Guest guest Posted May 12, 2002 Report Share Posted May 12, 2002 When I was in North Carolina, the same issue came up regarding the FD, the understanding I came away from the whole situation with was that if a person receives remuneration for a duty, that you cannot legally accept the same duty from them on a volunteer basis, even if they understand that it is volunteer. You cannot waive your FLSA rights. They took it a step further and told us that they were not able to perform any volunteer work for us regardless of the nature of the work, if they were in fact already on our payroll. We stood by that and would not allow anyone to volunteer if they were already on the payroll either as fulltime or part time. It's good that you acted in a proactive way by contacting the DOL, the unfortunate thing is that if you talk to three people, it is entirely possible to get three answers from them, and different answers as well. The only answer that really matters is the one from the person doing the interpretation when the complaint gets filed by the disgruntled employee. Mike Hatfield paid and volunteer Can anyone clear up the question of the legalities of having paid staff act as volunteers for the same service they work. Many services including ours has a paid daycrew but need volunteers at night and on weekends to staff the primary units.Those who volunteer are not required to stay at the station but may if they wish. They are required to be on the unit within 10 minutes of the initial page during the time they have volunteered for. All of the people who work as daycrew at this particular service would also like to volunteer for several night and / or weekend shifts per month. I have contacted the US Dept of Labor and they seem as confused as I am. Can anyone shed a little light on this subject? Thanks MF Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 12, 2002 Report Share Posted May 12, 2002 Thanks. Maybe we should go to the DOL office and get a written interpretation. Thanks again. MF paid and volunteer Can anyone clear up the question of the legalities of having paid staff act as volunteers for the same service they work. Many services including ours has a paid daycrew but need volunteers at night and on weekends to staff the primary units.Those who volunteer are not required to stay at the station but may if they wish. They are required to be on the unit within 10 minutes of the initial page during the time they have volunteered for. All of the people who work as daycrew at this particular service would also like to volunteer for several night and / or weekend shifts per month. I have contacted the US Dept of Labor and they seem as confused as I am. Can anyone shed a little light on this subject? Thanks MF Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 12, 2002 Report Share Posted May 12, 2002 I am getting 3 or 4 copies Christy paid and volunteer > > > > > > > > >Can anyone clear up the question of the legalities of having paid staff > > act > > >as volunteers for the same service they work. Many services including > > ours > > >has a paid daycrew but need volunteers at night and on weekends to staff > > the > > >primary units.Those who volunteer are not required to stay at the station > > >but may if they wish. They are required to be on the unit within 10 > > minutes > > >of the initial page during the time they have volunteered for. All of the > > >people who work as daycrew at this particular service would also like to > > >volunteer for several night and / or weekend shifts per month. I have > > >contacted the US Dept of Labor and they seem as confused as I am. Can > > >anyone shed a little light on this subject? Thanks MF > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 12, 2002 Report Share Posted May 12, 2002 Five copies??? Weird - I only hit send once. LOL Jane You wrote: >I recently received 5 copies of a post by Jane. > >Ronnie > paid and volunteer >> > > >> > > >> > >Can anyone clear up the question of the legalities of having paid staff >> > act >> > >as volunteers for the same service they work. Many services including >> > ours >> > >has a paid daycrew but need volunteers at night and on weekends to >staff >> > the >> > >primary units.Those who volunteer are not required to stay at the >station >> > >but may if they wish. They are required to be on the unit within 10 >> > minutes >> > >of the initial page during the time they have volunteered for. All of >the >> > >people who work as daycrew at this particular service would also like >to >> > >volunteer for several night and / or weekend shifts per month. I have >> > >contacted the US Dept of Labor and they seem as confused as I am. Can >> > >anyone shed a little light on this subject? Thanks MF >> > > >> > > >> > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 12, 2002 Report Share Posted May 12, 2002 I am getting 2 too.. jh paid and volunteer >> > >> > >> >Can anyone clear up the question of the legalities of having paid staff >> act >> >as volunteers for the same service they work. Many services including >> ours >> >has a paid daycrew but need volunteers at night and on weekends to staff >> the >> >primary units.Those who volunteer are not required to stay at the station >> >but may if they wish. They are required to be on the unit within 10 >> minutes >> >of the initial page during the time they have volunteered for. All of the >> >people who work as daycrew at this particular service would also like to >> >volunteer for several night and / or weekend shifts per month. I have >> >contacted the US Dept of Labor and they seem as confused as I am. Can >> >anyone shed a little light on this subject? Thanks MF >> > >> > >> > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 12, 2002 Report Share Posted May 12, 2002 Interesting. I only show one on my end after it posts. I will have to ask my ISP about this. Jane You wrote: >Jane: > >I don't know about every one else, but I am getting 3 copies of each of your >posts each time. > >BEB > paid and volunteer >> > >> > >> >Can anyone clear up the question of the legalities of having paid staff >> act >> >as volunteers for the same service they work. Many services including >> ours >> >has a paid daycrew but need volunteers at night and on weekends to staff >> the >> >primary units.Those who volunteer are not required to stay at the station >> >but may if they wish. They are required to be on the unit within 10 >> minutes >> >of the initial page during the time they have volunteered for. All of the >> >people who work as daycrew at this particular service would also like to >> >volunteer for several night and / or weekend shifts per month. I have >> >contacted the US Dept of Labor and they seem as confused as I am. Can >> >anyone shed a little light on this subject? Thanks MF >> > >> > >> > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 12, 2002 Report Share Posted May 12, 2002 I forwarded these to my ISP support group to see if the problem is on their end. Jane You wrote: >I am getting 3 or 4 copies >Christy > > > paid and volunteer >> > > >> > > >> > >Can anyone clear up the question of the legalities of having paid staff >> > act >> > >as volunteers for the same service they work. Many services including >> > ours >> > >has a paid daycrew but need volunteers at night and on weekends to >staff >> > the >> > >primary units.Those who volunteer are not required to stay at the >station >> > >but may if they wish. They are required to be on the unit within 10 >> > minutes >> > >of the initial page during the time they have volunteered for. All of >the >> > >people who work as daycrew at this particular service would also like >to >> > >volunteer for several night and / or weekend shifts per month. I have >> > >contacted the US Dept of Labor and they seem as confused as I am. Can >> > >anyone shed a little light on this subject? Thanks MF >> > > >> > > >> > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 12, 2002 Report Share Posted May 12, 2002 I forwarded these to my ISP support group to see if the problem is on their end. Jane You wrote: >I am getting 3 or 4 copies >Christy > > > paid and volunteer >> > > >> > > >> > >Can anyone clear up the question of the legalities of having paid staff >> > act >> > >as volunteers for the same service they work. Many services including >> > ours >> > >has a paid daycrew but need volunteers at night and on weekends to >staff >> > the >> > >primary units.Those who volunteer are not required to stay at the >station >> > >but may if they wish. They are required to be on the unit within 10 >> > minutes >> > >of the initial page during the time they have volunteered for. All of >the >> > >people who work as daycrew at this particular service would also like >to >> > >volunteer for several night and / or weekend shifts per month. I have >> > >contacted the US Dept of Labor and they seem as confused as I am. Can >> > >anyone shed a little light on this subject? Thanks MF >> > > >> > > >> > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 12, 2002 Report Share Posted May 12, 2002 I forwarded these to my ISP support group to see if the problem is on their end. Jane You wrote: >I am getting 3 or 4 copies >Christy > > > paid and volunteer >> > > >> > > >> > >Can anyone clear up the question of the legalities of having paid staff >> > act >> > >as volunteers for the same service they work. Many services including >> > ours >> > >has a paid daycrew but need volunteers at night and on weekends to >staff >> > the >> > >primary units.Those who volunteer are not required to stay at the >station >> > >but may if they wish. They are required to be on the unit within 10 >> > minutes >> > >of the initial page during the time they have volunteered for. All of >the >> > >people who work as daycrew at this particular service would also like >to >> > >volunteer for several night and / or weekend shifts per month. I have >> > >contacted the US Dept of Labor and they seem as confused as I am. Can >> > >anyone shed a little light on this subject? Thanks MF >> > > >> > > >> > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 12, 2002 Report Share Posted May 12, 2002 I forwarded these to my ISP support group to see if the problem is on their end. Jane You wrote: >I am getting 3 or 4 copies >Christy > > > paid and volunteer >> > > >> > > >> > >Can anyone clear up the question of the legalities of having paid staff >> > act >> > >as volunteers for the same service they work. Many services including >> > ours >> > >has a paid daycrew but need volunteers at night and on weekends to >staff >> > the >> > >primary units.Those who volunteer are not required to stay at the >station >> > >but may if they wish. They are required to be on the unit within 10 >> > minutes >> > >of the initial page during the time they have volunteered for. All of >the >> > >people who work as daycrew at this particular service would also like >to >> > >volunteer for several night and / or weekend shifts per month. I have >> > >contacted the US Dept of Labor and they seem as confused as I am. Can >> > >anyone shed a little light on this subject? Thanks MF >> > > >> > > >> > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 12, 2002 Report Share Posted May 12, 2002 Jane, This post appears SEVEN (7--count em) times. gg Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 12, 2002 Report Share Posted May 12, 2002 Cy-Fair VFD is currently undergoing the same scrutiny by DOL. It has been interpreted by DOL that you can't volunteer for the same unit that pays you. While it is still early, Cy-Fair has taken the stand that you need to decide if you want to be paid or volunteer...you can't be both. While not everyone agrees with the interpretation, it is still our responsibility to comply with DOL's interpretation. As of April 1 this year, everyone had to make the choice as to ppaid or volunteer. In the meantime, there is nothing to say that you can't get in touch with your city (or town) ligislators, as well as county, state, and even federal representatives to push for a favorable interpretation from DOL. On a personal note that is my opinion (and not necessarily the opinion of the Cy-Fair VFD), I think it's time for the government to back off and not tell me how I can and can not spend my free (spare) time. Dennis P. Lee, EMT-P Cy-Fair Volunteer Fire Department Houston, TX paid and volunteer Can anyone clear up the question of the legalities of having paid staff act as volunteers for the same service they work. Many services including ours has a paid daycrew but need volunteers at night and on weekends to staff the primary units.Those who volunteer are not required to stay at the station but may if they wish. They are required to be on the unit within 10 minutes of the initial page during the time they have volunteered for. All of the people who work as daycrew at this particular service would also like to volunteer for several night and / or weekend shifts per month. I have contacted the US Dept of Labor and they seem as confused as I am. Can anyone shed a little light on this subject? Thanks MF Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 12, 2002 Report Share Posted May 12, 2002 The DOL's interpretation is the law as I understand it, but I do have some thoughts about it whether or not it's the right interpretation in every case. It is unfortunate in a way, because it prohibits volunteerism in some instances where it would possibly be good for all concerned. However, the DOL's interpretation and it's strict adherence to it is in direct response to a history of abuse of volunteers by many services, and cynical efforts by many levels of EMS management to keep from paying a living wage to paid workers. There can be reasonable arguments made that exceptions ought to be allowed, but exceptions would only foster a further postponement of recognition that EMS people are professionals and need to be treated and compensated as such. It is nice to volunteer one's services when one is making a living wage from other sources. That doesn't mean that volunteers are in any way less competent or capable than paid workers, and in fact many volunteers posess a very high level of education and competence which equals or surpasses that of some paid personnel, but if the political entities responsible for providing EMS services to their residents attempt to do so without facing up to the realities of the cost of quality EMS and seek to get something for nothing, then volunteerism works against the public good. People want EMS to be there when they push their speeddial 911 button and want $159,000 worth of equipment and more than that in competent personnel to show up within the time limits for conversion of Ventricular Fibrillation without risk of hypoxic brain injury, but will they pay for it? I spent a lot of years providing volunteer service in an area that I thought couldn't afford paid service, but now that I think about it, I probably didn't do the EMS Profession any favors by doing so. I probably only helped postpone the reality check that is now happening to the residents of the area I served. Recently there was an extensive dabate on another list about whether or not medical care is a " right. " Most of the medical professionals who chose to expound on the subject argued that there is no right to medical care. They cut their own throats. Maybe the best thing that could happen to EMS would be for it to just go away for a couple of years. Then maybe people would make a decision about whether they had rather have good EMS or a good taxi service. Anybody know where I can get a yellow Ford Vic? gg Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2002 Report Share Posted May 13, 2002 In a message dated 5/12/02 2:53:33 PM Pacific Daylight Time, jehill@... writes: > Five copies??? Weird - I only hit send once. LOL > > Jane > > I am getting anywhere from 2 to 5 copies of your messages myself. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2002 Report Share Posted May 13, 2002 I have sent forwards of all these messages to Camalott to see if the problem is on our end. I know I only push Send one time. Weird... Jane Re: paid and volunteer > In a message dated 5/12/02 2:53:33 PM Pacific Daylight Time, > jehill@... writes: > > > > Five copies??? Weird - I only hit send once. LOL > > > > Jane > > > > > > I am getting anywhere from 2 to 5 copies of your messages myself. > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2002 Report Share Posted May 13, 2002 The ruling our City Attorney gave us several years ago said that we were liable for overtime, even for volunteer work, if they did it on our facility, and if it was similar to the kind of work they did on-duty. In our case, it was just guys wanting to teach CPR in our training room, OFF_DUTY, NO UNIFORM! But they said this was still related to their duties as a medic, and so we had to pay overtime and treat it as if they were on-duty. I'd bet you'll have to pay them for this work, as another shift. But I could be wrong. But your case is way more clear and directly related than ours was. =Steve= mike farris wrote: > Can anyone clear up the question of the legalities of having paid staff act as volunteers for the same service they work. Many services including ours has a paid daycrew but need volunteers at night and on weekends to staff the primary units.Those who volunteer are not required to stay at the station but may if they wish. They are required to be on the unit within 10 minutes of the initial page during the time they have volunteered for. All of the people who work as daycrew at this particular service would also like to volunteer for several night and / or weekend shifts per month. I have contacted the US Dept of Labor and they seem as confused as I am. Can anyone shed a little light on this subject? Thanks MF > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2002 Report Share Posted May 13, 2002 The ruling our City Attorney gave us several years ago said that we were liable for overtime, even for volunteer work, if they did it on our facility, and if it was similar to the kind of work they did on-duty. In our case, it was just guys wanting to teach CPR in our training room, OFF_DUTY, NO UNIFORM! But they said this was still related to their duties as a medic, and so we had to pay overtime and treat it as if they were on-duty. I'd bet you'll have to pay them for this work, as another shift. But I could be wrong. But your case is way more clear and directly related than ours was. =Steve= mike farris wrote: > Can anyone clear up the question of the legalities of having paid staff act as volunteers for the same service they work. Many services including ours has a paid daycrew but need volunteers at night and on weekends to staff the primary units.Those who volunteer are not required to stay at the station but may if they wish. They are required to be on the unit within 10 minutes of the initial page during the time they have volunteered for. All of the people who work as daycrew at this particular service would also like to volunteer for several night and / or weekend shifts per month. I have contacted the US Dept of Labor and they seem as confused as I am. Can anyone shed a little light on this subject? Thanks MF > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2002 Report Share Posted May 13, 2002 In my first post, I mentioned North Carolina, it is important to remeber that this is a federal issue, the interpretation will stand in all states. When in doubt, err on the side of caution..... Mike Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 15, 2002 Report Share Posted May 15, 2002 Jane: I sympathize. We are not subsidized by any taxes in McGregor. We bill Medicare, Medicaid and other insurance, plus we bill patients without insurance. We still get donations and " memorials " sent in, which are placed in the local paper " in remembrance of " type of thing. We run 2 trucks, BLS w/MICU, and actually just bought a new 2002 AEV this spring. Funding? Fund raising, creative ordering, constant cost comparisons, minimizing back stock of equipment, 2/3 volunteer with paid staff Monday - Friday 6 a to 6 p. And LOTS of volunteer working to improve the system. The public really does not understand what goes on, and we have attempted many times to run articles in the local paper about the work involved, the regulations we Must follow or we will lose all funding sources, and we hit brick walls lots of times. But we keep plugging on. As one volunteers states: " If we don't do it, who will? " Take heart, sometimes situations do change by miracles. Janette , EMTP McGregor Vol. EMS Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 15, 2002 Report Share Posted May 15, 2002 In our neck of the woods, we have a little over $300,000 that comes in every year in taxes that is supposed to fund the EMS AND the full time clinic. Folks don't understand that the EMS budget ALONE is going to be over $300,000/year. Many don't want to pay their copayments or co-insurance share or, if they have no insurance at all, many just don't feel like they should have to pay anyway cause they pay taxes. Oh, and God forbid you should hold a fundraiser to try and raise money to help defray expenses or buy needed equipment. It costs a lot of money to call for an ambulance, but that is because it costs a lot of money to RUN an ambulance service. The volunteerism days are just about gone, and EMS folks wants to earn a living. And most don't want to live in poverty to do what they love to do. They also don't want to run in junky, beat up ambulances, with little or no equipment. And for some reason they want malpractice insurance to cover them if these same people who don't want to pay bills want to file some suit about something that may or may not be legitimate. But the general public would rather pay $500 to take their friends on a trip to a ballgame or even more to go to the Super Bowl than to help fund EMS or pay their bill. It is EXPECTED that these services be rendered without renumeration by more people than I want to think about. In EVERY response area nationwide, EMS services suffer with patients who call for the ambulance for every little complaint (complaints that insurance won't pay for even if they have insurance) and they EXPECT EMS to transport them to a hospital of their choice and do not even want to DISCUSS the issue of who is paying the bill. Anyway, I will get off my soapbox now. Sorry. It is just frustrating when you think about how large the problem really is. Jane Hill Re: paid and volunteer > The DOL's interpretation is the law as I understand it, but I do have some > thoughts about it whether or not it's the right interpretation in every case. > It is unfortunate in a way, because it prohibits volunteerism in some > instances where it would possibly be good for all concerned. However, the > DOL's interpretation and it's strict adherence to it is in direct response to > a history of abuse of volunteers by many services, and cynical efforts by > many levels of EMS management to keep from paying a living wage to paid > workers. > > There can be reasonable arguments made that exceptions ought to be allowed, > but exceptions would only foster a further postponement of recognition that > EMS people are professionals and need to be treated and compensated as such. > > > It is nice to volunteer one's services when one is making a living wage from > other sources. That doesn't mean that volunteers are in any way less > competent or capable than paid workers, and in fact many volunteers posess a > very high level of education and competence which equals or surpasses that of > some paid personnel, but if the political entities responsible for providing > EMS services to their residents attempt to do so without facing up to the > realities of the cost of quality EMS and seek to get something for nothing, > then volunteerism works against the public good. People want EMS to be > there when they push their speeddial 911 button and want $159,000 worth of > equipment and more than that in competent personnel to show up within the > time limits for conversion of Ventricular Fibrillation without risk of > hypoxic brain injury, but will they pay for it? > > I spent a lot of years providing volunteer service in an area that I thought > couldn't afford paid service, but now that I think about it, I probably > didn't do the EMS Profession any favors by doing so. I probably only helped > postpone the reality check that is now happening to the residents of the area > I served. > > Recently there was an extensive dabate on another list about whether or not > medical care is a " right. " Most of the medical professionals who chose to > expound on the subject argued that there is no right to medical care. They > cut their own throats. > > Maybe the best thing that could happen to EMS would be for it to just go away > for a couple of years. > > Then maybe people would make a decision about whether they had rather have > good EMS or a good taxi service. Anybody know where I can get a yellow Ford > Vic? > > gg > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 15, 2002 Report Share Posted May 15, 2002 It's amazing that people think of EMS less than water service. They can't flush the toilet or water their lawns the way they want, once, and screams go to the rafters. Then there's a big brouhaha at City Hall the next day. City officials say, " to get quality water service, we've got to raise taxes and fees to support our water system. " Everybody says OK pays out and settles down. Apply the same principle to EMS, we say we're hurting and don't know if we can respond anymore, and need more support. We're told, " sorry no more money. Your volunteers, go cry in front of a few people and raise your own money. " Then one awful day, we're fresh out of volunteers, paid staff, and ambulances and shut down. Fingers point in a thousand different directions, quick, stupid, and ineffective solutions are put in place. EMS is set back to the stone age, but people can flush their toilets effectively. -aloha, mikey Emti554j@... wrote: > Jane: > > I sympathize. We are not subsidized by any taxes in McGregor. We bill > Medicare, Medicaid and other insurance, plus we bill patients without > insurance. We still get donations and " memorials " sent in, which are placed > in the local paper " in remembrance of " type of thing. We run 2 trucks, BLS > w/MICU, and actually just bought a new 2002 AEV this spring. Funding? Fund > raising, creative ordering, constant cost comparisons, minimizing back stock > of equipment, 2/3 volunteer with paid staff Monday - Friday 6 a to 6 p. And > LOTS of volunteer working to improve the system. The public really does not > understand what goes on, and we have attempted many times to run articles in > the local paper about the work involved, the regulations we Must follow or we > will lose all funding sources, and we hit brick walls lots of times. But we > keep plugging on. As one volunteers states: " If we don't do it, who will? " > > Take heart, sometimes situations do change by miracles. > > Janette , EMTP > McGregor Vol. EMS > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 15, 2002 Report Share Posted May 15, 2002 Which leads to the point... how many communities are prepared to *not* have ambulance services? How many will face this over the next year or two? My understanding is that EMS service is NOT required under state law (where fire and police protection are). Is this still true? If so, what's to stop places from simply not having EMS, especially if it's too costly and they won't fund it? Might it be time to look at a way to provide this service at a state level, much like DPS provides police coverage at a state level? Of course, the " state level " would be a very basic service (communities that wanted more could fund a service that provided more), but would provide *something* for those communities that couldn't or wouldn't fund a service? How would you determine coverage areas, response times, etc? Or, should communities simply be allowed to be uncovered (by their own choices at the ballot box)? Mike > -----Original Message----- > From: Emti554j@... > > times. But we keep plugging on. As one volunteers states: > " If we don't do it, who will? " > > Janette , EMTP > McGregor Vol. EMS Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 15, 2002 Report Share Posted May 15, 2002 Jane, Debbie, and others, I often get given grief about my presence in this list as I seem to be one who likes to stir the pot...maybe sometimes I do it just to liven things up a little...sometimes to spur conversation....sometimes because I am just fed up.... But after reading the posts from this thread all evening, something occurred to me and I want to see if I can get it down in type.... Just go with me for a second or two here: Could the reason that people don't pay our bills, or their co-pays, or fight for us with their insurance companies possibly be that we do not make enough of a point on the FRONT end that we charge for our services and that we expect payment??? Hang on, I am trying to get to the point....little old lady with chest pain doesn't want to go to the hospital because she cannot afford it and the field paramedics tell her " Don't worry about the cost...lets just worry about getting you to the hospital now.... " How many of the FIELD crews know precisely what an ambulance run costs? How many inservices have we had for FIELD folks educating them as to how their paychecks get paid or equipment gets paid for??? How many times can you buy 4X4's without having to read and/or sign a statement stating you WILL pay the bill when it is due??? How many services have exactly the same statements on their run reports....not the Medicare " if uncle sam doesn't pay you will be responsible " but actual statements telling people THEY are responsible for the bill? Maybe even leaving them an itemized copy with their signature on it? In the " Mother Jugs and Speed " days we were all reminiscing about, they took cash and plastic...no money...no ride....then we decided that was wrong...so we took the proverbial pendulum and swung it completely to the other stop....Don't talk about the money...it is immoral to discuss that when people need medical help....shhhh...just get them to the hospital and we will worry about the costs later....etc, etc. Maybe it is time we bring the pendulum from its peak back to MIDLINE....maybe we need to be more like a business and make sure people KNOW what they will owe when the bill comes due. Maybe we should educate our medics on medical necessity and insurance companies so they will know who pays and how much so patients can make an informed decision about spending their money on an ambulance for that broken toe vs. a cab.....and maybe it is time to get serious about collecting on EMS bills from these folks....I don't pay my American Express I bet they get serious about it. I agree...it is frustrating that people don't pay their bills...but what have we done to improve it? I don't see this thread being talked about on the " Cool Calls from the Street " email lists....I don't see EMS managers talking to EMT and Paramedic classes about medical necessity, funding, and how insurance works..... Maybe the reason that people are not serious about paying us money is because we have not been serious or forthright enough to stand up and say YOU HAVE TO PAY. I don't know....just a thought I had late this evening that I wanted to share. Enjoy, Dudley Wait Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 15, 2002 Report Share Posted May 15, 2002 AMEN!!! I want to jump up on that soapbox with you Jane. Sounds like the service in our neck of the woods with the exception of funding thru taxes. We get a paltry sum of $7500/yr from the county and $5500/yr from the city we're in. We cover 2/3rds of the county, pop. approx 15,000 (2 prisons in that total, and about 850 sq. miles). We make about 120 calls per month. We have 1 paid crew per shift and 3 units. Funding? What's that? Fund Raisers? Puleeze. You'd think we were asking for the moon. And don't even bring up ESD. That would be a mortal sin. What another tax? Over my dead body! My response: It just might be! What I don't understand is when it comes to the Fire Dept. the City will give them anything they ask for, they just bought them a new $245,000 truck (has to do with key rate on insurance I believe), and the public supports them 100%. WHY? Because they don't charge for their services. They're VOLUNTEERS! Believe me, all they have to do is stand on the street corner with a boot in hand and people are throwing cash at them. They may make 75 calls a year. Before ANYONE dogs me on slamming the FD. I'm a retired volunteer Firefighter with 15 years of service with that department. I've been on both sides of the fence so to speak. My point is, people seem to value their property more than their lives. They will never understand the regulations, supplies, equipment needs, insurance for us, our Board of Directors and Medical Director, payroll, maintenance, etc. that we have to worry about. They don't care that an EMS service is not required by Texas. They just want us there when they want us there. Then complain because it took 5 minutes to get there. And please don't get me started on the deadbeats. We have our fair share of frequent flyers that never pay a penny, have no insurance and don't blink twice as we show up for the 10th time that month. We can't refuse because we're a 911 service, and we all know about lawsuits from No Transports (thanks Gene)! While I'm at it, what about those hospital to hospital transports where the Doc says the patient has to go to the nearest big city for care unavailable in your area, and that it's not life threatening, and could go POV, but the family doesn't have any transportation to take them, then you have a caravan a mile long following your unit?!?! And the family members who call EMS for some minor thing that didn't need an ambulance, who want their loved-one to go to the hospital but they don't have transportation, and they beat you to the hospital. You're right Jane, it is frustrating. In 17 years at this nothing has changed in that area. Nothing gets thru except when you're not there. All the articles in the paper about who and what we are, what we're up against financially, what we need to survive, just doesn't get thru to them. I don't know what will. It's sad to see that this seems to be a common problem in Texas. Thanks for letting me vent. Whew! Debbie Reply-To: To: < > Subject: Re: paid and volunteer Date: Wed, 15 May 2002 11:58:26 -0500 In our neck of the woods, we have a little over $300,000 that comes in every year in taxes that is supposed to fund the EMS AND the full time clinic. Folks don't understand that the EMS budget ALONE is going to be over $300,000/year. Many don't want to pay their copayments or co-insurance share or, if they have no insurance at all, many just don't feel like they should have to pay anyway cause they pay taxes. Oh, and God forbid you should hold a fundraiser to try and raise money to help defray expenses or buy needed equipment. It costs a lot of money to call for an ambulance, but that is because it costs a lot of money to RUN an ambulance service. The volunteerism days are just about gone, and EMS folks wants to earn a living. And most don't want to live in poverty to do what they love to do. They also don't want to run in junky, beat up ambulances, with little or no equipment. And for some reason they want malpractice insurance to cover them if these same people who don't want to pay bills want to file some suit about something that may or may not be legitimate. But the general public would rather pay $500 to take their friends on a trip to a ballgame or even more to go to the Super Bowl than to help fund EMS or pay their bill. It is EXPECTED that these services be rendered without renumeration by more people than I want to think about. In EVERY response area nationwide, EMS services suffer with patients who call for the ambulance for every little complaint (complaints that insurance won't pay for even if they have insurance) and they EXPECT EMS to transport them to a hospital of their choice and do not even want to DISCUSS the issue of who is paying the bill. Anyway, I will get off my soapbox now. Sorry. It is just frustrating when you think about how large the problem really is. Jane Hill Re: paid and volunteer > The DOL's interpretation is the law as I understand it, but I do have some > thoughts about it whether or not it's the right interpretation in every case. > It is unfortunate in a way, because it prohibits volunteerism in some > instances where it would possibly be good for all concerned. However, the > DOL's interpretation and it's strict adherence to it is in direct response to > a history of abuse of volunteers by many services, and cynical efforts by > many levels of EMS management to keep from paying a living wage to paid > workers. > > There can be reasonable arguments made that exceptions ought to be allowed, > but exceptions would only foster a further postponement of recognition that > EMS people are professionals and need to be treated and compensated as such. > > > It is nice to volunteer one's services when one is making a living wage from > other sources. That doesn't mean that volunteers are in any way less > competent or capable than paid workers, and in fact many volunteers posess a > very high level of education and competence which equals or surpasses that of > some paid personnel, but if the political entities responsible for providing > EMS services to their residents attempt to do so without facing up to the > realities of the cost of quality EMS and seek to get something for nothing, > then volunteerism works against the public good. People want EMS to be > there when they push their speeddial 911 button and want $159,000 worth of > equipment and more than that in competent personnel to show up within the > time limits for conversion of Ventricular Fibrillation without risk of > hypoxic brain injury, but will they pay for it? > > I spent a lot of years providing volunteer service in an area that I thought > couldn't afford paid service, but now that I think about it, I probably > didn't do the EMS Profession any favors by doing so. I probably only helped > postpone the reality check that is now happening to the residents of the area > I served. > > Recently there was an extensive dabate on another list about whether or not > medical care is a " right. " Most of the medical professionals who chose to > expound on the subject argued that there is no right to medical care. They > cut their own throats. > > Maybe the best thing that could happen to EMS would be for it to just go away > for a couple of years. > > Then maybe people would make a decision about whether they had rather have > good EMS or a good taxi service. Anybody know where I can get a yellow Ford > Vic? > > gg > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 16, 2002 Report Share Posted May 16, 2002 Debbie, Boy, do you make some great points. Much of your description of your service sounds like our service. The income problem is constant and the dollar amount of unpaid bills is huge. If we collected everything owed to us for just the last 3 years we could probably pay cash for two brand new ambulances. And you're are also right in that many of these people just don't care whether or not their bill gets paid. I also find your suggestion about EMS not being a God-given right very interesting. EMS is a service that must be paid for. Someone must pay for it, so why not those who use it. We don't (and don't want to) put anyone's health or life at risk based on whether or not they can pay the bill. However, there is seldom any reason why they can't be cooperative or helpful about getting it paid later. We have the signed statement regarding responsibility, have a billing agency that takes care of all claim filing, file with insurance/Medicare/Medicaid is the patient has those, accept payment arrangements, and will also pursue collection through a collection agency. Still, many of them just don't care. Consider a comparison between EMS and water: Water is an absolute essential for life and health. Many of us pay taxes to a Municipal Water District. We still get a bill for the water we use . We do not have to pay for our water before we use it. The more we use, the more we are expected to pay. We expect our water to be there anytime we want it. The difference between water and EMS: If we don't pay our water bill, our water supply will be cut off. I would never want to refuse emergency care to anyone based on ability to pay. However, just as these same people expect to pay for the water they use, they should also expect to pay for the EMS they use. Maxine hire-Pattison EMS In a message dated 5/16/02 7:22:44 AM Central Daylight Time, bosslady73@... writes: > > Our service is a small close-knit family. While I had the honor of being > the Admin I can tell you that my co-workers we're well aware of what it > took > to run the service, from regulations down to finances. They knew all the > ins and outs and since WE own the service, they took an active interest in > the running of the service and had a say in what went on. These same > medics > helped with the supplies and ordering of such. And off the main topic for > a > moment, I find it outrageous that the medical suppliers out there charge an > > arm and leg for what you can get at Wal-Mart for next to nothing, i.e., > 4x4s, alcohol preps, glucometer test strips, things of that nature. If the > > medical suppliers didn't gouge us it would help keep cost down. OK, back > to > the main topic. > > We did tell the frequent flyers that there was a fee for transporting. But > > they soon learned that all they have to do was say the magic words " chest > pains " and that was all it took to get them in the box. As for sending > them > a bill or turning them over to a collection agency, these people don't > care. > They have no credit, will never have credit and are content to live off > the generosity of others, meaning our taxes. > Our run form did have the statement that THEY would be responsible for all > charges, it was read to them and they signed it. We made it perfectly > clear > that we expected and needed payment in order to stay in business. As for > giving them an itemized bill at time of transport, well, we had a billing > service and they handle that end of it. Our medics could give them a > ballpark figure, and the answer we received was, " That's ok, I understand, > I'll pay. " But you can't get blood out of a turnip as we all know. > > We never told our patients " Don't worry about the bill. " We told them > " We'll help work out something for you. " We helped them file if needed, > fought the insurance companies, and set up payment plans. If they were > eligible for Medicare/Medicaid we helped them get that. Those with a > conscience paid, those without didn't. > > Our medics educated the public whenever possible about what it takes to > keep > an EMS service in the area. We did the guest speaker thing at all the > local > clubs and charities and we got donations from such. But a few cannot carry > > the load for all. It seems the non-payers outnumbered the payers. But we > must also take into consideration that our economics are not that of say > Hollywood Park or Alamo Heights. We probably have more people living at or > > below the poverty level than we do living comfortably. Our citizens truly > do live paycheck to paycheck and struggle hard to make ends meet. But > should they be denied an ambulance because of this? We like to think that > no matter who you are and how much money you have, we are here for you. > But > on the realistic side, that kind of thinking doesn't pay our bills or keep > medics on the trucks. It's a neverending struggle for small town EMS. > > Maybe we need to come up with a new motto, " EMS is NOT a God given right, > it's a service you pay for. " > > OK, I'm thru whining for the day, well maybe. > > Debbie > > > From: THEDUDMAN@... > Reply-To: > To: > Subject: Re: paid and volunteer > Date: Thu, 16 May 2002 01:33:50 EDT > > Jane, Debbie, and others, > > I often get given grief about my presence in this list as I seem to be one > who likes to stir the pot...maybe sometimes I do it just to liven things up > > a > little...sometimes to spur conversation....sometimes because I am just fed > up.... > > But after reading the posts from this thread all evening, something > occurred > to me and I want to see if I can get it down in type.... > > Just go with me for a second or two here: Could the reason that people > don't > pay our bills, or their co-pays, or fight for us with their insurance > companies possibly be that we do not make enough of a point on the FRONT > end > that we charge for our services and that we expect payment??? > > Hang on, I am trying to get to the point....little old lady with chest pain > doesn't want to go to the hospital because she cannot afford it and the > field > paramedics tell her " Don't worry about the cost...lets just worry about > getting you to the hospital now.... " How many of the FIELD crews know > precisely what an ambulance run costs? How many inservices have we had for > FIELD folks educating them as to how their paychecks get paid or equipment > gets paid for??? How many times can you buy 4X4's without having to read > and/or sign a statement stating you WILL pay the bill when it is due??? > How > many services have exactly the same statements on their run reports....not > the Medicare " if uncle sam doesn't pay you will be responsible " but actual > statements telling people THEY are responsible for the bill? Maybe even > leaving them an itemized copy with their signature on it? > > In the " Mother Jugs and Speed " days we were all reminiscing about, they > took > cash and plastic...no money...no ride....then we decided that was > wrong...so > we took the proverbial pendulum and swung it completely to the other > stop....Don't talk about the money...it is immoral to discuss that when > people need medical help....shhhh...just get them to the hospital and we > will > worry about the costs later....etc, etc. > > Maybe it is time we bring the pendulum from its peak back to > MIDLINE....maybe > we need to be more like a business and make sure people KNOW what they will > owe when the bill comes due. Maybe we should educate our medics on medical > necessity and insurance companies so they will know who pays and how much > so > patients can make an informed decision about spending their money on an > ambulance for that broken toe vs. a cab.....and maybe it is time to get > serious about collecting on EMS bills from these folks....I don't pay my > American Express I bet they get serious about it. > > > I agree...it is frustrating that people don't pay their bills...but what > have > we done to improve it? I don't see this thread being talked about on the > " Cool Calls from the Street " email lists....I don't see EMS managers > talking > to EMT and Paramedic classes about medical necessity, funding, and how > insurance works..... > > Maybe the reason that people are not serious about paying us money is > because > we have not been serious or forthright enough to stand up and say YOU HAVE > TO > PAY. > > I don't know....just a thought I had late this evening that I wanted to > share. > > Enjoy, > > Dudley Wait > > > > > > > > > > _________________________________________________________________ > Send and receive Hotmail on your mobile device: http://mobile.msn.com > > > > > > Quote Link to comment Share on other sites More sharing options...
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