Unregulated cities

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Jgervin

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Does anyone have list of cities that have unregulated EMS? What I mean by unregulated is, in Houston, I fall ill I can call a private EMS company directly to pick me up.

Besides Houston, San Antonio and parts of DFW do not require citizens to call 911 for emergencies. Austin on the other hand requires ALL emergency calls to go through 911.

Does anyone know what other major cities (pop. over 400k) in the U.S. are unregulated?
 
There are only about 45 cities in the US with a pop over 400k, so the list probably isn't very long.
 
I would imagine that I can call any ambulance service if i'm having an emergnecy to take me to the hospital.

I mean, why can't I call a private ambulance to take me to the hospital? what is the penalty for doing this? will the cops arrest me? an ambulance is an ambulance is an ambulance, and if it takes me to the hospital that what's the problem?
 
I would think contracts would start to get in the way though. I would assume if someone called from homw requesting help from a private ambulance they would be forwarded to the 911 provider that's contracted to provide 911 response to that area.

So no, Dr.P you would not get in trouble, but I'm sure the private ambulance company sure could if the 911 provider caught wind of it and decided to make a thing out of it.
 
Robb said:
I would think contracts would start to get in the way though. I would assume if someone called from homw requesting help from a private ambulance they would be forwarded to the 911 provider that's contracted to provide 911 response to that area.

So no, Dr.P you would not get in trouble, but I'm sure the private ambulance company sure could if the 911 provider caught wind of it and decided to make a thing out of it.
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I get these calls from time to time, they call us instead of 911 because 911 won't take them to the hospital where their doctor is... which is dumb because that means they don't need to go by ambulance. Also get the occasional pain seekers who have tapped out their local hospitals and want to go further, or who 911 won't take anymore because they have them flagged as pain seeking behavior
 
Robb said:
I would think contracts would start to get in the way though. I would assume if someone called from homw requesting help from a private ambulance they would be forwarded to the 911 provider that's contracted to provide 911 response to that area.
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that's a huge assumption. I mean, they are the "911" provider, by contract, regulation, whatever. If you don't call 911, than the contract doesn't apply.

Like, I can set up an ambulance in Vegas, and tell everyone "call me instead of 911, we will get there quicker and treat you better." As long as they call the 10 digit number, it's a simple request for service, and whether or not they are the designated 911 provider is a moot point.

Now if they are jumping 911 calls that they hear on a scanner, that's a different story.
 
DrParasite said:
that's a huge assumption. I mean, they are the "911" provider, by contract, regulation, whatever. If you don't call 911, than the contract doesn't apply.

Like, I can set up an ambulance in Vegas, and tell everyone "call me instead of 911, we will get there quicker and treat you better." As long as they call the 10 digit number, it's a simple request for service, and whether or not they are the designated 911 provider is a moot point.

Now if they are jumping 911 calls that they hear on a scanner, that's a different story.
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An ambulance company that is not contracted as 911 provider must refer all calls that are emergency to local 911 provider. It's the city law. If company violates that they can be fined and eventually closed down if they do it a few times. Yes an ambulance is an ambulance but it's not contracted to handle 911. Now if 911 service company tells them to respond they are okay.
 
looker said:
an ambulance company that is not contracted as 911 provider must refer all calls that are emergency to local 911 provider. It's the city law. If company violates that they can be fined and eventually closed down if they do it a few times. Yes an ambulance is an ambulance but it's not contracted to handle 911. Now if 911 service company tells them to respond they are okay.
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+1.
 
looker said:
An ambulance company that is not contracted as 911 provider must refer all calls that are emergency to local 911 provider. It's the city law. If company violates that they can be fined and eventually closed down if they do it a few times. Yes an ambulance is an ambulance but it's not contracted to handle 911. Now if 911 service company tells them to respond they are okay.
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I'm pretty sure this varies form place to place, I know down here the mind set is "Why call 911 if the patients already in an ambulance, it's only going to delay definitive care. Transport them to the hospital and get them to an ER"
 
Hunter said:
I'm pretty sure this varies form place to place, I know down here the mind set is "Why call 911 if the patients already in an ambulance, it's only going to delay definitive care. Transport them to the hospital and get them to an ER"
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In his post he didn't mention that the patient was already in an ambulance. He/she just stated that the 911 contractor can tell the non 911 company to handle the call (meaning responding).

As for my area pretty much all private callers come to us (911 provider). There are a few that go to the other companies.

If a BLS/IFT (only 911 are ALS) has a critical patient they call their dispatch who normally informs them to call 911 directly.
 
DrParasite said:
that's a huge assumption. I mean, they are the "911" provider, by contract, regulation, whatever. If you don't call 911, than the contract doesn't apply.

Like, I can set up an ambulance in Vegas, and tell everyone "call me instead of 911, we will get there quicker and treat you better." As long as they call the 10 digit number, it's a simple request for service, and whether or not they are the designated 911 provider is a moot point.

Now if they are jumping 911 calls that they hear on a scanner, that's a different story.
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Doesn't matter if they dialed a 10 digit number or 911, they're requesting an "emergency" service thus the call should be forwarded to the Emergency Medical Services provider. Not saying it's right, just saying that's how it is in the vast majority of areas around the U.S.

Pretty sure in Vegas if you called the non-emergent number for Medic West or AMR for assistance with a fall you're going to be transferred to the 911 dispatch center.

Sounds like Houston is one of the few exceptions.

Hunter said:
I'm pretty sure this varies form place to place, I know down here the mind set is "Why call 911 if the patients already in an ambulance, it's only going to delay definitive care. Transport them to the hospital and get them to an ER"
Click to expand...

That's how it should be, unfortunately, in many places it isn't.
 
DrParasite said:
I would imagine that I can call any ambulance service if i'm having an emergnecy to take me to the hospital.

I mean, why can't I call a private ambulance to take me to the hospital? what is the penalty for doing this? will the cops arrest me? an ambulance is an ambulance is an ambulance, and if it takes me to the hospital that what's the problem?
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Some areas have policies in place requiring emergency calls under certain circumstances (generally "true emergencies") to be forwarded to the contracted 911 provider. Sure, you can call company ABC, but that doesn't mean that ABC will be allowed to dispatch an ambulance to you.
 
As a side note to work on a private ambulance in Houston you also have to have a permit from the city. Last time I looked it was around $130.
 
As stated before, this varies greatly from place to place. In Texas at least, it's generally handled by local statute making an ambulance service the exclusive provider of both emergency and non-emergency transport with in that territorial area.

The issue with saying all emergency calls are required to go through the 911 system is who defines "emergency".
 
Where I am from if you dial 911, you get the local FD EMS.

But you are free to call anyone you want. So if calling one of the less than reputable, private dialysis derby medicare raping services is what you want, go for it.

(although depending on the area, that might actually be better than the local FD)
 
In NYC, an ambulance is an ambulance so there are no issues (besides response time) with calling an IFT company to go to the hospital.
 
Nj DOH licenses ambulances, so a BLS truck is what it is and where it comes from makes no difference. All the SNFs have contracts with private services and will call them first before 911. Residents are free to call whomever they please to get to the hospital.
 
For agencies like mine and I believe Robbs, our agencies are the only one allowed to do 911 AND non emergency transports in our service area by LAW.
 
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Linuss said:
For agencies like mine and I believe Robbs, our agencies are the only one allowed to do 911 AND non emergency transports in our service area by LAW.
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Every service I have worked for had an exclusive operating area contract.
 
For those of you that are claiming it is the law that emergency calls must be transferred to the contracted 911 agency, please cite your source for this claim (be it state, county, or municipal law) and specify the area where it applies.

Because it is NOT the law in the entire country.
 
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