PRESENT: PSCJ MEMBERS: Darcy, Chairman; Albanese, Donovan, Wishnie, Mosiello, Stewart-Cousins. H & MC MEMBERS: Stewart-Cousins, Chair; Swanson, LaMotte. STAFF: Megan Perry, Department of Corrections; Gary Kriss, Director of Committee Services-BOL; Emilia Vita, Secretary to the Committee on Public Safety & Criminal Justice.

ALSO PRESENT: Marilyn Slaatten, County Attorney; Joseph Stancari, Commissioner of Corrections; Ted Tully, Director of Emergency Services-WCMC; Fred Miller, Deputy Commissioner-WCMC; Jo Brill, League of Women Voters; Legislator Kay Carsky-District 17; Dan Rodriquez, Assistant to the Chairman-BOL.

The two committees were called to order by their respective Chairpersons at 11:00 a.m.

Chairman Darcy suspended all other business before the Committee on Public Safety to discuss EMSA Contracts at the County Jail. Mr. Darcy said the Board of Legislators are concerned with the great deal of press concerning EMSA, specifically the lawsuits. Mr. Darcy asked the County Attorney how many lawsuits are facing the County.

County Attorney Marilyn Slaatten said she can respond to the number of lawsuits in a public session of the Committee and suggested the two committee Chairs move into Executive Session for more specific details.

Ms. Slaatten gave a brief background on the EMSA contract, which started on January 1, 1996, and runs to December 31, 1997. At the County’s sole option, there are two one year renewals. Ms. Slaatten explained that a renewal must be exercised by August 1st in order to renew the contract for the next year. According to the contract terms, this is the sole option of the County and not of EMSA.

In addition, in the EMSA Contracts there are two standard short-termination clauses, the first being a 30-day termination clause, for "cause" within 30 days, i.e. EMSA would have a right, once it is notified of a violation to cure the problem. The second is a 60 day termination clause, whereby the County determines that cancellation of the contract is in the best interest of the County.

The County Attorney said there are not many lawsuits, but there are a number of notices of claim. A notice of claim, simply puts the County on notice that an individual may go for forward with a lawsuit. These notices have to be filed against the County within 90 days after the incident. Currently, there are approximately 30 notices filed involving medical services, also involving other allegations in some notices of claim, at the Department of Corrections that deal with EMSA. The number of notices of claim regarding medical care at the Correction Department are at a normal level.

Ms. Slaatten said some notices are often non-specific and she is not aware of what the individual complaint is until she brings in a claimant for an interview. There are times when she can persuade the individual to withdraw because the allegations made are not truthful or there are times when the case can be settled after an independent investigation is conducted. Any more specific information needed from County Attorney can be discussed in Executive Session.

Legislator Stewart-Cousins said with the background given by the County Attorney, clearly states there are concerns needed to be discussed in Executive Session.

At 11:15, Chairman Darcy called for a motion to move the Committees of Public Safety and Health into Executive Session for the purposes of discussing pending litigation in the Department of Corrections. On the motion of Legislator Wishnie, seconded by Legislator Donovan; motion carried 8-0; all in favor, none opposed.

On the motion of Legislator Wishnie, seconded by Legislator LaMotte, the Committees on Public Safety and Health moved out of Executive Session at 12:00 p.m.

The Committees drafted a resolution to be sent to the County Executive calling for the immediate termination of the EMSA contract and that an alternate delivery system for health care be put into effect at the Department of Corrections.

Ms. Slaatten will be meeting with members of EMSA and will forward this draft resolution and relay the Committee’s concerns.

Both Committee’s will continue this discussion with the County Attorney in approximately three weeks (July 14th).

Legislator Wishnie suggested that the two committees send a letter to the Administration requesting an independent evaluation be made of EMSA’s services. Mr. Wishnie asked the County Attorney and the Commissioner if they can recommend anyone with the requisite skills and experience to conduct the evaluation. Commissioner Stancari said there was a consultant already doing a quarterly report on EMSA’s services and did not know if the report was available. Chair Darcy will request the report from Jamie Hastings.

Legislator Darcy asked Messrs. Tully and Miller where the County is with ambulance contracts. Fred Miller explained that as of March 1st the County has a contract with TransCare Company, which has responsibility for all of the services the County provides. This contract replaced the previous contract with Empress Ambulance, which was terminated at the end of February and to be consistent with the change in the County’s helicopter services. RFP’s were issued to attract interested ambulance services. The Empress contract was to run until the end of June but the Medical Center exercised its termination clause of thirty days appropriately because of the changes in helicopter services and other issues. Because ambulance services are exempt, RFP’s are not required. RFP’s were issued to acquire other interests and TransCare was an appropriate respondent to the proposals.

Legislator Swanson asked how many companies responded, Mr. Tully said seven companies answered and TransCare had operations in Westchester County and are based out of Long Island.

Legislator Darcy asked for the reason for terminating Empress. Mr. Tully said the termination was due to the fact of the changes in the County’s helicopter system.

Mr. Tully explained that the County operates two helicopters, one in Orange County and the other in Westchester County. In conjunction with the helicopters, there was a land mobile intensive care unit that was operated out of the Medical Center. In response to cutting costs in the system, the system was re-engineered and a land ambulance was put in Orange County and another in Westchester. This allowed the Medical Center to cut the team out of the land ambulance at the Medical Center. If a call comes in and it is appropriate to send a helicopter, the team, composed of 2 nurses and 1 pilot, go out and fly to the incident. If the call is appropriate to do by land, the team, which is headed by the same pilot, gets into the land ambulance and goes to the incident. Mr. Tully explained that he is using his pilots as drivers of the ambulances, therefore cutting out the costs of the ambulance drivers as well as the two nurses that occupied the land ambulance. This new system will save the County approximately $500,000.

Legislator Darcy asked what happens if a call comes into Eastchester for a land call and the pilot drives the team to the incident. Mr. Tully said they only respond to hospital calls, and this is the reason for having 2 helicopters on 24 hour call.

Legislator Wishnie asked about jurisdiction of services. Mr. Tully said the land ambulances have a CON license with the provider (TransCare); they have a Westchester license and New York State Law allows the services to go from Westchester County to any hospital in the State as long as they are taking the patient in or out of Westchester County. The ambulance services are not allowed to respond to 911 calls from communities.

When asked if a call was urgent, would the ambulance pick up a patient anywhere in Westchester County. Mr. Tully said if there was a critically injured individual that needed trauma care and could not be sent directly to the Medical Center and it was appropriate to transfer out of an ICU, it would be done by land ambulance. He explained the system never puts a helicopter out of business, there is always one helicopter available to take care of the business of the region, being the southern counties. Never are both units out on land at any one time.

Mr. Tully explained that the helicopter team gets into a separate ambulance, there is another ambulance staffed by paramedics that respond 24 hours a day to anything on the campus or ten minutes away from the campus. The difference between the previous contract and the new contract is the new company is now located on the campus and staffed by around the clock paramedics.

For the Committee’s information, Mr. Tully reported that the Empress contract cost $475,000, the current contract with TransCare is $120,000. The helicopter is a separate contract from the ambulance services. Under the old contract, the pilot was an EMT and was hired to fly the helicopter only, so when it was inclement weather, the pilot was not put to use. The savings come from numerous factors, one is the billing aspect of the contract. Mr. Tully said if TransCare collects over $120,000, the money comes back to the Medical Center, which can offset the costs of the ambulance programs.

Legislator Albanese said that when he was injured at the County Office Building last year, the White Plains Hospital ambulance did not take him to the Medical Center where his doctor is located. Mr. Tully said they were correct because of the City’s contract and the fact that the accident happened in the City of White Plains. Unless you are a burn or trauma patient, they would take you to the closest hospital in the City of White Plains. There is no choice to be made and most communities will abide by the same rule. Many services cannot take their vehicles out of the community for a long period of time.

The legislators inquired about the ambulance service dispute with Dr. Shabazz’s case. Mr. Tully said there were bad feelings since Empress’ contract was canceled, but the Medical Center knows there have been cases since the end of the contract that Empress made sure did not come to the Medical Center because "they are upset with the cancellation of their contract."

Legislator LaMotte asked if there was any attempt by Empress to be as creative on their RFP as TransCare. Mr. Tully said they did have a very competitive bid and if they were to be ranked they would have come out number two. The past history of Empress was a factor, requirements of documented reports were untimely and response times were a concern.

TransCare gave a better amount of insurance Empress did not. Revenue recovery aspects were also a concern as well as an agreement to a voluntary $100 fine if Empress did not meet the required response time reflected in the contract.

Legislator Carsky asked if the City of Yonkers was at fault when referring to the Shabazz case. Mr. Tully said the fault is with the contractor, not Yonkers. Individual EMT’s and paramedics are under strict guidelines within their employer, who instructs them where to take the patients, regardless of whether there is protocol. State guidelines say patients have to be taken to the trauma center of their region.

A complaint is under review with the State. If the State finds the County’s complaint is justified, they will fine and control the system in Yonkers, which the State has the authority to do.

With no other business to discuss, both Committees adjourned at 12:30 p.m. on the motion of Legislator Wishnie, seconded by Legislator Swanson.