So I’ve been thinking more about the FDNY‘s plan to charge Voluntary Hospitals for the use of their Emergency Medical Dispatch Center. Now let me be clear that this is NOT aimed at the dispatcher or communications personnel themselves. Heck, none of this is aimed at any provider for FDNY, even the ones who have drunk deeply from the department served Kool Aid!
One of my strongest recollections of FDNY BEMS Communications personnel was at the change of the Millennium New Years Eve 1999 when, surrounded by all the other city agencies in their shiny new communications/command vehicles, they were forced to work out of a converted 1974 camper with “FDNY BEMS Communications” written in marker on 3-inch wide medical tape stuck on the door. Irregardless of those deplorable working conditions, the personnel under Chief Pasquale persevered and their performance was absolutely amazing even when the East 42nd Street staging area was overrun. In fact, with the exception of a few Brooklyn Central incidents, I have always found them to be professional, respectful, helpful, and most importantly willing to do for us what they could so we were able to make it happen for the patient.
My issue is more specifically with Chief of EMS John Peruggia who had this to say with my own emphasis added:
“The 911 system cost-sharing initiative would allow the city to recoup the costs associated with 911 system dispatch and telemetry that are currently borne by the city, namely, the costs associated with the staffing and operation of the Emergency Medical Dispatch Center and Online Medical Control (Telemetry) center,” John Peruggia, FDNY’s chief of EMS command, wrote to one of the hospitals.
– Chief John Perggia, Metropolis 12/09/10 City To Charge For Ambulances
So now I’m going to do a little math, which I admit is really just estimates.
- 8.7 million is reportedly the cost of the hospitals for 35% of the units
- 16.2 million would then be the cost by FDNY for 65% of the units
- 24.9 million dollars total for the staffing of the Emergency Medical Dispatch Center and Online Medical Control
According to those numbers, that would then finance 415 employees making $60,000 a year if they were all Paramedics working 5 years.
The Emergency Medical Dispatch Center
Now let’s break down the actual Emergency Medical Dispatch Center staffing needs:
- 12 Radio Divisions
- 3 dispatchers for each platoon (2 dispatchers assigned per division)
- 3 8 hour tours a day
- 108 Dispatchers needed total
Now let’s be a little generous, because we are still talking about a beauracracy after all and let’s add 25% to that number and make the total 135 dispatchers to add the supervisors and support personnel.
Assuming the 135 are all paramedics with at least 5 years making $60,000 a year the total base salary staffing cost of Emergency Medical Dispatch Center is $8.1 million. Employees, whether they realize it or not, always cost more than their base salaries due to payroll taxes, various insurances, and of course benefits. For the most part they can cost 1.25-1.5 times their base salary. So assuming the 135 are all paramedics with at least 5 years experience costing the city $90,000 a year the total actual staffing cost of the Emergency Medical Dispatch Center is 12.3 million. That’s not taking into account for reduced cost when they shut Richmond down on the overnight or merge the other divisions together onto one frequency.
On Line Medical Control
Now let’s break down the actual Online Medical Control staffing needs:
- 2 REMAC Doctors for each platoon (1 REMAC Doctor per tour)
- 3 Paramedics for each platoon (2 Paramedic Assistants per tour)
- 3 8 hour tours a day
- 15 Personnel needed total (6 Doctors and 9 Paramedics)
Now let’s be a little generous, because we are still talking about a bureaucracy after all and let’s add 25% to that number and make the total 20 personnel (8 Doctors and 12 Paramedics) to add the supervisors and support staffing.
We’re going to be using the same $60,000 a year base salary and $90,000 a year actual cost figures from above for the Paramedics. For the doctors, we’re going to be generous, or perhaps cheap depending on how you want to look at it, and double the Paramedics cost to represent a doctor. Using those numbers the total base salary staffing cost of Online Medical Control is $1.7 million and the actual staffing cost is $2.5 million.
In conclusion the base salary staffing of both the Emergency Medical Dispatch Center and Online Medical Control is $9.8 million and the actual staffing cost is $14.8 million dollars. Both numbers fall very short of the estimated $24.9 million dollars that, based on the fees being charged to the hospitals, would be the budget for both of those departments. So is the city looking to make a profit on these services, or are they just that mismanaged?
Now I will admit it has been awhile since kindergarten, but can someone explain to me how or when the definition of sharing changed? Under this plan the Voluntary Hospitals are paying 59% of the actual cost for staffing the Emergency Medical Dispatch Center and Online Medical Control when they only have 35% of the units!
Special thanks to Rogue Medic for letting me figure out how to do Footnotes from his posts!