By David Wilcox
The Citizen
CAYUGA COUNTY, N.Y. 鈥� Providers of emergency medical services in Cayuga County aren鈥檛 entirely sure how those services will look beginning in 2024.
Since American Medical Response announced last month that it will end ambulance operations in the area on Dec. 31, the county and its remaining EMS providers have been working on a solution. Riley Shurtleff, the county鈥檚 director of emergency services, told The Citizen that data is being reviewed to predict the biggest gaps in coverage, as AMR鈥檚 two rigs are dispatched to 3,000 calls a year.
No decisions have been made, Shurtleff continued, but the county鈥檚 discussions with EMS providers are ongoing.
Still, some of those providers told The Citizen there鈥檚 only so much they can predict over the next two months.
鈥淪ome things won鈥檛 be known until this happens,鈥� said Kezia Sullivan, director of operations for Auburn City Ambulance. 鈥淭here鈥檚 a lot of factors at play. We don鈥檛 know exactly what鈥檚 going to happen.鈥�
Matt Smokoski, director of Four Town First Aid Squad in Moravia, is also uncertain, if a little more pessimistic, about AMR鈥檚 exit.
鈥淚 think it鈥檚 going to be bad,鈥� he said. 鈥淗ow bad? We鈥檒l see. There are many wheels that will need to turn to help everyone.鈥�
AMR informed the county in an Oct. 20 letter that it will cease ambulance services in the area due to 鈥渟tagnant reimbursement rates, rising costs of apparatus and medical supplies and the cost of a qualified workforce in a post-pandemic society.鈥� Shurtleff said the private ambulance company has since told county officials and EMS providers that its decision to close its Auburn station is final.
[PREVIOUSLY: N.Y. county officials look at AMR data in search for replacement ambulance service]
A major area of discussion between the county and EMS providers has been their capacity to handle additional calls, Shurtleff continued.
鈥淚t is clear that many agencies are struggling with the same situations that AMR has in deciding to close,鈥� he said in an email. 鈥淲ith the cost of employees, supplies and apparatus.鈥�
But some EMS providers in Cayuga County say they鈥檙e more prepared to pick up the slack left by AMR than others.
The Throop Fire Department, for instance, posted on Facebook last month that it has 鈥渟erious need鈥� for firefighters, medics and drivers. The department has formed a task force to address the need.
The department relies on AMR for 鈥渁 lot of our calls,鈥� Throop Fire Chief Brian Dahl said.
鈥淚 think this is going to be a hit to all the volunteers around the city,鈥� he said. 鈥淲e鈥檒l just have to manage our resources.鈥�
With one advanced life support ambulance and two medics who can鈥檛 always be available, the department may have to buy another rig and start billing patients, Dahl said, in addition to hiring more staff.
Southern Cayuga Instant Aid, meanwhile, has 鈥渁 little bit of excess capacity,鈥� Executive Director Jackie Dickinson said. The provider鈥檚 new advanced life support ambulance responds to about a call a day in the towns of Genoa, Scipio and Venice, as well as parts of Ledyard. Occasionally, the ambulance responds to calls in the villages of Union Springs or Aurora when AMR can鈥檛.
鈥淚f our crew is sitting there all day and they can take one more call once in awhile, that鈥檚 income for us,鈥� Dickinson said. 鈥淧lus it would help the wider community. So we鈥檙e open to filling the gap.鈥�
Dickinson said Southern Cayuga Instant Aid might be less open if it begins receiving too many calls. But the service has a second, older rig it could staff with volunteers if demand surges.
Like its neighbor on the southern end of the county, Four Town First Aid Squad will be less directly affected by AMR鈥檚 exit than what Smokoski called the 鈥渄oughnut towns鈥� that surround Auburn. But the Moravia provider 鈥� whose three ambulances and 18 staff members cover that town along with Locke, Sempronious, Niles and Summerhill 鈥� could see ripple effects beginning Jan. 1, he said.
鈥淚t鈥檒l affect everyone in the county one way or another,鈥� he said. 鈥淓ither we have to do calls somewhere else or we have to cover a neighboring agency because they鈥檙e doing someone else鈥檚 calls.鈥�
Similarly, Auburn City Ambulance expects it will be asked to respond to calls outside the city more frequently, Sullivan said. Last quarter, 2.9% of the city-run EMS provider鈥檚 calls were mutual aid to other municipalities. Another 3.2% of its calls required mutual aid into Auburn from providers like AMR, which Sullivan called 鈥渁 really good neighbor to us.鈥� Still, she鈥檇 like to lower the latter number.
One way she hopes to do that is reducing wait times at hospitals. Auburn City Ambulance staff is tied up accompanying patients as they wait for a room at the emergency department for an average of 46 minutes, Sullivan said. Smokoski also cited hospital wait times as a challenge for EMS providers, and added that he would like to see more public education on the subject from the county.
鈥淵ou don鈥檛 need an ambulance because your finger hurts,鈥� he said. 鈥淧eople are abusing ambulances and emergency rooms.鈥�
Though she anticipates more of a need for mutual aid, Sullivan said the city ambulance service has no plans of adding staff or rigs in response to AMR leaving the area. She hopes to fill an open paramedic position, and plans to shift to hiring full-time medics to fill existing shifts instead of relying on part-time medics or overtime. But she鈥檚 also prepared for the unknown beginning in 2024.
鈥淲e鈥檙e certainly going to do our best to continue improving coverage of the city and continue helping the municipalities surrounding us,鈥� she said.
鈥淲e鈥檙e in a pretty good position to do that, but we鈥檙e going to continue preparing and making sure our schedule鈥檚 covered.鈥�
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