MINUTES SPECIAL COMMITTEE ON FAMILIES
MARCH 14, 2000
MEMBERS: Paul Noto, Chair; and Amy Paulin
GUESTS: Jackie Hilly, Westchester Children’s Association
and Norma Dreyfus, District II, Chapter 3 American
Academy of Pediatrics and Westchester Children’s'
Association.
STAFF: Sally Schecter
The meeting was called to order at 3:15 p.m. The subject to be discussed was pediatric emergency care in area hospitals.
Westchester Children’s Association has been interested in this subject for the past few years and Norma Dreyfus brought it to the Association from the American Academy of Pediatrics. The residents of Westchester need to become aware of what services are and are not available in emergency rooms in the County for pediatrics. Dr. Dreyfus is presently working on a proposal from the American Academy of Pediatrics that will be making recommendations. The Academy had a concept a number of years ago for a program called EMS Too. This is an emergency medical program for children that would include education, prevention, pre-hospital emergency care, hospital emergency care and rehab. The Children's Association is concentrating on the emergency department part because children are not young adults and a lot of people who man the emergency room are not trained to treat children.
Is there a protocol for kids in the emergency room? There probably is a standard pediatric protocol. There was a program on television recently discussing whether emergency rooms need to have pediatric training to accept kids. And the answer is, yes. Should a pediatrician be assigned to every emergency room and the answer is not necessarily so but it should be a doctor that has been trained in pediatrics. Every doctor has a smattering of surgery, pediatrics, etc. but that is not enough. An Internist does not have enough pediatrics but a Family Practitioner does. You are either a pediatrician or a family practitioner with pediatric emergency training or you’re an emergency room doctor who has received specialized training in pediatric emergency medicine. Currently, other then the Medical Center in the County, 24-hour coverage of this nature is not available at other hospitals in Westchester. Along with this is the necessary apparatus that goes with it, a pediatric tray that is supposed to be maintained plus pediatric size equipment. The other part of this is the referral part among the hospitals in the County and among the emergency medical services that bring kids to various hospitals in the County. There is a 3-tier system once you join into the American Academy of Pediatrics plan in this area. One hospital can handle any emergency and has an in house group. The other end of the spectrum is a community hospital that doesn’t have any in house pediatric unit nor does it have the 24-hour emergency care. And the one in between has 24-hour emergency care and has a pediatric unit but doesn’t have special team services that are available in the advance pediatric unit. You have to be sure that kids get to the proper facility. Sound Shore could get that emergency piece taken care of. It has a pediatric floor and it has in house help that could be a secondary level. There are 3 trauma centers in Westchester. Sound Shore and Hudson Valley do not have 24-hour capacity to handle kids properly. Sound Shore has great people there but they do not have them 24 hours because it is expensive and how many kids do you get in the emergency room. This is true in trauma centers all over the country. There are only 2 or 3 pediatric trauma centers in New York – 1 is in Harlem and one is at NYU. We don’t have a pediatric trauma center in Westchester.
To get the personnel to man the emergency room for pediatrics costs money. That’s why Sound Shore was suggested because it is a trauma center and has a lot to offer. The equipment would not cost a lot but the added personnel would cost about $300,000 a year. It was suggested to train the existing personnel. Sound Shore and Hudson Valley should be contacted to see if they can plug the holes, establish the protocol that EMS would use, and the protocol those hospitals would use to communicate with the appropriate centers. We need 2 designated hospitals – one up County and one down.
It was decided to have a meeting with all the CEO’s of the 14 emergency rooms in Westchester on April 25 at 3 p.m.
When someone comes in for a pistol permit they sign an affidavit that says they haven’t violated any crimes. Then they do an FBI fingerprint check. They don’t do a NYSPIN check. When a permit is renewed, a NYSPIN is done and it is turning up people who have had orders against them. If you have an order, you can’t get a gun. It is a Federal law. But if we aren’t checking at the beginning, we don’t know that. There is no central registry for criminals or orders of protection. Why is there a system for the renewal but not the initial application. Amy called Greenburgh to check with them and they said it is a State problem. Amy then checked with Nassau who does a NYSPIN check when you apply for a permit and they have a central system. So it is not a state problem but a local one. Nassau is designed differently so it is easier for them. They have a central system that all the orders feed into so their County police are able to check for Orders of Protection and I would assume other things. Let’s invite the County Police and someone from the Clerk’s office. Let’s invite Gene Rogers and Commissioner Louis D'Aliso on 3/21 or 4/4 at 3 p.m.
Minutes for 2/25 and 3/1 approved by Amy Paulin and seconded by Paul Noto.
On neglect and abuse, Amy suggested having someone from Center for Preventive Psychiatry in to discuss what is going on with the new foster care regulations and then have Judge Cooney in or Judge Cooney in first. Decided on Judge Cooney. Suggested to invite Judge Cooney in on 4/11 or 5/2 at 12 noon.
Meeting adjourned at 4:25 p.m.