Our Current Certificate of Need Situation

NAVAC is currently involved in an unusual situation regarding a Certificate of Need. We believe that the eventual outcome of this situation will not only have an impact of the NAVAC organization as it exists today, but more importantly, it will have an affect on the community and it's guests which we have served since 1970.

We are providing the following information with the intent to further inform and educate our community of this situation as well ask for their support.

Anyone wishing to obtain further information is asked to contact Chris Bitner, our Executive Director at (315) 458-7514.

1.) What is a CON?
2.) What Is The Current Issue Relating to NAVAC’s CON?
3.) What Area Has NAVAC Been Serving?
4.) What Area is Specified on NAVAC’s Ambulance Operating Certificate
5.) So What’s the Difference?
6.) So What’s the Real Issue Here?
7.) What Has Transpired Regarding This Issue?
8.) What Has NAVAC Done to Resolve This Issue Above and Beyond The Legal Process?
9.) This Sounds Like a Spirited Issue, Has Any Other Maneuvering Occurred?
10.) So is NAVAC Fighting For the Money Too?
11.) As a Resident of One of These Areas, Why Should I Care Which Ambulance Comes to My Aid?
12.) What is the Current Status of This Issue?
13.) Can I See NAVAC’s Application?
14.) As A Resident of This Area or Stake-holder to This Issue Do I Have Any Say In This Matter?


1.) What Is a CON?

The real name for a CON is “Ambulance Operating Certificate”, which is issued by the New York State Department of Health.  The Ambulance Operating Certificate authorizes an ambulance to operate, and specifies the exact geographic area in which it may operate.


2.) What Is The Current Issue Relating to NAVAC’s CON?

Back in 1975 NAVAC was issued an Ambulance Operating Certificate that specified a geographic area.   However since 1970 NAVAC has been serving a geographic area which is slightly larger than that specified on the Ambulance Operating Certificate.

In October 2006 a neighboring ambulance corps, the Northern Onondaga Volunteer Ambulance (NOVA), challenged NAVAC’s right to serve the area we have been serving for the past 38 years.


3.) What Area Has NAVAC Been Serving?

Click on Map for larger image.NAVAC has been the ambulance service that responds to all areas serviced by the following fire departments:

  • Bridgeport Fire Department (in Onondaga County)
  • Cicero Fire Department
  • Hinsdale Fire Department
  • Mattydale Fire Department
  • North Syracuse Fire Department
  • South Bay Fire Department

Additionally NAVAC has served the Syracuse Airport and a portion of the area served by the Clay Fire Department.

 


4.) What Area is Specified on NAVAC’s Ambulance Operating Certificate

The certificate says “the North Syracuse Central School District”


5.) So What’s the Difference?

The difference is a relatively small area as follows:

Click on Map for larger image.


Click on Map for larger image.The Following Addresses On the North Medical Center Campus
Janus Park Drive – all properties
5100 West Taft Road
5112 West Taft Road

The Following Addresses In the Town of Clay
Buckley Road – 7162 – 7227
Dolshire Drive – All
Hibiscus Drive – 100 and 200 blocks
Marilyn Avenue – 300 and 400 blocks
Sandra Drive - 300 block

The Following Addresses In the Town of Salina
Dolshire Terrace South
Needles Drive
Needles Lane
Odessa Circle
Orchard Road East and West
Princeton Court
Shane Drive
Vickery Road


Click on Map for larger image.

The Following Addresses In the Town of Cicero
East Taft Road – 6475 to Route 298 on north side of road

 

 

 

 

 

 

 

 

 


6.) So What’s the Real Issue Here?

The real issue at hand, at least for NOVA, is the approximately 1300 calls per year that occur at the North Medical Center. Ambulance organizations that focus on income view these as “easy money”:

  • they are at one geographic location
  • the time of the calls is more predictable than “typical” calls
  • they all require transportation to the hospital, which yield bills and income
  • everyone transported from North Medical Center has the ability to pay for the transport.  

A letter from NOVA's attorney to the judge presiding in the court case (described below) is illustrative of this.


7.) What Has Transpired Regarding This Issue?

Once this issue was raised by NOVA, NAVAC sought the advice of the New York State Department of Health, who had already received a complaint from NOVA.   The NYSDOH instructed NAVAC to apply for a “grand fathered CON”.  After submitting substantial documentation that NAVAC had indeed been serving this area the NYSDOH expanded NAVAC’s operating area.

This expanded operating area was rather large, and in fact overlaid portions of areas already served by Brewerton Volunteer Fire Department Ambulance, East Area Volunteer Emergency Services, and the Village of Minoa Emergency Medical Services.  Representatives of NAVAC met with representatives of these other ambulance services and assured them that we have no intention of trying to operate in the areas they already serve.   In the subsequent year NAVAC did not operate in any of these areas.

In response to this NYSDOH decision Brewerton Volunteer Fire Department Ambulance, NOVA, John Marko, Dan Prietti, and Michael Stassi together filed suit in New York State Supreme Court in September 2007 to have the NYSDOH’s decision overturned.   The judge in this case issued a decision in May 2008 that the NYSDOH acted beyond its authority and indeed overturned that decision.  Further he instructed that NAVAC apply to the Regional EMS Council to have its operating area expanded as specified in the Public Health Law.


8.) What Has NAVAC Done to Resolve This Issue Above and Beyond The Legal Process?

We had one meeting with NOVA in October 2006 at which representatives of NOVA voiced their concerns about NAVAC’s response area, and brought this issue to light.  Despite attempts to reach a compromise or cooperative arrangement, NOVA insisted that NAVAC was operating illegally and had to stop serving those areas.

Since that initial meeting NAVAC and NOVA met in February 2008, and NOVA declined to discuss anything relating to this issue.  

NAVAC’s executive director and NOVA’s operations manager met five times throughout 2007 and 2008.  During these conversations NAVAC offered to share calls at the North Medical Center; NOVA declined.

Representatives of NAVAC and NOVA had two subsequent meetings scheduled in October 2008, and NOVA cancelled both of those.

Going back in time, in January 2006 the then Town of Clay Supervisor met with representatives of NAVAC and NOVA and posed the question “why does the Town of Clay need two ambulance services?”  He then asked that we consider merging/consolidating.   NAVAC readily agreed to the idea; NOVA did not.

Later that year NOVA sought funding from the Town of Clay, and the town included a clause in a proposed contract that asked NOVA to engage in discussions with NAVAC about consolidation.  NOVA rejected the contract and the funding.


9.) This Sounds Like a Spirited Issue, Has Any Other Maneuvering Occurred?

NOVA sent a letter to the company that performs NAVAC’s billing, claimed that NAVAC’s “illegal” operation causes the billing company to be operating illegally as well, and encouraged that the company stop performing NAVAC’s billing.   The billing company researched this threat and found it to be insignificant.


10.) So is NAVAC Fighting For the Money Too?

For NAVAC there is a whole lot more to this issue than money.

NAVAC has grown to meet the increasing demand of its service area (including North Medical Center) over the past 15 years, at a rate of about 10% per year.  We have purchased equipment and hired staff during that time to meet that growing demand.  To suddenly have to scale-back our operation by 30% is a bit painful.

More notably there has always been a strong working relationship among the ambulance corps in Onondaga County, and NAVAC has always been very generous about helping our neighbors without expecting anything in return.  Now suddenly one of those neighbors has turned into what can only be described as a bully that is not willing to cooperate or negotiate to work out an issue.

Finally, and most importantly, NAVAC has served and been supported by a community for 38 years and we are not simply going to accept another agency’s demand to abandon that relationship.


11.) As a Resident of One of These Areas, Why Should I Care Which Ambulance Comes to My Aid?

Simply put:     Distance = Time = Best Opportunity to Save Lives

The further away an ambulance is the longer it will take to get to you.  During a medical or trauma emergency a paramedic-staffed ambulance brings the emergency department to you.  The longer it takes to get this emergency care to you, the greater the risk to the person who is critically ill or injured.   In this particular case NAVAC is located closer to you than NOVA. Ambulances however can be moved around, much like a coin beneath a shell.

Another important aspect of this is that NAVAC has been a partner in an emergency medical services team that has been responding to these areas since 1970.   These areas are located within the service areas of the Bridgeport, Hinsdale, Mattydale and North Syracuse fire departments; NAVAC has been the ambulance service that responds along side of these fire departments to all of their emergencies.  Additionally we train with these fire departments, and we review our work and issues that arise on calls with these departments. 

Should this application not be approved those partnerships will be broken, and NAVAC will no longer be the ambulance that works side by side with those fire departments on all of their calls.   Instead NAVAC will respond to calls in parts of their services areas, and other ambulances will respond to calls in the remaining parts.   The value of the day-to-day working relationships, training, and review will be lost, and ultimately the customers/patients will suffer from that.  This is more clearly explained in our application to expand our operating area, as described below.


12.) What is the Current Status of This Issue?

In July 2008 the Onondaga County 911 Center stopped dispatching NAVAC to these areas and began dispatching NOVA instead.

In November 2008 NAVAC submitted an application to the Central New York Regional Emergency Medical Services Council to expand our primary operating area to match that to which we have been responding since 1970.    An important point that seems to be frequently overlooked or misrepresented is that we only want to continue serving the areas that we have been serving since 1970; we do not want to take away anything from any other agency.


13.) Can I See NAVAC’s Application?

Excerpts are available here; it is very lengthy.   A copy may be requested in accordance with the Freedom of Information Act from the Central New York Regional Emergency Medical Services Council, whose contact information is noted below.  NAVAC will readily provide a copy as well.

As a part of this application NAVAC submitted considerable documentation of our 38 years of consistent service as the primary ambulance provider to these areas.  This includes statements from:

Moyers Corners Fire Department Ambulance, Director (retired), Debra Chandler.

Onondaga County Fire Control Dispatcher and Assistant Fire Coordinator (retired), Richard Beach

As a part of the application process NAVAC was required to solicit endorsement for this application from:

  • All ambulance and advanced life support first response services within the proposed operating area
  • All regional EMS Medical Directors
  • The Onondaga County EMS Coordinator and the chair of the Onondaga County EMS Advisory Board
  • All hospital CEOs in Onondaga County
  • All hospital emergency department directors in Onondaga County
  • The CEOs of all municipalities in Onondaga County
  • All ambulance services in areas adjacent to the proposed operating territory

In response letters were received from the following individuals:

Bridgeport Fire Department, Chief Paul Smith

Cicero Police Department, Chief Joseph Snell

Crouse Hospital, Department of Emergency Medicine, Medical Director, Richard Steinmann, M.D.

East Area Volunteer Emergency Services, President, Vincent Stevenson

New York State Police, Captain Jeffrey Raub

North Medical Center, A. John Merola M.D.

North Syracuse Fire Department, Chief Mark Hogan

Northern Onondaga Volunteer Ambulance,  President, Russ Ziskind & Director of Operations, John Marko

Rural Metro Medical Services, Division General Manager, Michael Addario

St. Joseph's Hospital Health Center, President, Theodore Pasinski

Town of Salina, Supervisor Mark Nicotra

Upstate Medical University, Department of Emergency Medicine, Christopher Fullagar, M.D.

Western Area Volunteer Emergency Services, Executive Director, Al Kalfass

Rural Metro Medical Services, Follow Up


14.) As A Resident of This Area or Stake-holder to This Issue Do I Have Any Say In This Matter?

Anyone can express his opinion on this matter by sending a letter to:

Warren Darby, Chairman
Central New York Regional Emergency Medical Services Council
Jefferson Tower, Suite LL1
50 Presidential Plaza
Syracuse, New York 13202

Any letters that are sent must state that the principle of “need” as defined by the Public Health Law is understood.  “Need” is defined in NYSDOH Policy Statement 06-06 as:

“The Demonstrated Absence, reduced abailability [sic] or an inadequate level of care in ambulance or emergency medical service available to a geographical area which is not readily correctable through the reallocation or improvement of existing resources”

Additionally the Regional Emergency Medical Services Council will be holding a hearing on this application; a date has yet to be established.  You are entitled to speak at this hearing.

 
 

603 North Main St. • North Syracuse, NY 13212 • Phone: (315) 458-7514 • Fax: (315) 458-3567

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