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State EMS Requirements For EMS Ambulance Services

Rickey Stokes

Viewed: 1952

Posted by: RStokes
[email protected]
3347901729
Date: Nov 10 2019 3:20 PM

ALABAMA:    Since my association with Dothan - Houston County Emergency Management and with Cottonwood Ambulance and Rescue, I have learned a lot that I was not aware of.


In addition I have learned a lot of State of Alabama Department of Public Health - EMS Division - rules, regulations and requirements. In addition I have learned a lot about Medicare and Medicaid. 


I must admit I had never really paid much attention to the drama from government officials concerning Medicare and Medicaid. But now while involved with EMS I must say that it has my attention.


A REQUIREMENT FOR EMS   


When Emergency Medical Services responds to a call where the person is deceased the EMS is required to (1) examine the patient which appears deceased (2) call Medical Control and describe what they have and request orders to pronounce and not to perform CPR (3) wait on law enforcement and/or the Coroner (4) drive to the Medical Control of which they received orders not to perform CPR and get the Physician to sign the Patient Care Report. A requirement of the Alabama Department of Public Health - EMS Division.


One EMS had to drive 33 miles one way in order to get the Patient Care Report signed by the physician who issued orders not to perform CPR. And the EMS agency has 24 hours to get the signature.


MEDICAID


Under Medicaid, the EMS ( ambulance ) responds to a 911 call and transports a patient to a medical facility. Medicaid pays only 19% of the total charges.


Under Medicaid, the EMS ( ambulance ), under physician orders the patient must be transported on the ambulance, for a doctors appointment. Medicaid pays only 24% of the bill.


Average the two bills together, Medicaid paid only 22% of the charges the EMS              ( ambulance ) billed for.


That means the EMS ( ambulance ) loss 78% of the total charges billed for the two calls, one being a 911 emergency.


FUNDING   


Decades ago there was vision for fire. And tobacco taxes and fire fees for fire got passed.


Only Alabama State Representative Steve Clouse, Dale County Commission Chairman Mark Blakenship and members of the Dale County Commission ever established vision in order to provide EMS coverage.


Clouse, Blakenship and the Dale County Commission passed legislation for a $ 5.00 fee to added to license plates for EMS. ( Then the greed came out of some South Dale County Mayors who always turned blind eyes to the EMS problem. )


A new ambulance, a van ambulance which does not give much room for patient and EMS, especially if CPR in progress, new is somewhere between $ 94,000.00 to $ 100,000.00.


The monitor unit you see EMS carry into most scenes or homes, that is $ 35,000.00.


Just an example of some of the equipment costs.


THIS IS NOT A DIG ON A FIRETRUCK  because fire is very much integrated into EMS. But when was the last time you saw a patient placed on top of the fire truck for transport to the hospital? Even if EMS run through the fire department the same costs occur.


And the stretcher costs...unreal. 


HOUSTON COUNTY funds the EMS in the county with $ 26,000.00 a year, which is paid out in quarterly installments. Insurance eats up most of that money.


Some municipalities "helps" the County EMS units. Most of the municipalities just say thanks or pays little to help them.


Hopefully this next legislative session the local delegation that represents Houston County will follow Dale County and pass the $ 5.00 fee earmarked 100% to support County EMS and Dothan Fire EMS on their drug purchases. Your life could depend on it.


IN HOUSTON COUNTY RIGHT NOW...


One EMS in Houston County just returned to home base from a EMS call where the person was deceased on their arrival. The Houston County Coroner is on the scene as of this writing. That particular EMS had to leave the scene and travel to the medical doctor which gave them orders not do perform CPR and get signatures on the patient care report.


Another EMS in Houston County just arrived on a scene of a possible death and has confirmed it is a death. After law enforcement and/or the Coroner arrives on the scene that EMS will be required to drive to the medical provider for signature.


AND...before I hit post on this article Dothan Police just confirmed another death.


So the Coroner is on a death, and has two death calls pending to respond to. Three death calls since 1:35 PM today in Houston County. And the following is not meant as any disrespect, but with respect, to illustrate the need for EMS and funding - it is unknown the medical history of any of the three deaths this afternoon, but I can say none were planned for today.


That is not written with any disrespect and please do not take as such. But it is said because it is actually going on "real time" in Houston County as this article is written. But the comment is written to say, no medical emergencies or deaths are planned.


These three deaths were obvious when EMS arrived and there was absolutely nothing they could do. 


But that is not always the case.


So my point is, of which I want to be clear... you never know when you might need EMS ( ambulance ) for a trauma event or medical event on your life. They are not planned events.


EMS needs the funding because a question never asked on a medical emergency or trauma event - can I swipe your credit card? Do you have insurance? Can you pay?


EMS only jumps in taking care of the patient.





Family First Funeral Home

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