Guest guest Posted May 16, 2002 Report Share Posted May 16, 2002 G'Morning Dudley, I felt the need to respond to you on this. Being a past administrator of this particular EMS service, a non-profit organization, I feel I can answer your questions with some intelligence. A side note here, we are one of three services in the county. We have the largest population to cover. One service is city owned and the other is an ESD. Our area is hell bent on no new taxes and we've tried everything from trying to get an ESD in our area to adding on to the sales tax. The answer to our plea for help is " We'd like to help, but... " 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...
Guest guest Posted May 16, 2002 Report Share Posted May 16, 2002 Dudley, Thought provoking ideas. Perhaps this comes also as a result of our inability to decide just who we are: a Public Service or a Medical Profession. If we are a public service then it is up to the public to support us as they have mandated our existance. If we are a medical profession that serves the public in the prehospital field, then our " customers " should be paying us for our services and that should be made obvious to them. I know there are moral and ethical issues here but where does morality end and survival begin? Jeanne E. Amis, RN, LP Education Director Marfa City/County EMS Re: paid and volunteer > 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 16, 2002 Report Share Posted May 16, 2002 Dudley, Thought provoking ideas. Perhaps this comes also as a result of our inability to decide just who we are: a Public Service or a Medical Profession. If we are a public service then it is up to the public to support us as they have mandated our existance. If we are a medical profession that serves the public in the prehospital field, then our " customers " should be paying us for our services and that should be made obvious to them. I know there are moral and ethical issues here but where does morality end and survival begin? Jeanne E. Amis, RN, LP Education Director Marfa City/County EMS Re: paid and volunteer > 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 16, 2002 Report Share Posted May 16, 2002 Of course, we need to remember that " them " includes us. Are we willing to take this service away from ourselves, our families, friends, and neighbors. Probably not. Maxine Pate hire-Pattison EMS > > I think Gene Gandy came up with the best idea so far. > We need to all disappear and see how long it takes > " them " to realize we're needed. > > > E. Tate, LP > Tyler, Texas > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 16, 2002 Report Share Posted May 16, 2002 Maxine, Actually, I was calling the people that hold the purse strings and the people that could care less " them " . It's just too bad that it will take a total collapse of the EMS system across Texas and the country before people will listen to us. I see the day coming when fire departments and city third services are THE providers of EMS in the US. Maybe we can go to a " members only " type service similar to the first fire insurance company started in Philadelphia, Pennsylvania in 1752. We can come up with a snazzy EMS Seal that people will display in their yard if they are " insured " with us. See http://sln.fi.edu/franklin/statsman/images/fireseal.jpg for a picture of the original " FA " seal. People would buy into the fire insurance company, and the company would use the money to purchase fire fighting equipment. What of the non-members? Well, they had to rely on friends and family, but would not receive assistance from the insurance company. There are services like this in New York City now. I spent a week up there back in February, and talked to one paramedic that works for a Jewish community ambulance service. I don't recall the name of it, but he said they only transport people that are members of their company. The company was started within a synagogue and grew from there. They service a large number of people, and not all are Jewish. It's was a very interesting idea to say the least. Shall we start our own version of this? We can have the Republican Ambulance Service, the Democrat Ambulance Service, the Independent Ambulance Service, and No Particular Affiliation Ambulance Service. > Of course, we need to remember that " them " includes us. Are we willing to > take this service away from ourselves, our families, friends, and neighbors. > Probably not. > > Maxine Pate > hire-Pattison EMS > > > > > > I think Gene Gandy came up with the best idea so far. > > We need to all disappear and see how long it takes > > " them " to realize we're needed. > > > > > > E. Tate, LP > > Tyler, Texas > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 17, 2002 Report Share Posted May 17, 2002 I understand you perfectly, Janette. It is sad that no matter how hard we may try to educate the problem, they generally conceive that there really IS no problem. So why should they listen to us? We are just making a mountain out of a molehill. Besides, EMS MUST be offered no matter what. So there is not a problem, right? (Yeah, right.) Jane Hill Re: paid and volunteer > 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 17, 2002 Report Share Posted May 17, 2002 How right you are. Now, what IS the solution to our dilemma? Has anyone tried anything in their area that actually works to get the attention to financial concerns that we need? Are there any success stories out there? How did YOU get your shareholders interest and ultimate support? Jane Re: paid and volunteer > 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 17, 2002 Report Share Posted May 17, 2002 So just what legislation would it take to get EMS as a required service like law enforcement and fire? How would something like that work? Jane RE: paid and volunteer > 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 17, 2002 Report Share Posted May 17, 2002 Hey, I am glad I do not appear to be the only one with this problem still present in Texas. I am just sitting here wondering what I am missing. What do we have to do to get on the bandwagon? I was really upset recently when I talked to a FEMA representative about trying to get funding through them. We talked for about 30 minutes and then he said, " Wait, one thing. Are you affiliated with and/or run by your local Fire Department? " When I told him, " No " he said, " I am really sorry, but we can't help you. The money released by President Bush is specifically earmarked for Fire Departments and EMS services run by Fire Departments. " I was absolutely appalled!! Does the government think like the general public - that if EMS is not part of the Fire Department, they aren't JACK? Or is it that they think that private sector EMS and even 3rd city services don't experience or run into terrorism? Do they really think that our needs for this money for training and preparation are less than Fire Departments? Last time I looked, we would be right along with the FD on these type of responses. How do we solve this, folks??? Jane 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 17, 2002 Report Share Posted May 17, 2002 For once, Dudley, I agree with you. In fact, I have already started addressing that situation in our area. Our crews are told NEVER to do a wallet biopsy BUT, if the patient's condition does not warrant ambulance transport and would possibly not be paid by insurance, they are to politely inform the patient that it is possible that this might not be covered by their insurance. They tell them that they are more than happy to take them to the hospital, but that they must be up front and have them sign the Financial Responsibility statement just in case it is rejected. Normally there is not even an argument or question from the patient, although there have been a couple who got upset. When that happens, we just carry them and then put the paper in front of them again at the hospital with a simple, " Please sign here, Mr. , and we hope you feel better soon. " Many people do NOT understand that this is still a business - a very litigious business, but still a business. We are very careful to not push no transports, but we try to be honest with our patients. We really do them no favors by leading them into a false sense of security that their insurances are going to pay for things and that they will be billed for little or nothing. We should not REFUSE transport, but I feel like we should be honest. OK, let the flames begin. Jane Hill Re: paid and volunteer > 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 17, 2002 Report Share Posted May 17, 2002 Morality versus survivability??? Interesting thought.... Jane Hill Re: paid and volunteer > > > > 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 17, 2002 Report Share Posted May 17, 2002 > 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 17, 2002 Report Share Posted May 17, 2002 FEMA is taking comments on the first responder grants program till May 23. I know the lobby groups for Fire and Law Enforcement have been pushing hard for the money to go to them. If they succeed, then EMS has not been loud enough. Perhaps some of the energy wasted on this board lately could be better put to use in other ways. Whether you agree with me or not is irrelevant. Write in and say something. It is your EMS future. May 18, 2002 Re: FEMA Seeks Input On First Responder Grants Program. Release Number: 02-036 Dear interested parties: I would like to present some suggestions for FEMA in this endeavor. My name is Raina Dodson. I worked on the Texas-Mexico Border in Presidio Texas as a paramedic for nine and half years. We were defined then and now as an extreme frontier 911-service provider. We covered 3000 square miles of rugged Big Bend Country, and for much of my time there I was often the only paramedic in response, with one partner at the basic level. Additionally, I served on the Presidio County Disaster Task Force for 1999. The Presidio response area also included Redford, Texas, the site of the marine shooting of an 18 year old goat herder as well as much drug interdiction with the Border Patrol. It was and is a ruggedplace. Prior to 9/11, I was actively trying to raise concern over the dwindling rural EMS response across the nation. Revenue and staffing issues have truly affected the ability of the nation to provide emergency services and response in these rural areas. Places that are most in need of paramedics cannot realistically afford them nor can they support doctors or hospitals. Yet these places are often on the routes to tourist destinations, along major inter- and intra- state transportation corridors, along our nation's beleaguered Texas-Mexico border and lining the HAZMAT routes of the nation. Fire service is usually volunteer and may, like Presidio VFD, be under-trained, under-funded and understaffed to deal with any emergency response, much less the world of post 9/11. After 9/11, these disparities have suddenly sharpened in focus and these needs must no longer be ignored. Much of what needs to be done for emergency response on the local level in Presidio could be of much assistance on the national scale. Over the years of traveling the remote routes of Far West Texas and dealing with difficult and sometimes impossible critical calls, I made many observations that might be of assistance. Certainly it can be said that I have more experience than the average policy maker in assessing and dealing with the critical care and emergent needs of remote rural areas, at least in Far West Texas. A). Local Trauma Stabilization Centers with Obstetrical Capabilities should be in place in these isolated areas. Down time could be spent in training for hazardous materials, epidemiological surveillance, and other terrorism spawned directives. This would be a set up under the auspices of a medical director like a small triage ER center/OB unit with no more than 5-10 beds. Any patient that needed more than an overnight stay could be flown to a more intensive hospital and any critical patient could be stabilized immediately and flown (hopefully) or ground transported to the proper level hospital/trauma center. Staffing would be provided with a Physician Assistant, Registered Nurse or Nurse Practitioner, Paramedic and an EMT 24/7. A " quarters " type facility much like a FD or EMS station (dorms, day-room, kitchen) would be provided where the staff " lives " while on duty. Outside the facility would be a heli-pad. (It should be noted that Presidio has no access to air-medical services and all calls are ground transport. Further, there are not enough medics and EMT's to staff two ambulances, so even a multiple patient automobile accident is tended by ONE rig. Precious time is lost waiting for backup help to arrive from 60-90 miles away.) Shift change would occur at noon to allow for out of town staff to arrive from larger cities, and all personnel would train and work together to compliment and assist in the skills they can provide. Local EMS would also trained to be part of the team. An EMT and Paramedic would respond to 911 calls and the patients are brought back to the clinic for whatever they need. The clinic would have more " automated " clinical devices such as x-ray, lab testing equipment, and potentially CT scan where results can be seen at the clinic as well as by the attending physician in the sponsoring hospital. Helicopters (or EMS ground units) would then be used to move patients from clinic to hospital. Telemedicine (already in place in Presidio, but not utilized very often) could also be used to supplement patient treatment. There is always the problem of down time in a rural area. Emergencies tend to come in a feast or famine fashion. Down time could be spent in educational and training pursuits to allow for epidemiological, bio-terrorism, HAZMAT and continuing education classes. Fluid flexibility is the key. . Rural towns must " grow their own " healthcare and emergency response system. Local response in Presidio tended to be provided by people outside of the community. Classes were offered and scholarships were given but due to language barriers and a foundering educational system, few locals were able to succeed in successfully passing the State certification tests. Small, poor rural areas tend to have lower literacy rates, fewer job opportunities, and inadequate level of political functioning and security issues due to low levels of law enforcement professionals. For a place like Presidio, it is imperative that the city " grow their own " healthcare and emergency response system. The first stage of this answer lies within the auspices of the local school system and indeed cannot be done without them. We have to start with tomorrow's medics, EMT's and firefighters. This cannot be done with a solid partnership between the state, school system, and the local EMS or Fire/EMS service. Finding and funding the financial base to bring these classes into the school system is necessary. It is a win-win situation for the student, school, community and the state. I submit to you that the need for EMS becomes critical the more rural/frontier the service becomes. In many of these rural and underserved areas, EMS is the only healthcare /emergency response immediately available and as such is the only dependable and 24/7 service provider in many areas. Unfortunately, many of these calls are not adequately reimbursed (if at all) and the service bears the burden. We have fewer new medics waiting in the wings, as few people are interested in a job that requires 24/7 commitment, low wages and little or no benefits. Interestingly enough, in a number of these rural or frontier areas, the EMS providers are also part of the working poor without insurance. That alone should be enough to shame the leadership and policy makers of this great nation. The average Rural Health Center is only open at certain hours and even then is not equipped to handle major medical or traumatic emergencies, childbirth, heart attacks or even common simple fractures. They are certainly not capable of handling WMD incidents or multiple victims. Only ONE registered nurse staffs the Public Health Center in Presidio. She has no training in terrorism, epidemiology or HAZMAT emergencies; by her own initiative she is now trained as an EMT. However, one person is not the answer to homeland security. We are in the midst of a crisis in border and rural EMS. Those who are certified leave for more lucrative positions leaving the small town provider or opt out of all together once they realize they are at or below the poverty line and cannot live there. With hospitals failing in the small areas, EMS becomes an even more important link in the system. A day may come when there will not be anyone available on the other end of 911 in some areas of the US -Mexico Border. Unworkable Medicaid compensation policies such as unequal reimbursement policies due to formulas based on historical use unfairly penalize the poorer healthcare systems and destabilize the healthcare provider in these areas. It is easy to sit in the office and muse about the theoretical economic structure of healthcare. Living the life of a frontline healthcare provider teaches one very quickly that life cannot be packaged quite so neatly, and that money cannot be made the focus of the treatment priority. Emergency medicine is not, not will it ever be, a profitable enterprise. This fact has been ignored in the blind attempt to reform healthcare, which has instead redirected profit instead of taking it out of the equation. The primary crisis in EMS today is a lack of funding necessary to maintain the health of the EMS system and allow it to perform to its optimum potential. This lack of funding is caused by ill-considered HCFA policies and rules and the need to stretch municipal tax dollars further and further. The trickle down effect is the principal reason why EMS services cannot pay the salaries and benefits needed to attract and retain highly trained, long-term EMS professionals. While some legislative actions focusing directly on the need for increasing the numbers of EMS personnel will be useful, I believe that immediate funding must be opened up for operational support of services such as ours in communities which simply cannot afford to fund EMS adequately, but will be without emergency response, or in some cases, health care, without EMS. It goes without saying that without EMS we have no homeland security to speak of. Surely, in a country that utilizes formulas for every type of reimbursement and support imaginable one can be developed to assist EMS? Either every county or town of this great nation deserves the basic healthcare that EMS offers or it doesn't. If the answer is yes, then ensure that these very worthy services can survive. If not, let the people know so they can plan their lives accordingly. Standardized EMS educational initiatives have stabilized the once fractured state of EMS by creating and maintaining strict standard of care practices. Strict state certifications and licensing standards ensure that our services maintain a certain level of professionalism. However, somewhere along the way, the ideals of EMS have striven far ahead of what the realities of EMS are. EMS is currently being required to maintain the 911 system, train for HAZMAT accidents, school shootings and bioterrorism, manage more traffic on more highways, roadways, and interstates and higher rates of travel, provide high dollar medications to a wide variety of medical and traumatic emergencies, and to know and treat the myriad of illnesses and injuries that manifest themselves in the lives of victims throughout this country all without injuring the patients or ourselves. These individuals risk their health, their lives, their marriages and relationships and often times they fall victim to the hazards that being in EMS entails. As the situation currently stands, I am begging you to make emergency/long-term operational funding and include a provision which makes EMS part of the Health Care Provider Shortage definition a part of the vision for tomorrow's EMS. Most of the border Frontier services that I am familiar with has long depended on grants for their ambulances, their equipment and their training programs. However, most struggle day today to keep those rigs on the road. Without qualified personnel, the best ambulance in the world is useless. Being part of the Health Care Provider Shortage definition may open up operational funding from grant sources previously unavailable to us. The providers I know stay on call months or years at a time to ensure that 911 stay active. They work codes and calls on their friends and family members because they have no choice. They work with little or no benefits that the rest of the world (including many fire and police departments) take for granted. In many cases they are not recognized as a public safety member, or even have the role of an EMS provider recognized as a " real " job by local politicians. Most are demoralized that they could make more working in a fast-food restaurant than they do delivering babies, treating heart attacks or treating trauma victims. Many work with inadequate or non-existent insurance coverage and I know many paramedics and EMT's who even now suffer debilitating injuries or illnesses that leave them unable to work even while being hard-pressed to afford the health care they now need. These providers deserve a better hand than they have been dealt. September 11, 2001 is a day burned into the memory of fire fighters, EMS providers, and law. It was a dawning of slow horror to realize the line was drawn and we were standing on it. Thank you for your time. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 18, 2002 Report Share Posted May 18, 2002 Well, we start with the Local Government Code, Title 11, identified below: TITLE 11. PUBLIC SAFETY CHAPTER 341. MUNICIPAL LAW ENFORCEMENT CHAPTER 342. MUNICIPAL FIRE PROTECTION CHAPTER 343. MUNICIPAL PROVISION OF SCHOOL CROSSING GUARDS CHAPTER 351. COUNTY JAILS AND LAW ENFORCEMENT CHAPTER 352. COUNTY FIRE PROTECTION CHAPTER 361. MUNICIPAL AND COUNTY AUTHORITY RELATING TO JAILS CHAPTER 362. LAW ENFORCEMENT SERVICES PROVIDED THROUGH COOPERATION OF MUNICIPALITIES, COUNTIES, AND CERTAIN OTHER LOCAL GOVERNMENTS CHAPTER 363. CRIME CONTROL AND PREVENTION DISTRICTS CHAPTER 370. MISCELLANEOUS PROVISIONS RELATING TO MUNICIPAL AND COUNTY HEALTH AND PUBLIC SAFETY Currently, no definition exists there for municipal or county emergency medical service, and no mention is made (that I've found) of that service in any existing statute under Title 11. So, we'd need two new chapters - MUNICIPAL EMERGENCY MEDICAL SERVICES and COUNTY EMERGENCY MEDICAL SERVICES. They'd lay out like the above ones, and set definitions in place for what constitutes a service, how it would be required to be provided, who is authorized to pay for it, etc. After that, we'd have to scour the rest of Texas law to find every reference to fire and police and see if emergency medical services need to be included in those definitions. Interestingly (to EMSAT, I'm sure), collective bargaining rights are granted to certain organizations of fire and police personnel. Creating statutory definitions for EMS services and provision would allow statutory changes that would grant collective bargaining rights to EMS personnel w.r.t. cities, counties and the like - shortly said, if EMSAT had chapters (locally), and if the majority of the members of a service were members of EMSAT, and those members voted their local EMSAT chapter to be their agent, EMSAT (at least the local chapter) would be the bargaining agent at the table, sitting across from the city/county, representing EMS in it's area, BY LAW. Now, if I were an EMS employee, and I knew that joining EMSAT and defining a local chapter would give me a statutory power that required a city to bargain, with EMSAT as my representative (and with our local folks choosing our local officers for our local chapter, and with the collective knowledge of a state-wide organization and each other chapter combined), I'd be pretty darned incented to join. <grin> Of course, collective bargaining isn't the end-all-be-all of this... It's just an example that's relevant to recent discussions on the list. But the power is there - create the statues, get support for them, get them passed - become a real public service, not just a bunch of folks in ambulances (who happen to provide really good care and do a really good job, just not under any sort of official appointment). Caveat: Care would need to be taken so that cities/counties could CHOOSE who provided their EMS service, and allow for fire departments (or police departments, for that matter) to be their " choice " for EMS service, so that local fire departments already providing this coverage wouldn't feel in any way threatened or challenged, and would support (or at least not attack) the changes. Not bad for 2:30 AM on a Saturday morning. It's a start... Mike > Re: paid and volunteer > > > So just what legislation would it take to get EMS as a > required service like law enforcement and fire? How would > something like that work? > > Jane > RE: paid and volunteer > > > > 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 18, 2002 Report Share Posted May 18, 2002 All right, EMSAT members, what now? This looks like a good start. Gene, what do you think? Jane You wrote: >Well, we start with the Local Government Code, Title 11, identified >below: > >TITLE 11. PUBLIC SAFETY > CHAPTER 341. MUNICIPAL LAW ENFORCEMENT > CHAPTER 342. MUNICIPAL FIRE PROTECTION > CHAPTER 343. MUNICIPAL PROVISION OF SCHOOL CROSSING GUARDS > CHAPTER 351. COUNTY JAILS AND LAW ENFORCEMENT > CHAPTER 352. COUNTY FIRE PROTECTION > CHAPTER 361. MUNICIPAL AND COUNTY AUTHORITY RELATING TO JAILS > CHAPTER 362. LAW ENFORCEMENT SERVICES PROVIDED THROUGH COOPERATION >OF MUNICIPALITIES, COUNTIES, AND CERTAIN OTHER LOCAL GOVERNMENTS > CHAPTER 363. CRIME CONTROL AND PREVENTION DISTRICTS > CHAPTER 370. MISCELLANEOUS PROVISIONS RELATING TO MUNICIPAL AND >COUNTY HEALTH AND PUBLIC SAFETY > >Currently, no definition exists there for municipal or county emergency >medical service, and no mention is made (that I've found) of that >service in any existing statute under Title 11. So, we'd need two new >chapters - MUNICIPAL EMERGENCY MEDICAL SERVICES and COUNTY EMERGENCY >MEDICAL SERVICES. They'd lay out like the above ones, and set >definitions in place for what constitutes a service, how it would be >required to be provided, who is authorized to pay for it, etc. > >After that, we'd have to scour the rest of Texas law to find every >reference to fire and police and see if emergency medical services need >to be included in those definitions. > >Interestingly (to EMSAT, I'm sure), collective bargaining rights are >granted to certain organizations of fire and police personnel. Creating >statutory definitions for EMS services and provision would allow >statutory changes that would grant collective bargaining rights to EMS >personnel w.r.t. cities, counties and the like - shortly said, if EMSAT >had chapters (locally), and if the majority of the members of a service >were members of EMSAT, and those members voted their local EMSAT chapter >to be their agent, EMSAT (at least the local chapter) would be the >bargaining agent at the table, sitting across from the city/county, >representing EMS in it's area, BY LAW. > >Now, if I were an EMS employee, and I knew that joining EMSAT and >defining a local chapter would give me a statutory power that required a >city to bargain, with EMSAT as my representative (and with our local >folks choosing our local officers for our local chapter, and with the >collective knowledge of a state-wide organization and each other chapter >combined), I'd be pretty darned incented to join. > >Of course, collective bargaining isn't the end-all-be-all of this... >It's just an example that's relevant to recent discussions on the list. >But the power is there - create the statues, get support for them, get >them passed - become a real public service, not just a bunch of folks in >ambulances (who happen to provide really good care and do a really good >job, just not under any sort of official appointment). > >Caveat: Care would need to be taken so that cities/counties could >CHOOSE who provided their EMS service, and allow for fire departments >(or police departments, for that matter) to be their " choice " for EMS >service, so that local fire departments already providing this coverage >wouldn't feel in any way threatened or challenged, and would support (or >at least not attack) the changes. > >Not bad for 2:30 AM on a Saturday morning. It's a start... > >Mike > >> Re: paid and volunteer >> >> >> So just what legislation would it take to get EMS as a >> required service like law enforcement and fire? How would >> something like that work? >> >> Jane >> RE: paid and volunteer >> >> >> > 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 18, 2002 Report Share Posted May 18, 2002 Jeanne, Good point...if we are truly Public Safety...then we should be supported as such and potentially only charge fees to non-taxpayers we serve. If we are not, then maybe we need to explore BETTER how to provide the service AND be compensated. Survival as already taken precedence. Dudley Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 18, 2002 Report Share Posted May 18, 2002 Is EMS public safety? Or is it public health? Action vs. reaction. Donn Re: paid and volunteer > Jeanne, > > Good point...if we are truly Public Safety...then we should be supported as such and potentially only charge fees to non-taxpayers we serve. If we are not, then maybe we need to explore BETTER how to provide the service AND be compensated. Survival as already taken precedence. > > Dudley > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 18, 2002 Report Share Posted May 18, 2002 But, if we only charged fees to the " non-taxpayers we serve " , then we should have a tax base big enough to cover the expense of the TAXPAYERS. And currently, most areas do NOT have that big of a tax base. Even an ESD only allows up to 10 cents on the $100. With the very expensive cost of suppling EMS, this is still not enough to cover the cost. No easy answers out there, are there? Jane Re: paid and volunteer > Jeanne, > > Good point...if we are truly Public Safety...then we should be supported as such and potentially only charge fees to non-taxpayers we serve. If we are not, then maybe we need to explore BETTER how to provide the service AND be compensated. Survival as already taken precedence. > > Dudley > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 23, 2002 Report Share Posted May 23, 2002 If I remember correctly, the Texas Employee Handbook says an employee may not volunteer for a position that he or she was hired for. The volunteer work must be different and not related to the normal employment. example a medic may not volunteer on the ambulance as a medic, although the medic may volunteer his/her time doing blood pressure checks for EMS week programs at the local Walmart or a carwash to raise money for the organization. If the employee goes to the rodeo on standby status, then he/she is considered a medic the same as being on shift. And anything over 40 hrs. is still considered overtime at 1 1/2 times the normal hourly rate for that medic. RS > >> > > 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 24, 2002 Report Share Posted May 24, 2002 Federal labor laws do not allow for you to volunteer for a position in which you get paid in the same organization. Cypress Creek EMS has received an interpretation from the US Labor Department stating what was listed in the message below, you can check blood pressures, even run first-responder calls, work as a bike medic at special events, just as long it is not the EXACT same job you are expected to do on the unit. The items must be different job descriptions. Is that a fine line? Yes. Cy-Fair Volunteer Fire / EMS in Houston just went through the same thing. They made personnel choose, be a volunteer or go full-time paid. They were not given the option of doing both. Klein Volunteer Fire Department chose the same option with our " Duty Crew. " (paid staff working part-time weekdays on their day off from full time duty elsewhere) Most of the duty crew are off-duty Houston firemen. They were asked to volunteer or get paid, but you can't do both. Most of Northwest County departments are following this trend, but not all. I hope that makes it " clear as mud. " I believe that is the trend in most places. Our lawyers for Klein told our board of directors - " Make them decide, they can't do both. " Dan Rathe 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...
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