Advisory board warns St. Lawrence County EMS is 'at a crossroads,' urges county EMS coordinator and standby county ambulances

The county’s EMS advisory board told legislators the local emergency medical services network is strained and recommended immediate steps to stabilize response. Jay Moore, vice chair of the EMS advisory board, said the state now requires each county to develop a comprehensive county EMS plan and argued the county should use that process to build a “more reliable and sustainable EMS system.”

“New York State now requires every county to have a, or to develop a comprehensive county EMS system plan,” Moore said during the operations meeting. He and Chris Tyler, chair of the advisory board, showed maps and data illustrating large geographic coverage gaps and agencies with wildly varying call‑answer rates.

The advisory board proposed creating a dedicated county EMS coordinator to assemble up‑to‑date data, lead planning and oversee a phased county‑run backup agency. “The first step would be to hire somebody specifically who is a county EMS coordinator,” the presenters said, arguing that a single accountable position is needed to coordinate regulations, CON (certificate of need) timelines and operational planning.

As modeled in the presentation, a county backup agency would start with two basic‑life‑support ambulances and an ALS fly car operating seven days a week on 12‑hour shifts, with stationing driven by call volume and response‑time data. Presenters suggested leasing ambulances already owned by local agencies as a lower‑cost initial approach rather than buying new vehicles, noting lease rates as an alternative to $200,000–$300,000 capital purchases.

Board members pressed on staffing, cost and governance. Presenters said they were not asking the legislature to approve a budget yet — first the coordinator would collect accurate, current figures. “I don’t wanna be responsible for giving you a a fictitious number, and I’m not even gonna attempt to,” Moore said, urging that data collection precede financial commitments.

The presenters also discussed the Certificate of Need (CON) process: a municipal CON provides a 365‑day temporary operating window during which a county must demonstrate ongoing need. That timing, they said, makes readiness on the administrative and operational side essential before filing.

Why it matters: The presenters argued the county’s geography, aging population and hospital locations create long transport times in parts of St. Lawrence County and that a county‑level solution would allow flexible redeployment of ambulances where gaps are greatest. Legislators asked about volunteer retention and the risk that paid staffing might displace volunteers; presenters said models elsewhere still rely on volunteer contributions even where paid staffing exists.

Next steps: The advisory board recommended the legislature authorize or support hiring a coordinator who can return with firm budget numbers and a CON‑ready plan. The board took no formal vote on creating a county EMS agency at the meeting; the presentation was received and discussed.