Ever since the New York Post’s half-truth article about FDNY and the NYC Vollies, I have been approached by people who know that I am involved with them asking me when they were in fact closing. The fact is, that unless they are already in dire financial stress (which quite a few are), the NYC Vollies are not closing.

Apparently I am not the only one. Here is a Letter to the Editor of the Queens Chronicle who ran a much better story although the tone was similar as the Post article:

Dear Editor:
We write with interest in response to your front-page article featuring Queens volunteer ambulance corps in peril (“FDNY shuts out ambulance corps,” Jan. 21). Since this publication many of our members have been personally stopped on the street numerous times by residents with great concern over the perception of the potential closure of our ambulance service, the Woodhaven-Richmond Hill Volunteer Ambulance Corps. We would like to go on record in assuring all our residents that WRHVAC in the foreseeable future is not closing.
Actually, quite to the contrary, our ambulance service within the past year has seen a marked increase in call volume and the amount of tours which we have been putting out on the street to better service our communities. WRHVAC has a good and professional relationship with both the FDNY and hospital-based units which we interact with on an everyday basis. We are committed to providing the best, most professional service possible to the communities of Woodhaven, Richmond Hill and Kew Gardens.
This is not to deny that presently or in the past there have been issues between the volunteer and municipal (FDNY) sector. This being said, we hope that any issues which the volunteers have with FDNY will come to an immediate resolution reached professionally and tactfully on the party of both parties. WRHVAC hopes that recent articles in papers will not affect the ongoing relationship which most ambulance corps have with these units.
The WRHVAC is an all-volunteer ambulance service. To maintain our service we depend on committed communities members like you! If you are interested in getting involved please call us at (718) 296-7918.
The officers of the
Woodhaven-Richmond Hill VAC
Woodhaven
Editor’s note: Nothing in the article or an editorial supporting the ambulance corps implied that any might close. If you missed either item, find it in the archives at queenschronicle.com.

I wonder if this is the reaction those involved with the articles expected.

I highly doubt it.

Full Disclosure: I am a member of the Forest Hills Volunteer Ambulance Corps in Forest Hills, Queens and have been a member of that Corps since 1994

This is post #3 in a series. You can read post #1 here and post #2 here.

So here is where I put down for the first time in writing a blueprint for what I think the NYC Vollies will need to do in order to prevent their extinction. Now to be totally fair, I am not the one who originated this idea. I would gladly credit the person who first told me about it, but he has become a rather private person and is no longer heavily involved with the vollies but more involved with his family… which is completely understandable. If at anytime he wants me to insert his name here, I will be more than happy to do so.

Also in the interest of fairness and understanding, I will admit that when he first explained to me this idea I laughed at it and disagreed with alot of it. I did so then for the same reasons as those who will disagree with me today. There is the fear of change. The anxiety of a loss of control. The angst of being “forced” to accept things with which we do not agree. The disbelief that such a grand idea can be made into reality.

It’s kind of like the idea of man flying. It was such a grand idea no one thought it was possible. I think it is important to remember that there is truly nothing that is impossible. Impossible just takes a little longer. I like to think the Wright brothers would agree with me on that.

The Solution

My proposed solution in one word is: consolidation.

Changing The Organization

The first thing is the biggest and heftiest part of my solution, and while it can be painful, I think the benefits outweigh the negatives.

Abolish The Fiefdoms

It’s time to set aside these petty territorial disputes that seem to consume all the good will that these agencies were founded on. These arguments do neither the agencies involved or, more importantly, our communities any good. How do we abolish the fiefdoms you ask…

Consolidate Resources

Choose a geographical area that makes sense. Whether it be by borough or the entire city, form a new 501c3 entity as an umbrella organization. For the purpose of this post we’ll call it the NYC Vollie Corps.

This umbrella organization would be formed through a round table conference where two members of the current organizations represent their individual agencies. This group would comprise of the Executive Board of the new organization. From this actual group you would probably need to elect officers, at least one financial officer, one administrative officer, and one operational officer. Whoever is elected to those offices would effectively resign their association with their individual organizations and new reps from those organizations would be elected to the Executive Board.

It would be the responsibility of this new entity to:

• Provide a centralized communications and dispatch center
• Oversee an agency wide Quality Improvement Program
• Organize and administer for a training and education division
• Consolidate and oversee all administrative tasks including crew scheduling
• Consolidate and oversee purchasing to maximize the purchasing power that a large group now holds

While autonomy on many levels would be sacrificed, the individual agencies would need to repaint their vehicles, change their uniforms, and be active participants in their communities as the NYC Vollie Corps. They would be able to still maintain their own garages, their own crew rooms, and their members would still be able to work in the area they live in helping their direct neighbors.

Changing The Mission

The first thing the NYC Vollies Corps would need to recognize is that their mission needs to change from the previous entities. Instead of having a mission that focuses on serving members of the community in times of a medical emergency, it should be changed to serving the community in times of an emergency. This change of focus opens up a lot of possibilities.

One such possibility is to either integrate the Vollies with the local Community Emergency Response Team or have the Vollies form a CERT if there isn’t one already established. This is a fantastic way to refocus the efforts of the Vollies and to do so in a way that is not totally foreign but not so limiting.

This does NOT mean that the NYC Vollies Corps is going out of the ambulance business. The fact is that they can’t because providing ambulance service and collecting revenue through third party billing is their only true way to generate a steady income. It DOES mean that there are now opportunities for potential volunteers that do not have anything to do with the EMS aspect of it, and for that matter will enhance the offering and value to the community of these agencies.

In Conclusion

Now as I indicated before, this really is not a revolutionary idea, and what is above is more of a blueprint than anything else. It has been an idea discussed before. People have thrown out problems ( How would the new organization get a CoN? How would we be able to keep all the vollie bases open?) and there have been answers (Agencies can transfer their current CoNs over to a “DBA”… You may not be able to keep them all open, but the vast majority is definitely better than the minority or none at all) given in attempts to further the conversation and move us into this direction.

Unfortunately, as with most things that people emotionally invest themselves in, egos clash and politics plays a part to hinder change. The truth is that the current NYC Volunteer EMS agencies are no longer a community necessity for emergent pre-hospital care, but more of a community luxury. Change is something that needs to happen… but unlike their communities that have changed unconsciously, the Vollies have to be willing to change and do so consciously.

This is post #1 in a series. You can read post #2 here.

The alternate title of this post was “The Post When All The Vollies Cry Foul And Want My Head On A Spike“. Why would that be the case? Because the truth can hurt.

There was recently an article in the New York Post regarding the decision of the FDNY to remove NYC Volunteer EMS Agencies from their computer aided dispatch (CAD) system. I caught word of the article through an e-mail and then there was a post on it from Firegeezer.

So let’s look at what the claims being made are and what the truth actually is:

The Fire Department has booted the city’s volunteer ambulance companies from its emergency 911 system, The Post has learned. – NY Post Article

Truthfulness of Statement: False

The vollies have not been booted from the NYC 911 system, because they were never IN the NYC 911 system. Volunteer agencies have their own “hotline” phone numbers, have their own dispatchers, and their own run numbering systems. They are separate entities that do have a mutual aid agreement with the NYC 911 system lead agency, FDNY.

“They call us all the time. If not through their system, they call us on the mutual-aid radio system or just call us directly,” said Gunning, who also heads the Glendale Volunteer crew. – NY Post Article

Truthfulness of Statement: True and False

During the days of NYC*EMS, they maintained the Mutual Aid Radio System (MARS). This system gave each volunteer agency a radio designation based on their borough of service, so a 93 unit was from Brooklyn and a 94 unit was from Queens. It’s true that back in the days of NYC*EMS the vollies were called over the radio, but ever since FDNY inherited this system they did absolutely nothing more with it and THIS is what FDNY is actually ceasing operations of.

“If it weren’t for us, patient wait times would often be much longer. We get called in when the FDNY doesn’t have an ambulance to send. This change comes at the patient’s expense,” said Alan Wolfe, president of the Forest Hills Volunteer Corps. – NY Post Article

Truthfulness of Statement: True and False

The truth is that the NYC vollies generally respond to calls they hear over the NYPD radio or the FDNY BEMS radio. Yes, the truth is the volunteers “buff” or “jump” calls that are dialed into 911. Their response however does NOT mean there is no available unit. In fact, more often than not, the assigned unit responding continues in even though a vollie unit has decided to respond.

It is true that more often than not the volunteers WILL get to the scene faster than the assigned unit. This is for a number of reasons:

• The volunteers are traditionally very knowledgeable of their specific geographic location
• The volunteers are often already in the area whereas the assigned unit may be coming from an out of the area post or hospital
• The volunteers have a burning desire to get there first… which can be both good and bad

As for the expense of the patient… financially speaking volunteers do the job for free, but the vast majority of the agencies will still bill the patient’s insurance.

The medics who ride the units all have the same qualifications and certifications that any other medic units have. Many of the volunteers, in fact, are off-duty FDNY medics. – Firegeezer

Truthfulness of Statement: More False than True

First let’s clarify the term “medic” here is used very loosely. Out of the 35 (and I question that number too) reported agencies in NYC, I can think of only 3 or 4 that are providing ALS. Everyone else is a BLS agency using BLS providers.

Additionally, while the state certifications are the same, many of the volunteers are NOT employed with FDNY. In fact for that matter I think FDNY employees are the minority of the volunteers. I believe there is a far greater number of EMS professionals employed by both hospitals and privates volunteering their time than the municipal workers.

The volunteer squads are not only saving the city a lot of money, but they are seriously reducing response times in many instances. – Firegeezer

Truthfulness of Statement: False

The volunteer squads do not save the city ANY money. It is true the squads do not receive tax funding, but their existence does not decrease the budget in any one place. As for the response times, technically since the vollies are not in the system that measures response times (and haven’t been) they are in fact statistically not reducing any response times either.

In Conclusion… To Be Continued

In conclusion, there is no change to the status of the NYC volunteer agencies, because they are in all reality irrelevant to the emergency response in New York City.

But does it have to be that way? Are the NYC volunteers destined to close their doors and be a footnote in the history of emergency care in the city?

I say no. It doesn’t have to be that way. In my next post I’m going to explain the current volunteer system and what is wrong with it, and in my third post I will explain how (in my opinion) the volunteers can fix it.

Full Disclosure: I am a member of the Forest Hills Volunteer Ambulance Corps in Forest Hills, Queens and have been a member of that Corps since 1994

I came across a series of interesting posts from Greg Friese, Steve Whitehead, and Chris Kaiser regarding the common practice of “CPR Theater” or “Going through the motions for the family” when it comes to pediatric arrests. These are blogs that I read often, and I find myself often agreeing with their observations and points of view. This is not one of those times.

Just for a little background, I spent 2 years working in the Bronx. Out of the five boroughs the Bronx has the highest infant mortality rate of the city (6.3 deaths per 1,000 births in 2005) that has seen a decline in both birth rates and infant mortality over recent years. Both my first and last calls in the Bronx were infant arrests (speculated to be SIDS victims) and there were more than two handfulls inbetween, so I have a bit of insight into pediatric cardiac arrests and resuscitation efforts.

On every single one of those resuscitation efforts I did everything I possibly could, including transporting the pulseless child with their grief stricken parents up front, even when I obviously knew that there was no hope of regaining a pulse short of a biblical style divine intervention. I made sure the parents understood that not only was I doing everything that I could, but that the hospital would do everything they could when we got there. Say what you want about the hospitals in the Bronx, but they never failed me in doing exactly that even when they also knew there was no hope unless the new janitor was also able to turn water into wine amongst other things.

So why do it?

At their very core every parent ultimately wants the best for their children. Now as Dan Carlin points out in Suffer the Children, this was not always the case in society and while we may revert back to it at some time, right now as a society we place a high value on the very essence of life itself.

In fact, we place such a high value on life that we employee people trained to preserve that life the best way we think we know how whenever we know that the essence of life is threatened. We call those people EMTs and Paramedics. We have also scientifically found ways to extend the essence of life by performing changes on our own bodies (such as open heart surgery) and through machine augmentation (such as ventilators and bypass machines) so much that we have doubled the life expectancy of a person in 100 years.

Every parent wants the best for their child, including healthcare and efforts taken to preserve their essence of life. They want to know that everything that could have been done for them, was in fact done for them. So do it. Don’t “go through the motions” or perform “CPR Theater”… actually run the code, perform CPR, and transport as you would a viable patient.

Why?

Because as we hear every so often, there are plenty of patients that are viable when we don’t necessarily think so.

EMS personnel are also not trained or equipped to assist grieving parents either at home or on the scene. Not transporting is denying the parents the knowledge that everything was done for their child, you deny them access to a neutral place they may associate their grief, and professional help on “what happens next”. No parent plans for this event unless there is an underlying condition with an inevitable conclusion. Even if they consider the “what if” scenarios, rarely are they in a state of mind to follow through on what they should do next. This sort of training is beyond just knowing what to say (because in the death of a child there truly are no words, but we should allow our actions to speak for us instead), but more importantly about how to guide them as they step into their new reality.

But aren’t there undue risks involved to both EMTs and the public in transporting a pulseless patient that science says we should leave at the scene?

This is an argument where I sit on both sides of the fence.

On one side, I agree that transporting a patient that qualifies for field termination lights and sirens does create an undue risk and hazard to both personnel and the public.

At the same time, society demands that we respond to these threats to the essence of life expediently even though the perception of that threat may be increased upon by the caller and scientifically the patient’s essence of life is not threatened in the least.

This also creates an undue risk and hazard to both personnel and the public.

Therefore I would submit the argument that as long as society views protecting the essence of life, therefore employing EMTs and Paramedics to protect that essence of life, then the undue risk is an acceptable one. Once society no longer values the essence of life, then we can have real healthcare reform by not extending lifetimes past their expiration with radical treatments such as chemotherapy and radiation, we will be fine with patients who choose euthanasia, and we will no longer place personnel or the public at undue risk because there will be no more ambulances.

The fact is that perception plays as big a role in all of this as protocols. A field termination of a pediatric will leave the grieving family going through the shock of the 5 Stages of Grief without support from trained personnel.

One of the thoughts among them may very well be, “Those Paramedics did nothing! Nothing!” We already have cases of that, and adding that perception from a grieving parent will be damning to not just the agency, but the industry as a whole. This is not the perception we need to maintain. We need to show that our industry is not only able but willing to go that extra mile in the quest to preserve the essence of life.

In most instances, patients and their families do not know good patient care from bad patient care. They do know an effort from no effort and nice from not nice. Every now and then though we’ll come across people who know all three… and heaven help you if that child you chose to field terminate because you didn’t think they were viable happens to be the son of a Chief or Director of a large EMS Agency.

In Conclusion

There are a number of systems with field termination guidelines. While I am a proponent of field termination, specifically for the hospice enrolled patient, I am in opposition to any guideline allowing field termination of a patient under the age of 18 barring significant obvious trauma. Make “No Child Left Behind” more than a failed education initiative, make it your Pediatric Arrest Protocol.

In response to the Influenza Vaccine shortage New York State Department of Health Commissioner Doctor Richard F. Daines has instructed NYS Healthcare Providers to use vaccinations with a higher mercury level than previously considered safe for use as ordered by New York State Public Health Law Section 2112.

In a letter dated October 29, Dr. Daines points to the vaccination shortage as the primary reason why these vaccines that were disqualified for use previously because of the mercury level from the vaccine preservative Thimerosal. The FDA and CDC have encouraged all vaccine manufacturers to cease using Thimerosal since 1999. It is important to note that the recommended consumption amount has been based on methyl mercury toxicity levels and Thimerosal is actually a derivative of ethyl mercury. The FDA continues to recommend that pregnant women, women of childbearing age who may become pregnant, nursing mothers and young children do not consume certain kinds of fish that may contain high levels of methylmercury, the same at risk groups from the H1N1 Influenza Virus.

While the letter does instruct providers that informed consent is required for vaccinations, and consent should only be given to patients and parents authorized to provide consent, this does not change the fact that the NYS DOH has probably now stricken parents and pregnant women with the fear of mercurial poisoning from a vaccine that is already hotly debated.

More Information: Thimerosal in Vaccines from the FDA

Download: NYS DOH Thimerosal Waiver Letter

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See what happens when I go down to Florida for a few days in the interest of my own mental health? Sanity suddenly strikes the New York State Department of Health regarding the influenza vaccination mandate.

Last week New York State Commissioner of Health Richard F. Daines, MD submitted a letter regarding the previous influenza vaccine mandation for healthcare workers. He opens the letter by suspending the mandatory vaccination:

In August 2009 the State Hospital Review and Planning Council (SHRPC) adopted on an
emergency basis 10 NYCRR Subpart 66-3, requiring certain health care facility personnel to be vaccinated with influenza vaccines. I am writing to inform you of my determination pursuant to Section 66-3.2 of those regulations that supplies of seasonal and 2009 H1N1 influenza vaccines are not adequate and that such vaccines are not reasonably available. Therefore, I hereby suspend the requirement for the health care personnel to be vaccinated against both influenza viruses for the current influenza season (through April 1, 2010).

This suspension means that the temporary restraining order against the mandatory vaccinations is a mute point. While the scheduled October 30 hearing may still happen, the results those lawsuits have sought has already happened. What that hearing may however effect is this part of the letter from Dr. Daines:

The current emergency regulation mandating influenza vaccinations for health care workers will expire on November 11, 2009, and a second emergency regulation would not have the desired effect during the current H1N1 influenza season or the expected seasonal outbreaks expected later this year and in early 2010. Therefore, no new emergency regulations will be promulgated. Instead, the DOH is advancing a permanent regulation requiring health care personnel in these settings to be vaccinated. Draft regulations will be published soon for a period of public comment.

So while the mandate will not be enforced this year… they are looking to make it a permanent policy probably in time for next year.

The vaccine manufacturers are no doubt rejoicing.

Download: NYS DOH Letter

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The New York Times is reporting that an acting New York Supreme Court Justice has issued a restraining order temporarily halting the mandation of the controversial H1N1 Vaccine for New York State Healthcare workers.

The restraining order was issued by Acting New York State Supreme Court Justice Thomas J. McNamara in response to a lawsuit filed by three Albany Medical Center nurses who state that the mandation is a violation of their civil rights, and merged their lawsuit along with two other similar suits from New York State United Teachers Union and New York State Public Employees Federation.

The New York State Department of Health is planning to fight the restraining order, and has cited that the state has upheld similar requirements for vaccinations such as Rubella and Tuberculosis.

Justice McNamara will hold a hearing on October 30 regarding all three of the cases that he merged together.

The vaccine mandation was signed into law on August 13, 2009. It affected EMTs and Paramedics employed or contracted by healthcare facilities while free standing municipal agencies were apparently exempt due to the verbage used.

Source: New York Times Blogs

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Earlier this week I mentioned a video on STATter 911 that showed an EMT swipe a camera from a local activist in the name of the all powerful 1996 Health Insurance Portability and Acountability Act (HIPAA).

Now I’ll be honest, while the video is slightly disturbing I can understand why it happened. The activist was being obnoxious, rude, beligerant, and basically baiting the EMTs and Police Officers. Unfortunately this particular EMT, identified as Captain Ronald Leslie, took the bait and swallowed it whole like a wide mouthed bass. What I find to be more outrageous, and a blaring indicator to the actual problem, were the comments left on the original post.

So it begs to question how could a Captain be so blatantly wrong in his assertion that HIPAA prevents photographers/videographers from taking images on a public street and how can so many providers think that he was actually in the right?

The answer is that we provide an extremely poor education in not only HIPAA but also laws regarding photography. I’ve had my fair share of people tell me the same thing, including supervisors, chiefs and directors. I thought that we had done better in this area of education, but it appears we haven’t.

Who HIPAA Actually Applies To

To violate HIPAA it must actually apply to you. Some covered entities are:

• Doctors
• Nurses
• Clinics
• Hospitals
• Dentists
• Chiropractors

and since we bill health insurance for reimbursement…

• EMS Agencies
• EMTs
• Paramedics

Anyone notice something missing? Yes, Firefighters don’t necessarily make the list. However if you are certified as a healthcare provider or belong to a fire based EMS system then you are included as well. For Firefighters who are members of a fire department who does not respond to medical emergencies, are not healthcare providers and therefore do not bill for compensation, HIPAA does not apply.

As for everyone else, such as the media and John Q. Public with a Flip UltraHD Camcorder
or a cellphone camera, since HIPAA does not cover them then the rules governing patient privacy do not apply to them. Therefore they cannot “violate” them.

3 Of The 10 Legal Commandments of Photography

Laws will vary from state to state and city to city, but there are some very basic guidelines that are universal thanks to the US Constitution and its Amendments. An excellent guideline to these rights are The Ten Legal Commandments Of Photography. In the case above there are three specific Commandments that apply:

I. Anyone in a public place can take pictures of anything they want. Public places include parks, sidewalks, malls, etc. Malls? Yeah. Even though it’s technically private property, being open to the public makes it public space.

So is a courthouse open to the public? I would hope so. Therefore it is indeed legitimate to photograph/videograph inside of that building. Government buildings deal with highly sensitive materials in regards to national security may indeed prohibit photography as per Commandment IV, but I don’t think the Keene Courthouse is harboring anything of that nature.

V. People can be photographed if they are in public (without their consent) unless they have secluded themselves and can expect a reasonable degree of privacy. Kids swimming in a fountain? Okay. Somebody entering their PIN at the ATM? Not okay.

So this dispels the whole argument about the photographer not having consent forms for the people they photographed. If indeed it is in a public place, it can be photographed. Now what those photographs can be used for is a different issue. If for arguments sake someone wanted to use one of those photographs as an advertisement for a product inferring an endorsement, because it is now for commercial use they will probably need consent forms. The chances of that however are highly unlikely.

VI. The following can almost always be photographed from public places, despite popular opinion:

* accident & fire scenes, criminal activities
* bridges & other infrastructure, transportation facilities (i.e. airports)
* industrial facilities, Superfund sites
* public utilities, residential & commercial buildings
* children, celebrities, law enforcement officers
* UFOs, the Loch Ness Monster, Chuck Norris

Once again, these are things within public view and therefore are legally within the realm of the photographer without the need for any special dispensation.

A few months back I posted the NYPD OPS Order On Photography. If you read the OPS Order it is very specific that the laws and practices the NYPD abides by follows the Ten Commandments very closely.

It is important to realize that these permissions are truly in our best interest as a society. While it may seem not in the best interest of the patient, if the freedom to do so didn’t exist then the video of Paramedic Maurice White getting choked by Trooper Daniel Martin would be illegal as well. Ultimately it is important that Responders understand and respect both their responsibilities to and the rights of their patients and those around them, especially photographers and the media.

This is also a great reason why your agency should be involved in Social Media. If the Keene Fire Department would have had a Social Media presence instead of this webpage, they would have been able to defend themselves in a more direct fashion. If you’re from the Keene Fire Department and reading this, it’s not too late to get started in Social Media.

Video Source:ObscuredTruth.com via STATter911

The Ten Legal Commandments of Photography Source: Photojojo that is now available in book form as Photojojo!: Insanely Great Photo Projects and DIY Ideas

I’m sure at some point I’ve previously mentioned that I tend to listen to the evening news podcasts the morning after they are broadcast. My current work flow at night just makes catching up on the news the next day easier but it does have it’s drawbacks. Namely it means that it takes me an extra day to call out insane reports like this one…

Here are some disturbing items (besides the sight of the FDNY Bureau of Emergency Medical Services crew scrubbing a mattress down on a metal stretcher with a broom) that I just want to point out…

• The FDNY is NOT mandated like other services to give their responders the H1N1 vaccine because they are technically not contracted with a health care facility. There is NO guarantee that the FDNY EMT or Paramedic responding to your emergency has been vaccinated for the flu
• FDNY Physician Dr. Carrie Kelly indicates that FDNY members “get the message” to stay home if they feel sick… but according to the Center for Disease Control the people infected with seasonal and 2009 H1N1 flu carry the virus and may be able to infect others with it from 1 day before getting sick to 5 to 7 days afterwards… meaning that someone may be contagious and still be on their shift infecting others who have not received the H1N1 vaccination
• FDNY Commissioner Nicholas Scoppetta states that, “We have a very high percentage of medical runs.” According to the Fiscal Year 2009 FDNY Vital Statistics, FDNY Fire Suppression responded to 209,547 medical calls or roughly 30% of FDNY Fire volume. However, FDNY BEMS transported 936,488 medical patients during the same year… over 4 times the amount of FDNY Fire medical responses and more than FDNY Fire medical and fire responses put together. Yet they are not required to get the vaccination… which is more evidence in my opinion why we should switch over to an EMS based fire service
• Finally, FDNY is banking on the fact that if they have a high amount of people out sick then there will still be plenty of people willing to work extra shifts. I think this is an overly optimistic outlook, especially since basically what they are saying is that we the taxpayers will be paying for the overtime because they did not mandate their personnel to get a free flu vaccine

Is FDNY really ready for the next round of H1N1? Based on what I know and the report above, I don’t think so.

What do you think?

Fiscal Year 2009 FDNY Vital Statistics

There has recently been discussion in the news about New York State mandating that healthcare providers receive the H1N1 Vaccination. Title: Subpart 66-3 – Health care facility personnel – influenza vaccination requirements provides the following definition for “Personnel” affected by the mandation:

(b) “Personnel” means all persons employed or affiliated with a healthcare facility, whether paid or unpaid, including but not limited to employees, members of the medical staff, contract staff, students, and volunteers, who either have direct contact with patients or whose activities are such that if they were infected with influenza, they could potentially expose patients, or others who have direct contact with patients, to influenza;

This verbage essentially requires private and hospital based EMS services (31 agencies in New York City alone) to vaccinate their EMTs and Paramedics since they would be considered as either employed by the healthcare facility or contracted by them. Volunteer agencies and municipal agencies are not included in this verbage and are therefore exempt from the state mandation.

State Health Commissioner Richard F. Daines M.D. wrote an open letter on the subject, and was responded to with an open letter from a group of healthcare workers against the mandatory vaccinations. With the verbage of the law being pretty clear, EMTs and Paramedics will have direct contact with patients throughout a healthcare facility in the performance of their duties, and are therefore included.

I know that there are alot of people upset by this. Some are upset because they have lost the choice to decide for themselves. Some are upset because they don’t feel the vaccine is safe, have families they need to provide for, and can’t afford for something to go wrong. I truly understand both these positions and I can understand the strong desire to want to decline.

It’s important to remember that this is NOT being mandated by the services, but by the State Government. There are plenty of precedents to the government doing something like this, such as the polio and rubella vaccine requirements to attend elementary school. While there are religious and medical exemptions available for those vaccines and it may very well be possible to get a medical exemption for this vaccine, where does that put you? This has been declared a pandemic situation so just because you get a medical exemption from receiving the vaccine does not mean that healthcare facilities need to let you in to care for their patients. How are you going to do your job (and get paid) to provide for your family then?

Honestly, I think this is overkill. I think the signing of this bill illustrates why Governor David Patterson has an approval rating practically in the negatives. Personally I will be letting my vote for whoever decides to be his opponent speak as to my displeasure of his draconian methods. Until then, when the vaccine is available and since I’m mandated to get it, then I’ll take it.

Chances of this law getting overturned? Slim to none. Of course, if healthcare workers were really serious about protesting this… they would organize a Facebook Group just like the EMS Professionals Against NBC’s Trauma… because you know… it may be a bad thing to force treatment onto someont… but it’s a worse thing when medics are hot blondes.

NYS Health Care Personnel Influenza Vaccination Requirements

NYSDOH Health Advisory H1N1 Vaccine