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1987-11-19 SPM316 A Special Meeting was held by the Town Board of the Town of Wappinger on November 19, 1987 at the Town Hall, Middlebush Road, Town of Wappinger, Dutchess County, New York. Supervisor Paino opened the meeting at 7:05 P.M. Present: Irene Paino, Supervisor Vincent Farina, Councilman David Reis, Councilman Robert Valdati, Councilman June Visconti, Councilwoman Elaine H. Snowden, Town Clerk Others Present: Thomas Wood, Attorney Joseph E. Paggi, Jr., Engineer Notice of this meeting was sent to all Board Members on November 17, 1987, calling said meeting for November 19, 1987 at 7:00 P.M. Notices were also sent to the News Media and posted on the Town Clerk's Bulletin Board on said day. This meeting was called by Supervisor Paino for the sole purpose of considering the creation of an Ambulance District in the Town of Wappinger. Mrs. Paino stated that a second public hearing would be held to consider the Establishment of an Ambulance District reflecting new boundary lines for the proposed district. MRS. PAINO moved to set a public hearing on the Establishment of an Ambulance District on Monday, December 7, 1987 at 7:00 P.M. at the Town Hall, Middlebush Road, Town of Wappinger, New York, to hear all interested people. Seconded by Mr. Reis Motion Unanimously Carried MR. REIS moved to close the Special Meeting, seconded by Mr. Farina and unanimously carried. The Special Meeting closed at 7:08 P. i)gcbt E•aine H. Snowden Town Clerk A Public Hearing was held by the Town Board of the Town of Wappinger on December 7, 1987, at the Town Hall, Middlebush Road, Town of Wappinger, Dutchess County, New York, to consider the Establishment of an Ambulance District in the Town of Wappinger. Supervisor Paino opened the Hearing at 7:06 P.M. Present: Irene Paino, Supervisor Vincent Farina, Councilman David Reis, Councilman Robert Valdati, Councilman June Visconti, Councilwoman The Town Clerk offered for the record the Affidavits of Posting and Publication duly signed and notarized. (These Affidavits are attached hereto and made part thereof of the Minutes of this Hearing). Mrs. Paino invited the public to view the map in front of the Meeting Room outlining the area that would be excluded from the Ambulance District. Mrs. Paino asked if there were any comments or questions from the audience regarding the boundaries of the proposed Ambulance District. Joseph Incoronato asked what this district was going to cost the taxpayers. Mrs. Paino reminded him that the public hearing pertains to the legal description of the proposed district and once that is determined and the district created, the Board will then invite proposals from the ambulance services. An informal bid has been received from Sloper- Willen and Plan A provides for a bill to be sent to the person using the service and whatever amount is not paid by their insurance carrier will be paid by the Town; this will be a charge of $24.00 or $27.00 per year. If they should choose Plan B, no bill will be sent out, however, the charge will be approximately $40.00 per household per year. Another question from Mr. Incoronato---what happens if the rate triples next year. The Attorney responded that this will be an annual contract and if the cost becomes exhorbitant, the Town Board can rescind the district. Robert Janicker, Chelsea, noted that the rate quoted was per household, what about large tracts, such as Montclair. Mr. Wood replied that it would be assessed just like the taxes are larger assessments, larger cost. In reply to Mr.Janicker's question on the rate per thousand, Councilman Valdati, having previously calculated the amount, responded that it would amount of $.23 per thousand on Plan B, and $.151 on Plan A. If they chose the Plan which involved insurance payments, what about those whose insurance pay the whole bill, such as Mr. Janicker's policy, why should he be charged for the district. As the boundaries are now he is included in the district, but he is supplied with full coverage so he doesn't need the district. Alberta Roe---she's in the same boat, but who will service you if you don't have a district. Sloper Willen will have to service you once there is a district, but without one they don't have to if you don't have the money. Connie Smith said it was her understanding that if the Town got into this district and then finds it's not exactly what they want, they can get out of it. Mary Schmalz asked if there were other towns in the State with an ambulance district and how are they forming this district, what is it patterned from. Mr. Wood replied that the Town of Fishkill has such a district and the same day that the State approved special legislation for us they did for the town of Shodak in Ulster County and there are other towns in the State that have been given the authority to form an ambulance district. Mrs. Schmalz continued her questions relating to what towns actually have the district and what about their cost. The Town always gives money to Sloper Willen, did they give it this year, and if so what is it for. The response was that the Town received $60,000 this year and it goes toward defraying the cost of those who use it but not significantly. Had the Town done a survey on how many people in the Town do not have coverage, do they have a percentage. Mrs. Schmalz reiterated Mr. Janicker's concern on having full coverage and paying for a district they don't need--they're actually paying for other people's service. Phil Pessia--if their amounts are correct, it appears that Sloper Willen anticipates recovering about 30% of their cost through insurance under Plan B. He showed an ambulance bill for services to him dated 4/22/85 for a trip to the Beacon Hospital, in the amount of $293.00 which he felt was extraordinarily exhorbitant and he has not paid the bill. He recommended that the Town scrutinize Sloper Willen's budget that they base their needs on as it will probably be equally exhorbitant. Jim Tompkins--on phone all day questioning lawyers in Albany re an ambulance district. For comparisons---Village of Fishkill pays $7,500 contract 15 per thousand, they collect the insurance and the Village pays the remainder; Town of Fishkill in the Ronbout Fire District just formed this year, total bill $49,235; they also collect the insurance and the Town pays the remainder. The Town of Poughkeepsie, New Hamburg Fire District have the same arrangement, doesn't have kire figures. He questioned why the Town of Wappinger is $149,000, why that much, we're not bigger. There are questions to be answered. Mrs. Paino said they would have to look at the population of these districts and compare them with our Town. Our figure is approximately 27,000 minus the Chelsea Hamlet, that's a large figure. Once the district is formed and the Board is looking at proposals these factors will be considered. Mr. Tompkins asked if anyone had contacted the Beacon Ambulance Corps -- are they going to cover Chelsea, do they want money from the Town of Wappinger--is the Town ready to supply money to them as they have to Sloper Willen. Stan Straub, Vice President of Sloper Willen, not here in that capacity, just want to address a few item; the figure quoted is based on service that Sloper Willen has provided the Town of Wappinger during 1986. If the district existed in 1986, the figures quoted are those that would be used; he also had questions on the carrier for Chelsea, that being BVAC, are they willing to accept responsibility for that area and if they are,are they going to provide the service free, if not, is the Town willing to pay them for providing the service, if so, where are the monies coming from. The bill referred to by a previous speaker probably included life support equipment. They have to take into consideration that the ambulance service exists 24 hours a day, 365 days a year and there's always someone on duty to answer the call. There's Mutual Aid for everybody, they cover each other. Another questioned raised was whether Sloper would refuse to service anyone if an ambulance district wasn't formed---Sloper Willen never has refused to go to anybody when called. There are a lot of senior citizens who won't call an ambulance when they need one due to the cost. Medicare doesn't pay the full cost of an ambulance bill. This will be avoided if a district is formed since it won't cost them anything out of pocket. He pointed out that Sloper Willen is a non profit organization, the monies they collect from the users goes to the operation of this service for the ambulances, equipment and the paid personnel. Joan Paustian, Circle Drive, wished to speak on behalf of the senior citizens who could not come to the Hearing. For example, her father-in-law needed the services of Sloper Willen a couple of times within a few months. His income is $500 a month, Social Security, the ambulance bill is $320 each time he used it. This left them little to live on during the emergency time. This was something she wanted to point out during this hearing. The senior citizens will be taken care of without worrying about paying the bill if the ambulance district was formed. She wondered why Chelsea was receiving free service and a couple of blocks away they had to pay for it. Connie Smith, questioned whether they could create a district when there was uncertainty on the Beacon Ambulance Corp. Mrs. Paino stated that any action on this district would be based on the information and comments that is being offered at this hearing. Apparently there is still more information to gather and the Attorney will check with BVAC for their input. Mr. Valdati presented a letter from Dr. John G. Keene who is associated with St. Francis Hospital, which he felt would provide some necessary information. November 23, 1987 Dear Mr. Valdati: As Chairman of the Mobile Intensive Care Committee for the Dutchess County EMS System, I read the article in the newspaper pertaining to the Village of Chelsea not wanting to be part of the Wappingers Ambulance District. I can understand the Chelsea residents reluctance to pay for a service, which they perceive that they are now getting for free. That, however, overlooks a key factor. That is making the assumption that the service Sloper-Willen and the Beacon Volunteer Rescue Squad provide is exactly the same. The Beacon Volunteer Rescue Squad is a very active and dedicated service, that is doing a wonderful job. However, they function at a basic life support level. This limits them to transporting patients, immobilizing injured parts, administering oxygen and performing CPR, if the patient has a cardiac arrest. They cannot start intravenous lines, administer medications, intubate patients to assist their breathing or defibrillate patients whose hearts have stopped beating. By opting to stay with the service provided by Beacon Volunteers, the residents of Chelsea are denying all of the potential life-saving techniques that advanced pre -hospital life support can provide. As a specialist in emergency medicine who has been deeply involved in pre -hospital care for many years, I can assure you that advanced prehospital life support can make a difference and does save lives. My comments are in no way a slight to the fine work that the Beacon Volunteer Rescue Squad is doing, It is, however, a factual appraisal of the limitations under which they operate. I am afraid the residents of the Village of Chelsea may be reacting to the superficial side of the issue, which is the $25.00 per year cost. The more critical issue is what kind of care they can receive, if they have a medical emergency. If someone's heart stops beating or if they are having an abnormal cardiac rhythm, a respiratory emergency where they cannot breathe or any number of other emergencies, there may be only a brief window of opportunity to treat these conditions. Advanced pre -hospital life support can take those treatments to the patient, rather than having to wait until the patient is brought to the hospital. I would encourage you to make every effort to inform the citizens of the Village of Chelsea of this critical issue they may be overlooking. Dr. Robert Strauss, the other Director of the Emergency Department here at Saint Francis Hospital in Poughkeepsie, Jim O'Connor, our EMS Coordinator, Gary Nelfeld, the Director of the Emergency Department at Saint Francis Hospital in Beacon and I would all like to serve as resources and help to resolve this issue. Please do not hesitate to contact us, if you would like to discuss this further or you would like us to discuss this with the citizens of Chelsea. Thank you very much for your attention. Wishing you the best of health. Sincerely, s/ John G. Keene, M.D. June Wyant agreed with Dr. Keene, however she pointed out that life support systems are not always available at Sloper Willen so you can't say that they will be there, if needed. Another thing is that with a heart attach victim, you must reach them within six minutes to save them and it takes a lot longer than that for them to reach Chelsea. Rick Kosowski has attended all the public sessions held on this matter and felt that the trouble is there has nothing clearly set before the public, no analysis, no figures, no benefits of having an ambulance district brought forth. He suggested to the Attorney and to the Town Board that they outline to the people exactly what they have now and what they will be getting through the establishment of an ambulance district. He disagreed that the people of Chelsea are against the district, it's more a matter of them not knowing what it really means. What will people pay for this ambulance district, what about those who are fully covered, or on Medicare, etc. etc. etc. The Board may find no opposition to the district once the residents are aware of all this information. They will then be able to make an informed decision which they cannot do at this time. Jim Tompkins spoke on the time it takes BVAC to answer a call, about 10 minutes; on the other hand when you call Sloper the ambulance is on the road as soon as you call. Christopher Bremer agreed with Mr. Kosowski in that there are not enough facts available to make a decision. From what he understands the Board wants to raise his taxes for a service he's expected to pay for anyway, if he uses it. Now they're asking him to subsidize it as well as pay for it. He doesn't mind subsidizing the senior citizens if they have trouble meeting expenses, but he sees no advantage to this as it has been presented. Mr. Kosowski differed with this interpretation and explained that the only payment will be the assessment for the district; if Mr. Bremer's insurance does not fully cover the expense of a trip he may need, then the Town pays the balance from the monies allocated to the ambulance district. Councilman Farina reiterated the mechanics of both proposals in front of the Board and the residents just in case there was some misunderstand- ing. Proposal A includes a bill to the insurance company and Proposal B does not, but would cost the taxpayers more. Councilwoman Visconti recommended that they contact BVAC and discuss the plan with them, determine what they intend to do about the Chelsea residents, then the Board can go forward and make a decision. Alberta Roe had previously mentioned that the proposals were not clear to her until Rosemary Summers, from Sloper Willen, provided her with written information and now she understands it. Councilwoman elect, Constance Smith pointed out that this should be done for all the residents, they need knowledge and once they have it, they could be in favor of this district. June Wyant asked if the Town could legally decide on the boundaries of this district. The Attorney replied that there are two ways that an ambulance district can be created; under the General Municipal Law any town in the State can form a district that is town-wide, meaning all are served and all pay; the special act of legislature which was approved for the Town of Wappinger provides, in addition to that the Town can create a district the same way they create an improvement district and the determination for the Town Board to make on creating the boundaries is---are all the properties within this district benefited by the service. What they have to determine tonight is whether or not to create a district; the first hearing was for all the Town outside the Village of Wappingers Falls and when the Chelsea residents reacted in a negative manner, a public hearing was set for tonight on a change of boundaries to exclude the Chelsea area. The issue on how much service the taxpayers want, what kind of service and how much you want to pay for it, are questions that would then be determined at a budget hearing which would take place if and after the district is formed. Various companies might provide different figures and once the district is formed, the Town Board can work on contacting these companies and inviting them to bid. George Coughlin, Chelsea, over 70 years of age and more likely to be a candidate for ambulance service than others, stated that his concept of an ambulance service is different that the Doctor who wrote in with comments about the Beacon Corps. His concern was to have an ambulance get him to the hospital and have sophiscated service in a emergency room, rather than this sophiscated service in the ambulance. Joan Paustian asked if the boundaries shown on the map are the official ones for Chelsea or are they just for the ambulance district. The Engineer answered that they were drawn for the purpose of the district. Where then does the boundary end for the hamlet of Chelsea, Mrs. Paustin asked and was told there is no legal description for the hamlet of Chelsea since it is not a legal entity onto itself. Discussion ensued on the boundary line of Chelsea as shown on the map which was prepared by the Engineer to portray the proposed bound- aries for the district to exclude Chelsea. The residents were confusing the area serviced by BVAC and the boundaries on the map. The Attorney explained that BVAC legally services below the Town of Wappinger. Herb Mueller, Chelsea stated that the boundary line on the map is not the boundary line as it is now; the boundary line runs down the middle of Chelsea Road to the river. At the last public hearing the boundary line was drawn as Mr. Mueller described it, however, after the residents objected, the proposed boundary for the ambulance district was changed as they requested. Jim Tompkins said he wanted to be in the district and suggested to the Board that they form a citizens committee and question the residents of the hamlet on whether they want to be in the district, or not, before they decide after listening to just a few who object to the district. Mary Schmalz did not think anyone present objected to giving money for ambulance service to make sure everyone has it. She's sure that every- one present thinks Sloper Willen is a good organization and many dedicated people. She related her experience years ago when she and her son were in an auto accident and this service save their lives. To this day noone was every billed ---not her, not her insurance company. This service is a very expensive proposition and everyone knows that but that's not what they're objecting to. It's the sudden they're given a mandatory tax which they what they are up tight about. If the residents item budget on Sloper Willen, they would be knowledgable. They should also incorporate fact that all of a must pay, that's were given a line surprised but the number of also more volunteer hours put in for this organization. She doesn't have the answer but the Board should take a different direction than saying to the residents, here it is, you're assessed this amount for a district we're forming. The people with full insurance coverage do not need this, but maybe if they know it's helping out someone else who has little or no insurance, they could accept it. More knowledge is needed. Mrs. Schmalz then asked the Attorney if a district is formed and contract approved, where is the Town as far as insurance and liability are concerned. Under the law if you hire an independent contractor, they will be responsible for their own acts. Stan Straub, referring to the "line item" budget, noted that Sloper Willen would have no reason to provide a budget to the Town unless a district is formed. How would it help anyone --the numbers which have been given to the Town Board are those that are estimated for 1988 based on service to the Town of Wappinger in the past and it was divided by the tax assessment and that's how they arrived at the figures stated. Their budget is not a secret, they have nothing to hide, they are a non profit organization and whatever is collected is used to pay the personnel. There are volunteers who help keep the cost down but they must have paid professional people, too. In answer to Mr. Pessia's statement that the ambulance charged a lot, Mr. Straub noted that the cost goes up when people like him fail to pay their bill. The service is there, 24 hours, 7 days a week. If they went to contract with the Town, the service calls will probably be reduced since they will be collecting from the Town and the insurance company. The reduction would be in 1989 since they would be in contract in 1988 and able to collect with no problems as they have now in getting people to pay. Dave Kellogg, has not need more information from $25 this year to it gets out of hand. heard of any need for this district and they do than he has heard tonight. It could snowball, maybe $50 the next year, then $100 and $150, The press has not written on any need nor has the Town, so if nothing is broken, don't fix it. At this point, Mrs. Paino addressed the public, since she felt that all who wished to comment or question, had done so and as the public Oho hearing this eyeing was held for the purpose of reviewing the amended boundaries of the proposed ambulance district all had participated and added their input to the change in the boundaries and discussed other concerns as well. The bottom line to the residents, she realized is what is it going to cost and what will it provide, etc. This is the second public hearing on the subject matter, plus informal discussions and a prolonged discussion at a Town Board meeting, so the public should be well aware of what it entails and how the figures are arrived at. Other facts have to be known before a definite cost can be determined. Before any of this can take place, first of all the boundaries must be set in place and then the district formed as the Attorney explained previously. Sloper Willen's budget was discussed at the first hearing and estimated figures were given for the first map presented and the second map presented tonight and figures for both Proposal A & Proposal B pertaining to the boundaries. A large number of residents are evidently served by the Beacon Corps and were not happy about being taxes for a service that they receive free. This may not be a legal service for residents in the Chelsea area, so Mrs. Paino requested the Attorney to contact BVAC to learn first hand what they do provide and what area they serve at no charge and is this a permanent situation. It appears that the very people 060 who rejected the proposed ambulance district are now concerned about their future service and will BVAC continue it. The Attorney will investigate this plus other concerns on monies involved, whether they be donations or definite charges, will the Town have to make an arrangement with them, or will they stop this service since the Chelsea people can be included in our district, if that is what they want. All these questions must be This subject will be on the this evening and Mrs. Paino the proposed district until answered prior to any further action. Agenda of the Town Board meeting later recommended that they table action on further information is received. At that point they might want to follow up on suggestions from the residents recommendations to question the Chelsea residents on whether they want the service as presented. Once the boundaries are established they can proceed with the exact numbers of residents involved and the exact cost involved and this information will be available to the residents. Mr. Valdati wished to address Mrs. Schmalz and noted that during work shops with Sloper Willen the Board did receive a sheet which gave not so detailed budgetary considerations. It was broken down to personnel, buildings, grounds, ambulance equipment, supplies, what monies are raised by revenues, contributions, transfer standbys and formulas to determine how much use the Town would be requiring from Sloper Willen. It may not be as detailed as some residents were looking for but they did have budgetary figures from Sloper to justify the rates arrived at. Mrs. Schmalz thanked the Supervisor for having the public hearing announced on the radio stations today. MRS. PAINO moved to close the public hearing, seconded by Mr. Reis and unanimously carried. The Public Hearing closed at 8:27 P.H. Ambulance Distr. 12/7/87 P 779L9.. Elaine H. Snowden Town Clerk 3