# Solano County threatens to suspend ambulance company



## emtpche (Mar 23, 2011)

Here we have the mom and pop taking on the 800lb gorilla.  Good times.

http://www.mercurynews.com/breaking-news/ci_17665852?nclick_check=1


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## jgmedic (Mar 23, 2011)

emtpche said:


> Here we have the mom and pop taking on the 800lb gorilla.  Good times.
> 
> http://www.mercurynews.com/breaking-news/ci_17665852?nclick_check=1



This would seem difficult to prove. What does providing paramedic care mean? Any ALS procedure? What if as an ALS unit you are assigned a BLS transfer and the patient codes? Like hell I would wait for the "preferred provider", or are they talking about AMR actually jumping 911 calls or taking ALS transfers? More info is needed than this article has.


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## emtpche (Mar 23, 2011)

The county contract is for any ALS transport that requires a paramedic.  Not only do they have the system calls they also have all IFT's that need paramedic scope of practice.  Only BLS and CCT are left for facilities to contract with other providers for.

The issue is that AMR has BLS contracts(mainly Kaiser) that come into their system that would qualify for paramedic intervention. They send a unit out to the call and the crew then calls for ALS on scene after assessing.  This seems to be the major point of contention from Medic.  Their issue is that AMR knows that certain calls need to be sent over to the competitor and they are not. 

I am sure that there are other issues as well.


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## jjesusfreak01 (Apr 4, 2011)

If I had to guess (as a BLS medical transport and EMS provider), this is probably more a case of AMR responding to what are essentially 911 calls that are called to their dispatch, rather than simply providing "paramedic" services. I don't know how you can even separate paramedic from CCT skills, unless they are starting lines or dropping tubes. I've run a few calls where I transported non-emergent patients to ERs, but our company has permission to do that in a few of the counties we run, and they are always pre-arranged transfers (we don't choose the ER we're going to) nonetheless.


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## Farmer2DO (Apr 5, 2011)

emtpche said:


> The county contract is for any ALS transport that requires a paramedic.  Not only do they have the system calls they also have all IFT's that need paramedic scope of practice.  Only BLS and CCT are left for facilities to contract with other providers for.
> 
> The issue is that AMR has BLS contracts(mainly Kaiser) that come into their system that would qualify for paramedic intervention. They send a unit out to the call and the crew then calls for ALS on scene after assessing.  This seems to be the major point of contention from Medic.  Their issue is that AMR knows that certain calls need to be sent over to the competitor and they are not.
> 
> I am sure that there are other issues as well.



That's implying that every patient, every time, is properly triaged, meaning that the appropriate level of provider is sent for the patient.  Having done hundreds, maybe more than a thousand even, IFTs, the doctor tells the nurse, who tells the secretary, who calls the service, who dispatches the crew.  Many times our crews have gotten to the hospital only to find the patient not presenting as originally called in. 

So, a BLS crew gets there and finds the patient needs ALS.  After driving to the hospital, they're supposed to then give up the call and let the competition have it?  I'd tell them to pound salt.  And if I was the hospital, I'd also tell the county that we will call whoever we want to.


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## CAOX3 (Apr 5, 2011)

So I have the right to choose my doctor, the hospital and where I want to have my surgery, but I can't choose who I call when I am in the midst of a medical emergency.  If I choose to open the phone book rather then call 911contacted provider I think Im well within my rights.

No?


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## emtpche (Apr 6, 2011)

Never said it was a good system just the way it currently works.


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