Is an ambulance enough?

CHEST PAINS, a car crash, too sick to drive. These and many other conditions would cause most of us to dial 911. Sometimes police officers or firefighters arrive on the scene first, and they can–and do–save lives. But if you were desperately ill or injured, what you’d most want to see is a paramedic and an ambulance.

That’s what emergency services consistently provide in most Columbia County communities. In New Lebanon and half of Canaan, however, the Lebanon Valley Protective Association Ambulance service does not have state paramedic certification. Its volunteer members and paid staff have undoubtedly saved countless lives, and while their level of skill is welcome and useful in emergencies, it’s not the same as a paramedic’s.

Public expectations about the level of service that Americans need have grown, even in New Lebanon, one of the most rural communities in this rural county. Of the seven squads that serve the county, the LVPA Ambulance squad has the least advanced certification. It operates at what’s called the Basic Life Support level, while all but one of the other squads offer Advanced Life Support. The difference can be critical.

Some taxpayers might consider it a fair tradeoff to have a less-advanced level of response if it came with a substantial cost savings. But the ambulance squad recently received a “reminder” from the state that it may not charge for its services because it is part of the volunteer fire company. Revenue from ambulance service bills came to over $105,000 last year. This year, without the authority to bill, the squad needs to make up that revenue from somewhere, and it wants taxpayers to pick up the tab.

That’s asking a lot in this troubled economy, and Canaan Supervisor Rick Keaveney has begun talks with the Chatham Rescue Squad to see whether that squad can cover all of his town. Meanwhile, LVPA Ambulance has asked the towns for large increases instead of actively pursuing other options, like merging with one of the neighboring rescue services or recreating itself as a new, independent service. That seems remarkably out of touch with the hard-pressed taxpayers in the communities the ambulance squad serves.

That said, it’s only fair to point out the remarkable achievement of LVPA Ambulance in keeping alive a small rescue squad. As businesses have closed in New Lebanon, residents have had little choice but to commute far from town to reach their jobs, assuming they can find work. Like volunteer fire companies everywhere, there are certain times when it becomes nearly impossible to round up enough people to augment the services provided by paid squad employees. And even in the best of circumstances, only a handful of volunteers are willing to sacrifice the time and sleep and energy it takes to help sick and injured strangers.

It would be a mistake to leave the LVPA to work out this current financial crisis on its own. In purely technical terms, the residents of New Lebanon and half of Canaan constitute the most underserved folks in the county when it comes to medical emergency responders, and if another squad or squads pick up coverage of the places LVPA Ambulance used to serve, that switch will undoubtedly produce unanticipated ripple effects in neighboring towns.

For years, the county has tried unsuccessfully to play a much larger role in coordinating rescue squad policies and procedures. Then last fall the Board of Supervisors adopted a resolution to operate a countywide ambulance service. The LVPA Ambulance crisis creates an opportunity for the county to take the lead in the effort to ensure that everyone who lives here has the best possible emergency medical response service.

In the past, it didn’t matter much what ambulance showed up at a medical emergency; there wasn’t a lot that could be done for a patient until he or she reached the hospital. But advances in technology and training mean that lives can be saved and health restored with state-of-the-art rescue procedures and professional personnel.

Instead of offering a plan to upgrade its operation to match that of other local squads, LVPA Ambulance has proposed squeezing more from taxpayers for the same service. This attachment to the status quo smacks of self preservation rather than the squad’s tradition of public service. It’s time, then, for others to determine the future of medical emergency response in the county’s northeast corner. 

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