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Norwalk Hospital ambulance availability under scrutiny

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A Norwalk Hospital ambulance heads up East Avenue.

NORWALK, Conn. – Norwalk Hospital ambulances fan out across the region, answering more calls in Wilton than Wilton volunteers do and almost as many calls in Weston as Weston volunteers take on, according to the most recent statistics available from the state.

That has led some Norwalk residents to wonder if calls outside of Norwalk are at times delaying help for people in the city.

The discussion at last week’s Health, Welfare and Public Safety Committee was inspired by East Norwalk activist Diane Cece, who said she wanted to open a dialogue on “whether or not we have adequate ambulance service.”

Cece is not alone in her suspicions. NancyOnNorwalk has recently gotten regular emails from a Norwalk “scanner jockey” complaining of slow ambulance response time because Norwalk ambulances are out of town in a program known as mutual aid.

“When I think about ambulance service, there’s a number of components,” Cece said. “I think about quantity, the number that are here, which I understand are all operated through Norwalk Hospital, the primary ambulance service. The quality of service, meaning are there EMTs in these ambulances, are there paramedics on these ambulances? I think it makes a big difference as to the staffing. Then the response time of the ambulances – in addition to having tools like defibrillators, you have to get the ambulance there.”

Cece said she had heard the hospital only has two or three ambulances. Assistant City Clerk Erin Herring said she had spoken to Norwalk Hospital Director of EMS Alan Henschke.

Herring is the city staff person assigned to the Health, Welfare and Public Safety Committee.

There are usually two or three ambulances on duty, but the hospital has five in total, Herring said, quoting Henschke.

“Mutual usage has declined. They track all of this,” she said.

The latest statistics available online from the Connecticut Department of Public Health show that, in 2011, Norwalk answered 13,350 calls; 3,235 were out of town. In other words, 24 percent of Norwalk Hospital’s runs were outside of Norwalk:

Service calls in Darien

Norwalk 30

Darien 1,405

Service calls in New Canaan

Norwalk 1,221

New Canaan volunteers 1,578

Service calls in Norwalk

Norwalk 10,115

American Medical Response of CT 63

Darien 119

New Canaan 74

Stamford 1

Weston 6

Westport 94

Wilton 74

Service calls in Stamford

Darien 38

New Canaan 5

Norwalk 3

Stamford 12,139

Other 14

Service calls in Weston

Norwalk 532

Weston 577

Westport 5

Service calls in Westport

Norwalk 44

Weston 3

Westport 2,838

Wilton 2

Service calls in Wilton

Norwalk 1,435

Wilton 1,348

Norwalk Hospital does not get any money from the city for its ambulance service and never outsources, Herring said.

“The staff that are on these are top notch – they are like little emergency rooms. It’s not just like picking somebody up and bringing them to the hospital,” she said. “Henschke said they are upgrading the dispatch system, getting new software. What they try to do is gear the annual amount of ambulances that they have on call for either the time of year, the day, the month. You know, if there is a natural disaster you’re going to need more, obviously. But they keep track of  all the calls that come in so they can measure the response time. They do work with the fire department all the time. There’s an open communication just so they can improve the response times.”

Cece said it troubled her greatly that the decision of which ambulance would go where was made by the hospital.

Mayor Harry Rilling, who was sitting in on the meeting, said that is because city dispatchers don’t know which ambulances are available, he said.

“The hospital dispatch center, if their ambulances were out, would then request mutual aid from another area depending on where the call is. … It’s a joint effort. There’s really no one hard and fast rule as to who calls for mutual aid. It depends – it’s situational.”

The “rather instantaneous” call for mutual aid would be 30 seconds after a 911 call, Rilling said. Norwalk Hospital ambulances sometimes do a “turnaround,” meaning they drop off a patient and then head right back out to tend to a new one, he said.

Committee Chairwoman Michelle Maggio (R-District C) said she thought that was “kind of weird.”

“Don’t they have to clean (the ambulance) out?” she asked.

“It depends on the situation,” he said. “They put another gurney in.”

Herring said Henschke is willing to come in and discuss the service. Maggio said she would arrange that for the next meeting.

2011_Yearly_Report ambulances

Comments

38 responses to “Norwalk Hospital ambulance availability under scrutiny”

  1. EveT

    When some Norwalk residents complain that Norwalk taxes are too high and argue that it’s a better deal to live in a neighboring town, they don’t think about factors like emergency medical care. It’s great to live in a remote, leafy suburb until you have a medical emergency. Perhaps Darien, New Canaan, Wilton and other towns should be taxed for their use of Norwalk’s health care resources.

  2. Inquirying Mind

    “Cece said it troubled her greatly that the decision of which ambulance would go where was made by the hospital.”
    .
    Is there an actual problem here, or is it just that Ms. Cece would like to tell the hospital dispatch how she thinks it should be done?

  3. Diane C2

    @Inquiring – with our very sophisticated and supposedly state of the art emergency dispatch services, you can see where I would assume that our first responders make these types of decisions, especially someone actually on the scene.
    If the hospital can and does make the final decision, perhaps they can share with Norwalk residents some of the criteria they use, and let’s hope none is related to the affluence and rate of insured from one city to the next town.
    Additionally, our elected officials should consider how the hospital ambulance response time would differ if our fire fighters were not first responders with AED’s and EMT/Paramedics.
    Finally, let’s compare our ambulance service to that of other like-sized cities (both population and geography) and see how we compare.

  4. Diane C2

    @Eve – the issues of the burden of services is certainly valid, but don’t forget that our mutual aid agreements mean that neighboring towns will send equipment and staff here when needed, including fire, police, canine units, ambulances, probably bomb and swat teams, etc.

  5. SilenceDogood

    Diane C2…”and let’s hope none is related to the affluence and rate of insured from one city to the next town.”
    Once again , Ms.C2 raises a valid subject matter of ambulance service, mutual aid, chain of command decision-making and then tarnishes it with her subliminal snide comment. Her questions are worth researching in a meaningful and objective manner, without resorting to her not-so-hidden biased agenda which she thinks is so cleverly cloaked. Isn’t it time for her to run for elective office or to submit her resume for consideration for appointment to a board or commission where she can transparently raise her concerns and be responsive to your constituents for your actions? I think so.

  6. Jlightfield

    I seem to remember a line item for the City reimbursing the hospital for any ambulance calls initiated by Police officers. It was awhile ago so not sure if it is still the practice.

  7. Diane C2

    @SilenceDogood – There are a bunch of “sacred cows” in Norwalk, and probably dozens of 500lb elephants in the room. We citizens can choose to hide our heads in the sand so as not to air legitimate concerns that make some uncomfortable, or we can ask questions in the full light of day, to uncover the facts – whatever they may be. I think my concern was both overt and unbiased.
    One way to uncover facts is to examine root causes of problems/issues. One effective tool to use is simply to ask “why?”, and enough times to get to the cause(s). In this case, am important piece of data to further examine was the statistic that shows 24% of our ambulance calls in 2011 were mutual aid responses to other towns – it IS legitimate to ask why. One possible explanation that cannot be dismissed or ignored is the existence of a “profit center” strategy that, either by design or subliminally, sends crews based on the highest return on investment.
    Another very legitimate question that may make some uneasy is whether or not calls originating from inner-city neighborhoods, including the homeless shelter, get farmed out routinely to mutual aid.
    I’m not cleverly cloaking anything – I am not tip-toeing around what could be ugly suspicions. I believe I was diplomatic in my wording, but also direct and demanding.
    As to elective office or commission appointments: I’m so happy to live in a country where one does not have to be an elected official to have access to information and to ask questions.

  8. spanner

    There’s really no one hard and fast rule as to who calls for mutual aid. It depends – it’s situational.”

    What about fly cars? I didn’t see it mentioned it all.This tells me maybe the hospital has some more numbers to share or tell us about fly cars.

    An ambulance emergency response vehicle, also known by a variety of local names including ‘fly-car’ and variations on ‘response vehicle’, is a vehicle operated by an emergency medical service to respond to medical emergencies either in addition to, or in place of, an ambulance capable of transporting patients.

    Emergency response vehicles can be used to reach a scene more quickly than a standard ambulance, as they may be able to move through traffic with greater ease, or travel at greater speed, to bring additional or more skilled resource to a scene, or to simply to avoid sending too much resource to medical problems that do not require it.

    They exist in Norwalk they too are a very important tool in transporting.The numbers are great but as we all know after some shootings,stabbings and bar fights victims bring themselves to the ER or are driven and left at the front door.Why does this matter its another figure that should be considered when seeking for more resources as to the total number of people seeking transport to the ER, in addition to walk in traumas.

    When a chase car or fly car meets an ambulance coming to Norwalk Hospital on the road there can be other reasons.The Hospital should be able to elaborate on this.

    Mayor Rilling understands,when his men use to ask if an ambulance was dispatched or even coming becuase its been a long time waiting.You think one of the most important things to think about is when our firefighters have a fire and an ambulance is pulled from the fire not a good idea if a firefighter gets hurt or they find a victim after a secondary search.It would clearly mean they need another rig when most cities send a ambulance to stay at a fire until they are no longer needed.There has been some injuries over the years of firefighters not made public the condo fire in Norwalk a few years back left one fireman out of work for a while.No one ever reported injuries to the media.

    How many times has a police cruiser transported,its a scoop and screw clearly for a serious injury.If I’m not mistaken when a Stamford cop was hurt on a 95 overpass in Norwalk he was taken by police car to Norwalk ER so yes it happens and for good reason.

    It seems the subject is starting to create some smoking mirrors among those who should know what the answers are before the question is asked.

    If one or more are injured at any scene it sometimes takes an ambulance per victim that is when the wait happens you need the first ambulance to make the call they need two unless the fly car says otherwise,so how many fly cars and if only one and its out of the city then what? The fire dept goes on every call and is there usually first or right after the cruiser, with its own ambulance time would be saved if they were calling the shots like so many other fire departments.

    I have faith in the Norwalk firefighters but not the way the depts been run,just came by the new fire station today how many red passenger cars do they need I counted five all little compacts sitting like ducks outside wasn’t the new fire station and the repair garage suppose to shelter the city fire vehicles? I think they would make great fly cars and save the city some money.We have them use them. I know why they are there but why are they parked outside all the time.

    Response time is the issue you can’t convince some of us it can’t get better.

  9. spanner

    The hospital dispatch center, if their ambulances were out, would then request mutual aid from another area depending on where the call is. … It’s a joint effort. There’s really no one hard and fast rule as to who calls for mutual aid. It depends – it’s situational.”

    I thought it was fly cars making decisions or in some cases when one or more victim needs transport,1 ambulance per one victim or Pt is the norm.No one seems to talk about fly cars are they considered also in the five ambulances?
    5 ambulances Assistant City Clerk Erin Herring said, quoting Henschke.

    There are those times a second ambulance is requested after the first has arrived issue at hand is response time not what our rolling stock is as it is we are not hearing anything about fly cars.Does Norwalk use them?

    An ambulance emergency response vehicle, also known by a variety of local names including ‘fly-car’ and variations on ‘response vehicle’, is a vehicle operated by an emergency medical service to respond to medical emergencies either in addition to, or in place of, an ambulance capable of transporting patients.

    Emergency response vehicles can be used to reach a scene more quickly than a standard ambulance, as they may be able to move through traffic with greater ease, or travel at greater speed, to bring additional or more skilled resource to a scene, or to simply to avoid sending too much resource to medical problems that do not require it.

    If fly cars are used and they are out of the city then what as our mayor said joint effort means the fire dept calls for a mutual aid and if not why?They are there usually behind the cruiser and before the ambulance response time seems to be an issue.

    Police cars are used to transport walk ins and drop offs are common among gunshot,stabbing and bar brawlers,they should be added to the amount if they are trauma cases if seeking more coverage for the city.

    I think more information should be coming from our Hospital on what is going on.

    Response time is important no matter how small the injury sounds like turning the ambulance around as opposed to have enough is cost savings, yet not transporting a victim can cost more to treat if there is a lasp if its heart related.The next question is has any calls been stacked so someone gets the ambulance first?Who makes that decision I would think its a on site call.

    What about the study that was done where is that?

  10. irishgirl

    I don’t think Diane CeCe has the kahoonas to run for office – she is one of these types of people who can and does attack whatever got her goat and hide behind “because in America, I can” shield.
    *

  11. Diane C2

    @irishgirl – I have the courage to post comments under my own name – who are you? And why does asking questions equate to an “attack” in your view?

  12. SilenceDogood

    Posting or not posting one’s name is hardly an act of courage. Many of us have held leadership positions in the private, public, nonprofit sectors, and continue to do so. We have tested our positions, beliefs with the public through the ballot box, through our active participation on boards and commissions. It well may be time for you to step into the arena-let your positions which you believe are so right for our community be subjected to the same level of public scrutiny you desire from others.

  13. Diane C2

    @Silence: it’s sad that holding leadership positions in Norwalk and not being afraid to express yourself openly are apparently mutually exclusive. Since someone’s past, present and potential future public service seems to the most common reason I’ve seen cited for remaining anonymous by posters here and elsewhere, for sure I would rather forego the ballot box forever and not be either self-censored, or worse, censored by some political machine.

  14. SilenceDogood

    No one is asking you to remain anonymous or public- just become publicly engaged in a decision-making capacity. You may find you have support, or not for your positions. It’s easy on the sidelines for sure-no heavy lifting. The decision is yours.

  15. Suzanne

    Wow! There is certainly a lot of talk on this forum about the activities of Diane Cece and her effectiveness without being an elected official: let me make this clear. I have NEVER known ANYONE so clear on regulatory process and governmental strategy as Diane. She is a constant presence at all kinds of Norwalk, town-related meetings asking the elected officials pointed questions about adherence to City by-laws, codes, etc. All of you who would like to criticize her participation, you haven’t a clue about what kind of effort and HOURS she puts in to represent the constituency. That she wants to recuse herself from the political process is her choice – just like you all have the right to sit in judgement without half the participation she has shown over the years. You should be thanking her for representing you as a constituent and taxpayer and showing the power of that WITHOUT having to be an elected or appointed official. If that were necessary, every last one of you would need to do the same to back your words and opinions and my guess is you would not want to do that nor would you have the will, perseverance and focus Diane does to do what she does on behalf of YOU.

  16. irishgirl

    Suzanne,
    Diane does nothing on my behalf, she has taken these tasks all unto herself for herself.

  17. irishgirl

    @Diane,
    It doesn’t matter who I am nor am I attacking you for asking questions.
    All I’m saying is that you don’t have the guts to run for office.
    *
    Does it matter to you what I think? Probably not, just my two cents.
    *
    I just see you as someone who has pet peeves that need to be itched.

  18. irishgirl

    And as for the ambulances going to the more affluent towns first – maybe they are really needed there but maybe because they make revenue back from people who actually pay their bills.
    *

  19. nwkprobate

    If you ask me, Nancy and all other online publications should stop the use of anonymous handles. The lack of civility and poison published under these anonymous names is out of control. Nationally, more and more online news services are requiring posters to disclose their identity. Norwalk should join the trend.

    Thank you Diane Cece for all you do!

  20. David

    What are we talking about here? Ambulance service is not owned or funded (for the most part) by the City, it is, for all pretense and purposes, a private company.
    .
    Norwalk Hospital has a contract to provide services to the city of Norwalk, the question is whether those services are being provided in an appropriate manner. Are they meeting these service levels? If so, there shouldn’t be any more questions.
    .
    Getting into a conversation about mutual aid agreements with surrounding towns is like arguing about any Norwalk business that provides critical services outside of Norwalk. There’s a contract between the City and a privately held organization. That organization can earn money any way it wants, as long as it is meeting its contractual obligations.

  21. Intheknow

    The state statistics are wrong. Norwalk hospital contracts with surrounding towns to staff their paramedic fly cars. They are not city of Norwalk units and this staffing takes nothing from the city of Norwalk coverage, different units. Those stats for new Canaan, Wilton, Weston are their (not Norwalk) fly cars. Due to how data is reported to the state, the state has a disclaimer on the reports: their is an explanatory note on page one of the report for 2011. Go to http://www.ct.dph.gov search for OEMS (office of ems).

  22. Harold Cobin

    Erin Herring pops up out of nowhere is this story quoting Alan Henschke. Is Herring the city’s liaison to Norwalk Hospital for ambulance services?
    Harold Cobin

    1. Mark Chapman

      @ Harold

      Erin Herring is the city staff person for the council’s Health, Public Safety and Welfare Committee. Should have been in the story. We will add it.

  23. spanner

    I agree in part David but if everyone else can make money why can’t Norwalk be one of the vendors?Your thoughts are great it goes beyond my response time challenge.One suggestion would be clock response times and see who picks up where in the city if New Canan picks up in Rowyaton and Darien picks up near Calf Pasture is it fair to those waiting for a ride no matter what the emergency is.Its not always been the the most conveniant bus available I doubt if you here very little complaints if one of the fire ambulanes was stationed in Rowyaton or station five in South Norwalk I know my family and friends would indeed feel better served. Michelle Maggio council member had a legit question there is a guide on how to decontaminate an ambulance and times it takes to do so,turnaround time can vary and that is part of the business that has rules under OSHA.No matter what is said whats right should prevail for all residents in all cities and towns. Norwalk residents are not the only ones effected,in the case of others needing an ambulance while yours is in Norwalk should be considered. Hate to keep adding questions but is a transport the same as a medical call? Going home from the hospital is not responding to a service call is it?

  24. spanner

    Intheknow good info, but when a fly car is on 95 or the Merritt in Norwalk who pays for that? Over the years I have seen many fly cars in Norwalk its why I asked,to see one thing and to know is another.This is where its hard to take fact and match it to what one has been seen.Pictures are great I encourage those who see something to take a picture then when asking it becomes fact more so than second hand info.

    Good question Harold I was wondering the same thing.

  25. David

    @Spanner: (In the interest of full disclosure, I used to work in EMS.)
    .
    When you say “everyone else can make money” – this is a highly specialized, highly regulated industry, we’re not talking about a lot of money, so the question is whether the city would like to assume the risk and responsibility of managing a service like this one or, in essence, outsource it to those with the requisite skills. Many Ambulance services struggle to stay afloat, so it’s not like “a lot” of money is being generated.
    .
    Regarding your additional questions, “transports” refers to whether or not a patient was moved to a medical facility via that ambulance. Because Norwalk EMS is an emergency service, they *should* only be servicing emergency calls (911 for example). There are other private transport companies that deal with non-emergency calls. Regardless, a call can involve basic or advanced interventions. The latter generates greater billing and requires higher trained / certified staff.
    .
    But again, this comes back to the service levels agreed to by the city. One criteria would be average response time to a call within Norwalk. Yes, decontamination is a consideration in returning a crew into service, but I’d hazard to guess that 2/3 of emergency calls are medical in nature, in our area, so it’s not like a full decontamination is the norm.

  26. Intheknow

    First, so you can judge the source: I am a Paramedic in Fairfield county, have been for over 20 years. I am a Norwalk tax payer and citizen. I do not represent Norwalk Hospital or the City of Norwalk in any way.

    The facts:
    1. The city of Norwalk pays $0 for the provision of ambualnce sercviecs in the city of Norwalk. Look at Greenwich and Stamford. Their theird party non-profit ambulance services, like Norwalk Hospital is, get millions of dollars from their cities/towns for the provision of ambualnce services AND the services bill the patients they transport.

    2. There is no contract between the City of Norwalk and Norwalk Hospital for ambualnce services. There is no $ given to Norwalk hospital by the city of Norwalk.

    3. Norwalk Hospital has provided ambulance sercvices to the city of Norwalk since 1893. They had some fo the first Paramedics in CT and are a leader in EMS. Their paramedics work in the ED with the Emergecny Mediciane doctors when not on 911 calls. This provides a very high skill and competency level.

    4. Norwalk Hospital also has contracts with the towns of New Canaan, Wilton, Weston adn Westport. They provide one paramedic in New Canaan, Wilton and Weston combined (they share a paramedic) and Westport 24/7.

    5. Norwalk Hospital provides Paramedic level ambualnces to the city of Norwalk for 911 use only, 24/7. The number of ambualcnes varies by time of day, day of the week. This is caleld system status management, an industry standard. Stamford, Greenwich and other large cities (bridgeport, etc.) do the same thing. It matches on duty ambulances to historical call volume paterns to provide an efficient system.

    6. The Norwalk Hospital Ambulance service responds to 911 calls only. They do not do non-emergency transports. This does not mean if someone calls 911 for a stubbed toe they do not get an ambulance. They do. This is a problem country wide. If someone dials 911 they go. They can not refuse to transport a patient becaise its a minor issue/problem.

    7. Norwalk Hospital ambulances, just like Greenwich adn Stamford and mnay, not all, smaller services bill patients for the transports only. In CT they can not bill for non-transports, as a genreal rule. There are very few none transported patients that an ambualnce can bill you for; such as, cardaic arrest that was pronounced DOA but received some care in the field. Not every service bills these. I do not know about Norwalk billing those, my service does.

    8. EVERY ambulance service in Fairfield county particiaptes in the regional mutual aid agreement. If a service can not cover their own call, they call the regioanl EMS disaptch center (CMED). CMED dispatchs the next closest/available ambulance. EVERY town/services uses mutual aid. Its part of the state EMS system.

    9. Listening to Norwalk EMS, they have significantly reduced their use of mutual aid over the last 5 years. Other towns have increased their use. Norwalk, like every other town, does do mutual aid to other towns. NO WAY is it 1300 calls. That state data is wrong and the state knows it. Ask why no data for 2012 or 2013 is there. The state has a database issue and cant provide that data. The city just needs to ask Norwalk Hospital for the data. They ahve it, like every other EMS service does. My observations are Norwalk does far more mutual aid to other towns than come into Norwalk. They have obviously increased their staffing (ambulances on duty). I hear it on the radio. They use to have one ambulance on the overnight years ago and now they have at least 2. In addition, Norwalk is surrounded by volunteer ambulance services. It is often quicker for a Norwalk ambulance to “turn around” for another city of Norwalk call (from a previous call) than calling mutual aid. Ambulances are not Out of Service after transporting a patient for decon. We wipe down the serfaces the patient contacted (usually just the stretcher) with wipes and we go on the next call in under a couple minutes. This is the same with every serviuce, including Norwalk. In rare occasions, an ambualnce may need top to bottom cleaning. This is very rare (shootings, major motor vehicle accidenst, known infectious patients, etc.). That is why most services have spare ambualnces. My service we just use a spare if the primary unit needs cleaning. I know my friends at Norwalk do the same, they have told me. The spare ambulances also provide coverage for maintenance, mass cassualty events, standbys, etc.

    10. I fully support a system to evalaute the EMS services provided to the city of Norwalk. EMS is a system. The PD and FD are furst responders. Their staffing adn response times matter too. The PD is rovign the community. They ahve the quickest resposne times. The FD has stations stratigiccally located in the city. They have the next quickest response times. Norwalk EMS responds from the hospital. They have good response times for that design. If the citizens want quicker ambualnce response times, mabye the city should help pay for it or provide room in the fire houses for ambualnces to station their. This is what Stamford does (pays Stamford EMS, gives them locations to place ambulances around the city).

    11. Finally, FD, PD adn EMS are dispatched by the city of Norwalk Combined Dispatch center, the 4th responder in the system. Its dispatchers are trained in EMD (emergecny medical dispatch). They triage the calls, give prearrival instrcutions and dispatch the responders. Another highly trained group of responders. The industry standard is the use the EMD inforamtion to disaptch the closest ambualknces to the highest priority calls. So, if they are enroute to a sick call/ fever with no difficulty breathing and a Chest pain is received, the ambulance should be diverted to the Chest pain. I do not think Norwalk is diverting to high calls yet; but, it is part of the EMD/EMS systems in many cities and most are moving to this.

    12. Fly cars. Many services use Fly cars. I believe Norwalk uses its fly car for the on duty EMS Supervisor. They will co-respond with the ambulances for severe calls and if an ambulance is not availabel, the fly car will respond and render paramedic care until the Norwalk ambulance or mutual aid ambualnce arrives. In addition, the Norwalk Paramedic fly car will respond to calls in other towns when their paramedic is not available.

    I could go on and on about how EMS operates in CT and Norwalk. This is s snap shot of waht my very highly trained collegues in EMS do. Every EMS system has areas for improvement. Fairfield county has ome of the best services and providers in the country. It is sad that the City’s and tax payers do not support EMS as well as they do FD and PD. Just my opinion from the inside of EMS.

  27. David

    @Spanner: “Intheknow good info, but when a fly car is on 95 or the Merritt in Norwalk who pays for that?”
    .
    I’m not sure what you mean. Norwalk Hospital fronts the capital and operational costs – the car, supplies and EMT/Paramedic. They then recoup the costs through the service they provide. Mostly billing insurance companies medicare/medicaid and/or the individual themselves. Or a combination of the above.

  28. Intheknow

    A fly car is not billable. If Norwalk Hospital sends a fly car to call it cost the patients and city nothing. Its a resource used to provice EMS services. I am not sure the Norwalk Hospital flycar does many calls. I listen to the regional EMS frequency for my job and do not hear the Norwalk Fly car doing many calls. Its usually an ambulance. I know thye staff the fly car with a Supervisor Paramedic more now and they are probably doing supervisory duties AND covering 911 calls when an ambualcne is delayed or mutual aid.

    The area towns use Paramedic flycars to respond with the EMT/BLS level ambulances. If the Paramedic is needed (approximitly 40-50% of the time) based on patient condition, the paramedic moves their equipment to the Ambulance for the transport. If you are “seeing fly cars” in norwalk all the time, I bet its the area services fly cars (with an EMT driving) following the Ambulance (with the Paramedic on it) to the hospital. Once at the hospital, the paramedic moves their gear back to the fly car and is available for another call, with another ambulance.

    Its also important to know that less than 505 of the 911 calls for EMS require a Paramedic level care. Of the 50%, my quess less than 10% are truly life threatening calls where EMS is needed to save the life. Most 911 EMS calls require transport only. There are numerous studies looking at this. A big one in Canada really questions if Paramedic ambualcnes are needed. Staff BLS/EMT ambulances with a few Paramedic fly cars for the critical calls. Thats one idea. Fairfield county tends to use paramedic level ambualnces in the cities (greenwich, stamford, norwalk, bridgeport) and EMT/BLS ambulances in rural towns (Darien, New Canaan, Wilton, Weston, etc.).

  29. spanner

    @intheknow Your info is great thankyou this helps others to understand. Never said the quality of care or the professionalism had anything to do with response the same for those firefighters who help .A man by the name of Rick Serino over the years set standards granted he just retired last week but up till then his strive for standards was welcomed by all.He himself set some standards for himself that everyone uses in fact he was without a doubt was thee leader for a long time.Ricks knowledge came from hands on his programs and teachings are now textbook.

    @David my point is how can you be two places at once most calls come in groups depending on all outside reasons when I ask for better coverage it doesn’t reflect in those who are busting their arse making it work.

    I was told studies were going to be made years ago by Norwalk Hospital I have been unable by request to get them in some cases I was recently told they may not exist.

    My suggestion after reading your post arming our first responders with their own ambulance makes sense.That takes nothing away from what you have given us to think about.

  30. Intheknow

    Also, to think a 911 ambualnce picks what town they want to respond to (for 911 calls) based on the pay mix is outragious, and illegal. Every geographical area of the state has its EMS services assigned by the State of CT. It’s called a PSA, primary service area. Most are based on city/town boundries. Norwalk Hospital EMS is the PSA holder for ambulance and paramedic services to the city of Norwalk. If they are dispatched by the regional EMS communications center to another town, it is not the choice of Norwalk Hosptial EMS. It is based on the regional mutual aid contract.

  31. Intheknow

    First responders can not have ambualnces, per the state of CT. They are not cetified to do this. Norwalk has an ambulance provider designated for it by the state, it is Norwalk Hospital.

    Also, where are the FD and PD going to get staff for an ambulance? They will need to hire more staff, on city pay roll and pentions. As a tax payer, I dont want to pay for that or reduce FD and PD coverage to staff another ambulance service in the city when we have one.

    It would be cheeper for the city to negotiate with the Hospital to increase staffing, set response time criteria and fund some of the operations. This is what Stamford and Greenwich (and most of the CT cities this size) do.

    Currently the city has no performance criteria with the Hospital EMS, from what I am told by my sources. This is probably due to no $ going to the Hospital ambulance services from the city.

    Another reality is that medicare/medicaid and private insurance payments for EMS is going down. Ambualcne services all over the country are in trouble. Adding more resources to an already financially taxed EMS system will be very difficult. Someone needs to pay for it.

  32. Casey Smith

    @ InTheKnow -Thanks for all the great information about how the ambulance system works. I appreciate it, and all that you and your fellow workers do. In the past ten years, I’ve had virtually all of my family members transported at one time or another by ambulance for medical needs. So, let me take a moment and sincerely say THANK YOU!!!!
    .
    Uh, now, back to my original question…why was this an issue in the first place? Yes, yes, Ms. Cece, I know you gave me a detailed explanation earlier in the thread and I know you are an “community activist” and you apparently think that Norwalk is somehow being cheated out of its rightful service – but this issue was not just plucked out of thin air. So, where did it come from?

  33. Diane C2

    @Casey – I never said that Norwalk is being “cheated out of its rightful service”.
    But you’re right that the “issue” was not plucked out of thin air. Like lots of Norwalk “issues” that come to light out of seemingly nowhere, it came from months, maybe years, of information from different sources. In this case, the data suggesting that PERHAPS Norwalk could use more ambulances, with paramedics, and improved response times. It was the alarming issue of how mutual aid works (or not) that led me to the common council’s Health Safety and Public Welfare Committee to see if they would get some facts and data on ambulance service here.

  34. Casey Smith

    “I never said that Norwalk is being “cheated out of its rightful service”….It was the alarming issue of how mutual aid works (or not)…”
    .
    Well now, that explains it. I’d imagine that Westport was more than grateful when the Saugatuck Church caught fire two or so years ago and we sent our brand new tiller truck to help save the structure. Or that Newtown was just as happy to have some of our officers available last December when the unimaginable happened. We were just as grateful when Officer Matt Morelli died or when the truck hit the tree out by Exit 16 and it took hours to get the driver out of the wreckage and Westport sent some equipment to help. Yeah, mutual aid is a drain on our resources.
    .
    PERHAPS you’re right. PERHAPS Norwalk doesn’t have enough ambulances with paramedics to render mutual aid. PERHAPS each town should deal with its own stuff and let our neighbors, be they rich, poor, or otherwise, deal with whatever. Too bad if it happens to be your family, neighbors or friends. So, tough luck for the pregnant woman who goes into labor at The Outback in Wilton. PERHAPS someone will be able to drive her to Norwalk Hospital or the Wilton ambulance will get there before the baby’s born because Norwalk MAY need its ambulances for something so we can keep our response time low. And God bless the kid who has a seizure at the ice rink in Darien. PERHAPS Explorer Post 53 will be able to respond.
    .
    I can imagine your response right now. You’re going to say that you never suggested such a thing…and you’re right, you didn’t. But what you are suggesting is that the City government tell the Hospital and the private ambulance services how to manage their businesses. The Council and the Mayor have enough to deal with already with potholes, aging infrastructure, and developers who want to build Trump Towers on a quarter acre parcel. There are more than enough issues to keep the Council and the Mayor busy for the next two years.
    .
    Of course you never said that the poor pregnant woman in Wilton (whose going to have twins, by the way…) wouldn’t have access to the Norwalk ambulances. It’s an Reductio Ad Absurdum [Latin, Reduction to absurdity.] In logic, it’s a method employed to disprove an argument by illustrating how it leads to an absurd consequence. And before you shake your head in amazement and say ‘Never Happen in a million years’, think of all the news stories in the media about how zero tolerance in the schools has resulted in kids being suspended for chewing Pop Tarts into capital “L” shapes and pretending they are guns, or wearing a t-shirt with the picture of the Minute Man or the portrait of a relative in the armed services on it. I’m not being facetious here because I remember how hard the Ordinance Committee worked to upgrade the Blight Ordinance. You supported that effort up to the last month and then said the Committee should kill it because it wasn’t as good as Stamford’s. So you wanted all that hard work would have been just kicked to the curb because you didn’t approve.
    .
    Personally, I’d rather let the Hospital and the private ambulance services figure out what their needs are and how they wish to handle it. And I’d be extremely careful of messing with any kind of mutual aid agreements. You never know when you are going to need them.

  35. Diane C2

    @Casey – the question at hand is about the adequacy of our local ambulance service. Why do you continue to make this very important dialogue about me, rather than help seek the answers from the authorities who hopefully can provide facts and data.
    Speaking of facts and data, you have it wrong on the blight ordinance. I was in 2008, am now in 2014 and always will be adamantly opposed to one. Yet another waste of my taxpayer money

  36. Casey Smith

    Why do you continue to make this very important dialogue about me, rather than help seek the answers from the authorities….
    .
    Maybe it’s because:
    .
    “The discussion at last week’s Health, Welfare and Public Safety Committee was inspired by East Norwalk activist Diane Cece, who said she wanted to open a dialogue on “whether or not we have adequate ambulance service.”
    .
    “Cece said she had heard the hospital only has two or three ambulances.”
    .
    “Cece said it troubled her greatly that the decision of which ambulance would go where was made by the hospital.” “If the hospital can and does make the final decision, perhaps they can share with Norwalk residents some of the criteria they use, and let’s hope none is related to the affluence and rate of insured from one city to the next town.” (!!!!)
    .
    And from your own posts on this thread:
    .
    “Finally, let’s compare our ambulance service to that of other like-sized cities (both population and geography) and see how we compare.”
    .
    “We citizens can choose to hide our heads in the sand so as not to air legitimate concerns that make some uncomfortable, or we can ask questions in the full light of day, to uncover the facts – whatever they may be. I think my concern was both overt and unbiased.”
    .
    “Another very legitimate question that may make some uneasy is whether or not calls originating from inner-city neighborhoods, including the homeless shelter, get farmed out routinely to mutual aid.”
    .
    “Speaking of facts and data, you have it wrong on the blight ordinance. I was in 2008, am now in 2014 and always will be adamantly opposed to one. Yet another waste of my taxpayer money.”
    .
    You are correct in that you have repeatedly stated that you felt the blight ordinance was based on “slippery slope of subjectivity” both in 2008 and again in May of 2013 and stated your concerns about the ordinance being a watered down version of Stamford’s ordinance. You also had concerns about the proposed ordinance being a “good enough” ordinance that would never receive fine tuning.

  37. Matthew Podolsky

    I gotta say, I knew that Norwalk has had a terrible emergency responding call system for years! I live in Fairfield. I know what Norwalk is like because I attended Winston Prep in Norwalk for 4 years. I have always witnessed the Ambulances drive like 5-20 miles per hour when responding to an emergency medical call. Plus, the Ambulances’s sirens are so woozy that it takes longer time for the vehicles to pull over. Look, my Grandpa went to Norwalk Hospital a few years back. When I visited him, I saw lots of Norwalk Hospital “Volunteer” EMS ambulances parked in the Hospital’s emergency room parking lots. Especially, with the fact that time there weren’t anybody in them with the engines off. I feel like more deaths in Norwalk are on the rise because the city and Norwalk Hospital EMS do not do enough to add more ambulances out on the streets! Cleaning the ambulances, yes indeed, is important, especially to the patient’s health when traveling in an ambulance. And, I had never seen Norwalk’s own News 12 Connecticut do a report on the response times for selected towns and cities in the state, medical response wise! I’m pretty sure that News 12’s employees may have had medical emergencies when working at their headquarters in their side of the history. I’m mentioning News 12 because they’re a key business in Norwalk! Why won’t Norwalk’s Rillings, Moccia and Norwalk Hospital just admit that as of now they have a very terrible emergency responding time for Medical emergencies! In my opinion, I had seen AMR in Fairfield do an excellent job with their medical emergency call performance for years. Why won’t AMR expand their businesses even more toward Norwalk? I do not want to hear another word on the news that someone dies in Norwalk in the news because the Norwalk volunteer ambulances do not help enough to save someone’s life!

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