Relates to the provision of municipal advanced life support first responder service or municipal ambulance service.
TITLE OF BILL: An act to amend the public health law, in relation to the provision of municipal advanced life support first responder service or municipal ambulance service
This bill provides that a municipality or fire district acting on behalf of a municipality, and acting through its local legislative body, in hereby authorized and empowered to adopt and amend local laws, ordinances, or resolutions to establish and operate advanced life support first response services or municipal ambulance services within the municipality or fire district when they meet or exceed all standards set by the department for appropriate training, staffing, and equipment and upon filing with the New York State Emergency Medical Services Council, a written request for such authorization. Upon filing, the municipal service shall be deemed to have fulfilled all the requirements of a determination of public need for two years. At the conclusion of the two-year period this bill would require the Commissioner of Health to approve a subsequent application for the permanent operating authority unless the municipality or fire district failed to meet the appropriate standards set by the department.
SUMMARY OF PROVISIONS:
Subdivision 7 (b) of section 3008 of the Public Health Law is amended by removing the requirement that a municipality or fire district apply to their requisite regional emergency medical services council for permanent operating authority at the conclusion of their initial two-year period and instead requires the Commissioner of Health to approve a subsequent application for permanent operating authority unless the municipality or fire district has failed to meet all standards set by the department for appropriate training, staffing and equipment.
EXISTING LAW: Currently, under § 3008 of the Public Health Law, municipalities, or fire districts acting on behalf of a municipality are granted a two-year presumption of need. Upon two years of operation and the expiration of the presumption, an application must be filed with a regional council for a determination of public need prior to the continued operation of a municipal advanced life support first response service or municipal ambulance service.
Municipalities that provide advanced life support first response services or municipal ambulance services have shown that their services reduce costs, increase efficiency, and generate revenue. Despite this, municipalities continue to find themselves at a distinct disadvantage when applying to a regional counsel for a certificate of need to continue providing such services. The regional council's make-up of not less than two-thirds industry representatives makes it difficult to prove
that the current service is inadequate, particularly where a private sector agency is similarly providing services.
Previous amendments to § 3008 have acknowledged this disadvantage and attempted to cure it by creating a presumption in favor of granting a municipality or fire district's application in 1992 (L. 1992, ch. 850) and then five years later establishing an automatic two-year certificate of need for municipalities and a strong presumption in favor of granting a subsequent application for a permanent certificate (L. 1997, ch. 510). As late as 2012, § 3008 was amended to permit the City of Utica to apply for a permanent certificate of need directly to the Commissioner of Health. Yet, municipalities find themselves mired in the application process with the regional councils.
Given that many municipalities around the state have spent great time and expense in training municipal employees in advanced life support and have the appropriate equipment and staffing necessary to provide the service, they should not be subject to the additional scrutiny of the regional council and should be allowed to continue to operate provided they meet the appropriate standards.
Municipal ambulance services have shown to provide faster response times because municipal firefighters know the neighborhoods and are already responding to the emergency call. Additionally, treatment and transportation can be provided by one responder as opposed to waiting for a second provider to arrive on scene for transportation. Such consolidation of personnel and equipment results in greater efficiency in the system and in increased patient care and reduced costs. Moreover, municipal ambulance services can generate revenue that will offset expenses for the operation of municipal first responders and other financial difficulties for the municipality.
For instance, the City of Saratoga Springs has operated its ambulance service since 2012 and reported an 18-month average response time of almost half that of other ambulance providers in the same area and reported revenue totaling $222,940.90 for 2012 and $119,103.86 for the first seven months of 2013 after deducting costs associated with additional firefighters including salary, overtime, health insurance and pension benefits. The City of Utica and the City of Glens Falls also reported the successful operation of revenue-generating municipal ambulance services in its first two years but still endured long application processes with their respective regional councils. In addition, in 2010-2011 the City of Utica reported municipal revenues in the amount of $1,774,705 and the City of Glens Falls reported $679,724.
It is likely that opponents to the bill will argue that removing the regional council from the application process will adversely affect the private sector's ability to provide services. This is the same argument that opponents made to the 1992, 1997, and 2012 amendments, but they are unable to show any adverse effect by municipal ambulance services. In fact, municipal and private entities continue to collectively operating in areas throughout the State.
LOCAL FISCAL IMPLICATIONS:
Cost savings to local governments and potential generation of revenue to offset first responder services. In addition, localities currently operating advanced life support first response services or municipal ambulance services have used such service to offset large municipal tax increases under the new tax cap.
This act shall take effect immediately and shall apply to any municipality or fire district that has a temporary determination of public need, any application made by a municipality or fire district for a permanent operating certificate that is currently in the administrative appellate process or on appeal before any Court of competent jurisdiction.
STATE OF NEW YORK ________________________________________________________________________ 6515 IN SENATE January 31, 2014 ___________Introduced by Sen. LITTLE -- read twice and ordered printed, and when printed to be committed to the Committee on Health AN ACT to amend the public health law, in relation to the provision of municipal advanced life support first responder service or municipal ambulance service THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Paragraph (b) of subdivision 7 of section 3008 of the public health law, as amended by chapter 464 of the laws of 2012, is amended to read as follows: (b)
[In the case of an application for certification pursuant to this subdivision, for a municipal advanced life support or municipal ambu- lance service, to serve the area within the municipality, where the proposed service meets or exceeds the appropriate training, staffing and equipment standards, there shall be a strong presumption in favor of approving the application.]Notwithstanding any other provision of this article, any [city with a population of fourteen thousand seven hundred or sixty-two thousand two hundred thirty-five, according to the two thousand ten federal decennial census, or fire district acting on behalf of any such city, that]MUNICIPALITY WITHIN THIS STATE, OR FIRE DISTRICT ACTING ON BEHALF OF ANY SUCH MUNICIPALITY, WHICH applies for permanent certification pursuant to this [section]SUBDIVISION at the conclusion of the two year period [provided in]CONTAINED IN PARAGRAPH (A) OF this subdivision, shall not be required to apply to its regional emergency medical services council [or the state emergency medical services coun- cil]for a determination of need, and the application shall be submitted to and SUCH APPLICATION FOR A MUNICIPAL ADVANCED LIFE SUPPORT OR MUNICI- PAL AMBULANCE SERVICE TO SERVE THE AREA WITHIN THE MUNICIPALITY SHALL BE approved by the commissioner unless the [commissioner finds that the municipal advanced life support first responder service or municipal ambulance service has]PROVISION OF SERVICES HAVE failed to meet the appropriate training, staffing and equipment standards. S 2. This act shall take effect immediately and shall apply to any municipality or fire district that has a temporary determination ofEXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD13644-02-4 S. 6515 2
public need, any application made by a municipality or fire district that is currently in the administrative appellate process or on appeal before any court of competent jurisdiction.