Yorktown’s Advanced Life Support (ALS) program is a mystery to most homeowners – even though it’s an important emergency service we pay for in our taxes. And although I knew something about program, the April, 2024 presentation to the Town Board by our four volunteer ALS commissioners was an eye opener for me. An eye opener that led me to write a column about the program for the Yorktown News.

That was May.  Fast forward to August when I was elected to the Town Board and in my new capacity as councilwoman began meeting with both the ALS commissioners and members of both the Yorktown and Mohegan Volunteer Ambulance Corps. The result of these meetings led to a second Yorktown News column published in September.

Like having insurance you hope you’ll never need, I hope you’ll never need the services of either the ambulance corps or the paramedics in the Advanced Life Support program.  But, like insurance, do you want to know that the emergency medical services are there – if you ever do need them?

Here’s the issue.  And, as a member of the Town Board who will be voting on the 2025 budget that will determine your town taxes, I’d welcome your thoughts on the issue.

Yorktown News Column, May, 2024

What Is Your Life Worth?

The lead article in last month’s Yorktown News reported a possible 51 percent increase in the tax rate for our Advanced Life Support  (ALS) services.  The  increase would cover the additional $390,000 needed for a second ALS flycar that responds to 911 calls and a second paramedic on the night shift.

WOW. 51 percent sounds like an awful lot. But wait.  51 percent of what?  What does a 51 percent increase in some unknown number translate to in dollars and cents? As taxpayers, we relate to, and understand, dollars and cents — not percentages which are often misleading.

For example, this year’s 10 percent increase in our garbage tax is costing us an extra $52. But — if you read through to the end of the article about the possible ALS increase, you would have learned that the 51 percent ALS tax increase would cost the average homeowner with a $10,000 assessed value only an additional $30.  For many homeowners with lower assessed values, the added ALS tax would be less than the cost of a pizza.

Is your life worth $20-$30? Or the life of a family member, friend or neighbor?

What is ALS and why it’s so important

The ALS emergency medical service is separate and distinct from the services provided by our two very dedicated ambulance corps.

Ambulance corps services are provided by volunteers with 165 hours of EMT training.  They’re funded by donations and insurance company reimbursements for the rides they provide.

The ALS service is provided by an outside company (Empress) under contract with the town. The contract includes one flycar and, depending on the shift, one or two paramedics who, in contrast to the ambulance corps volunteers, receive thousands of hours of training.

The ALS service funded by a separate ALS tax on our April town tax bill, in 2024, $57 for a house assessed at $10,000.

Both the ambulance corps and ALS flycar respond to all 911 calls — but only the paramedics can provide critical life-saving measures or administer critical life-saving drugs.

If you’ve ever watched a medical show on TV, you’ve seen emergency responders hook up IVs or incubate a person having breathing difficulties.  That can only be done by paramedics, either onsite or in the ambulance on the way to the hospital when 10 minutes can mean the difference between life and death.

In simple terms, ALS paramedics bring the emergency room into your living room.

Yorktown started providing ALS services in 1994. Since then, the number of calls have tripled, from 1,000 in 1994 to 3,000 in 2023 — but we’re still relying on only one flycar. Which creates a problem that can delay the  paramedic’s response time:  What happens when the single flycar is in the northern part of town and a 911 call comes in from the southern part of town?

Yes, there’s “mutual aid” when Yorktown’s first responders call on the services of our neighboring towns. But what if those services are in use?  Again, it’s all about response time.

Paying for the services we want

It all boils down to money: How much are you willing to pay to know that life-saving emergency medical services will be there if and when you need them?

In all the years I’ve attended Town Board meetings I don’t recall any discussions about ALS services and whether it was time to increase our level of services, and if so what the cost implications would be.  There have been presentations from both ambulance corps, but to the best of my recollection, none about ALS.

Which is probably why most residents aren’t familiar with the differences between the ambulance corps and the paramedic ALS contract, let alone what they’re paying for the ALS service.

Isn’t it time we learned about this service that we’re paying for?

Isn’t it time we spoke up about what services we want and may be willing to pay for?

Supervisor Lachterman said he’ll likely hold an informational meeting about ALS. Let’s take him up on that. But not part of a regular Town Board meeting. It should be a special meeting devoted exclusively to ALS, and a meeting at which residents, not just Town Board members, can ask questions.

We also need to understand how an increase in the ALS tax would impact the 22 other tax rates that are part of the town budget and the state tax cap. It’s complicated, but it can be explained. It needs to be explained. Afterall, we’re the ones paying the taxes.

We need to get the facts so we can decide what’s in our best interest.  And when we know that, we need to let our elected officials know what’s important to us.

So please Supervisor Lachterman, schedule the ALS meeting ASAP — and before you start work on the 2025 budget.

Yorktown News Column, September 18, 2024

Is saving a life worth the cost of a pizza?

Last May, one of the last columns I wrote for the Yorktown News before being elected to the Town Board  was about why Yorktown’s Advanced Life Support (ALS) program needed an additional $400,000 to fund a second flycar that responds to 911 calls and a second paramedic on the night shift.

In the column I posed this question: Is your life, or the life of a family member, friend or neighbor worth an additional $20-$30 in taxes?  The cost of a pizza.

In the ensuing weeks, I heard from many residents who read the column and appreciated the explanation of the difference between the emergency services provided by the Yorktown and Mohegan volunteer ambulance corps and the ALS program and why the ALS program needed a second flycar and extra shift.

While my question was theoretical in May, it’s now a very real ─ and current ─ question that needs answering. It’s real because now is budget time.  Now is when Supervisor Lachterman is putting together his Tentative Budget for 2025. Now is when the supervisor has to decide how he’ll respond to the request from the ALS commissioners for the additional $400,000, a request they made two years ago but which was either ignored or rejected.  (If $400,000 is added to the ALS budget, the separate ALS tax would increase between $20-$30.)

Then, in November, the full Town Board will review the supervisor’s Tentative Budget. At that time, the four councilmen will have an opportunity to suggest changes to various budget line items. We’ll also adopt a Preliminary Budget that will be the subject of a public hearing in December.

As Supervisor Lachterman prepares his 2025 Tentative Budget, he has two basic choices:

• He can reject the ALS commissioners’ request in order to limit the size of the 2025 total tax increase for all town services, or
• He can add the $400,000 to the ALS budget, increasing the ALS tax and total town tax bill for town residents.

If Supervisor Lachterman does choose to add $400,000 to the ALS budget, and if that increase means that the total tax levy for the town’s 26 separate budget funds exceeds the state imposed tax cap, he then has two more choices:

• He can stay within the tax cap if he decreases the tax levy for one or more other budget funds which would likely require decreasing the expenditures in those funds.
• He can exceed the tax cap and use his bully pulpit to explain to residents why he believes saving a life is worth the cost of a pizza.

The tax cap can be overridden by a majority vote of the Town Board. There’s no penalty if the tax cap is overridden.

Is your life, or the life of a family member, friend or neighbor worth $20-$30?

If your answer is YES, you need to tell that to Supervisor Lachterman – now ─ as he begins the challenging task of figuring out how to continue funding town services while limiting the increase in town taxes. Not an easy task. And because the four councilmen will have an opportunity to make changes to the supervisor’s budget in November, you also need to let them know ─ now ─ that you’re willing to pay the additional ALS tax so that Supervisor Lachterman knows he’ll have their support when they have to vote on the budget.

If you want to make sure the paramedics will be there when you need them, now is the time to speak up. Email the supervisor and four councilmen; their addresses are on the town’s web site, yorktownny.org.  Use social media to alert your friends and neighbors.  Attend Town Board meetings and speak at Courtesy of the Floor.

Your elected officials need to know what YOU want and what services you’re willing to pay for.

Fluoridation chronology

• In 1965, Yorktown adopted a local law requiring fluoridation.
• The system was down from roughly 2017 to August, 2024 for an equipment upgrade.
• On September 26, 2024, Supervisor Lachterman unilaterally shut down the system in what he called a “pause” in response to a district court’s decision (see below).
• The supervisor’s action violated Section 1100a of the NYS Public Health Law that requires municipalities to give the state Department of Health 90 days notice of its intent to discontinue fluoridation and also to consult with health care professionals prior to any discontinuance.
• On October 15, 2024, the Town Board held a public hearing on a local law that would repeal the 1965 requirement and, in its place, adopt new language that would allow the Town Board to decide whether or not to fluoridate our water supply. The Board’s decision would be by resolution and would not require a public hearing. The hearing was closed with a written comment period open until October 22nd.
• A decision on the proposed local law is listed on the Tentative Agenda for the Board’s October 22, 2024 work session meeting

Why the current controversy over fluoridation

In September, 2024, a United States district court judge issued a ruling in a 2017 lawsuit involving the EPA.

• The judge never ruled that fluoridated water was injurious to public health or lowered the IQ of children. All he said was that based on his interpretation of the 2016 amendments to the Toxic Substances Control Act (TSCA), there was sufficient evidence that fluoride “posed a risk of unreasonable harm to health.”
• The judge didn’t ban He simply found that under the terms of TSCA, the EPA needed to do additional studies because there was sufficient evidence that fluoridation posed a risk of lowering the IQ of children. He directed the EPA to come up with rules regulating the use of fluoride, rules that could range from requiring a simple warning label to banning the chemical. The law also said the EPA’s rules could be limited to “a particular use.”
• The judge’s decision relied heavily on an August, 2024 monograph prepared by the National Toxicology Program (NTP) that looked at existing studies of the impact fluoride might have on a child’s IQ. The monograph stated in bold that it “did not address whether the sole exposure to fluoride added to drinking water in some countries […in the United States] is associated with a measurable effect on IQ.” The document further stated that “[m]ore studies are needed to fully understand the potential for lower fluoride exposure to affect children’s IQ.”
• The NTP studies were based on urine from pregnant women and were conducted primarily in China, India, Iran, Pakistan and Mexico where the water had fluoride levels that were as much as 3x the level used in the United States.

Fluoridation benefits versus risks

• Based on 75 years of research and studies, all leading United States public health agencies support fluoridation as a way to reduce dental cavities, the leading disease in children.
• Opponents of fluoridation cite studies that allege that fluoridation causes numerous illnesses and, most recently, a decrease in the IQ of children. They say it’s a toxic substance that should not be in our water supply and that there are other ways people can get fluoride if they want it, e.g., in tooth paste.
• Who to believe? It boils down to who you  choose to listen to and what their public health credential are.
• At the October 15th three hour hearing, the Town Board heard from many residents opposed to fluoridation. I could be wrong, but I don’t think any of them provided any details about the source of their public health credentials. The Board also heard from doctors and dentists and deans of dental schools who urged Board members to consider the FACTS. The hearing starts at 1:45 on the meeting video, https://tinyurl.com/5n9793y5

My position

• Because I don’t have any science training, when I need information about a public health issue, I go to recognized public health sources. And based on what I’ve read so far from qualified health care professionals, I believe the proven benefits of fluoridation far outweigh the unproven allegations of its potential harm to a child’s IQ.
• The first two drafts of the NTP monograph, the basis of the judge’s decision which, in turn was the justification for Supervisor Lachterman’s decision, were rejected by peer review panels as falling short of accepted scientific research standards; the third and final draft was reviewed by a hand picked panel.
• The NTP monograph very clearly stated that its findings were not based on the fluoride dosage used in Yorktown. And, as the doctors and dentists made clear at the October 15th hearing, it’s all about dosage; any chemical, any medicine, can be toxic and harmful at excessive levels.
• More peer reviewed studies are needed, especially ones regarding the 0.7mg/L dosage level used in the United States. The studies should also consider the use of fluoride for specific demographic groups, similar to the caution warning for pregnant women not to eat certain fish.
• For more information about fluoridation, you may want to check out this FAQ from the Missouri Coalition for Oral Health.   There’s a long list of references at the end of  36 questions.

https://www.oralhealthmissouri.org/images/1055/document/11.-shortened-qa_1360.pdf

Conclusion

Finally, I’m concerned that some of my colleagues on the Town Board are unapologetic about openly and knowingly violating the state’s Public Health Law – and on shaky grounds; while there’s 75 years of evidence that fluoridation benefits our children, there’s NO generally accepted scientific evidence that fluoridation is harmful.

We are a country of laws. We don’t get to pick and choose the laws we’ll obey or ignore. When we disagree with a law, we have three choices:1) obey it; 2) challenge it in court; 3) get it revised or repealed. Ignoring or intentionally violating the law is not an option.