Governor's Change to EMS Information

This page last updated on 04/15/2012

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  • SAMPLE LETTER - PLEASE COPY AND PASTE ON YOUR AGENCY LETTERHEAD - SEND VIA EMAIL OR FAX TO STATE LEGISLATORS ASAP!!

March 31st - The NYS budget was voted on by the legislature and signed by the Governor on Friday. After a review of the budget documents, we have confirmed that our cautious optimism was well placed and all of the proposed revisions to  Article 30 were removed from the budget process.  The successful defense to the proposed law changes was based on the grass roots effort started by the Council Officers and carried by the providers of our region and you, the members of the council.  From the beginning, we felt that the proposed changes would be detrimental to the delivery of pre-hospital care and would impinge on local representation and administration.  The support provided by the multitude of EMS agencies and their providers in our region was enormous and proved to be the deciding factor to the elected Legislators.  This support, combined with similar actions from our partners in Suffolk and NYC helped turn the tide and provided the impetus for the Legislature to confront those supporting these changes and successfully removed it from the budget process.  I am sure that some manner of a revision process for Article 30 will occur in the future and we look forward to working with the legislature towards a rational and reasonable revision process. 

I would like to especially thank Senator Dean Skelos, the senate majority leader for his tremendous support and leadership.  I would also like to thank all of our State Senators and Members of the Assembly elected from Nassau who endured our phone calls, visits, emails and faxes and supported us in this endeavor.  

Please take a  moment to contact your Elected Members of the State Legislature and thank them for their efforts on behalf of the EMS providers of our region!

March 10th - We would like to thank all that attended the recent town hall meetings in Oceanside and Great Neck regarding the pending Article 30 Law Changes. We are cautiously optimistic but still ask that you contact your state legislator ASAP! We have about a week before the budget process heats up for a vote - all agencies should write a letter or use our sample letter on the website to send to the legislators.. members and their families should contact their legislators by email or on their websites also... Keep up the Fight! We are asking to remove the entire law change from the budget and sit down at a later date to rationally discuss article 30 changes. We are not in favor of or support the "EMS Coalition" of state agencies that are asking for a transition period - that indicates that the fight is over...

I am writing this page to provide and update on the current concerns and status with the law changes contained in the Governor's proposed budget.  We recently had a special Executive Committee meeting to review this issue and the effects to our organization and the pre-hospital providers in our region. 

Several weeks ago, we started hearing chatter about proposed changes to multiple NYS laws and the upcoming budget.  We were finally able to obtain the proposed budget and the section containing the law changes.  One of the many laws slated for major change is the Public Health Law, including Article 30.  Article 30 of the NYS Public Health Law is the primary EMS law and the statute that the Councils and REMAC operate under. 

Now, a little background - the Council reports to the State EMS Council (SEMSCo) and the REMAC reports to the SEMAC through our REMSCo.  Our Council and the Program Agency (the business office we have located at NUMC) logistically and for funding, report to the NYS DOH Bureau of EMS (BEMS).  So, as of today, we have heard NOTHING from the NYS DOH including BEMS.  When we contacted them, we have been advised that they have been issued a gag order and are not allowed to discuss the proposed law changes.  In regards to the SEMSCO, nothing has been received from them either but, 2 weeks ago at the scheduled state meetings, there was a "town hall" type meeting at which the multitude of draconian changes to the law were announced and had limited discussion.   

Since then, we have learned of the existence of a state "EMS Coalition."  This umbrella group consists of FASNY (Firemen's Assoc of NY), NYS Assoc of Fire Chiefs, NYS Volunteer Ambulance and Rescue Assoc and UNYAN (United New York Ambulance Network - representing proprietary and commercial EMS Agencies).  They issued a joint statement basically stating that these changes were occurring as a result of a Governor's Committee and the changes represent a positive updating to Article 30 and although they remain cautious, we will see the changes. We do not support this letter and both myself and other members of the council and program agency have challenged their position and statements.  We have been forwarded to other people and given ambiguous answers.  We are now being told that the changes are a "done deal" and we should make the best of it.  As I touch on some of the proposed changes, hopefully  you will agree that we cannot accept these answers. 

Some of the proposed changes:

·        Consolidation of SEMSCO, the State Trauma Committee (STAC) and the EMS for Children Committee (EMS-C) into one State advisory board without statutory authority, only the ability to make recommendations to the commissioner of health.  The SEMAC would be disbanded.  Currently the SEMSCO has 31 seats and would drop to 23 seats even though its merging with other committees.  All of the members would be appointed by the commissioner of health and not the mandated regional representatives as we have now.  The loss of the SEMAC eliminates a major interface for physician involvement in EMS, a strong facet of pre-hospital care.

·         The eighteen REMSCo's, each with 30 seats representing their local constituencies would be ELIMINATED, replaced with SIX regional advisory boards across the state.  Again, the size would shrink to 23 seats and again all appointed by the commissioner of health and not the local constituencies.  The new regional advisory boards would not have the current statutory authority, again only sending recommendations to the state and if the commissioner of health deems a region inactive, the state advisory board can take over.  The law still requires 1/3 of the seats to be from provider agencies but if covering a larger region, we would only have several seats rather than the full 30 devoted to Nassau now.  Unfortunately the state doesn't believe in the saying "Those who cannot remember the past are condemned to repeat it."  Prior to 1993, Nassau was part of the Nassau-Suffolk regional council and in 1993 it was split as it was no longer feasible and didn't provide the representation to each county.  Not long after, Westchester also received their own council after splitting from Hudson Valley for the same reasons.

·         There is some confusion about the REMAC's.  Some of the state agencies and other regions are advising that the REMAC's will remain in place BUT, a review of the law states: Section 3003.3.2nd subparagraph (e) states that the Regional Board will “recommend to the commissioner individuals to appoint to its regional medical advisory committee” clearly indicating that there will be a single committee for each Board, hence there will be only 6 REMACs.  This limits physician involvement and especially local physician interaction.

·         The program agencies are ELIMINATED.   The office at NUMC will be closed, all four employees terminated and all functions, including PCR's, public access defibrillation, mutual aid plans, quality assurance and the like are transferred to the state.

·         Mutual Aid plans now reviewed and approved by the REMSCo will now have to be reviewed by the regional advisory board, NYS DOH and the commissioner of health.

·         Technician credentialing now performed by the REMAC will be done by the commissioner of health.

·         The law changes include mandating that EMS agencies supply their own PCR's as directed by the commissioner of health.

·         The current threshold for mandatory electronic PCR's, is any agency that prepares more than 20,000 per year and will be changed to the discretion of the commissioner of health.

·         There are a multitude of changes to the Education and Training sections, including giving the commissioner of health the power to set minimum standards for completing certification courses and gives the state the ability to eliminate written and practical skills exams.

·         There are some positive changes, such as defining mutual aid on a par with other statutes, streamlining public access AED, and epi-pens procedures and NYS compliance with federal EMS curriculums and standards. 

The vast majority of the proposed changes are draconian in nature, will not improve efficiency or streamline government.  We believe it will have the opposite effect.  It is also budget neutral, it does not reduce expenditures as the funding for the program agencies and councils are dedicated funds from the DOH and will just revert to the DOH.  If this sounds like a conspiracy to shift power and funding to the State Government, you will need to make your own opinions but you can hear the theme to the twilight zone in the background.  

These changes are being blamed on the Governor's SAGE commission (Spending and Government Efficiency Commission) which was created to " modernize and right-size State government, this administration will propose the Spending and Government Efficiency (SAGE) Commission whose charge will be to undertake a comprehensive review of every agency of state government and recommend structural and operational changes to it.“The SAGE Commission[‘s]…charge will be simple: make our State government more modern, accountable and efficient.”  We are extremely concerned over the far reaching impact of these changes and the lack of input and process for these changes.  If the legislature approves the budget, the changes take effect. 

So, what is the status?  We have been conversing with other regions and as of this week; Suffolk, NYC and Westchester are all aligned with us.  Some upstate regions and program agencies are either waiting to see what happens and how the changes will affect them or are cautiously and politically supporting the changes.  Unfortunately there is no direction of any kind for the councils and program agencies. 

We have decided that we are going to fight these changes to the best of our ability and protect and support the pre-hospital providers and their agencies in our region.  The latest update from the "EMS Coalition" is that they are trying to negotiate a 180 day transition period and enhanced coordination for "rural EMS." 

We are pleased to announce that we have spoken to Senator Dean Skelos and his chief of staff at length and he is supporting our concerns and stance in regards to these changes.  As of Friday he advised that he is "working on these issues."  Additionally,  the attached letter was prepared at his request.  This letter is being sent to all of our State elected representatives from Nassau asking for their support.

I am asking that each of you contact your elected State legislative members about this issue and ask them to intercede. An email, phone call or comment on their web site is the least we ask.  

Thanks for your assistance and please contact the Council Office for any information or even to update us.

Scott Glazer, Chair 

 
 

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