FONDA — Montgomery County has purchased a used ambulance and has another brand-new emergency medical vehicle ordered for delivery later this year to back up local agencies, according to Sheriff Jeffery Smith.
“It’s all about being prepared,” Smith told leaders from local ambulance agencies and emergency management officials at the Montgomery County EMS Advisory Board meeting on Tuesday. “We continue to move forward.”
The Montgomery County Legislature in April authorized using up to $250,000 from the fund balance to purchase a new ambulance and all needed equipment from Vander Molen Fire Apparatus Sales & Service. Excess funds could be put towards buying a used backup ambulance.
“That’s in case one ambulance goes down, that doesn’t do any good if you don’t have a backup,” Smith said. “The county will not put two ambulances out at once.”
A brand-new ambulance was ordered for $129,400 for expected delivery in November or December. A used ambulance has been purchased and delivered for $20,000. Roughly $80,000 has additionally been spent on medical technology and equipment to be shared between the vehicles.
The county plans to run the ambulance as needed when other agencies seek support due to high call volumes, staffing shortages or vehicle breakdowns. The county was previously granted a municipal certificate of need for ambulance service operating authority by the state Department of Health. Service would be provided by medically certified deputies or volunteers with the Montgomery County Office of Emergency Management.
Since the county does not plan to hire staff or operate the ambulance daily, Thomas Pasquarelli, director of operations at Lake Valley EMS, said the initiative will not impact operations at his agency. Lake Valley was formerly known as the Greater Amsterdam Volunteer Ambulance Corps (GAVAC) prior to its recent acquisition by Priority Ambulance, a national for-profit agency.
“The county has come out clearly and said they don’t necessarily want to be in the ambulance business, but they have to be prepared should something happen to a local service,” Pasquarelli said. “The goal is that they never need it.”
Four certified members of the sheriff’s office were previously tapped to respond to emergency medical calls, using their patrol vehicles as medical fly cars, when ambulances are unavailable or delayed and the officers are free from urgent police tasks. Deputies have rendered on-site-only aid at approximately five calls since the service rolled out over a month ago.
“That’s a benefit to every county resident, it gets first responders to the scene that may be closer than the nearest ambulance and they can perform that BLS [Basic Life Support] care until the ambulance arrives on scene,” Pasquarelli said. “We’ve had proven cases where that has worked.”
Local officials have sought to help stabilize local ambulance services following the shutdown of multiple providers throughout the region, including the Ambulance Service of Fulton County in Gloversville and Johnstown Area Volunteer Ambulance Corps.
Closures have led to greater reliance on a handful of area agencies that are grappling with increasing call volumes amidst far-reaching staffing shortages and financial tumult from low insurance reimbursement rates.
Lake Valley and St. Johnsville Area Volunteer Ambulance Corp (SAVAC) are the primary providers in Fulton and Montgomery counties. The Amsterdam Fire Department responds to emergency medical calls within the city. The Johnstown Fire Department does the same in its city with some mutual-aid capabilities.
Local leaders have repeatedly said acquiring an ambulance will position Montgomery County to ensure the long-term continuity of emergency services in the event any existing agencies falter, while immediately helping relieve the strain on agencies by partnering with them to offer support when needed.
The used ambulance is being serviced by the Montgomery County Department of Public Works and will be ready to begin operations when needed equipment has been received, according to Smith, who could not provide an exact timeline.
“We’re not ready yet but, when we are, we’re going to communicate with St. Johnsville and Lake Valley to see if we can support them in any way,” Smith said.
Shannon Countryman, chief administrative officer at SAVAC, has been critical of the plan, which she says will put the county in competition with local agencies already strained by staffing shortages and tight margins. She has suggested the money could be better spent on direct financial support to existing ambulance services.
Montgomery County Executive Matthew Ossenfort last week said discussions are ongoing surrounding the potential for financial support for local agencies.
“We’re just trying to be prepared and helpful and all of the options are on the table,” he added.
Nearby, Fulton County funds its three existing ambulance providers through negotiated contracts. The total cost last year was $516,300 combined, out of which $71,000 was paid to the Johnstown Fire Department, $156,200 to SAVAC and $289,100 to GAVAC. Ambulances responded to 7,899 calls, meaning the county paid approximately $65.36 for each call.
Steven Santa Maria, director of emergency management for Fulton County, last week said officials came up with the payment system to help sustain providers while taking a more active role in agency oversight to avoid the abrupt closures from years past that came without warning.
“We looked at a lot of options,” Santa Maria said. “We feel this was a good way to go and it has seemed to work out pretty well.”
It would have cost the county more to operate its own ambulance, according to Santa Maria, who estimated 24/7 operations for a single vehicle at around $500,000 to $600,000.
“It would have been a huge expansion of government and it would be a pretty good hit to the tax base,” Santa Maria said.
Although he said neither GAVAC or Lake Valley ever advocated for Montgomery County to take a similar approach, Pasquarelli acknowledged direct financial support would be welcome in a field with low reimbursement rates, where only services involving transports can be billed.
“We’re fortunate enough that we’re very strong as an agency,” Pasquarelli said, “but, certainly, anything to offset costs would be great.”
Reach Ashley Onyon at [email protected] or @AshleyOnyon on Twitter.