The end of VAAS is emblematic of the inexorable decline of an all-volunteer EMS

The Enterprise — Sean Mulkerrin

Out with the old, in with the new: The former home of the Voorheesville Area Ambulance Service is now known as the New Scotland Station of the Albany County Sheriff’s Office Emergency Medical Services.

VOORHEESVILLE — The building in the heart of the village that once housed Voorheesville’s now-defunct volunteer ambulance squad is being transferred to the town of New Scotland and village of Voorheesville.

Albany County Sheriff’s Office Emergency Medical Services now occupies the brick building, with a Star of Life window centered in its gable, at 21 Voorheesville Ave. The sheriff’s EMS — a paid service — continues to broaden its reach as a once-healthy pool of volunteers subsides.

Dennis Wood, the lieutenant in charge of Albany County’s EMS division, has seen firsthand the steep decline in volunteer ambulance services.

“When I first started, it was 100-percent volunteer,” said Wood. “There was no such thing as paying the staff of an ambulance … and it has just dropped so fast, so hard. And in the past five years, I’d even say that it is almost sad to see — but you know, the [training] requirements are so insane.”

Would-be volunteers, Wood said, just don’t have the time anymore to commit hundreds of hours to training and keeping up with certifications.

Volunteers, especially the Hilltowns, he said, have dwindled to the point where only two or three responders in each remaining squad, Westerlo and Helderberg, are doing all the work. However, those volunteer ambulance squads, Wood said, “are both still doing very, very well with very, very, limited manpower.”

“It’s almost amazing to see what they doing with the few that they have; it’s inspiring,” Wood said, because, there is a Helderberg volunteer who is nearly 80 years old and still makes about about three-quarters of the ambulance runs.

In Westerlo, there is a volunteer who is on about 90 percent of calls, Wood said, and “he’s not a younger gentleman; probably getting closer to retirement age.” He was referring to Gerald Cross of Berne who, in October, will receive a state award recognizing his 57 years of service.

“We try to tell the other agencies that are existing, ‘Look, we don’t want to come in and take over,’” Wood said, for one simple for reason: cost.

“If we were to close down every volunteer agency in the rural part of Albany County right now,” Wood said, “the cost to the taxpayer would be astronomical.”

Albany County EMTs are paid $14.50 an hour, said Wood; paramedics, $21.50 per hour. The wage disparity is due to the paramedic’s education and training, he said, which is more extensive than that of an EMT.

Volunteer agencies, Wood said, need to be helped; they need to stick around for as long as possible. “Volunteer agencies are saving taxpayers hundreds of thousands of dollars,” he said.

The lack of volunteers for the Voorheesville Area Ambulance Service led to the squad’s slow demise, and the transition and takeover by the sheriff’s office.

The transition, Wood said, took place over a period of five to six years.

“When we started out (in 2012), we would just cover calls if they [VAAS] didn’t get a crew for a call,” Wood said. “Then it slowly transitioned into us doing all the calls Monday through Friday, [6 a.m. to 6 p.m.], and, then finally it got to the point where they said, ‘You know, look, we can’t even get night or weekend crews anymore; we’re just going to shut down and let you guys take over.’”

The sheriff’s office has serviced full-time the former Voorheesville Ambulance area since October 2016; Delmar-Bethlehem EMS is its primary back up.

In May, after a long legal process, Voorheesville Area Ambulance Service merged with Delmar-Bethlehem Emergency Medical Services. Three former volunteers from VAAS made the move to Delmar, according to Steve Kroll, chief of Delmar-Bethlehem EMS; two are still in training and one is a crew chief.

May’s merger was a bitter conclusion a decade in the making.

In 2007, the relationship between the village and its first responder fractured, when Voorheesville wanted VAAS to collect insurance money from the patients it transported — volunteers objected. It took about three years for the ambulance service to start billing patients.

By 2013, the relationship had become so contentious that the village board was ready to let the service contract expire, and replace the squad’s emergency medical services with re-trained village firefighters.

With volunteers dwindling, by 2015, the Voorheesville Area Ambulance Service had to supplement its service with paid workers from E5 Support Services of Queensbury.

In August 2016, it was announced that the volunteer squad would cease operations by October of that year. The Enterprise, in September 2016, reported that a request had been made of the county’s EMS division to expand its services to full-time coverage starting the morning of Oct. 15.

Along with the ambulance that it staffs in Voorheesville, now known as the New Scotland Station, the sheriff’s office also staffs one in Rensselaerville, because, in June 2017, Rensselaerville Volunteer Ambulance closed its doors.

The costs have added up.  

In Rensselaerville, Wood said that, although he didn’t have the exact figure, the burden on the town to switch to paid employees was “very significant.” He added, “It shot up.”

New Scotland and Voorheesville split the cost of the sheriff’s ambulance service. The town pays about $82,000; the village kicks in $53,000. In 2007, New Scotland paid about $49,000 to VAAS for services, about $58,650 in today’s dollars, when adjusted for inflation.

But the sheriff’s office has tried to help with costs, Wood said, and there are other benefits. “Having an ambulance in the Hilltowns,” he said, “helps us augment the other volunteer agencies.”

When the county first put an ambulance in the Hilltowns, he said, the sheriff’s office picked up half the costs; in the second year, it was 40 percent; and the third year, 30 percent. “Eventually, the Hilltowns paid for 100 percent,” Wood said, adding that Sheriff Craig Apple “knew that he couldn’t drop the cost on the Hilltowns, all at once.”

Kroll’s Delmar-Bethlehem EMS, with 60 to 65 volunteers, is in a much more enviable position than most volunteer departments. “There is a volunteer shortage statewide for people in EMS and certainly that is one of the challenges that Voorheesville had,” Kroll said. He estimated that VAAS had about 12 volunteers at the end.

However, Kroll’s department responds to calls only from 6 p.m. to 6 a.m. The day shift is staffed by full-time paid responders, subcontracted from the sheriff’s office.

There are obvious benefits to having a paid staff, Wood said, a faster response time chief among them. “Our crews are in the building, in the station, in uniform, ready to go at the drop of a hat,” he said.

That’s important, Wood said, because not too long ago — the late 1980s and early ’90s — in the Hilltowns, it was not unheard of to wait 45 minutes for an ambulance. That doesn’t happen anymore because the county’s ambulance staffed by full-time paid employees will respond to every call, he said, and, if a volunteer squad responds as well, the sheriff’s ambulance will return to its station.

Kroll said that his department made the decision about 10 years ago to pay for a full-time day squad. “We made the decision because we realized that we had a really good core of volunteers, but during the day most of them were either in school or working,” he added.

There was a time, Kroll said, when daytime coverage wasn’t a problem, but the nature of work has changed. Prior to having a paid daytime shift, he said, volunteers would sometimes have to stay home from work to cover the shift.

When the Albany County Sheriff’s Office Emergency Medical Services program first started, in 1996, Wood said, it had two paramedics and supervisor. Today, the service has eight vehicles — both ambulances and “fly cars,” a non-transport EMS vehicle — on the road, staffed by five paramedics and five EMTs.