Summer 2007

To Fellow Fire Island Pines Residents:

The Pines Care Center proposes to establish a EMS Care Tax District that would fund an Emergency Medical Service (EMS) in Fire Island Pines as well as fund the Pines Care Center budget. Below are some questions and answers relating to this proposal.

Cost:

The cost of this proposal would be approximately $350 annually, plus or minus $50, per average assessed value per house in Fire Island Pines.

Current Situation:

The western communities of Fire Island rely on the Marine Police for emergency medical services; this is a unique situation in the State of New York. Eastern Fire Island is perhaps the only populated area in the State that lacks emergency service from paramedic emergency medical service workers.

Scope of Demand:

Emergency calls through the 911 system typically number 30 per year for Fire Island Pines, during recent calendar years; this compares to 22-24 calls from communities such as Cherry Grove and Davis Park. This Pines number, however, likely represents an undercount of such emergencies as any medical call that also includes the need for police action is counted as a police call, not a medical call. The Pines Care Center typically evaluates over 300 unique patient encounters per season.

Weaknesses of the Current System:

The Marine Bureau provides emergency medical transportation, and most of their members are trained at Basic Life Support level of emergency medical service. Of significance is that the Marine Bureau can be delayed an hour or longer to respond to medical emergencies as they cover all of Fire Island. In the case of a storm, they might be unable to respond at all. Additionally, they are not trained in Advanced Life Support, so they do not have most medications available to EMS personnel found on the mainland. The EMS helicopter does have paramedic EMS personnel available and can arrive in a reasonable time, when available and when the weather permits.

The Pines Care Center attempts to have a doctor available from the end of May to the end of September, seven days a week. When a doctor cancels at the last minute, Callen Lorde has sent a doctor from their medical facility in New York City at the last minute, pulling that doctor from their duties in New York. Callen Lorde has realized the cost of staffing and supervising doctors in Fire Island Pines is four or five times what they have charged the Pines Care Center over the last two years. The Pines Care Center might not be able to continue to pay what Callen Lorde projects it will need to be reimbursed to continue this relationship in 2007. This would mean that if the Pines Care Center will need to assume responsibility for its own staffing needs, and there may be uncovered weeks in the 2007 season. Note that even under the current relationship with Callen Lorde, their director, Jay Laudato, has encouraged the Fire Island Pines community to establish a higher level emergency medical service than we currently have.

As most of us are aware, health care costs have risen appreciably over the last few years. The Pines Care Center negotiated with Callen Lorde an acceptable increase in administrative costs for the 2006 season; it is unlikely, however, that we can agree to the increases Callen Lorde requires after this year. The Pines Care Center has always relied on donor’s generosity in funding the Center, and we have been fortunate to always meet our expenses. However, there is no guarantee we will be able to do so in the future (barring some major donation to the Center), especially given escalating costs, and we certainly cannot provide paramedic EMS service given our current fund raising levels.

What the EMS Tax District Will Do:

Approval of the EMS Care Tax District would result in an added tax on the assessed value of each home in the Pines. The revenue from this tax would be used exclusively to provide EMS service, 24/7 throughout the season, and to pay for the seasonal operation of the Pines Care Center and its resident physician.

Experience of Other Fire Island Communities:

The western communities on Fire Island generally under the jurisdiction of Islip have EMS available at the paramedic level. They have two fully equipped ambulances and volunteers within the community. Ocean Beach began providing EMS service in 1994 under their Fire District; they have agreements with Atlantique, Fire Island S Club, Cornielle Estates, Seaview, Point of Woods and Ocean Bay Park. Of Ocean Beach’s 77 active fire fighters, they have two paramedics, five EMT critical care technicians, 19 emergency medical technicians, and one field physician. This district responds to 208 emergency medical calls, versus 62 fire calls in the average year.

What is the role of the Pines Care Center in the Pines Community?

The Pines Care Center provides access to a doctor to treat medical problems, mostly urgent, that are able to be handled within the limitations of a summer medical clinic. Our doctors are generally from diverse medical backgrounds; most doctors are certified in Advanced Cardiac Life Support, few are certified in Advanced Trauma Life Support, none are pediatricians, and none are not trained or equipped to transport patients in emergency situations. The Care Center doctor’s role would remain the same with the establishment of an EMS in the Pines; people with medical problems that fall within the scope of the doctor in the Pines Care Center would continue to have the option of being treated in the Pines Care Center.

Other Explored Solutions:

A letter was sent to Police Commissioner Dormer, head of the Marine Police, to explore the possibility of upgrading the training level of the marine police to the Advanced Life Support Level. Commissioner Dormer sent a response saying that, even though we offered funding through our Pines Fire District to pay for such training, they are not interested in upgrading the skills to that level due to the demands of the training.

Can the Fire Island Pines Fire District Establish a Voluntary EMS District:

Setting up a voluntary EMS service in Fire Island Pines under the Fire District has not been popularly supported. About five individuals expressed interest in participating. Of note is that the training involves 145 hours for the first level and about 200 hours at the advanced life support level to qualify; then, this amount of training must be repeated in three year intervals. A meeting was held with the Fire Island Pines Fire Commissioners and the Pines Care Center last year, and it was clear that the Fire District does not have the resources in manpower or the interest in establishing a volunteer EMS District in Fire Island Pines.

Solution:

The Pines Care Center is willing and capable of establishing a certificate of need to create an EMS. The Pines Care Center Board of Directors supports the concept of petitioning the town of Brookhaven to create a EMS Tax District for Fire Island Pines; this would create a new tax district similar to the Harbor Tax District and the Beach Erosion Tax District. The proposal would include funding for the Pines Care Center as well.

Establishing this district is subject to the same vote needed for the other tax districts, a vote of 50% or greater of assessed property values within Fire Island Pines. The Fire Island Pines Property Owners Association Board of Directors has also voted to establish this district. We appeal to individual home owners to vote yes on this issue.

Respectfully submitted,

Pines Care Center
Board of Directors