Legal issues setting up on a campus? (successful examples please)

mycrofft

mycrofft

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A recurrent issue is about "EMS clubs" and others setting up personally or organizationally to provide some service to their campus and sometimes neighboring community.

IS there a blanket model to follow for these folks, as evidenced by successful organizati0ns of that type currently working at colleges, universities, or such? (I remember Boy's Town in Nebraska used to have their own vollie fire dept...).
 
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Virgina Tech rescue Squad is a "EMS club" all are students or faculty of Virgina Tech (VPI, or VT depending who you are) they have evolved into a ALS transport company that responds to emergancies both on the campus and as secound due to Blacksburg Fire-Rescue in the area's around the campus.
 
Yes, there are a whole bunch of very successful models used for college EMS systems, and they are becoming a growing trend. The umbrella organization is NCEMSF (Nat'l Collegiate EMS Foundation), which maintains a set of resources for start-up groups, supports existing groups, and hosts an annual conference for involved students.
Personally, I am involved in the administration (daily operations and training) for one of the older (and I believe well established) groups in the country. We arent ALS transporting with 6 ambulances (because our campus doesnt need it), but we properly serve our community, and have for some time.

There are a few current or former college EMTs around (including an unnamed CL) that can answer questions about how their particular campus works.

While I am ranting, I will say this, each campus requires a different organization model, based on the population on campus, current infrastructure with police and regional EMS, and there is no cookbook model that works everywhere.

The purpose of campus EMS, in many situations, is to provide optimum response time, filter out student complaints that do not require transport, transport students in need of care to appropriate facilities, serve the neighboring community, provide professional training and leadership experience to students, and decrease the liability of university police on ambitious calls. Ultimately, the prime purpose is to provide patient care to students, staff and faculty.

Challenges to College EMS groups are much of what you see in volunteer EMS. We struggle to train and maintain excellently skilled members, but admit, institutional memory on a college campus is only four years. On my campus, we strive for consistency over time, through protocols and guidance from our medical director.

I will add, on many campuses, EMS groups arent "clubs" or interest groups, but university departments or entities often associated with the University Health Center, or Public Safety (Police) departments. On other campuses, student EMTs are responsible for standby (details) at sporting events or large gatherings, it all depends on the circumstances.

I urge you, mycrofft, to read some resources from NCEMSF, or ask members who are involved in campus EMS if you are interested in more information.
 
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Thanks, I was mostly asking on behalf of other folks.

And to screen my own ignorance!;)
 
there are many different models to look at actually.
Personally I like Georgetowns, George Washingtons, MITs, Clemson, VTech, Villanova, Fordham, Columbia, UVM, UCLA, and SUNY New Paltz.

Those are just a sample of ones you could technically consider "successful" models.
 
Blanket model? Never. Scope of practice varies really widely. However, to second emt.dan, there are some basic requirements. A squad should at least be capable of determining whether ALS or transport is required for a call. It should be able to respond to on-campus calls significantly faster than local fire/EMS. This can mean anything from some students with jump bags and bikes to a bunch of full-out ALS rigs.

There are some problems specific to campus EMS, though. A college campus is often a major source of a local EMS service's calls, and so they sometimes actively oppose it existing at all. A common compromise is to allow campus EMS to show up and stabilize only, but not transport. Student safety when responding to calls can also pose a liability issue, particularly when the call is something like a shooting. Meanwhile, getting student volunteers to show up and maintain their certs can be a problem. At some places, the squad turns into more of a frat that occasionally treats sprained ankles; at others, it's extremely professional and provides good quality care. The medical director is very important in determining what the end result will look like, because s/he is the only source of long-term institutional memory.
 
emt.dan said:
...
The purpose of campus EMS, in many situations, is to provide optimum response time, filter out student complaints that do not require transport, transport students in need of care to appropriate facilities, serve the neighboring community, provide professional training and leadership experience to students, and decrease the liability of university police on ambitious calls. Ultimately, the prime purpose is to provide patient care to students, staff and faculty...
Click to expand...


Well... NCEMSF is a good place to start for lots of info.

One part of Dan's comment reminded me of something.

Transport to appropriate facility by our University Quick Response team sometimes involves putting the Pt. in the front seat of their SUV and driving them to the University Health Center. Not everything needs to go to the ED.
 
I think this was a good question. The original poster was specifically asking about legal issues... As said before, the NCEMSF has some good information. Specifically, I have seen the following issues come up. I am sure there are more, these are just some of the big ones I can think of right now...


1. Will the program be licensed under the state as an EMS program? Or will they provide just first aid under the auspices of a campus department?

2. Who will insure and assist in managing the program? Public safety on campus? The local EMS service? The institution's health service or clinic?

3. Billing patients - will you? Where does the funding come from? Is it wrong to "double bill" with tuition fees that partially fund the service.

4. If only providing first aid, first responder, or BLS services; when can the service sign-off or otherwise release patients without the community ALS provider responding? Is this enough calls to justify the service, or will ALS have to respond to a majority of calls?

5. Is the community service on-board with the program? What happens when they receive a 911 call (i.e. cell phone)? Do they have a liability in passing the call to EMS?
 
redcrossemt said:
I think this was a good question. The original poster was specifically asking about legal issues... As said before, the NCEMSF has some good information. Specifically, I have seen the following issues come up. I am sure there are more, these are just some of the big ones I can think of right now...


1. Will the program be licensed under the state as an EMS program? Or will they provide just first aid under the auspices of a campus department?

2. Who will insure and assist in managing the program? Public safety on campus? The local EMS service? The institution's health service or clinic?

3. Billing patients - will you? Where does the funding come from? Is it wrong to "double bill" with tuition fees that partially fund the service.

4. If only providing first aid, first responder, or BLS services; when can the service sign-off or otherwise release patients without the community ALS provider responding? Is this enough calls to justify the service, or will ALS have to respond to a majority of calls?

5. Is the community service on-board with the program? What happens when they receive a 911 call (i.e. cell phone)? Do they have a liability in passing the call to EMS?
Click to expand...

Great start. I'll add some other issues:

1) Current infrastructure, and the impact of new EMS system on that. How will student EMTs interface with the campus police department? Health Center? Student Government? Administration? Regional EMS system? Who is responsible for the insurance?

2) Consistency. With institutional memory at 4 years, what guarantees can be made that qualified students will continue to be interested, and participate? What happens to infrastructure if there are no longer students to support? Who is the safety net?

3) Does this service provide coverage to neighborhood surrounding campus? Under who's auspices?

4) What are the legal implications if campus EMS arrives at patient who has consumed ETOH, so legally cannot refuse, but will not gain from transport and care at ER? What about patients who call to be "checked out", are advised of treatment and transport options, then defer choice to EMTs?

5) What are the implications of multiple simultaneous calls? Any calls get immediate ALS dispatch? Legal burden of dispatch to send ambulance?
 
I am familiar with 2 college agencies, Syracuse University Ambulance and Rutgers Emergency Medical Services. Both are college based EMS systems, and both are pretty well developed. But the differences end there.

SUA (http://sua.syr.edu/)is a 100% volunteer agency, with 2 BLS ambulances, a supervisor's vehicle, and a MCI trailer. they typically staff 1 ambulance 24/7, and respond to calls on campus. they have their own dispatch center, their own private 7 digit phone number, and also have on campus emergency calls forwarded to them by the SU department of public safety. They do have a full time dispatch supervisor and EMS manager. ALS is handled by Rural/Metro, the city's ALS ambulance provider

RUEMS (http://rues.rutgers.edu/ems.shtml) is a division of the Rutgers Emergency Services. They are 100% paid, and staff 1 BLS ambulance 24/7. they are composed of students and non-students from the local area. While their primary role is the campus, they also provide mutual aid to the local areas on a regular basis. ALS is provided by RWJUH EMS, the local ALS agency.

most places that start an agency generally need the "blessing" of the local ems agency. usually as first response system, they work hand and hand with the local EMS system. as the system developes, an ambulance might be added with transport capabilities.

problems that occur include 4 year life span of all members, incorporating external/prior training into existing systems, and FUNDING. usually though the health center, public safety might also provide funding. one other thing to keep in mind is how to handle calls that go to the 911 center instead of the campus dispatch center

no need to reinvent the wheel, the NCEMSF is a great source of information. but it isn't an easy process, and it is a lot of work. good luck
 
One other question to consider is whether or not the campus EMS system would be a closed medical system. The staff might be EMT or Paramedic Certified... but if it's a closed system, they may (or may not) have a different scope of practice and/or protocols than the Local EMS system has...

A 911 call from a campus phone might go to the Campus dispatcher who would then have to determine whether or not to transfer the call to an "outside" PSAP or request "mutual aid"...

Interesting issue.
 
Do churches (mega) fall under the same tax exemptions/benefits/guidlines as universities in setting up their own volunteer EMS staff?
 
A friend of mine worked for the University of Alaska Fairbanks Fire Department a few years ago. If I remember right they run pretty much just like any other FD would. You have to be a student unless you are a officer. They are paid, have ALS transport, and also do fire. I think they cover more than just their own campus though, so I'm not sure how it all works legally.
 
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