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Fitness and Competency

One responsibility of the application process is to insure a high quality of ownership and management of an ambulance or ALS-FR service to the degree of attempting to identify any issues of character that would be detrimental to this highly personal service. With this as a purpose, the REMSCO shall address issues relative to the competency and fitness of the applicant and/or officers of the corporation as prescribed in PHL 3005(5).

The REMSCO may request the Department to conduct the detailed review. The review shall include multiple factors such as the individual or group of individuals standing in the community, an evaluation of the applicants prior record as an ambulance service operator or health care provider, and if applicable, a statement of experience in the industry, or related industries. The REMSCO may augment the fitness and competency review, however it must have a documented process.

The review will also include an evaluation of past history, including computer searches of legal filings and judgements, business ownership as well as any convictions for a crime or crimes involving moral turpitude including, but not limited to, murder, manslaughter, assault, sexual abuse, theft, robbery, drug abuse, the sale of drugs or fraud. The fitness and competency review will also include an applicant's history with both Medicaid and Medicare programs.

In addition to original applications and municipal applications, a fitness and competency (F&C) determination must be made by the REMSCO for all transfers of ownership.

The applicant shall submit a completed Affirmation of Fitness and Competency (DOH-377 for each principal owner and/or operator. The REMSCO or upon request, the Department shall conduct a review of the applicant's fitness and competency in accordance with the provisions of PHL Section 3005. A current resume for each principal owner and/or operator must be attached for each affirmation submitted.

Public Notice

The REMSCO shall establish a date, time and location for a public hearing(s) to review the application and receive all comments.
The hearing(s) shall be held within 30 calendar days of accepting a complete application and the notice shall be postmarked at least 14 calendar days prior to the hearing date.
The hearing(s) shall be established at a time and place(s) logical to the application, preferably in the county or central to the proposed service area. Considerations for public access must be included.
More than one public hearing may be held if it is in the best interest of the application and so long as the same application and information is presented by the applicant at each hearing and they are held within the appropriate time frames.
One public hearing can be held to serve the needs of several REMSCOs, if it is in the best interest of each REMSCO and applicant.
Letters of notice shall be sent in accordance with PHL 3008, by certified mail to:

"The chief executive officers of all general hospitals, ambulance services, and municipalities operating within the same county or counties where the service seeks to operate..."

Hospitals adjoining the proposed service area and ambulance agencies with adjoining primary service areas and the local health systems agency shall also be included in the notice.
The letter of notice shall include the date, time and location of the hearing session, the definition of public need, a solicitation of response to the application by a specific date and provide a mechanism for any interested party to obtain and/or review the application.
The REMSCO shall maintain a copy of the letter of notice, a list of recipients, and all postal receipts until final disposition of the application is made.
The information contained in the letter of notice shall be published in the newspaper designated by the REMSCO to receive legal notices. As necessary this shall include newspapers designated by the REMSCO.
The Public Hearing

The REMSCO shall establish a committee to hear each application. The Committee will usually consist of five members. Normally one member shall be from the county or area the applicant proposes to serve, and one member shall represent the majority of the ambulance constituency in the proposed service area.
The REMSCO must use a hearing officer designated by the REMSCO and charged with finding fact and preparing a report for the REMSCO. REMSCOs can utilize individuals who are authorized by various state agencies (DEC, State, etc.) to act as hearing officers or other individuals with similar training and experience. Ideally, a hearing officer should be familiar with Public Health Law and the administrative hearing process. The hearing officer will moderate and insure the hearing process follows generally accepted procedures.
The purpose of the hearing is to provide a technical review and objective evaluation of the applicant's statement of need as well as any other testimony presented.
The committee may hear witnesses, receive written statements, ask questions and accept testimony in any form that will lend credibility to the hearing and the ultimate determination.
The REMSCO shall complete and maintain a record of the proceedings of any and all hearings. This shall be in stenographic or tape form. The record must be transcribed and considered along with all other evidence in making the determination, especially pertinent are all discussions relating to public need.
A written summary of the hearing shall be prepared that includes a finding of fact and a recommendation to support or deny the motion to approve the application and detailed justification for the recommendation made. Any other pertinent findings for presentation to the REMSCO must also be included. If a hearing officer's report is the principle process, the committee should review the report and prepare the recommendation for the REMSCO following a similar outline. It is recommended that the committee meet at a time other than immediately prior to the REMSCO meeting for its deliberations.
Determination of Need

The recommendation of the hearing committee comes to the floor of the REMSCO as a seconded motion for debate.
Opportunity shall be provided for REMSCO members present to make inquiry and ask questions prior to making a determination. As the application and the public hearing (s) constitute the appropriate forum to introduce/provide new information, this is not an opportunity for REMSCO members or non-REMSCO members to introduce/provide new information.
The REMSCO may place binding contingencies on the approval of an application as long as the conditions are in the best interest of the EMS system and are not in conflict with any State law or regulation. The applicant may amend the application so long as it is occurs prior to the public hearing.
Each REMSCO may establish a policy within the framework mandated by NYS Ethics Rules and established by the State EMS Council regarding members abstaining from voting in cases of conflict of interest.

This policy shall address members who have a pecuniary (financial) interest in a competing service and those who serve as an officer in an organization deemed to be in direct competition with the applicant.

Each REMSCO has the obligation to discuss and record in the record, all pertinent points and issues of the application relating to need, the definition of public need, and specific reasons and rationale for and against the application based on the application, evidence presented and testimony from the public hearing.
It is proper format for a motion to approve the application. The motion is supported by a recommendation from the committee for or against the application and shall contain rationale and justification, positive and negative, for the recommendation presented.
The REMSCO shall make its determination by a roll call ballot of the members present to accept or reject the recommendation of the committee. The motion must be made in the form of an approval of the application. Based on the Department's Bureau of House Counsel opinion (Appendix 3), in order to make a determination, it must be passed by not less than a majority of the entire members authorized to vote, not those members present for the meeting.
A statement shall be entered into the stenographic record that clearly defines the authority of alternates to vote in the procedure and a statement of the needed majority to pass the motion. A written record of the roll call vote shall list all voting members of the REMSCO and include at least the following information:
Member name, affiliation and status as member or alternate;
Present or absent for ballot;
Voting for, against or abstaining;
Declarations and/or decisions of conflict of interest;

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Allowable Transfer Circumstances

Transfers of operating authority are allowable in the following circumstances with approval of the appropriate REMSCO and the Department:

Any change in the individual who is the sole proprietor (3010.2(a));
Any change that results in adding new partners (3010.2(b));
Any transfer, assignment or other disposition of ten percent (10%) or more of a corporation's stock (3010.2(c));
Any transfer of all or substantially all of the assets of a corporation to a new corporation or owner (3010.2(d));
A municipality that has transitioned to a permanent operating authority.
Examples: the change in an operator without changing the territory of a sole proprietor, a sole proprietor incorporating for the first time or a fire department service and assets being assumed by a volunteer ambulance corp.

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The powers and duties of the Board shall be to:
A.
Advise the Town Board of the Town of Rotterdam on all matters regarding emergency medical services affecting the health, safety and welfare of the people of the Town, including emergency preparedness.
B.
Facilitate cooperation, leadership and strong working relationships between all emergency service providers in the Town.
C.
Promote quality patient care through collaboration.
D.
Advise the Town Board of the Town of Rotterdam of new development in technology and cost-saving measures affecting basic life support, advanced life support and transportation services.
E.
Seek to coordinate, assist and unify the efforts of private groups and individuals within the Town of Rotterdam in accord with the purposes of this chapter.
F.
Carry out such other duties as may be assigned from time to time by the Town Board and to carry out such tasks or responsibilities, consistent with the objectives of this chapter, as may be assigned by resolution of the Town Board.

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The members of the Board, including ex officio members, shall receive no compensation for their services as members thereof but may be reimbursed for reasonable and necessary expenses incurred in the performance of their duties within the appropriations made available thereto.

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The membership of said Board consists of the following:
A.
Two members from the Rotterdam Town Board.
B.
Two members from the Rotterdam Police Department.
C.
Two members from the current Town-based ambulance service provider.
D.
Two members from the fire department rescue squads as nominated by the Rotterdam Chief's Association.
E.
Two residents at large from the Town of Rotterdam.

Quoted from CICERO

I meant physically tied to transport.  Paramedics had their own vehicle.  So if a call comes in for BLS, they were not dispatched.  They were still available for ALS calls.  Now they will be arriving at all calls, even if not needed.  Tying up a paramedic unnecessarily.  I don't see how mathematically service increases with this restructuring.  This was purely financial, which I'm fine with, if the residents benefited financially, not the "friends and family" club.  Which is the real reason behind this move.

Quoted from exit3

aside from the job loss and bickering  

i want to know who switched sides?

is Gadfly now a Democrat  - and what does DVOR have to day about this ?

or is Gadfly showing her Copservative side?

Gadfly, Harry and Wayne all on the same page   what gives......

or maybe it is the other way around

orit is just bumbles way, they have crossed paths and some are only in it for the money  - the some not being the Gadfly

all in all it is a very interesting read over the past 10 years

it is too bad friendships will be broken and the things that now divide rotterdam will fester for 50+ more years.  Cutting off any growth this town might see at the knees

it might be best summed up by the following words



FOR SALE

Quoted from gadfly

As Shadow mentioned....paramedics often ride with the transporter under ALS circumstances. Town paramedics had ALL of their own equipment....and yes,
that included their own vehicles....all part of the steadily rising cost of providing that service.....especially without the return on the investment, which would
also rise comparably with the rising costs of paramedic services in general. Whether a paramedic is tied up with BLS transporters, necessary or not, it is not
at our cost....and like BLS availability....paramedics can also be covered as needed. It is not service that is increasing, just coverage in this regard. The
argument that REMS is superior in terms of compassion and life saving ability simply because it is REMS is ridiculous.....it isn't REMS....it is simply the
nature of that business.

I do strongly agree with your distaste for the motivation behind it all....as I said, it is disappointing and unfortunate that neither this administration, nor
any others before them would do this out of mere common sense and financial responsibility....a long, long time ago....as they should have.

Quoted from gadfly

Whether a paramedic is tied up with BLS transporters, necessary or not, it is not
at our cost....

Quoted from CICERO

I'm not making arguments for or against REMS on service.  I have no horse in the race, I have no sentimental attachment to REMS.  This is business.  My problem is with the elimination of the paramedics and the reallocation if the savings into the already well paid salaries of a few town workers.  

The town could have contracted Mohawk for their services and kept the paramedics on staff.  Or they could have reduced the staff by one, along with a vehicle, and had Mohawk use them if needed in support, or to respond to those emergency calls where REMS would show up to a call to help up an elderly woman that fell and could not get up.  

If the tax money is going to be spent anyways(on increased salaries), it may as well be for the good of the residents, and use the paramedic to help people in non emergencies without billing them.  The same thing REMS did when they responded to those types of calls and "soft billed".