When will they come?

First responders say new policy means injured will wait

RED ROCK–A county policy called “Emergency Medical Dispatch Response Assignments” means that dispatchers will no longer send local Basic Life Support First Responder fire companies to non-life-threatening situations in most local communities. The policy, put in effect last July by Columbia County 911, is seen as a way to handle emergencies more efficiently. But some fire companies say it may leave patients with injuries like broken bones waiting for up to half an hour for assistance.

According to County 911 Director Rob Lopez, dispatchers are trained in a unified, medically approved system to determine the priority of incoming calls and to dispatch appropriate help. Non-life-threatening calls can be Priority 3 (broken bones, allergic reactions) or Priority 4, (general illness). According to the policy, “the appropriate response… will be automatically selected by the software.”

 

But in interviews with representatives of both the Red Rock and Austerlitz fire companies, and in subsequent phone calls to other fire chiefs, The Columbia Paper has learned that some fire companies are displeased with the new policy, fearing that the residents of their districts will suffer as a result. And while the fire companies have an “out”–they can sign an agreement holding Columbia County and its 911 division harmless and maintain “at their own expense” a million-dollar liability insurance policy, only Canaan has done so.

Mr. Lopez said that his agency has imposed the insurance and liability requirements because in dispatching the First Responders the county would be violating its new policy.

But the policy itself has come as a surprise to some fire companies. Red Rock firefighters said they learned of the change on the ColumbiaPage, a privately maintained firefighter information website. The Austerlitz company learned of it only when its trucks were not sent on a Priority 3 call from one of the company’s own volunteers.

Mr. Lopez said that the policy was first discussed at a meeting in Claverack in 2008. But local fire company members contacted for this article don’t recall attending that meeting or even receiving notification of it.

“And I was chief then,” said Niverville Fire Chief Wayne Huyck, who said he did not know of the Claverack meeting.

Red Rock Assistant Chief Tab Eigenbrodt said that he requested minutes of the meeting and was told that none existed.

In a letter to Red Rock Chief George Hoover, County Attorney Robert Fitzsimmons said that part of the reasoning for the change was based on “the use of lights and sirens and the inherent risk associated with their use.” But Mr. Eigenbrodt pointed out that Priority 3 and 4 calls don’t involve the use of lights and sirens; those are used only for responding to the life-threatening Priority 1 and 2 emergencies.

Mr. Fitzsimmons also said in that letter that the new system’s protocols “dispatch the appropriate level of response” for the call. But under the new policy, ambulances with professional paramedics, the most highly trained responders, are now responding to low-priority calls.

That use of paramedics appears to contradict the National Academies of Emergency Dispatch position that “proper classification of medical calls can conserve precious [Advanced Life Support] response units for the most serious cases.”And the new approach may result in tying up an ambulance on a lower priority call when a Priority 1 comes in, Red Rock Vice President Don Fischer said.

East Chatham Chief Matt Distin said that in some low-priority calls, “We’ll get out on the scene and they get upgraded” to a situation more serious than what the dispatcher thought, perhaps because the condition of the patient has worsened in the interim. If local companies aren’t dispatched, he said, “it could be half an hour before somebody could be on the scene. That was the whole reason we started the First Responder program and it’s like we’re taking steps backward.”

Churchtown Chief Winnie Hotaling says that his company is writing a letter to the county government saying that the fire company wants to respond to the Priority 3 and 4 calls “for the community and for public relations.” He said a couple of people have complained about the new policy, and there were “a couple of calls where it could have gone bad real quick.”

Red Rock has already sent such a letter.

But Mr. Fischer, the Red Rock vice president, said his fire company won’t comply with the county’s conditions on insurance and liability “on advice of counsel.”

“Red Rock Fire Company has a contract with three towns to provide our services. Columbia County is simply our dispatching agency. We have no contract with them,” Mr. Fischer said.

Mr. Huyck believes that the change was based on a letter from his company asking to be relieved of Priority 3 and 4 calls. His guys were getting “burned out, and Niverville Rescue response is quick,” he said. But it was not his intention that the policy should apply countywide. “It should be up to the fire department,” he said.

Not all companies are as concerned. Tri-Village is okay with the change. Chief Ed Knott said that responding to the calls “was a burden on an already overworked group of people.” But he agrees that the county should not force its policy on responders: “We are a completely independent organization,” said Chief Knott.

Stottville Chief Mike Briscoe has no problem with the new policy. His area is served by Greenport Rescue. While he didn’t know the response time, he estimated it at less than five minutes.

Those companies unconcerned with the change have a “response ambulance less than five minutes away,” said Mr. Eigenbrodt, the Red Rock assistant chief. In those situations, he agrees the policy makes sense. “But way out here it doesn’t. You would think you would want to send the closest responder.”

To reach Gail Heinsohn, email

 

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