Combining Fire and EMS

[bigbendbombero]

I am from a small west Texas town that has an incorporated fire department (all volunteer) and a volunteer EMS that is "owned" by the county. We are seeking to combine the services as our County Commissioners took our ambulance away and contracted with a service that is 32 miles away! We are an unincorporated community that serves 2,800 square miles of rugged tourist country. Yes, 2,800, not 280 or 28.
I am seeking information on liability issues, funding sources, input from departments that have gone through the same thing, etc. Any help is appreciated. If you have links to helpful sites you can send them to me at txvff@yahoo.com. Thanks

[Station2Capt]

bigbend

I am not really sure what you are trying to ask can you make it a bit clearer for my pea brain. are wanting information that you can take to your county leaders on why your department should run the EMS
I am sorry but I and others may be able to offer help but I was confused sorry. let me know.

[bigbendbombero]

The questions I have are many, but for starters here it goes.
1. Are there any sources for funding for items such as training outside of the RAC and TDH? I tried to get a scholorship for an EMT class through the HB2604 funds but was turned down because it does not "directly lead to firefighter certification" (which I happen to disagree with, it is just a little more advanced that what SFFMA requires)
2. I am concerned with the liability issues, but have been unable to locate (on the internet) what type of insurance that is needed, and what changes are needed in insurance for higher levels of care.
3. Has anyone been involved with a volunteer department that absorbed the governing entities EMS service, and what problems did you encounter?
4. The county currently wants the FD to respond as first responders, package the patient, and wait for the ambulance (Paid Personell) to drive 32-100 miles to pick up the patient for transport. I am unwilling to do this as a permanent solution, but feel that we should have the ambulance here. I am REALLY concerned about the liability that the FD could face if we were to do something wrong. What is your opinion? Wouldn't we have about the same liability as first responders as if we were a public ambulance service? Just does not seem cost effective to me.
5. I am really needing a starting point. I am not an emt and do not know how the service works, just got thrown into this.

By the way...Was in class with some good guys from the Longview FD at A&M this summer.

[hfdgrp17]

What a tricky place you are in.

First off as for insurance questions how about calling Blue Cross/Blue Shield or one of the other major insurance carriers accross the country. They will be ab le to explain what is needed as far a coverage is concerned. In your conversation also have them explain the MONEY...yes I said MONEY...that will be RETURNED to the county for services rendered. For an example, my town receives from ambulance recipts almost $1 million directly into the general fund ( a sore point I know). and that's from a department that does close to 3500 EMS calls a year.

Second, as far as the liability issue you raised on transferring a patient. A good referance point for you to reach out to would be the states Office of Emergency Medical Services or the states Department of Public Health.

Do as much reaserch as you can. Having to go against a private coporation can be taxing. Good luck

[EMT377]

BigBend, here are some ideas I think may help you. First of all find out what the contract with private service is, does the county pay them for service,personnel,equipment etc. does the service bill pt's for runs? if they get paid from county and bill for runs then it would save them $$ for your dept to run it, by not paying $$ for contract but to bill the pt's. in order to start running ems transport you may need a certificate of need from state or county giving authority to operate in your area. you will! need to have a medical director who is an M.D. but check with your state ems licensing board. approach your county govt with good info including call volume annually, response times for your dept vs. contracted dept. length of transport time to hosp. so your local govt. can see the problems with lengthy wait times for pts. at the service I work for we charge approx. $600 base rate for bls calls plus $8.00 per loaded mile when transporting pt. also any stock used. we also charge an additional $250 per pt immobilization fee for mvc's. we bill all mvc's to auto ins. direct. you also said you are in a tourist area. if alot of the calls involve non-local people you may be able to bill only for out of county pts. saving local residents money. hope this helps. p.s. I work for a private ems service in K.Y. we have 10 ambulances but run 3 2man crews 24/7 and average 8-9000 runs per year. if there is any way I can help further let me know. stay safe. emt377

[firedawg803]

I am just a hop skip and jump away from you, about 35 miles north of Carlsbad, NM. We are also a county entity, and are not allowed to transport due to liability issues. A dept. in Loco Hills, which is about 30 miles from Artesia, has an ambulance as its rescue wagon. They will transport, in an extreme emergency only, and meet ALS intercept on the way to town. Usually meet them about halfway. They do this against county policy, but the powers that be look the other way, due to the distance factor. If you still have an ambulance, you might try it and see how it goes over.

[hfdgrp17]

AAccording to firedawg803...

"They do this against county policy, but the powers that be look the other way, due to the distance factor."

What kind of troubles me with this practice is that...God Forbid...something go wrong where does that leave you and the transporting service in the relm of Liability. If this is truely against county policy and possibable against your regional protocols then if something happens are you screwed?

It may be better the direct this and other questions to the State Office of Public Health or Emergency Medicine, etc. It would be a shame you someone to lose their ticket just because..."that's the way we've always doen it".