Preview
FILED: QUEENS COUNTY CLERK 06/04/2024 01:41 PM INDEX NO. 711706/2024
NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 06/04/2024
Bay Community Volunteer
Ambulance Corps
BAY
COMMUNITY
V
O
CORPS
Application for Operating Area Expansion
March 2021
FILED: QUEENS COUNTY CLERK 06/04/2024 01:41 PM INDEX NO. 711706/2024
NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 06/04/2024
Table of Contents
Introduction.................................................................................................................................................. 4
Proposed Area of Expansion......................................................................................................................... 5
Impact Statement......................................................................................................................................... 6
Positive Effects and Benefits ........................................................................................................................ 9
Public Need................................................................................................................................................. 10
New Expanded Service Description........................................................................................................ 10
Population Demographics ...................................................................................................................... 11
Description of Calls................................................................................................................................. 12
Response Times...................................................................................................................................... 13
of Service.................................................................................................................................... 14
Quality
Mutual Aid.............................................................................................................................................. 15
Employee/Member Qualifications ......................................................................................................... 16
Skill
Retention......................................................................................................................................... 17
Communications..................................................................................................................................... 18
Fiscal
......................................................................................................................................... 19
Stability
Organization and Administration ........................................................................................................... 20
Cost Benefit
Ratio................................................................................................................................... 21
............................................................................................................................... 22
Community Support
Government Support.............................................................................................................................. 23
Reallocation of Existing Resources......................................................................................................... 24
Statement from the Agency's Medical Director..................................................................................... 25
Appendix..................................................................................................................................................... 26
Proposed Operating Area Expansion...................................................................................................... 26
Sample Application Endorsement Letter................................................................................................ 29
Application Endorsement Letters Received ........................................................................................... 31
Acknowledgement......................................................................................... 57
Agency Medical Director
Request for Application Endorsement Solicitation List .......................................................................... 60
Application Endorsement Correspondence USPSMailing Receipts....................................................... 62
EMSService DOH#3777 ................................................................................ 72
NYSDOHApplication for
NYSDOHCompetency and Fitness DOH#3778 ..................................................................................... 76
Directors...................................................................................................................... 76
Agency Board of
................................................................................................................................ 94
Agency Biographies
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FILED: QUEENS COUNTY CLERK 06/04/2024 01:41 PM INDEX NO. 711706/2024
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Board of Directors .............................................................................................................................. 94
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FILED: QUEENS COUNTY CLERK 06/04/2024 01:41 PM INDEX NO. 711706/2024
NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 06/04/2024
Introduction
The Board of Directors of the Bay Community Volunteer Ambulance Corps submit the
following comprehensive application for a NewYok State Department of Health (NYS DOH)
Bureau of EMSexpansion of operating area.
The Bay Community Volunteer Ambulance Corps is looking to restore Bayside based volunteer
ambulance service to the Bayside community, in the county of Queens, back to January 2018
levels. in June of 2018, the Bayside Volunteer Ambulance Corps lost its NYSDOHoperating
certificate. Since then, the Bay Community Volunteer Ambulance Corps has extended all its
community services, such as education outreach, training, and mobility assistance equipment
loaners to the larger Bayside community, except for our ambulance service.
After an depth and careful review of our current fiscal, operational and administrative
in
components, we have concluded that the organization is properly positioned to enter into a
response area expansion, that would service the community of Bayside. The Bayside
Volunteer Ambulance Corps still exists today; it has a building in the heart of Bayside and
currently owns ambulances. Wehave entered into a strategic partnership with the Bayside
Community Volunteer Ambulance Corps to get these assets back to serving the Bayside
community.
Our interest based on restoring Bayside community-based volunteer EMS
to expand is
services to Bayside. Bayside was left with a void since the Bayside VACstopped its services in
June of 2018. Weare happy to undertake this initiative and look forward to providing our
recognized services to all of Bayside.
Contained within this document is information about our organization, its current capabilities,
and its ability to expand beyond its current borders.
FILED: QUEENS COUNTY CLERK 06/04/2024 01:41 PM INDEX NO. 711706/2024
NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 06/04/2024
Proposed Area of Expansion
The Bay Community Volunteer Ambulance Corps intends to expand its existing volunteer
community-based EMSservices into the Bayside community in Queens. The area is south of
our existing NYSDOHapproved operating community of North Bayside within Queens
Community Board 7 and Community Board 11.
This additional 3.1 square mile area expansion would take our service area south and slight
west, ending at the Long Island Expressway in Queens Community Board #11. Bay Community
111th POliCe
VAC already operates within a portion of Community Board #11 and the NYPD
precinct and has existing and established relationships with community members, elected
leaders and public safety officials.
24th
The expanded area comprises an area South of AVe betWeen CrOSS Island Parkway and
26th
Bell Boulevard, South of Ave between Bell Boulevard and the Clearview Expressway,
201st 26th Ave between
South of 23rd ÁVebetWeen ClearView Expressway and ST, South of
up to Long Island Expressway in Queens Community
201st St and Francis Lewis Boulevard
111th and 109tu Police Precincts.
Board 7 and 11, within the confines of the NYPD
23rd
The geographical area being requested bound by the Long Island Expressway in the South,
is
Lewis Blvd to
Ave, and 26th Ave in the North, Cross Island Pkwy in the East and Francis
24th
Ave,
the West. These boundaries are those that encompassed the previous Bayside Community
Volunteer Ambulance Corps.
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FILED: QUEENS COUNTY CLERK 06/04/2024 01:41 PM INDEX NO. 711706/2024
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Impact Statement
A)
The NewYork City region contains an extremely broad spectrum of EMSresource availability. There are
22 Commercial, 13 Hospital based and 2 Municipal agencies that are currently authorized to provide
EMSservices in the proposed area. In addition, there are 6 Volunteer EMSagencies that border the
proposed expansion area. Each agency provides varying levels and types of service to their respective
service delivery areas.
Many of these agencies retain the authority to provide service within all five counties of the NewYork
City region, while some provide service in dedicated areas, based on their delivery model or operating
certificate.
The Bay Community Volunteer Ambulance Corps was approved to operate a Volunteer EMSservice in
1968 and has since, provided Emergency Ambulance response, local non emergent transportation,
medical standbys at community events, as well as lifesaving training for the community in topics of
CPR/AED,Stop the Bleed, First Aid, What to do Until Help Arrives, as well as other civic/community
requested programs and speaking engagements.
Since its inception, community has been the North Eastern Queens community of North
our operating
Bayside, which includes Bay Terrace, Fort Totten and East Clearview communities. In 1996, due to the
Base Realignment and Closure program (BRAC) military housing closed on Fort Totten, Bay Community
VAClost over 100 acres of housing in our operating area. Since then, Fort Totten has had no residents
and has mostly become a park. Bay Community VAChas maintained the same operational capacity
while serving a decreased population.
The agency operates as a BLS service and complies with minimum NewYork State Department of Health
and Regional staffing parameters, as necessitated.
Our response times to Emergency assignments average 4.75 minutes. Our organization on average
handles 150 calls for assistance annually. The volume is predicated around a population that is located
near health facilities and historically does not call for EMSunless they are not capable of self-
transporting to their local personal care physicians or Emergency departments.
The Bay Community Volunteer Ambulance Corps participates in the Regional Volunteer EMSMutual Aid
Plan, as dictated in NYSDOHpolicy statement 12-06. Whenwe are unable to respond to a request for
response, the call is transferred to an adjoining EMSagency or the FDNYEMS911 system, as available.
The current service delivery model provided by Municipal, Commercial and Hospital based EMSservices
that have authority in the affected area can operate at the ALSlevel of care. Adjacent Volunteer EMS
providers operate only at the BLS level.
It is our belief that there will be no adverse financial impact to any of the above referenced service
models, as this proposed area expansion will restore a previously existing community-based volunteer
EMSresource that ceased to provide ambulance service due to poor management, after over 50 years.
The service delivery models of each of these service providers do not support the multi-faceted
approach and services of a community centric EMSservice that is designed to service a particular
geographic population that remains within their community.
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As previously noted, there are also no adverse effects on existing services. There would be no loss in call
volume to the commercial and hospital sectors, whose models do not include servicing and remaining in
community area only. It is to be noted that no other authorized provider has solicited
or
a particular
provided information to these prospective communities, to contact them for EMSservices, nor have
interest to
there been any advertisements placed in the local online and print periodicals, showing their
as they
service these communities as well. The adjacent volunteer services are not adversely affected,
have no current NYSDOHoperating authority in the prescribed area, per NYSArticle
30.
B)
As previously stated, the NewYork an extremely broad spectrum of EMSresource
City region contains
availability. Currently, there are 22 Commercial, 13 Hospital based, 2 Municipal and 31 Volunteer EMS
agencies that provide varying levels and types of service to their respective service delivery areas.
the authority to provide service within five counties of the NewYork
Many of these agencies retain all
while some provide service in dedicated areas based on delivery model or operating
City region,
certificate.
as Level 1
The proposed area consists of Four (4) primary area hospitals. 2 of these facilities are certified
Trauma and Thrombectomy Centers, with another, categorized as a Stroke and STEMIcenter. These
facilities generate Non-Emergent/Non-EMS call volume that is supported by their Institution's Core EMS
Transportation network. The anticipated expansion would have no impact on these services, as they
currently are self-supported, and our current service delivery model does not include specialty,
interfacility or discharge EMSservices.
in Two (2) Regional EMSparticipation agreements. The first is
Bay Community VACcurrently participates
01/2013), which conforms to NYSDOH
the NYCVolunteer EMSRegional Mutual Aid Plan (instituted
Plan, which was most
Policy Statement #12-03, as well as the REMSCO
of NYCMutual Aid Mobilization
recently instituted on behalf of the FDNYfor the COVID-19daily EMSresponse.
Communications systems for our agency are laid out in Three (3) ways. First, our organization maintains
its own Two-WayRadio system for daily dispatch and notification. Second, is a regional system for
amongst other volunteer EMSpartners in Queens County. Thirdly, when operating
interoperability
within the EMS911 system, our daily activity is dispatched and coordinated via the FDNYEMS
Communications Center (PSAC). Our agency also employs other point-to-point methods of
communicating with resources when we deploy for local and civic
medical standby events.
Medical Director, Dr. Robert Crupi, who is intimately
Bay Community VACworks closely with our agency
involved in the medical and patient care delivery aspect of our operation. He has served as our medical
director for over 20 years. Together with our Training Committee and officers, they regularly discuss
model.
current and emergent procedures and how they affect our operation and patient care delivery
provides EMSCall Review Sessions available to us, and other agencies in our current
Dr. Crupi regularly
and neighboring region could attend and discuss various relative EMScall scenarios. Dr. Crupi also
and oversight of our BLS medical care capabilities and engages regularly with our
provides the authority
Quality Improvement team. EMSMedical Direction is provided by New York-Presbyterian Brooklyn
Methodist Hospital OLMC facility. Our agency, via NYSDOH, REMAC,as well as internal Standard
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Operating Procedures, follows applicable protocols and general operating procedures, as provided, for
our CFRand EMT providers.
Currently, Bay Community VACregularly utilizes area hospitals as their final patient destination. These
include, Long Island Jewish Medical Center, North Shore University Hospital, NewYork Presbyterian
Queens, and Flushing Hospital.
From an economic viewpoint, this area expansion is of zero cost to the regional and other EMSdelivery
models. Our organization will provide community-based responses and other services to this
geographical area without additional expense, while providing additional EMSresources. This method
will better utilize the existing resources within our organization as well as the assets of the Bayside VAC,
which the residents of Bayside provided via donations for over 50 years, to augment the underserved
communities of Bayside, which, in 1955, had established a need for additional EMSresources.
Unfortunately, Community Volunteer Ambulance Corps officially
the vibrant Bayside ceased to operate
ambulance service in June of 2018. Based on data provided for responses within this area, we believe
the need for additional EMSservices remain, as shown by various response time data to be provided
within this document. In manycases, 911 EMSresponse times are close to Eight (8) Minutes for priority
assignments, which is above the average when compared to all of Eastern Queens. Bay Community VAC
maintains a 3-5 minute critical or life-threatening emergency response time, as provided by our
response and care reporting data. This is significantly below the current area average. Although one
would argue that the current Municipal or Commercial system could easily solve this problem by
allocating additional resources to this area, the Municipal system does not retain the requisite staffing
to do such deployment, as evidenced by the current and previous public promotions of "understaffing".
Currently, Basic Life Support ambulance resources are placed at the outlying areas of the intended
communities, to service a larger geographical area. This opens the door to leaving this area uncovered
when they are dispatched into other communities due to increased volume.
During EMScall surge ambulances need to be reallocated throughout the borough, etc. to
scenarios,
satisfy the increased COVID-19 EMSCall surge, ambulances were not
need. As recent as the previous
readily available and additional EMSresources were activated from the Volunteer and FEMAsectors. It
is true that this was unprecedented; however, the system's daily response model does leave room for
response vacancies in this proposed expanded area.
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Positive Effects and Benefits
The proposed area expansion would benefit the community and our organization in manyways. First
and foremost, the expansion would provide for improved and expanded EMSResource utilization with
existing resources immediately. There would be no inherent delay to operationalize our response within
the proposed expansion area. Bay Community VAChas secured the right to use an ambulance currently
owned by Bayside VACand to garage it at their building at 214-29 42 Ave centrally located in the area of
expansion. This would place an additional ambulance in Bayside like had existed previously in early
2018.
It also promotes an infusion of already existing BLS resources without cost to the City of NewYork and
patients, while assisting in the reduction in critical call response times.
As in our current service delivery model, we would provide Emergency Medical Standby teams at local
community and civic events. Although we sometimes receive contributions for these services, our
service and scheduling are not predicated on a predetermined mandate of fees paid for services
rendered.
As has been the practice manyyears, our expanded operations base would permit increased training
for
resources and opportunities for new EMTsthat wish to enter the region's EMSsystem. Training would
also be done out of Bayside VACbuilding as well as our headquarters on Fort Totten. Many of our
mentors and trainers possess decades of EMSexperience and would continue to serve as a valuable tool
for training new providers. These volunteer providers are able to gain experience and exposure while
attending school or remaining in their current employment.
Bay Community VACwill continue its outreach of offerings to the expanded communities for training in
life-saving procedures - CPR/AED, First Aid, Stop the Bleed, and opiate overdose awareness. Bay
Community VACwill also continue to provide mobility assistance equipment to the Bayside community.
Lastly, our agency has maintained an active youth squad for over 30 years. This permits teenagers 14-17
to meet, trainand develop critical thinking and lifesaving Over the past generations, many more
skills.
have gone on to become excellent doctors, nurses, EMTs, paramedics, and respected leaders in the
emergency medical field.
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Public Need
New Expanded Service Description
The Bay Community Volunteer Ambulance Corps intends to expand its current operating area
into the adjacent community, utilizing its Two (2) Modular-Type ambulances as well as, if
granted, placing 1 additional Modular-Type ambulance out of the garage at
into operation
214-29 42 Ave, into an adjacent area that has been left without community-based EMSsince
the NYSDOH operating certificate for Bayside Community VACwas surrendered in May 2018.
The additional communities that encompass this 3.1 square mile area include Bayside, Bayside
Hills and Oakland Gardens. Currently, Bay Community VACis authorized to operate in a
portion of Bayside. This additional area would add to our existing community of service within
Queens County of North Bayside.
Our volunteer staff has averaged 25 to 30 volunteers who are EMTs, CFRsand First Aid/CPR
certified drivers in our agencies over 50-year history. Scheduling of these EMSproviders is
based around a 4 Tour per day model, inclusive of in-house and on-call crews. This pattern of
operation is available to the communities we service 24/7/365.
Ambulances fielded by our organization consist by the NYSDOH
of staffing patterns regulated
and NYC REMACas indicated. Our minimum base crews consist of One Emergency Vehicle
Operator and One EMTfor a Basic Life Support crew. Typically, our ambulances are staffed
above this minimum with 2 EMTs on a BLS crew.
Our services are made available community 24 hours a day, seven days a week.
to our service
Weutilize in-house and on call area crews to handle the calls as indicated. Our telephone lines
are answered 24/7 and have direct communication and two-way alerting of our responding
volunteers.
As approved by NYSDOH, our agency is authorized to provide BLS EMSservices; our operating
certificate has just been renewed and we are certified until February 2023.
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Population Demographics
Bayside is a neighborhood in the NewYork City borough of Queens. It is bounded by
Whitestone to the northwest, the East River to the north, the Long Island Sound and
Little Neck Bay to the northeast, Douglaston to the east, Bellerose and Floral Park to the
southeast, Queens Village to the south, Hollis to the southwest, and Fresh Meadows to
the west. It is in Queens Community Board # 7 and 11 and is patrolled by the NewYork
109th preCinCt and 111th Precinct.
City Police Department's Politically, Bayside is
represented by the NewYork City Council's 19th and 23rd Districts.
Based on data from the 2010 United States Census, the population of Bayside was 43,808,
Covering an area of 1,857.24 acres the neighborhood has a population density of 23.6
inhabitants per acre (15,100/sq mi; 5,800/km2).
The NYCHealth's 2018 Community Health Profile indicates an average life expectancy for these
communities as 84.7 years. This is higher than the median life expectancy of 81.2 for all New
York City neighborhoods. Most inhabitants are youth and middle-aged adults: 19% are between
the ages of 0-17, 26%between 25-44, and 31%between 45-64. The ratio of college-aged and
elderly residents was lower, at 6%and 18% respectively.
The population of these communities listed above is a static estimate. Weproject that this
value significantly increases dynamically, by an additional 75%during daily business, school,
restaurant, and congregant traffic. The area in question continues to see a rise in house sales,
reconstruction, and business expansion, thus dictating an increased need for EMSservices in
the area. Many of the small one-family style homes have been converted, due to large lot sizes,
into larger structures, which can now house or multifamily
larger units. Although not always
reflected accurately in standard population databases, these inherent increases, although not
as readily identifiable, continue to play a role in the population increase, traffic flow and need
for services.
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Description of Calls
As researched the NYCOpen Data website, we have been able to determine that there
via
were approximately 2,871 requests for EMSassistance for calendar year 2019 within the
proposed expansion area. Of these calls, approximately 1,080 (38%) of these requests were of
high priority, according to the FDNYEMSsystem of typing EMSassignments. This yields on
average, 7.87 calls per 24-hour period
Based on the projections and observations, it becomes more evident that the placement of
additional municipal or commercial resources would be cost-and/or volume prohibitive, as it
would detract from areas currently more underserved and with even higher volumes of calls,
needs or response times. However, it is apparent that permitting the expansion by Bay
Community VAC into this area, would help reduce delays in responses to this area, without
additional costs. In essence, it would better utilize existing and restore community resources,
which would in turn have a multi-beneficial outcome for the community, as well as the regional
EMSsystem.
Bay Community VACpredicted an annual increase to its annual call volume would yield an
additional 150 responses, at minimum in the first year, totaling approximately 300 total
responses for the new combined areas.
Direct Dial, Mutual Aid from adjacent EMSpartners, 911 Activations and Inquiries when our
agency is closest to a priority assignment, are the methods for the agency's receipts of requests
for various levels of EMSassistance and response.
our operational
Initially, plan is to garage an additional ambulance, such that we can maintain
our 3-5-minute response time to our expanded, as well as the existing response areas.
The following EMSHospital destinations
are currently utilized by our crews when transporting
patients and will be employed under the area expansion.
Long Island Jewish Medical Center - New Hyde Park, NY
North Shore University Hospital -
Manhasset, NY
NewYork Presbyterian Queens - Flushing, NY
Flushing Hospital - Flushing, NY
St Francis Hospital -
Roslyn, NY
NYUWinthrop Hospital -
Mineola, NY
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Response Times
Bay Community's average response time in the previous year (2020)
was 5 Minutes and strives
calls. The
to maintain a response time range for all emergencies of 3-5 minutes for critical
available priority EMSresponse statistics comparisons available for the FDNYEMSsystem in
the previous Three (3) years (2017, 2018, 2019) in this protracted area in consideration,
yielded response averages of 07:57, 08:04 and 07:47 respectively. This response time data is
also compared to the same statistical values for the entire East Queens Community (East of the
Van Wyck Expy), whereby these response values were lower overall at 06:50, 07:04 and 07:19
respectively in the same period. As noted, our response time values are over 2 minutes lower in
each segment. This decrease can directly be linked to the patient's overall prognosis.
Data for EMSrequested by local medical facilities is not readily available, nor is it reported.
Historically, these facilities contract privately for services based on need and the abilities of
the inherent provider.
Unfortunately, the relatively volume for this small area does not dictate
low annual call
placement of significant levels of EMSresources. As such, although Municipal, Hospital and
Commercial EMSDelivery models may assign a particular resource into a segment of this area,
it is often assigned or re-deployed to calls or areas that necessitate the need. This leaves the
proposed area uncovered. This then requires other resources to backfill the area's call volume,
oftentimes, from greater distances than is optimal.
This circumstance is a slippery slope to navigate, as agencies must determine the
placement of resources based on need and overall response times.
Our agency's model has always been community-based; as such, we maintain our
availability within our service area, thereby maintaining our target response times.
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Quality of Service
Currently, there is no standard metric place to develop a reporting
in model on the
Quality of services and their effects. When you look at Certifications and baseline
our CFRsand EMTs are subject to the
training, identical State and Regional credentialing
programs and procedures.
receives certification from the credentialing body, there appears
However, once the clinician
to be a distinct disparity in their agency-based orientation and training, prior to being
released as a lead provider.
Bay Community VACis proud of our orientation program, whereby any new entry CFR, EMT,
or Driver, must complete in-person ambulance orientation and agency specific medical device
and medication training/review.
Wehave transitioned all our patient care records from paper to electronic. Weare using
our second E-PCRprogram. Weoffer regular in-house training provided by our members
who are NYSEMTsas well as being higher
Preview
FILED: QUEENS COUNTY CLERK 06/04/2024 01:41 PM INDEX NO. 711706/2024 NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 06/04/2024 Bay Community Volunteer Ambulance Corps BAY COMMUNITY V O CORPS Application for Operating Area Expansion March 2021 FILED: QUEENS COUNTY CLERK 06/04/2024 01:41 PM INDEX NO. 711706/2024 NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 06/04/2024 Table of Contents Introduction.................................................................................................................................................. 4 Proposed Area of Expansion......................................................................................................................... 5 Impact Statement......................................................................................................................................... 6 Positive Effects and Benefits ........................................................................................................................ 9 Public Need................................................................................................................................................. 10 New Expanded Service Description........................................................................................................ 10 Population Demographics ...................................................................................................................... 11 Description of Calls................................................................................................................................. 12 Response Times...................................................................................................................................... 13 of Service.................................................................................................................................... 14 Quality Mutual Aid.............................................................................................................................................. 15 Employee/Member Qualifications ......................................................................................................... 16 Skill Retention......................................................................................................................................... 17 Communications..................................................................................................................................... 18 Fiscal ......................................................................................................................................... 19 Stability Organization and Administration ........................................................................................................... 20 Cost Benefit Ratio................................................................................................................................... 21 ............................................................................................................................... 22 Community Support Government Support.............................................................................................................................. 23 Reallocation of Existing Resources......................................................................................................... 24 Statement from the Agency's Medical Director..................................................................................... 25 Appendix..................................................................................................................................................... 26 Proposed Operating Area Expansion...................................................................................................... 26 Sample Application Endorsement Letter................................................................................................ 29 Application Endorsement Letters Received ........................................................................................... 31 Acknowledgement......................................................................................... 57 Agency Medical Director Request for Application Endorsement Solicitation List .......................................................................... 60 Application Endorsement Correspondence USPSMailing Receipts....................................................... 62 EMSService DOH#3777 ................................................................................ 72 NYSDOHApplication for NYSDOHCompetency and Fitness DOH#3778 ..................................................................................... 76 Directors...................................................................................................................... 76 Agency Board of ................................................................................................................................ 94 Agency Biographies 2 FILED: QUEENS COUNTY CLERK 06/04/2024 01:41 PM INDEX NO. 711706/2024 NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 06/04/2024 Board of Directors .............................................................................................................................. 94 3 FILED: QUEENS COUNTY CLERK 06/04/2024 01:41 PM INDEX NO. 711706/2024 NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 06/04/2024 Introduction The Board of Directors of the Bay Community Volunteer Ambulance Corps submit the following comprehensive application for a NewYok State Department of Health (NYS DOH) Bureau of EMSexpansion of operating area. The Bay Community Volunteer Ambulance Corps is looking to restore Bayside based volunteer ambulance service to the Bayside community, in the county of Queens, back to January 2018 levels. in June of 2018, the Bayside Volunteer Ambulance Corps lost its NYSDOHoperating certificate. Since then, the Bay Community Volunteer Ambulance Corps has extended all its community services, such as education outreach, training, and mobility assistance equipment loaners to the larger Bayside community, except for our ambulance service. After an depth and careful review of our current fiscal, operational and administrative in components, we have concluded that the organization is properly positioned to enter into a response area expansion, that would service the community of Bayside. The Bayside Volunteer Ambulance Corps still exists today; it has a building in the heart of Bayside and currently owns ambulances. Wehave entered into a strategic partnership with the Bayside Community Volunteer Ambulance Corps to get these assets back to serving the Bayside community. Our interest based on restoring Bayside community-based volunteer EMS to expand is services to Bayside. Bayside was left with a void since the Bayside VACstopped its services in June of 2018. Weare happy to undertake this initiative and look forward to providing our recognized services to all of Bayside. Contained within this document is information about our organization, its current capabilities, and its ability to expand beyond its current borders. FILED: QUEENS COUNTY CLERK 06/04/2024 01:41 PM INDEX NO. 711706/2024 NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 06/04/2024 Proposed Area of Expansion The Bay Community Volunteer Ambulance Corps intends to expand its existing volunteer community-based EMSservices into the Bayside community in Queens. The area is south of our existing NYSDOHapproved operating community of North Bayside within Queens Community Board 7 and Community Board 11. This additional 3.1 square mile area expansion would take our service area south and slight west, ending at the Long Island Expressway in Queens Community Board #11. Bay Community 111th POliCe VAC already operates within a portion of Community Board #11 and the NYPD precinct and has existing and established relationships with community members, elected leaders and public safety officials. 24th The expanded area comprises an area South of AVe betWeen CrOSS Island Parkway and 26th Bell Boulevard, South of Ave between Bell Boulevard and the Clearview Expressway, 201st 26th Ave between South of 23rd ÁVebetWeen ClearView Expressway and ST, South of up to Long Island Expressway in Queens Community 201st St and Francis Lewis Boulevard 111th and 109tu Police Precincts. Board 7 and 11, within the confines of the NYPD 23rd The geographical area being requested bound by the Long Island Expressway in the South, is Lewis Blvd to Ave, and 26th Ave in the North, Cross Island Pkwy in the East and Francis 24th Ave, the West. These boundaries are those that encompassed the previous Bayside Community Volunteer Ambulance Corps. 5 FILED: QUEENS COUNTY CLERK 06/04/2024 01:41 PM INDEX NO. 711706/2024 NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 06/04/2024 Impact Statement A) The NewYork City region contains an extremely broad spectrum of EMSresource availability. There are 22 Commercial, 13 Hospital based and 2 Municipal agencies that are currently authorized to provide EMSservices in the proposed area. In addition, there are 6 Volunteer EMSagencies that border the proposed expansion area. Each agency provides varying levels and types of service to their respective service delivery areas. Many of these agencies retain the authority to provide service within all five counties of the NewYork City region, while some provide service in dedicated areas, based on their delivery model or operating certificate. The Bay Community Volunteer Ambulance Corps was approved to operate a Volunteer EMSservice in 1968 and has since, provided Emergency Ambulance response, local non emergent transportation, medical standbys at community events, as well as lifesaving training for the community in topics of CPR/AED,Stop the Bleed, First Aid, What to do Until Help Arrives, as well as other civic/community requested programs and speaking engagements. Since its inception, community has been the North Eastern Queens community of North our operating Bayside, which includes Bay Terrace, Fort Totten and East Clearview communities. In 1996, due to the Base Realignment and Closure program (BRAC) military housing closed on Fort Totten, Bay Community VAClost over 100 acres of housing in our operating area. Since then, Fort Totten has had no residents and has mostly become a park. Bay Community VAChas maintained the same operational capacity while serving a decreased population. The agency operates as a BLS service and complies with minimum NewYork State Department of Health and Regional staffing parameters, as necessitated. Our response times to Emergency assignments average 4.75 minutes. Our organization on average handles 150 calls for assistance annually. The volume is predicated around a population that is located near health facilities and historically does not call for EMSunless they are not capable of self- transporting to their local personal care physicians or Emergency departments. The Bay Community Volunteer Ambulance Corps participates in the Regional Volunteer EMSMutual Aid Plan, as dictated in NYSDOHpolicy statement 12-06. Whenwe are unable to respond to a request for response, the call is transferred to an adjoining EMSagency or the FDNYEMS911 system, as available. The current service delivery model provided by Municipal, Commercial and Hospital based EMSservices that have authority in the affected area can operate at the ALSlevel of care. Adjacent Volunteer EMS providers operate only at the BLS level. It is our belief that there will be no adverse financial impact to any of the above referenced service models, as this proposed area expansion will restore a previously existing community-based volunteer EMSresource that ceased to provide ambulance service due to poor management, after over 50 years. The service delivery models of each of these service providers do not support the multi-faceted approach and services of a community centric EMSservice that is designed to service a particular geographic population that remains within their community. 6 FILED: QUEENS COUNTY CLERK 06/04/2024 01:41 PM INDEX NO. 711706/2024 NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 06/04/2024 As previously noted, there are also no adverse effects on existing services. There would be no loss in call volume to the commercial and hospital sectors, whose models do not include servicing and remaining in community area only. It is to be noted that no other authorized provider has solicited or a particular provided information to these prospective communities, to contact them for EMSservices, nor have interest to there been any advertisements placed in the local online and print periodicals, showing their as they service these communities as well. The adjacent volunteer services are not adversely affected, have no current NYSDOHoperating authority in the prescribed area, per NYSArticle 30. B) As previously stated, the NewYork an extremely broad spectrum of EMSresource City region contains availability. Currently, there are 22 Commercial, 13 Hospital based, 2 Municipal and 31 Volunteer EMS agencies that provide varying levels and types of service to their respective service delivery areas. the authority to provide service within five counties of the NewYork Many of these agencies retain all while some provide service in dedicated areas based on delivery model or operating City region, certificate. as Level 1 The proposed area consists of Four (4) primary area hospitals. 2 of these facilities are certified Trauma and Thrombectomy Centers, with another, categorized as a Stroke and STEMIcenter. These facilities generate Non-Emergent/Non-EMS call volume that is supported by their Institution's Core EMS Transportation network. The anticipated expansion would have no impact on these services, as they currently are self-supported, and our current service delivery model does not include specialty, interfacility or discharge EMSservices. in Two (2) Regional EMSparticipation agreements. The first is Bay Community VACcurrently participates 01/2013), which conforms to NYSDOH the NYCVolunteer EMSRegional Mutual Aid Plan (instituted Plan, which was most Policy Statement #12-03, as well as the REMSCO of NYCMutual Aid Mobilization recently instituted on behalf of the FDNYfor the COVID-19daily EMSresponse. Communications systems for our agency are laid out in Three (3) ways. First, our organization maintains its own Two-WayRadio system for daily dispatch and notification. Second, is a regional system for amongst other volunteer EMSpartners in Queens County. Thirdly, when operating interoperability within the EMS911 system, our daily activity is dispatched and coordinated via the FDNYEMS Communications Center (PSAC). Our agency also employs other point-to-point methods of communicating with resources when we deploy for local and civic medical standby events. Medical Director, Dr. Robert Crupi, who is intimately Bay Community VACworks closely with our agency involved in the medical and patient care delivery aspect of our operation. He has served as our medical director for over 20 years. Together with our Training Committee and officers, they regularly discuss model. current and emergent procedures and how they affect our operation and patient care delivery provides EMSCall Review Sessions available to us, and other agencies in our current Dr. Crupi regularly and neighboring region could attend and discuss various relative EMScall scenarios. Dr. Crupi also and oversight of our BLS medical care capabilities and engages regularly with our provides the authority Quality Improvement team. EMSMedical Direction is provided by New York-Presbyterian Brooklyn Methodist Hospital OLMC facility. Our agency, via NYSDOH, REMAC,as well as internal Standard 7 FILED: QUEENS COUNTY CLERK 06/04/2024 01:41 PM INDEX NO. 711706/2024 NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 06/04/2024 Operating Procedures, follows applicable protocols and general operating procedures, as provided, for our CFRand EMT providers. Currently, Bay Community VACregularly utilizes area hospitals as their final patient destination. These include, Long Island Jewish Medical Center, North Shore University Hospital, NewYork Presbyterian Queens, and Flushing Hospital. From an economic viewpoint, this area expansion is of zero cost to the regional and other EMSdelivery models. Our organization will provide community-based responses and other services to this geographical area without additional expense, while providing additional EMSresources. This method will better utilize the existing resources within our organization as well as the assets of the Bayside VAC, which the residents of Bayside provided via donations for over 50 years, to augment the underserved communities of Bayside, which, in 1955, had established a need for additional EMSresources. Unfortunately, Community Volunteer Ambulance Corps officially the vibrant Bayside ceased to operate ambulance service in June of 2018. Based on data provided for responses within this area, we believe the need for additional EMSservices remain, as shown by various response time data to be provided within this document. In manycases, 911 EMSresponse times are close to Eight (8) Minutes for priority assignments, which is above the average when compared to all of Eastern Queens. Bay Community VAC maintains a 3-5 minute critical or life-threatening emergency response time, as provided by our response and care reporting data. This is significantly below the current area average. Although one would argue that the current Municipal or Commercial system could easily solve this problem by allocating additional resources to this area, the Municipal system does not retain the requisite staffing to do such deployment, as evidenced by the current and previous public promotions of "understaffing". Currently, Basic Life Support ambulance resources are placed at the outlying areas of the intended communities, to service a larger geographical area. This opens the door to leaving this area uncovered when they are dispatched into other communities due to increased volume. During EMScall surge ambulances need to be reallocated throughout the borough, etc. to scenarios, satisfy the increased COVID-19 EMSCall surge, ambulances were not need. As recent as the previous readily available and additional EMSresources were activated from the Volunteer and FEMAsectors. It is true that this was unprecedented; however, the system's daily response model does leave room for response vacancies in this proposed expanded area. 8 FILED: QUEENS COUNTY CLERK 06/04/2024 01:41 PM INDEX NO. 711706/2024 NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 06/04/2024 Positive Effects and Benefits The proposed area expansion would benefit the community and our organization in manyways. First and foremost, the expansion would provide for improved and expanded EMSResource utilization with existing resources immediately. There would be no inherent delay to operationalize our response within the proposed expansion area. Bay Community VAChas secured the right to use an ambulance currently owned by Bayside VACand to garage it at their building at 214-29 42 Ave centrally located in the area of expansion. This would place an additional ambulance in Bayside like had existed previously in early 2018. It also promotes an infusion of already existing BLS resources without cost to the City of NewYork and patients, while assisting in the reduction in critical call response times. As in our current service delivery model, we would provide Emergency Medical Standby teams at local community and civic events. Although we sometimes receive contributions for these services, our service and scheduling are not predicated on a predetermined mandate of fees paid for services rendered. As has been the practice manyyears, our expanded operations base would permit increased training for resources and opportunities for new EMTsthat wish to enter the region's EMSsystem. Training would also be done out of Bayside VACbuilding as well as our headquarters on Fort Totten. Many of our mentors and trainers possess decades of EMSexperience and would continue to serve as a valuable tool for training new providers. These volunteer providers are able to gain experience and exposure while attending school or remaining in their current employment. Bay Community VACwill continue its outreach of offerings to the expanded communities for training in life-saving procedures - CPR/AED, First Aid, Stop the Bleed, and opiate overdose awareness. Bay Community VACwill also continue to provide mobility assistance equipment to the Bayside community. Lastly, our agency has maintained an active youth squad for over 30 years. This permits teenagers 14-17 to meet, trainand develop critical thinking and lifesaving Over the past generations, many more skills. have gone on to become excellent doctors, nurses, EMTs, paramedics, and respected leaders in the emergency medical field. 9 FILED: QUEENS COUNTY CLERK 06/04/2024 01:41 PM INDEX NO. 711706/2024 NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 06/04/2024 Public Need New Expanded Service Description The Bay Community Volunteer Ambulance Corps intends to expand its current operating area into the adjacent community, utilizing its Two (2) Modular-Type ambulances as well as, if granted, placing 1 additional Modular-Type ambulance out of the garage at into operation 214-29 42 Ave, into an adjacent area that has been left without community-based EMSsince the NYSDOH operating certificate for Bayside Community VACwas surrendered in May 2018. The additional communities that encompass this 3.1 square mile area include Bayside, Bayside Hills and Oakland Gardens. Currently, Bay Community VACis authorized to operate in a portion of Bayside. This additional area would add to our existing community of service within Queens County of North Bayside. Our volunteer staff has averaged 25 to 30 volunteers who are EMTs, CFRsand First Aid/CPR certified drivers in our agencies over 50-year history. Scheduling of these EMSproviders is based around a 4 Tour per day model, inclusive of in-house and on-call crews. This pattern of operation is available to the communities we service 24/7/365. Ambulances fielded by our organization consist by the NYSDOH of staffing patterns regulated and NYC REMACas indicated. Our minimum base crews consist of One Emergency Vehicle Operator and One EMTfor a Basic Life Support crew. Typically, our ambulances are staffed above this minimum with 2 EMTs on a BLS crew. Our services are made available community 24 hours a day, seven days a week. to our service Weutilize in-house and on call area crews to handle the calls as indicated. Our telephone lines are answered 24/7 and have direct communication and two-way alerting of our responding volunteers. As approved by NYSDOH, our agency is authorized to provide BLS EMSservices; our operating certificate has just been renewed and we are certified until February 2023. 10 FILED: QUEENS COUNTY CLERK 06/04/2024 01:41 PM INDEX NO. 711706/2024 NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 06/04/2024 Population Demographics Bayside is a neighborhood in the NewYork City borough of Queens. It is bounded by Whitestone to the northwest, the East River to the north, the Long Island Sound and Little Neck Bay to the northeast, Douglaston to the east, Bellerose and Floral Park to the southeast, Queens Village to the south, Hollis to the southwest, and Fresh Meadows to the west. It is in Queens Community Board # 7 and 11 and is patrolled by the NewYork 109th preCinCt and 111th Precinct. City Police Department's Politically, Bayside is represented by the NewYork City Council's 19th and 23rd Districts. Based on data from the 2010 United States Census, the population of Bayside was 43,808, Covering an area of 1,857.24 acres the neighborhood has a population density of 23.6 inhabitants per acre (15,100/sq mi; 5,800/km2). The NYCHealth's 2018 Community Health Profile indicates an average life expectancy for these communities as 84.7 years. This is higher than the median life expectancy of 81.2 for all New York City neighborhoods. Most inhabitants are youth and middle-aged adults: 19% are between the ages of 0-17, 26%between 25-44, and 31%between 45-64. The ratio of college-aged and elderly residents was lower, at 6%and 18% respectively. The population of these communities listed above is a static estimate. Weproject that this value significantly increases dynamically, by an additional 75%during daily business, school, restaurant, and congregant traffic. The area in question continues to see a rise in house sales, reconstruction, and business expansion, thus dictating an increased need for EMSservices in the area. Many of the small one-family style homes have been converted, due to large lot sizes, into larger structures, which can now house or multifamily larger units. Although not always reflected accurately in standard population databases, these inherent increases, although not as readily identifiable, continue to play a role in the population increase, traffic flow and need for services. 11 FILED: QUEENS COUNTY CLERK 06/04/2024 01:41 PM INDEX NO. 711706/2024 NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 06/04/2024 Description of Calls As researched the NYCOpen Data website, we have been able to determine that there via were approximately 2,871 requests for EMSassistance for calendar year 2019 within the proposed expansion area. Of these calls, approximately 1,080 (38%) of these requests were of high priority, according to the FDNYEMSsystem of typing EMSassignments. This yields on average, 7.87 calls per 24-hour period Based on the projections and observations, it becomes more evident that the placement of additional municipal or commercial resources would be cost-and/or volume prohibitive, as it would detract from areas currently more underserved and with even higher volumes of calls, needs or response times. However, it is apparent that permitting the expansion by Bay Community VAC into this area, would help reduce delays in responses to this area, without additional costs. In essence, it would better utilize existing and restore community resources, which would in turn have a multi-beneficial outcome for the community, as well as the regional EMSsystem. Bay Community VACpredicted an annual increase to its annual call volume would yield an additional 150 responses, at minimum in the first year, totaling approximately 300 total responses for the new combined areas. Direct Dial, Mutual Aid from adjacent EMSpartners, 911 Activations and Inquiries when our agency is closest to a priority assignment, are the methods for the agency's receipts of requests for various levels of EMSassistance and response. our operational Initially, plan is to garage an additional ambulance, such that we can maintain our 3-5-minute response time to our expanded, as well as the existing response areas. The following EMSHospital destinations are currently utilized by our crews when transporting patients and will be employed under the area expansion. Long Island Jewish Medical Center - New Hyde Park, NY North Shore University Hospital - Manhasset, NY NewYork Presbyterian Queens - Flushing, NY Flushing Hospital - Flushing, NY St Francis Hospital - Roslyn, NY NYUWinthrop Hospital - Mineola, NY 12 FILED: QUEENS COUNTY CLERK 06/04/2024 01:41 PM INDEX NO. 711706/2024 NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 06/04/2024 Response Times Bay Community's average response time in the previous year (2020) was 5 Minutes and strives calls. The to maintain a response time range for all emergencies of 3-5 minutes for critical available priority EMSresponse statistics comparisons available for the FDNYEMSsystem in the previous Three (3) years (2017, 2018, 2019) in this protracted area in consideration, yielded response averages of 07:57, 08:04 and 07:47 respectively. This response time data is also compared to the same statistical values for the entire East Queens Community (East of the Van Wyck Expy), whereby these response values were lower overall at 06:50, 07:04 and 07:19 respectively in the same period. As noted, our response time values are over 2 minutes lower in each segment. This decrease can directly be linked to the patient's overall prognosis. Data for EMSrequested by local medical facilities is not readily available, nor is it reported. Historically, these facilities contract privately for services based on need and the abilities of the inherent provider. Unfortunately, the relatively volume for this small area does not dictate low annual call placement of significant levels of EMSresources. As such, although Municipal, Hospital and Commercial EMSDelivery models may assign a particular resource into a segment of this area, it is often assigned or re-deployed to calls or areas that necessitate the need. This leaves the proposed area uncovered. This then requires other resources to backfill the area's call volume, oftentimes, from greater distances than is optimal. This circumstance is a slippery slope to navigate, as agencies must determine the placement of resources based on need and overall response times. Our agency's model has always been community-based; as such, we maintain our availability within our service area, thereby maintaining our target response times. 13 FILED: QUEENS COUNTY CLERK 06/04/2024 01:41 PM INDEX NO. 711706/2024 NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 06/04/2024 Quality of Service Currently, there is no standard metric place to develop a reporting in model on the Quality of services and their effects. When you look at Certifications and baseline our CFRsand EMTs are subject to the training, identical State and Regional credentialing programs and procedures. receives certification from the credentialing body, there appears However, once the clinician to be a distinct disparity in their agency-based orientation and training, prior to being released as a lead provider. Bay Community VACis proud of our orientation program, whereby any new entry CFR, EMT, or Driver, must complete in-person ambulance orientation and agency specific medical device and medication training/review. Wehave transitioned all our patient care records from paper to electronic. Weare using our second E-PCRprogram. Weoffer regular in-house training provided by our members who are NYSEMTsas well as being higher