Last week FDNY announced its plan to charge the voluntary hospitals that provide 35% of the 911 ambulances at no cost to the city a fee for dispatch and on line medical control usage. While the cover story for this move is an effort to reduce the city’s budget deficit, in reality it is the city being an extortionist bully to fiscally strapped hospitals who have picked up the city’s slack in good faith for years.
Now Rogue Medic has already done some research into the cost differential associated with the FDNY work force which may be a real eye opener for some. I want to focus on something slightly different, that of unit hours:
- FDNY operates 614 8-hour tours every 24 hours for a total of 4,912 unit hours. Assuming a conservative cost of $75 per unit hour, that equates to $368,400 per day or $134,466,000 per year
- Voluntary Hospital operate 353 8-hour tours every 24 hours for a total of 2,824 unit hours. Assuming a conservative cost of $75 per unit hour, that equates to $211,800 per day or $77,307,000 per year
If the Voluntary Hospitals choose not to pay the fee that FDNY wants to impose in order to save $8.7 million dollars, New York City will need to spend $77.3 million dollars to replace those lost unit hours the city is currently getting for free, hence the term voluntary.
What’s absolutely worse is that the hospitals have been put on notice by Mayor Bloomberg that if they choose not to pay the fee and no longer voluntarily participate in the 911 system that patients will no longer be brought to their emergency departments…
“If they don’t want to have the patients in their hospitals, they won’t get ‘em,” said Bloomberg, referring to the possibility of hospitals no longer participating in the city’s 911 system.
– Mayor Michael Bloomberg, Metropolis 12/09/10 City Vows To Fill Potential Ambulance Void
I am and always have been a big proponent of patient’s choice. I believe that getting a patient in an emergency situation to a facility they prefer is a huge stress reliever and will improve their chances for recovery. It appears the mayor not only doesn’t care about what the patient wants, but doesn’t care about the anti-kickback legislation that is in place. By simply changing some options in the FDNY dispatch system, the Mayor can follow through on his threat by having any hospital that withdraws its voluntary participation not appear as an option for transport on the unit’s mobile data terminals. It’s just that simple.
So let’s say the hospitals withdraw, the mayor and FDNY say they’ll replace those tours in the system just as they’ve promised to do before, right? Nope.
The really big problem is that FDNY has been unable to fill the void left by hospitals that have already left the system due to closure and bankruptcy proceedings. The closures of Cabrini Hospital (MA), North General Hospital (MA), Mary Immaculate Hospital (QN), and St. John’s Hospital (QN) removed at minimum 36 tours a day from the city. While some of the units were re-assigned to other voluntary hospitals, the lost units the FDNY claims they have been filling has been done through overtime or running down other units in a popular dispatch shell game.
The proof of this neglect is in the proverbial pudding of city-wide response times:
So how will charging Voluntary Hospitals for dispatch “services” reduce response times and improve service? Bottom line, it doesn’t. For that matter response times are getting worse and other than taking personnel to attempt to harvest kidneys from those who possibly suffer a negative outcome from those longer response times, FDNY doesn’t seem to be doing much else to improve their service delivery which just doesn’t make sense.
Actually… now it does make a lot more sense…