I do not live in the County. If I did, I would be a lot more upset about the changes to the delivery of emergency services. As it is, we have a long time relationship with the Seminole Trail Volunteer Fire Department as Chris remains a volunteer there. Interestingly, we spend a lot less time there since Chris has been promoted, but our commitment to volunteerism and the department remains strong.
When the City wanted to implement cost recovery for ambulance service in order to support the expansion of the fire department into ambulance service, I balked. I support Charlottesville Albemarle Rescue Squad (CARS) as an institution in our community. I think having CARS in our community saves taxpayers money in two ways: we dont pay for people and equipment to expand emergency services and we dont pay for the increase in health insurance premiums and copays as a result of localities billing for the service.
The County has not been transparent with the change from supporting CARS to implementing a very expensive ambulance service. The public did not have an opportunity to weigh in on this change. Where do the supervisors stand on this expansion of paid ambulance service? What was the hurry in implementing this change? Why does the County believe that billing health insurance companies for service is a win win situation for taxpayers? Do they honestly think that health insurance companies wont pass that cost onto users? What about increasing copays (our copay for an ambulance ride is $150.00, and we are told it is relatively good insurance)? I also worry about whether folks who are unable to pay are being harassed by collection agencies or the billing departments of health insurance companies who dont receive their copay.
CARS and the other volunteer emergency service departments in the County are very professional, they have served our community nobly for many decades. I remain convinced that the County should work with the organization in a way that serves county taxpayer and supports the volunteer organizations. I am not saying that just because things have always been this way nothing should change. I am saying these decisions should be made more transparently and the process should be inclusive of all stakeholders.
Please ask your County Supervisor where he/she stands on this issue and demand answers to these questions.
Showing posts with label CARS. Show all posts
Showing posts with label CARS. Show all posts
Thursday, February 07, 2013
Wednesday, December 19, 2007
What is going on here?
Over on www.CvilleNews.com, a commenter (hey Karl) asks 'what is the backstory here?' with respect to the new EMS program at the fire department.
A good place to start is the presentation by the chair of the oversight committee and the report the committee created.
You know the saying, "the ends justify the means"? It is kind of what is going on here. I am going to take this story backwards since at the end here it started to make a little sense.
The Chair of the Committee (MaryLooseDeviney- and I know I butchered her name, apologies) was the one who described it best- when she visited the emergency communications center on a weekday- all the ambulances (3) were out on calls at some point (she got there at 8, the time all ambulances were on calls was 9:15). She then details her thoughts, if at that time, one of her customers falls on the downtown mall, what would happen, who would come to their aid?
In reality- a first responder would until an ambulance was cleared. Cville/Albemarle (and many other jurisdictions) have a tiered response system- fire engine goes first with a medic/EMT onboard to administer care. The ambulance comes next.
Notice she didnt mention anything about response times? Funny...
In fact she stated there is no problem with the response times on CARS end. (the report [pdf] indicates the CFD has some issues with response times, but apparently is outside the scope of inquiry).
There is this lovely thing called ambulance utilization yadda ya- it is a metric, the metric for Cville is 3.5 ambulances (I am not an expert on this stuff), CARS has three ambulances during the day. The report indicates this metric standard is used widely but "much debated." um, ok.
Again nothing to do with response times.
What the CFD is pleased about is getting rid of the tiered system, they are seeking to collapse the tiers into one, one in which they will be the only ones to respond, I suppose CARS will still respond too since CFD is only seeking 2 ambulances ($530,000 over ten years) and 6 paid medics (high level training). Will this translate into quicker response times? I dont think it matters for CARS since that is not an issue for them, but for CFD? I hope so.
Finally the emergency communication center will still have to ask tier questions for County calls. An argument made by Taliferro is 'you never trust the person on the phone to be as accurate as an impartial observer' about the condition of the patient. And here I absolutely agree with him. But I dont think it is worth spending all of this money on since the same tier system questions will likely still be asked of every caller.
A great aspect of the Oversight Committee is the creation of standards for performance. I know everyone will benefit from that.
So despite the means being about CARS response times, the ends of creating an taxpayer subsidized ambulance service justified that tarnishing of CARS (I jest of course). I wish the CFD had approached it in a better, more honest way.
The question left unanswered by everyone "how are these recommendations going to change the response times for first responders?" Lynch asked some good questions that were answered in very circular fashion thus creating frustration and confusion by those of us who thought the questions were reasonable.
I know reasonable people differ, I respect the folks who created this new service and hope it does create a better service for the community since we are spending so much money on it. My opinion is ultimately the committee didnt need to rely on the 'four' chiefs to come up with a proposal, an innovative, more cost effective plan could have been achievable and workable. I will gladly change my thoughts on the subject if I see a dramatic improvement, so stay tuned.
A good place to start is the presentation by the chair of the oversight committee and the report the committee created.
You know the saying, "the ends justify the means"? It is kind of what is going on here. I am going to take this story backwards since at the end here it started to make a little sense.
The Chair of the Committee (MaryLooseDeviney- and I know I butchered her name, apologies) was the one who described it best- when she visited the emergency communications center on a weekday- all the ambulances (3) were out on calls at some point (she got there at 8, the time all ambulances were on calls was 9:15). She then details her thoughts, if at that time, one of her customers falls on the downtown mall, what would happen, who would come to their aid?
In reality- a first responder would until an ambulance was cleared. Cville/Albemarle (and many other jurisdictions) have a tiered response system- fire engine goes first with a medic/EMT onboard to administer care. The ambulance comes next.
Notice she didnt mention anything about response times? Funny...
In fact she stated there is no problem with the response times on CARS end. (the report [pdf] indicates the CFD has some issues with response times, but apparently is outside the scope of inquiry).
There is this lovely thing called ambulance utilization yadda ya- it is a metric, the metric for Cville is 3.5 ambulances (I am not an expert on this stuff), CARS has three ambulances during the day. The report indicates this metric standard is used widely but "much debated." um, ok.
Again nothing to do with response times.
What the CFD is pleased about is getting rid of the tiered system, they are seeking to collapse the tiers into one, one in which they will be the only ones to respond, I suppose CARS will still respond too since CFD is only seeking 2 ambulances ($530,000 over ten years) and 6 paid medics (high level training). Will this translate into quicker response times? I dont think it matters for CARS since that is not an issue for them, but for CFD? I hope so.
Finally the emergency communication center will still have to ask tier questions for County calls. An argument made by Taliferro is 'you never trust the person on the phone to be as accurate as an impartial observer' about the condition of the patient. And here I absolutely agree with him. But I dont think it is worth spending all of this money on since the same tier system questions will likely still be asked of every caller.
A great aspect of the Oversight Committee is the creation of standards for performance. I know everyone will benefit from that.
So despite the means being about CARS response times, the ends of creating an taxpayer subsidized ambulance service justified that tarnishing of CARS (I jest of course). I wish the CFD had approached it in a better, more honest way.
The question left unanswered by everyone "how are these recommendations going to change the response times for first responders?" Lynch asked some good questions that were answered in very circular fashion thus creating frustration and confusion by those of us who thought the questions were reasonable.
I know reasonable people differ, I respect the folks who created this new service and hope it does create a better service for the community since we are spending so much money on it. My opinion is ultimately the committee didnt need to rely on the 'four' chiefs to come up with a proposal, an innovative, more cost effective plan could have been achievable and workable. I will gladly change my thoughts on the subject if I see a dramatic improvement, so stay tuned.
Saturday, March 31, 2007
Transparency
Open & transparent government is a major theme of my campaign. My experiences with the Parks & Rec board, CDBG Task Force, my neighborhood association & this year's budget process solidified the need for such an emphasis in my campaign.
I expect a coherent process with open debate on key matters before Council, something that citizens and staff can rely on to facilitate process. If elected, I will help make the local government process much more open and transparent, and hopefully helping people to either understand the rationale for a decision or how the decision was actually made.
Here is my quote from the Hook article cited below:
"City Council candidate Jennifer McKeever is looking at the expenditure from a taxpayer perspective. "We wouldn't want expansion of these services without meaningful public dialogue," she says. 'I don't believe it's a ... issue as much as a taxpayer issue.'"
Someone emailed me the following quotes, widely available in the local weeklies:
"...says he's disappointed the issue has become so public. 'It's just one of those major changes...'" From the Hook.
From Cville Weekly
"We have been trying to avoid any public debate so that it would be all under the radar,” ...says. “Hopefully ... would’ve embraced the additional resources in a way that it would’ve been a silent transaction.
...indicates who or what the issue is (see the articles, I am not trying to harp on one particular issue).
My platform on Open & Transparent Government.
1) Outline Council priorities early in the budget process.
2) Before major new initiatives or cuts, the public will have the ability to add to the discussion through the public hearing process.
3) As a councilor, I will bring information to our residents, not listen only to those who come to the public hearings. I will quite simply be available, return calls, and come to small and large gatherings throughout the City.
4) I will be an advocate for all residents by asking relevant questions and thoroughly researching all the material prior to making decisions.
I expect a coherent process with open debate on key matters before Council, something that citizens and staff can rely on to facilitate process. If elected, I will help make the local government process much more open and transparent, and hopefully helping people to either understand the rationale for a decision or how the decision was actually made.
Here is my quote from the Hook article cited below:
"City Council candidate Jennifer McKeever is looking at the expenditure from a taxpayer perspective. "We wouldn't want expansion of these services without meaningful public dialogue," she says. 'I don't believe it's a ... issue as much as a taxpayer issue.'"
Someone emailed me the following quotes, widely available in the local weeklies:
"...says he's disappointed the issue has become so public. 'It's just one of those major changes...'" From the Hook.
From Cville Weekly
"We have been trying to avoid any public debate so that it would be all under the radar,” ...says. “Hopefully ... would’ve embraced the additional resources in a way that it would’ve been a silent transaction.
...indicates who or what the issue is (see the articles, I am not trying to harp on one particular issue).
My platform on Open & Transparent Government.
1) Outline Council priorities early in the budget process.
2) Before major new initiatives or cuts, the public will have the ability to add to the discussion through the public hearing process.
3) As a councilor, I will bring information to our residents, not listen only to those who come to the public hearings. I will quite simply be available, return calls, and come to small and large gatherings throughout the City.
4) I will be an advocate for all residents by asking relevant questions and thoroughly researching all the material prior to making decisions.
Friday, March 16, 2007
Budget Dilemma part 1
CARS- the Charlottesville-Albemarle Rescue Squad held a press conference today. The Hook has some of the details. There is much more to the story. I will be at the Community Budget Forum tomorrow so I am hoping this issue is discussed.
My two main concerns are 1) $400 (or more) ambulance transport fee 2) ~$1,000,000 expenditure of taxpayer money for services we get for free at this moment (this is just the first year expenditures, there will be ongoing expenses of salaries, benefits and maintenance). CARS has never been a part of the City's budget, therefore Charlottesville residents have received highly professional service from CARS for free. CARS has relied significantly on its annual fundraising to continue its quality service. Even the threat of charging for transport (by the City's fire department, not CARS) reduces the amount of contributions.
The Fire Department argues CARS service has declined and points to the County Fire/Rescue model. I have not seen data on response times. I will give the fire department the benefit of the doubt- BUT for educational purposes, the Charlottesville fire department is considered a first responder. It is not a surprise if an ambulance comes in behind the fire engine since there are 3 fire stations in the City and only 1 rescue squad. Commonly, the fire department has been the first to arrive and provide initial care.
The County Fire/Rescue model has come about because of a significant population explosion, new, widespread development & increase in number of calls from the County. To supplement CARS, the County has added daytime fire/rescue personnel on CARS ambulances. It makes sense for County taxpayers to add personnel and equipment especially north where the next station is being built (an ambulance is already running from this station). The County has proposed new stations in Ivy and Pantops to further alleviate the burden on CARS and thus response time issues in the City. Charlottesville has not seen the explosion of growth and the County's investments have made it easier for CARS to respond to City residents.
Public safety is essential, this year's proposed budget has the fire department in line to receive ~$2.5 million more than last year. I support the renovation of Headquarters on Ridge Street which is $1.5 million of the money. I strongly support a dialogue between CARS, Fire Dept, and taxpayers, who will be asked to fund the dispute between the two, before we start charging City residents for ambulance transport and commit to a significant, ongoing expense parallel to an existing organization.
My two main concerns are 1) $400 (or more) ambulance transport fee 2) ~$1,000,000 expenditure of taxpayer money for services we get for free at this moment (this is just the first year expenditures, there will be ongoing expenses of salaries, benefits and maintenance). CARS has never been a part of the City's budget, therefore Charlottesville residents have received highly professional service from CARS for free. CARS has relied significantly on its annual fundraising to continue its quality service. Even the threat of charging for transport (by the City's fire department, not CARS) reduces the amount of contributions.
The Fire Department argues CARS service has declined and points to the County Fire/Rescue model. I have not seen data on response times. I will give the fire department the benefit of the doubt- BUT for educational purposes, the Charlottesville fire department is considered a first responder. It is not a surprise if an ambulance comes in behind the fire engine since there are 3 fire stations in the City and only 1 rescue squad. Commonly, the fire department has been the first to arrive and provide initial care.
The County Fire/Rescue model has come about because of a significant population explosion, new, widespread development & increase in number of calls from the County. To supplement CARS, the County has added daytime fire/rescue personnel on CARS ambulances. It makes sense for County taxpayers to add personnel and equipment especially north where the next station is being built (an ambulance is already running from this station). The County has proposed new stations in Ivy and Pantops to further alleviate the burden on CARS and thus response time issues in the City. Charlottesville has not seen the explosion of growth and the County's investments have made it easier for CARS to respond to City residents.
Public safety is essential, this year's proposed budget has the fire department in line to receive ~$2.5 million more than last year. I support the renovation of Headquarters on Ridge Street which is $1.5 million of the money. I strongly support a dialogue between CARS, Fire Dept, and taxpayers, who will be asked to fund the dispute between the two, before we start charging City residents for ambulance transport and commit to a significant, ongoing expense parallel to an existing organization.
Monday, September 04, 2006
The great outdoors
I have told Chris "I do not enjoy camping," so of course many of the Labor Day weekends I have known him, I have spent camping with his family and him at Lake Gaston. Charlottesville is so different than the rest of the world is my conclusion.
What is it that draws people to camping; peace and quiet, back to nature, comraderie among campers, drawing from ones own skills to survive? Here are some brief reflections: smoking, noisy motor boats and jet skis, yelling and cursing, ill-mannered children victimizing younger children, motor homes with satellite tv and air conditioning, & smoking. All of my senses were embattled, not the way one expects when camping.
I actually do like camping a little bit, unfortunately lots of elements of this weekend reminded me why I dont like camping. Thankfully Chris does lots of the heavy lifting and soon the boys will be old enough to go with daddy and mom can go to the spa (right!).
What is it that draws people to camping; peace and quiet, back to nature, comraderie among campers, drawing from ones own skills to survive? Here are some brief reflections: smoking, noisy motor boats and jet skis, yelling and cursing, ill-mannered children victimizing younger children, motor homes with satellite tv and air conditioning, & smoking. All of my senses were embattled, not the way one expects when camping.
I actually do like camping a little bit, unfortunately lots of elements of this weekend reminded me why I dont like camping. Thankfully Chris does lots of the heavy lifting and soon the boys will be old enough to go with daddy and mom can go to the spa (right!).
Wednesday, August 30, 2006
Misc. Thoughts
First, Hurricane John is a Cat. 4 hurricane, um does anyone care? The news is all about Ernesto and that is now a tropical depression and folks in central VA are stocking up on supplies for when that strong rain storm hits. Incongruent. BTW- what is the difference between a typhoon and a hurricane?
Next, I really appreciate the musical interludes on Charlottesville...Right Now - but none can possibly compete with the theme from Dora the Explorer (after Coy's daughter says "youre listening to my dad on Charlottesville...Right Now" or something like that. Anyway, the kids LOVE it! I always smile, even when the kids arent in the car and it comes on. David says "Dora" real loud whenever it comes on.
Finally, a follow-up in WaPo re: dinner to go places. Marijean recently asked about such a place in the 'ville, alas the answer is no as far as I can tell. If anyone wants to open one, I know a family or two who may jump at the opportunity to patronize such a business. Please...I know it wont be in town though, I suppose I would drive to the North of town occassionally to have meals made for those nights it is too crazy to make meal.
Next, I really appreciate the musical interludes on Charlottesville...Right Now - but none can possibly compete with the theme from Dora the Explorer (after Coy's daughter says "youre listening to my dad on Charlottesville...Right Now" or something like that. Anyway, the kids LOVE it! I always smile, even when the kids arent in the car and it comes on. David says "Dora" real loud whenever it comes on.
Finally, a follow-up in WaPo re: dinner to go places. Marijean recently asked about such a place in the 'ville, alas the answer is no as far as I can tell. If anyone wants to open one, I know a family or two who may jump at the opportunity to patronize such a business. Please...I know it wont be in town though, I suppose I would drive to the North of town occassionally to have meals made for those nights it is too crazy to make meal.
Wednesday, June 07, 2006
Spring Makeover?
I won! How exciting. Put your business card in the fishbowl at Origins and you too can win a free spring makeover. I think if you walk in and ask for a makeover they will likely give you one too. I wanted new makeup since it had been a long time since I bought makeup so what the heck? Dont put your card in if you dont want to win.
I usually use Clinique products for makeup- no reason except one day about two years ago (that long already?), I went to Clinque's counter and the counterperson (probably called something fancy like technician) put makeup on me and it looked nice. Since I know what looked nice, I continued on in that same vein.
Origins ,for all I know, probably owns Clinique. The cosmetic industry is full of companies that compete but are owned by the same parent company (usually Este Lauder).
So I bought lots of makeup and discovered more great products made by Origins.I already am addicted to "A Perfect World" skin guardian which I love and recommend because it smells nice. The person who did the makeup for me was really charming in a good way. I was surprised to receive such great service there.
A fun book "Dont Go to the Cosmetics Counter Without Me". The author goes through every product line and argues the relative merit/demerit of the products based on her knowledge of the ingredients.
I usually use Clinique products for makeup- no reason except one day about two years ago (that long already?), I went to Clinque's counter and the counterperson (probably called something fancy like technician) put makeup on me and it looked nice. Since I know what looked nice, I continued on in that same vein.
Origins ,for all I know, probably owns Clinique. The cosmetic industry is full of companies that compete but are owned by the same parent company (usually Este Lauder).
So I bought lots of makeup and discovered more great products made by Origins.I already am addicted to "A Perfect World" skin guardian which I love and recommend because it smells nice. The person who did the makeup for me was really charming in a good way. I was surprised to receive such great service there.
A fun book "Dont Go to the Cosmetics Counter Without Me". The author goes through every product line and argues the relative merit/demerit of the products based on her knowledge of the ingredients.
Wednesday, May 03, 2006
Cycling about town
Tour of Shenandoah is over. Priority Health's Brent Bookwalter won his first General Classification race. I got a chance to stop by the festivities after the race, the guys were quite happy- champagne and trophies littered the parking lot. Congratulations to Priority Health.
The final stage is a criterium in Waynesboro. Waynesboro is at the base of the mountains, so one may think the crit is relatively flat- one would be wrong. The course is brutal and Chris was (and is still) feeling laid up from allergies. So he put in a few good laps before being called off (DNF). Certainly several riders didnt finish and he was one of the last to be called off. He was hurtin'. But a teammate of his did finish strong (Dave). The race was really exciting since the riders came by twenty times, the race unfolded in front of us. At one point a rider had a huge breakaway going, but in two or three laps the peloton had reeled him in. A UVA cyclist won. I cant complain about that result. I dont know who won the omnium and I cant find it on the ToS website.
Wintergreen Ascent (a time trial) is next. Chris is going to the doctor today so perhaps he will get some relief from the allergies and be in good form on Saturday. He loves the mountains, but this is just insane.
The final stage is a criterium in Waynesboro. Waynesboro is at the base of the mountains, so one may think the crit is relatively flat- one would be wrong. The course is brutal and Chris was (and is still) feeling laid up from allergies. So he put in a few good laps before being called off (DNF). Certainly several riders didnt finish and he was one of the last to be called off. He was hurtin'. But a teammate of his did finish strong (Dave). The race was really exciting since the riders came by twenty times, the race unfolded in front of us. At one point a rider had a huge breakaway going, but in two or three laps the peloton had reeled him in. A UVA cyclist won. I cant complain about that result. I dont know who won the omnium and I cant find it on the ToS website.
Wintergreen Ascent (a time trial) is next. Chris is going to the doctor today so perhaps he will get some relief from the allergies and be in good form on Saturday. He loves the mountains, but this is just insane.
Thursday, February 16, 2006
Spring is coming...
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