A lot of you are probably wondering why the topic of ambulance service is still being reviewed here in Logan County. Fair question. The answer though lies in a number of very complex issues that are all being carefully examined by a multi-disciplinary task force that has been meeting weekly since September of 2010.
To get down to the most simple of answers to that question though; the biggest issue really centers around the ability to financially sustain the current level of service being provided by Life Care Ambulance. The call volume and the reimbursement and collection rates on billings are just such that it has grown increasingly difficult for a private company to afford to continue to do business using this model. Reimbursement rates from Medicare and insurance have gone down, and its likely that trend will continue – and this situation only continues to make things worse for EMS providers across the country – especially small private providers like we have here in Logan County (Sterling is the smallest community in Colorado with this type of system in place). In order for private ambulance services to be profitable, they must run a significantly higher number of calls than what is possible in a rural area. Even the very largest and most financially sound private EMS companies only have a 2-3% profit margin.
The current system has been examined now on three different occasions: First, with the 2009 campaign to join EMS with the Sterling Fire Department to create a separate organization that would manage both services. The second review came a year ago as a group of experts were brought together from around the state through the Colorado Department of Public Health and Environment, to do an independent review and assessment of the current system – their report was finalized last summer. And finally, the current task force has thoroughly reviewed both of the first two efforts, as well as separately examining the current system in comparison with others across Colorado. It is universally agreed among task force members that a change is necessary.
The current task force is made up of people who have a great deal of respect for each other and who are all working towards coming up with the most sensible solution for everyone in the county. There are 14 voting members and a number of other folks who attend to provide their expertise and insight. Agencies represented include Life Care Ambulance, Sterling Regional MedCenter, Logan County and City of Sterling, rural fire protection districts (Sterling, Fleming, Crook, Peetz, Merino), Logan County Office of Emergency Management, Sterling Fire Department, Northeast Colorado Health Department and the Northeast RETAC (Regional EMS/Trauma Advisory Council).
At this point, the task force is still weighing various options and methods for providing the best service possible, as well as a number of different funding options with possibilities that include creating a self-sustaining organization, up to potential support from the taxpayers if needed, by means of either a sales tax or property tax.
At a recent meeting, the current owner of Life Care Ambulance made a motion that the task force look at forming a governmental authority – permitted under state statute and established through written agreements between two or more governments. The nature of the authority is what the group is still working on, with options on the table such as operating as a stand-alone EMS organization, combining the Sterling Fire Dept and EMS into one agency, or even the possibility of combining with adjacent counties to form a regionalized EMS service.
No matter how you slice it this undertaking is a difficult chore, but it is important for the citizens to know that while the members might come into this from different perspectives with differing ideas and concerns, all of the issues are being carefully weighed and debated and everyone is sincerely focused on trying to make the most sound decisions as we move forward. Our priority is to ensure a system is in place that will be most beneficial to the citizens when a crisis arises and they are in need of emergency care.
Dont forget to take a look at the comments that others have posted below for additional information -- and try to look through the responses from the task force before making additional posts in case your questions might have already been answered. We definitely want a free and open exchange of ideas, but we also dont want a crazy volume of traffic that becomes so cumbersome that viewers give up on following the blog.
Thank you!
I'm curious to know why 3 of the voting members are life care employees and there are no sterling fire employees?
ReplyDeleteGreat question - and thanks for asking!
ReplyDeleteTechnically speaking, there are two voting members representing Life Care Ambulance - the third person is actually sitting on the task force as a voting representative of the Fleming Rural Fire Protection District.
The Sterling fire chief attends all of the meetings to provide technical advice and expertise from the fire service. A review of the October 14th minutes shows that the chief specifically chose not to be a voting member. Other SFD personnel have attended meetings and made presentations, and could be asked to do so again in the future if necessary.
The feeling from the group is that the two voting members already representing the City of Sterling would be who should shoulder any votes on behalf of making obligations for the city and/or the Sterling Fire Department. If SFD also had a vote then the city's interests would be represented disproportionately to the other agencies.
Beyond that, the city officials who are voting members really will need to be the ones to make the decision as to what extent city resources are incorporated into any future plans, if at all.
Hopefully that helps clarify things. If you have additional questions please pass them along!
Thanks for the quick answer. I understand your rationale. It just doesn't seem right that the fire districts who make very few calls and who would not be affected by a change in the EMS system are represented. But the department that makes 99% of the calls and that could potentially split from the city isn't represented.
ReplyDeleteThat is a valid way to illustrate the concern. It hadn't been framed in that manner during discussions with the task force to this point.
ReplyDeleteThe public can be assured that long and careful consideration was given in no less than seven different weekly meetings regarding how to build the voting membership of the task force (see minutes from Oct 7 thru Nov 5, and Jan 6 & 13).
It is important to reiterate that while SFD isnt directly represented as a vote perse, the department is represented by the chief (and others) during the weekly conversations and debate. His input is carefully considered along with that of all the other members of the group. Being an agent of the city, the fire department ultimately will carry out whatever decisions are agreed upon by the city council; whether that is to just continue on unchanged or to be incorporated into a modified overall system in the future.
What 'has' been clearly voiced by the task force is that gathering thoughts and concerns from the employees of both Life Care and of the Sterling Fire Department will be an important step before we get too far down the road in any direction. There has been specific discussion (see the minutes from Jan 6) about meeting with the rank-and-file from both organizations for input and ideas, and that will happen once other important debate is fleshed out.
The regular meeting scheduled for Feb 17th has been cancelled due to a scheduling conflict for the fire chief and city manager. That should reflect the importance placed on having them at the table for discussion. When we resume on Feb 24th, we'll make certain that this topic is brought before the group for further consideration.
Thanks again for your input!
The voters did not pass the LESA proposal. Colorado State Statute requires the County to provide Ambulance Services, it seems the county is just trying to pass the buck. We all pay taxes to the County. Why does the County not "suck it up" and provide the service or increase payments to the existing service?
ReplyDeleteYou are certainly not alone in your feelings.
ReplyDeleteA review of the meeting minutes will reveal that the task force is very careful that whatever direction is ultimately chosen, it is 'not' LESA. There has been a great deal of realization and discussion regarding the shortcomings of the 2009 attempt at modifying the system.
To be clear, the county itself is not required to actually "provide" ambulance service (only to license the service), but what they have been doing here in Logan County is to also assure that the provision for EMS service is being made somehow. This is being done through their current contract with Life Care Ambulance, and they are looking into the future by bringing together the task force to examine ways to cultivate and ensure that a sound EMS system continues for years to come. Life Care Ambulance is represented at every step of this process, and the owner is actually the task force member who made the motion which was approved (2/3 majority vote is required to pass all motions) to pursue creating a governmental authority to assume management of the EMS system as we move forward.
The overwhelming conclusion is that the current system simply does not have enough money coming into it. That is not the sole concern (as outlined in the 2010 assessment facilitated by the state health department), and the solutions are not nearly as simple as they might seem. If they were, then more than 20 community leaders wouldn’t feel the importance in devoting time each week for the past four months (and for many months yet to come) to researching and developing the smartest long-term solutions on behalf of our loved-ones, friends and neighbors.
There is much work yet to be done, and it is being approached in a thoughtful and reasoned manner. Ultimately, if we as a community wish to maintain the same level of service we currently enjoy (the same number of ambulances, staff, level of training, response times, etc.), or improve it in the future, then as a community we have to come together to find additional funding relief somehow. There are several options still being vetted, a couple of which may not even require additional tax dollars from the voters at least in the short-term.
If you have thought-provoking suggestions or recommendations please feel free to formulate those and email them to the task force at loganemstaskforce@gmail.com , or alternatively, concerned citizens may join us at our regular weekly meetings (next meeting, Feb 24 @3pm) to address ideas and/or questions with the group.
In the mean time, we encourage anyone who is interested in this process to take a look at the meeting minutes (click on the tab at the top of the page) for a better understanding of the direction of our talks.
Thanks again for the great conversation and we hope that everyone finds this blog useful as we move forward!
Just a suggestion as you post comments:
ReplyDeleteRather than selecting "anonymous" please select the "name" option and enter a distinctive handle (or a first name). That will make it easier to keep straight who is saying what to whom.
Thanks!
I would agree with
ReplyDelete"Colorado State Statute requires the County to provide Ambulance Services, it seems the county is just trying to pass the buck. We all pay taxes to the County. Why does the County not "suck it up" and provide the service or increase payments to the existing service?"
The City of Sterling is already covering the majority of the County by using its Fire Department. The County needs to "buck up" and take the ambulance on. The cost to maintain the Fire Department is nearly 1.7 million a year, the County is only paying 90,000 a year for the ambulance. That is a substantial difference.
The city cannot afford to support or pay for an ambulance service. The city already pays horribly low wages and cannot compete with surrounding cities. The city has a huge deficit (29 million) for the new water system. They cannot afford to pay additional costs for an ambulance service.
This is where the county needs to step in. They should subsidize an ambulance service or run a Logan County ambulance service similar to Morgan County. It seems as if they are betting on the city to bail them out.
Another idea would be to become the City and County of Sterling. Combine the services and split the bill evenly between the County and the City. 50/50 across the board. This will relieve the city of its costs while splitting the cost with the county. Has this been discussed?
ReplyDeleteThank you for your thoughts, 'Interesting'...
ReplyDeleteNobody on the task force is asking or expecting the city to fund an ambulance service, even partially.
“If” the city enters into an agreement to partner in the authority it is unlikely that they would provide any funding other than that which is already covering current SFD expenses. In fact, based on recent conversations it could even be less than that due to savings that might surface through economies which can be realized by combining fire and EMS.
Many counties in Colorado do not provide 'any' direct funding to support ambulance service. Logan County is actually obligated for $120,000 in 2011 -- but keep in mind that as a private, for-profit business Life Care Ambulance is also collecting many times that amount on their regular patient billings. Those collections would continue to be available to help fund whatever system is in place in the years to come.
Logan County has stepped up by engaging a lot of knowledgeable people (including Life Care) in trying to find a smart way to stabilize a system here for the long haul. That is exactly what this whole process is all about.
What complicates the funding issue is the fact that Logan County just doesnt have several hundred-thousand dollars (or more) sitting around to put into an EMS service (every year from now on). If that were the case, the solution could have been very simple.
We are still some time off from uncovering concrete funding requirements and solutions, so additional speculation or angst at this point is premature.
Thanks for the great conversation today everyone! Enjoy your weekend.
Just to clarify, Colorado Revised Statute, does not require counties to provide an ambulance service. It does require that Counties license them however. That involves a physical inspection and documentation. Logan County has supported a private for profit ambulance service as the costs of doing business exceed the reimbursements from providing a service. Which has created a historical obligation to continue, but it is not based in statute.
ReplyDeleteI think it's also important to note that Morgan County is running into issues with funding. They operate as an enterprise fund which supports itself, which means they get no money from the city or county. If you search the Fort Morgan Times, you will find an article which shows their ambulance service can no longer continue as is.
ReplyDeleteI think it's easy to point the finger at the county and say "buck up and provide service." The reality is that the money just isn't there.
As I understand it, Morgan County EMS can receive public funds up to 10% of its budget and still operate as an enterprise. Does anyone know how much Life Care actually brings in from billing? Doug may be letting his business go in the red but he is taking home a profit. It seems like that amount plus $120,000 would be a good starting point for negotiations. The city and county need to stop belly aching about how much the other doesn't contribute. Get rid of all the old farts who keep the conflict alive and let's move forward! EMS task force, what is the best system for our county? Please decide what is best so we can do it. It was a mistake to give 3 Life Care employees voting power because Doug will vote for selfish reasons without regard to what is best for our community and his two employees will agree with him.
ReplyDeleteThe task force has spent time looking at numbers from several different services around Colorado, including Life Care. We know what the typical call volume is for Logan County so we can gauge fairly closely what the average collection/reimbursement rates might be in the future.
ReplyDeleteThe problem is that there can be a big gap (for most EMS services) between what is collected and what it actually costs to keep the doors open. Some of that gap is controlled by how many ambulances you want/need to have available, how many staff you want trained at each level (EMT-Basic, EMT-Intermediate or EMT-Paramedic), how many ambulances you want staffed at all times, the type and quality of the equipment on each ambulance, continuing-ed training, etc., etc.
Logan County could get by very cheaply on an ambulance service if all the citizens want is a ride to the hospital with only a minimum level of care, and they dont care how long it takes for an ambulance to arrive on scene.
If, however, people want access to a high level of emergency care in the field provided by highly trained paramedics on ambulance that arrives quickly with the right high-quality equipment on board, and then also have more ambulances on stand-by for additional calls that might happen simultaneously (which is fairly frequently even here) - then that is significantly more expensive.
We dont know what the system will look like yet, there are still a lot of variables and details to consider. This will be the place to keep up with developments as they happen.
And regarding votes, one last time, any motion before the task force has to have a 2/3 majority vote in favor of passing it -- so no one organization or level of government can make things happen independent of convincing 2/3 of the people in the group to vote the same way. That is a pretty high standard.
Again, we cant thank you all enough for your interest! We've had nearly 400 views of this blog so far (almost 300 just in the last three days), and that is great! Keep it coming!
Since the Fire Department is already going to 80% of the ambulance calls anyway, why not have them take an ambulance to the call instead of a gigantic fire truck? It doesn't make sense to have to separate companies going to the same medical call. Does the Fire Department use the medical calls as a reason for their existence? You take away those 80% (medical) calls and there really is no justification for having a fully staffed/paid Fire Department. Get rid of Lifecare and assign the Fire Department the ambulance responsibility without the hoopla of another station and doubling of the personnel (you may need to add some, but not double). This will justify the existence of a paid Fire Department here. You could also have Logan County splitting a portion of this bill.
ReplyDeleteThe only issue that I see with my above post is transports. Maybe contract transports out or have the off duty Firemen take transports as overtime shifts. They currently work two days (48 hrs) out of 7, they have plenty of days off and I am sure the majority of them would be willing to take overtime for the transports.
This is my idea/opinion, so please don't be disrespectful. I am open to thoughts about it.
Most of what you mention are things that the task force has discussed at our meetings. They are valid questions and are certainly worth continuing to explore.
ReplyDeleteFire apparatus (of some kind) responding to medical calls along with ambulances is far more the rule than the exception these days. Under our current system all of the firefighters are also EMT's and that that allows for a much more robust emergency response when people are in crisis and need help. Its easy to criticize this type of coordination until a loved one needs an urgent 911 response.
Right now when the call goes out for a medical response, you have no idea what you'll find when you arrive on scene -- it could be someone trapped in their basement, it could be a 400lb person that needs carried down a flight of stairs, it could be someone behind locked doors that require special equipment to gain entry, it could be any number of things that cause the need for more than two medics that show up by themselves on an ambulance. You dont want to send more than one ambulance to a scene just to transport additional personnel as a rule, because then it is tied up if the next medical call comes in. What has been discussed that could be done with a new system though, is to have an arrangement where fire personnel respond in something like a Suburban (so they can still carry some equipment) rather than on a big fire truck.
There are two buildings in use under the current system -- fire trucks and ambulances are not things that can just sit outside year around. No matter the system that is developed, there will need to be two buildings to house equipment, period. If EMS and fire are combined, there is no additional room at the current fire station to put several ambulances. Even if they're not combined, there still has to be another building just to house ambulances and staff.
It is unlikely, but not impossible to think that the city would take on EMS service. The problem with that is that the EMS side of the department would be responding county-wide (and beyond), and asking city employees to do this on a routine basis becomes problematic.
Right now the only option that we can definitely say is completely off the table is utilization of a privately owned business as the primary 911 ambulance service throughout the county.
Hope everyone has a great week!
to answer;
ReplyDelete"The only issue that I see with my above post is transports. Maybe contract transports out or have the off duty Firemen take transports as overtime shifts. They currently work two days (48 hrs) out of 7, they have plenty of days off and I am sure the majority of them would be willing to take overtime for the transports."
As inter-facility transports can be where the most complex care takes place. Again there is not enough volume in the system to have a private company come in and provide that service.
A day off in a 24 hour shift system is a day off, if an off duty person fire or otherwise comes in on a day off then it's overtime. To query off duty people to see if they want to takes time and in the medical field we find time is precious.
An EMS system is more than 911, its a system of care moving patients to a hospital and in some cases between hospitals. The inter-facility transport ambulances should be staffed and available.
The good thing about inter-facility transports is that the cost per call is closer to what is reimbursed.
A question came up over on the Journal-Advocate blog about staffing at the fire department. Here is some additional information that many people may not be aware of regarding benefits of having a full-time paid fire department. These are things we have discussed at task force meetings and will certainly continue to be important points to consider as any decisions are made regarding possible changes to our fire and EMS system.
ReplyDelete*Posted by permission from the author*
The Sterling Fire Department maintains a minimal staffed fire department, not a fully staffed department. The citizens and business owners enjoy a large savings in insurance premiums due to the department having a lower ISO (Insurance Services Office) rating than a volunteer department. The fire department is utilizing city resources (firefighters) to its maximum to help each and every person in the community, no matter if it a fire or medical call. Staffing must stay the same for the cost savings to continue.
It is tough to see, but the fire department is truly a cost saving mechanism because of the lower ISO rating.
The quality of life in Sterling is enhanced because of the prevention, protection, care and training activities our firefighters conduct every day.
My family is very well protected by all the services the city provides, and I am happy for that.
For more information on ISO visit http://www.isomitigation.com
I disagree with this comment
ReplyDelete"Right now when the call goes out for a medical response, you have no idea what you'll find when you arrive on scene -- it could be someone trapped in their basement, it could be a 400lb person that needs carried down a flight of stairs, it could be someone behind locked doors that require special equipment to gain entry, it could be any number of things that cause the need for more than two medics that show up by themselves on an ambulance."
We cannot live off of assumptions and "what if's." The calls can be screen through the dispatch before sending units, therefore they would know if there is a 400 lb guy stuck in the basement.
Under this idea, we might as well start sending the Police as well. Why not send 10 Police officers to a bar fight, a medical or to a domestic call? It won't happen, because there is absolutely no need for it and it would be a misuse of the tax payers money. Same goes for sending a fire truck and and an ambulance to the same scene. It is a waste, in my opinion.
A lot of folks are curious about why fire departments respond to medical calls...
ReplyDeleteJoint fire and EMS response is industry standard across the U.S., and for good reason. That level of redundancy and service is not unique to Sterling and we are very lucky to have it.
The world of emergency preparedness and response is built around "what if's". If we dont plan for the unexpected then eventually something bad is going to happen... and none of us want to be the person whose life or health is affected.
Again, there havent been any concrete decisions made as to the exact involvement of SFD within the new system. The task force has considered these types of issues and concerns, and will continue to do so as the new system is mapped out.
Seems the county is still dragging it's feet to NOT cover an ambulance service combined with the FD. And the county has been VERY nice to Doug and LifeCare as to help him use his powers in the county to be the ONLY aambulance provider. Remember when there was a time that there was more than one agancy in Logan County?? I believe one of the board meembers know that very well as he was once part of trying to have a company in town.
ReplyDeleteIf the County does not want to assist/provide medical services. Why doesn't Logan county open it up to bids and see what happens?? This costs very little and it might open a new door for the county? What does the county have to lose at this point?
There have been no hard decisions yet.. it seems ponderous I know, but difficult choices need to be made, each choice must be weighed against "what is affordable, supported through initiatives, best for the patient" its going to be a balancing act, and as such maybe no one group is going to be completely satisfied.
ReplyDeleteIt will be a consensus decision made by a group of individuals who have donated alot of their time. The decisions that will be made, will not be made in seclusion.
Being involved in the multiple agency licensing in Logan County some years ago, it was a prescription for failure, There is just not enough volume in the system to sustain one, let alone 3. When Medicare scaled back reimbursements in 2007, it has put multiple EMS agencies as risk.
Why would a private industry be out of the question? Have they ever opened it up for bid to see the actual numbers?
ReplyDeleteLogan County has had bids in the recent past. Bids from large, profitable companies like AMR would cost the taxpayers significantly more, and bids from smaller companies would come with the same concerns as we have now over sustainability due to the limited number of calls.
ReplyDeleteThe simple fact of the matter is that if Logan County residents wish to maintain the same level of service we currently enjoy (or if we want to make improvements) then private companies are just not a viable option in our circumstance.
Just commenting on Anonymous post on Feb. 11th. (It just doesn't seem right that the fire districts who make very few calls and who would not be affected by a change in the EMS system are represented.) So what this person is saying is that there is no need for the area volunteer fire departments to voice there concerns about the EMS system.I know for a fact that the area departments have at least 1 quick response unit to respond to calls and to make life saving transports if need be. So I feel that the area departments need to have a voice in the say of what happens with the current system because thay are all affected too.
ReplyDeleteThis comment has been removed by a blog administrator.
ReplyDeleteEveryone, please make sure to review the "Comment Policy" to the right. Any posts containing personal attacks, regardless of their nature will be removed.
ReplyDeleteWhen this is done, it must be done for the entire post even if there is other valid information contained within.
If you have a post removed due to a violation of the Comment Policy, we encourage you to reword your thoughts and repost if you have comments or questions that can still be addressed.
Thank you for your understanding.
What will the EMS task force do when the Life Care employees who haven't been paid for going on 6 months decide to stop showing up to work? And has this issue even been addressed?
ReplyDeleteWhile the task force is not in a position to speak on specific business practices, there are plans that can be implemented in the event of a critical interruption of ambulance service for whatever reason.
ReplyDeleteFirst, everyone should understand that each of the fire departments in the county has the ability to respond to EMS calls, so 911 emergencies would still see an immediate response regardless of whether or not Life Care were able to send their own resources for some reason.
Second, the county commissioners have negotiated a contingency contract with a large ambulance company to bring a minimum level of coverage to Logan County on short notice if anything should happen that would stall or eliminate ambulance service under the current system. If we reached that point due to a gap in coverage, the expense to the county on a monthly basis would be significantly higher. Its obviously something we want to avoid if at all possible.
And finally, in the interim, emergency and inter-facility transport calls can/would be covered utilizing mutual aid ambulances from nearby agencies. This type of backup though, is only a very short term solution.
EMS personnel in general have a keen sense of responsibility to their friends, neighbors and the stranger down the street, and its hard to imagine a scenario where those type of people would simply abandon a community and leave a critical void when lives are on the line.
Well, this board must like to protect Doug as my post was removed when all it stated was the FACTS of Logan County!! Again this is why we are stuck with this issue!! Thanks to another great board!!!
ReplyDeleteMaybe you shoud remove the post about Life Care not paying it's employeees!!! Thats a personal attack too!!
Logan County Resident since 1956: If you have suggestions for the task force, or questions that will help you to better understand our process/progress, we are more than happy to support those on this blog.
ReplyDeleteIf you (or anyone) have concerns that you aren't able to address here without risking a Comment Policy violation, you are welcome to email those to us and if it is an issue that can be addressed within the scope of the task force, we will reply appropriately.
loganemstaskforce@gmail.com
Thank you for helping us to keep the atmosphere here on the blog cordial and welcoming to all of our visitors.
To all Logan County citizens I apologize for trying to bring to light what has been hidden by many "higher ups and so called boards" in Logan County.
ReplyDeleteThis issue has been and will always be an issue for us in Logan county as long as certain people are involved!! And I guess this blog site is only to try and pump up support for certain individuals and companies, as my comments to let other citizens of Logan County know of the past have been removed. Again, another reason I NO longer will serve on a board as a business owner in Logan County, which is unfortunate to say the least!
i for one appreciate that this thread is trying to stay on track and not turn nasty like it did with the lesa vote. i have learned alot so far and really dont to want to watch people bicker over old news. i just want an ambulance to coem if i need it again.
ReplyDeleteHas thought been given to establishing a hospital-based EMS system? I don't know if this would suit your needs, but it is a symbiotic relationship and could provide for good continuity of care.... They also have access to many different funding programs that a stand-alone EMS agency wouldn't have... they have deeper pockets and can buy medical supplies at greater volume discounts.
ReplyDeleteFire Based EMS is really two separate services housed in and under one larger system. Although it can successfully provide EMS, I think it mostly an after-thought and a way to provide meaning to a Fire Service that has just about put themselves out of business (a good thing, not derogatory). If given the responsibility of providing EMS, Sterling Fire will find itself in a situation of "learning" the "EMS Business"... might not work out so well for patient care... and they may not do so well at making it pay either.... Has anyone thought about what it would cost to "start-up" a brand new transport agency in Sterling Fire? $90,000 a year or double that would be pocket change in comparison.
The idea of "Regionalizing" EMS is a great idea in my opinion. Compartmentalized EMS (and Fire for that matter, Fire)lends itself to higher costs and redundant assets. Trying to get a bunch of "type A" personalities together to agree on the structure and administration of same will probably be what stops it... This would give great uniformity of care and service, cut costs, and could really provide a better product to the public. A Regionalized Hospital-Based System? May work even better...
An outsider's point of view ....
There has been discussion about the possibiity of a hospital based EMS system, and while it can be a great way to manage an EMS service in some locations, it isnt something that Banner Health is willing to pursue at this time.
ReplyDeleteAs for a stand alone transport agency, again there just isnt enough call volume to support such an endeavor. If you take transports away from your main 911 EMS service then they lose a considerable amount of potential revenue.