Emergency Medical Services Q&A
How does Edgemont receive and fund EMS services today?
Currently, Edgemont receives EMS through multiple agencies and funding sources:
- Our 30+ Greenville Fire District’s career firefighters are trained as emergency medical technicians or paramedics. They are licensed by New York State to provide “non-transport basic life support EMS” which includes comprehensive on-scene care, but not rides to the hospital. In its agency participation agreement with the Greenbugh Police Department, the fire district is described as a "Basic Life Support First Response (BLS-FR) EMS agency."
Headquartered on Central Avenue, the fire district is often first on the scene at medical emergencies in Edgemont, which account for approximately 45% of all fire district calls. This service is paid for exclusively by Edgemont and would not change upon incorporation.
- In its agreement with the Greenville Fire District, the Greenburgh Police Department also provides Basic Life Support and ambulance transport. Related expenses (primarily, civilian EMT drivers and stipends to patrol officers with EMT training) are part of the unincorporated Greenburgh “B” police department budget. This component of EMS is self-funded by revenues derived from hospital trips in the unincorporated area, including Edgemont.
- The Greenburgh Police Department, located off 119 approximately 4 miles north of Edgemont, provides paramedic (or “advanced life support”) service to the entire Town, including the villages. As all village and the unincorporated area pay for this service through the small Town-wide property tax (less than 2% of total bill), so too would an incorporated Edgemont receive these services. (Note: the Town-wide tax also funds the Town’s fleet of ambulances but, according to the Town, not the ambulance drivers.)
How might incorporation affect current EMS services?
As a special district contiguous with the Village, the Greenville Fire District will become the Edgemont Village Fire Department and its first-responder non-transport EMS services will remain in place.
Further, since Edgemont will continue to pay Town-wide property taxes, the village will also continue to receive Town-wide paramedic services like the existing six villages (that is, assuming the paramedic service remains available. If the Town chooses to terminate advanced life support (which is supposed to be funded Town-wide) due to Edgemont’s incorporation, then the unincorporated area has been subsidizing the villages, and the Town-wide tax should be adjusted accordingly.)
Bonds for ambulances and paramedic equipment are also paid by the entire Town. Therefore, residents of the entire Town (including those in Edgemont, incorporated or not) have an equitable claim to the benefits of the assets. However, the Town has stated that, as a Village, Edgemont would no longer be entitled to the use of ambulances because the drivers are not funded on a Town-wide basis.
Click here for a simple table that summarizes current services EMS in Edgemont and highlights the transport aspect of EMS, the one piece the Village would be required to replace if Edgemont does not contract with Greenburgh for police/EMS.
Is there a way to for Edgemont to maintain current EMS services?
Yes. If Edgemont contracts with Greenburgh for police at current service levels, there would be no change to the EMS status quo: the fire district and police department would continue to provide EMS jointly per their inter-municipal agreement. In this Edgemont-Greenburgh cooperative scenario, the Village of Edgemont would still run an estimated $1.3 million budget surplus at current tax rates, as shown here.
See the police page of the website for detailed Q&A on Edgemont-Greenburgh police contracting.
Besides contracting with Greenburgh, what other EMS options are available to the Village?
While the EIC believes that Village-Town intergovernmental cooperation for EMS and other services would be mutually beneficial for Edgemont (service continuity) and Greenburgh (revenue preservation), there is no assurance that the Town will offer police and EMS services to the Village.
If Greenburgh does not provide police services to Edgemont, the Village will have the opportunity to choose among multiple excellent options, all of which:
- Are within existing Village budgetary capacity at current tax rates and allow for a comfortable surplus;
- Are based on EMS models used by nearby municipalities (including NYC, Greenburgh, Pelham, and New Rochelle);
- Would include 24/7 Edgemont-based coverage, which we do not enjoy today;
- Are customizable to meet the community’s demands; and
- Would consolidate EMS service accountability under one governmental entity (the Village).
Potential options are as follows:
VILLAGE POLICE DEPARTMENT EMS
As noted above, the GPD’s “B” budget BLS program is funded by ambulance transport revenues, which comfortably exceed BLS transport costs. An Edgemont Village Police Department, if established, could also adopt a budget-neutral EMS “shared-service” approach like Greenburgh provides today and as the 2005 EVEC report envisioned.
To this end, the EIC’s January 2017 EIC feasibility study modeled the labor costs of the proposed Village police by utilizing Greenburgh’s materially higher, EMS stipend-included officer salaries rather than the materially lower pay scales of peer village police departments. (Note: GPD officer salaries are consistently about 10% above the Westchester average due, in part, to the GPD’s “double-duty” incentive system in which patrol officers can earn stipends for serving as EMTs. Click here for a comparison of GPD and County PD pay scales.)
Further, the feasibility study excluded transport revenues—estimated at $250,000—for ambulance trips originating within Edgemont. These revenues would flow to the Village (just as they are currently credited to the Town’s “B” budget) and offset marginal EMS costs, resulting in a $2.5 million overall budget surplus, slightly favorable to the conclusions in the feasibility study and a relatively higher surplus compared to other options.
In this scenario, Greenburgh Town-wide paramedic/ALS service is assumed to remain in place.
Click here for a pro forma budget assuming EMS is provided by the Edgemont Village Police Department.
VILLAGE FIRE DEPARTMENT EMS
In this scenario, the Village would contract with the Westchester County Department of Public Safety for police services. EMS would be provided entirely by the Village fire department, with no involvement from the Town of Greenburgh (other than mutual aid).
The cost of any such expansion would depend on how the fire department reconfigures/supplements its current 30-person firefighter/EMS staff. The Village’s governing body may choose to add civilian EMT drivers; add firefighter EMTs and/or paramedics; adjust its current fire/EMS/rescue coverage model; or implement some combination thereof.
While this approach would result in a lower budget surplus due to increased personnel costs, it remains comfortably within the Village’s revenue capacity at current Town tax rates. Further, it would bolster the department's general capacity.
Click here for a pro forma budget assuming EMS is provided by the Edgemont Village Fire Department.
THIRD-PARTY CONTRACT WITH EMPRESS EMS
Empress was founded in 1985 and provides all aspects and levels of EMS services to over 400,000 residents in lower Westchester (about 2/3rds of this area’s population), making it the largest such provider in the County. With a large staff of EMTs and paramedics, Empress responds to tens of thousands of calls annually, including mutual aid responses to New York City (for which it is a primary provider) and area municipalities.
Empress has EMS contracts with Westchester local governments including Yonkers, White Plains, New Rochelle, Mt. Vernon, Yorktown, and Pelham (Town). Further, Empress provides a variety of services to area hospitals and private care facilities.
Empress has indicated to the EIC that the Town of Pelham’s EMS contract is a useful template for a potential Village of Edgemont EMS model. In Pelham, Empress maintains a 24/7 paramedic-staffed fly car domiciled in a Pelham firehouse. Along with Pelham’s EMT firefighters, the Empress fly car/paramedic responds to all medical emergencies (about 800 calls per year) across the Town’s 12,000 population, which includes both the Village of Pelham and the Village of Pelham Manor.
Since the Empress fly car/paramedic never leaves Pelham, its response time is almost always within 3-5 minutes. If transport is needed, Empress guarantees an ambulance within 8 minutes 95% of the time.
Given the company’s scale and number of units in lower Westchester at any given time, Empress almost never requires mutual aid (although mutual aid is part of its governmental contracts).
Assuming the Pelham model* is utilized for Edgemont’s approximately 7,500 residents and 400-450 estimated calls per year, Empress provided the EIC with a contract cost estimate of $400,000 which assumes a) Empress collects all transport fees; b) Empress finances the fly car itself and houses it on Central Avenue at GFD headquarters; and c) the GFD continues to provide the same level of non-transport basic life support (in this case, in partnership with Empress instead of with the Greenburgh Police).
In this scenario, EMS would be provided entirely by a combination of the Village fire department (specifically, first-responder non-transport BLS, the same services provided by the Greenville Fire District today) and Empress. Other than mutual aid, there would be no level of involvement from the Town of Greenburgh.
Click here for a pro forma budget assuming Edgemont Village EMS is provided by Empress. The surplus is lower than the police EMS option, but higher than the fire EMS option.
*Note: the Town of Pelham approach is one of many dedicated, Edgemont-based EMS models that Empress could design and provide to the Village at current levels of taxation.
When would the Village determine how EMS is delivered to an incorporated Edgemont?
State law provides for a transition period; click here to learn more. Beyond the transition date, the Town is required to continue to provide all police services, without distinction between villages and unincorporated areas, indefinitely unless and until the Village secures its own such services.
Why isn’t an independent ambulance company (like the “VACs” in the Greenburgh villages) one of the listed options?
Logically, Edgemont would not establish an entirely separate, highly duplicative EMS operation/entity when it could either a) leverage its police department, like Greenburgh does; b) leverage its professional fire department (which already attends to every EMS call in Edgemont); or c) contract for the service.
Then why do the existing villages have separate ambulance companies?
The existing villages developed differently from Edgemont. They require stand-alone volunteer ambulance corps ("VACs") for local EMS because, unlike the Greenville Fire District, the village volunteer fire departments do not offer basic life support.
I heard that fire departments can’t charge for ambulance transports. Is that correct?
No. Only volunteer fire departments, which are not themselves local governments, are prohibited by state law from charging for ambulance transports. Municipalities that provide EMS through professionally staffed departments (like the FDNY, the Town of Greenburgh, and the Village of Edgemont) are permitted to charge for ambulance transports.
Did the EIC feasibility study fail to budget for EMS transport?
No. The EIC study provided funds for EMS transport in two ways:
- By duplicating Greenburgh’s EMS model and embedding "EMS double duty" stipends in the Edgemont Village Police Department (EVPD) budget projections. (Note: this same approach was utilized by the EVEC study in 2005.) As explained in the VILLAGE POLICE DEPARTMENT EMS OPTION above, the EIC report used Greenburgh's police salary scales which are about 10% above countywide averages. Given the nearly $5 million of projected police salary and benefits in the EIC study, that 10% "GPD premium" represents upwards of $500,000 in available budget capacity if the Village does not contract with Greenburgh for police/EMS.
- By not including ambulance transport charges in Village revenue projections. If Edgemont does not contract with Greenburgh, the Village would be entitled to revenues derived from ambulance trips originating in Edgemont. That amount is estimated at $250,000.
These sources of budget capacity are available for all EMS scenarios including Village PD, Village FD, and Empress contract.