night.

Molino only said "no comment."

Mercy Flight today received official word from the New York Department of Health that it can operate a ground ambulance service.

The Ambulance Service Certificate, No. 12071, was issued some time today.

County Manager Jay Gsell also said that he's been told by Mercy Flight that 15 of the 16 City of Batavia ambulance personnel who applied for jobs with the new service were hired.

Mercy Flight is scheduled to take over ground ambulance service in Genesee County on Sept. 1.