Vol EMS question

DesertMedic66

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They already do when they get billed for the ambulance ride. Do you seriously think they will accept being taxed for that too?
If all the citizens have to do is say no and nothing changes then there is absolutely no reason why they would say anything at all. “Hey guys, all we have to do is say no we don’t want a paid ambulance service and that means we will still have an ambulance service”.

If you want resources in town you must pay for those resources. If you want resources but do not want to pay for them the answer should never be “let’s start a volunteer department”.

Until the citizens know for sure it is serious and what they will be loosing, there is no reason for them to do anything.
 

ffemt8978

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If all the citizens have to do is say no and nothing changes then there is absolutely no reason why they would say anything at all. “Hey guys, all we have to do is say no we don’t want a paid ambulance service and that means we will still have an ambulance service”.

If you want resources in town you must pay for those resources. If you want resources but do not want to pay for them the answer should never be “let’s start a volunteer department”.

Until the citizens know for sure it is serious and what they will be loosing, there is no reason for them to do anything.
Good point. Yet the most common plan to bring paid EMS stated in this thread can be summed up as "pay for it or we'll take our ball and not play". So far @akflightmedic is the only one to propose any type of actual solution.
 

mgr22

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Hybrid departments with paid people to supplement volunteers work well in many areas.
 

DrParasite

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The same way you provide police protection to those same areas.
extended ETA for state police, one officer covering multiple towns, wasn't there a town that disbanded their local PD, contracted with someone else, and were unhappy with the results? and anyone who works in the rural areas knows you usually don't have quick responses.
 

DrParasite

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I'm 100% in favor of billing every person for transports. The days of begging for donations to provide EMS service should be long gone.

I'm also 100% in favor of eliminating unprofessionalism in EMS.... sadly, simply receiving a paycheck doesn't equal professionalism

for those that say just stop showing up and see what the town does.... well, what about all of the unincorporated rural areas? where I currently live, there are a ton of them, and the volunteer FDs provide first responder service to the paid EMS agency, which might have a 20 minute or greater response, depending on where in the county they are coming from. heck, there are some counties where there are two ALS ambulances for the ENTIRE COUNTY.

the AHJ determines the level of service it will provide. whether it's volunteer EMS, private service EMS, or county-funded ALS, that decision is not, and will never be made by the EMS agency or its providers. and while I would fully support an EMS system where there were enough ambulances to ensure a 4-minute response time to all EMS calls (and no more needing the FD first responder to stop the clock), that means the AHJ would need to pay for it, and very few are willing to do that.

I live in an area that has a county-wide EMS system. and I have worked in other counties that have countywide EMS systems. and worked in rural areas. many assumptions that are made (if volunteer EMS went away, things would improve, volunteers are bringing down EMS, county-wide EMS systems will help rural areas, etc) are simply wrong.

There is no excuse for not having 100% paid 3rd service EMS systems in urban areas, as well as in suburban areas where the towns can afford it. But the majority of the US isn't urban, or incorporated.
 

OceanBossMan263

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Long Island here. My hometown has a hybrid program that has grown over the years. The County police department runs an ambulance service, which has always been supplemented by the local fire departments and ambulance corps. Lately, hospital-based ambulances have gotten some contracts for villages.

My hometown fire department took several steps to get where they are today. It started as fully volunteer EMS. Eventually they started using a few of the district staff for emergency response- The Fire Inspector (EMT-CC at the time) would take the first responder car on his rounds. If there was no volunteer response after a short time, he would respond to the scene while another maintenance employee would drive the ambulance to meet him. About 12 years ago, paid ALS providers were added. Initially coverage was 0900-1800 M-F, then expanded to weekend coverage, then 0600-1800, adding one medic in a fly car at night, and finally to 24/7 paid service with 2 medics. Volunteers provide the response for alarms when the paid unit is engaged, as well as a lot of the public relations work (stand by at football, soccer, fairs, etc). The volunteer unit is mostly BLS, and each member attends a preceptor program with the paid staff before being cleared to go solo.

2 of the medics are full time employees and handle administrative duties on top of responding. Everyone else is per diem, and a lot of them work full time for one of the other ambulance services in the county, as well as a few PAs or RNs that still moonlight on the rig. The response district is about 6 square miles and may handle around 1000 calls requiring some kind of EMS response. The system seems to work, and annual fire tax which covers the service is cheaper than whatever the ambulance bill would have been for the other services in the area.
 

Carlos Danger

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extended ETA for state police, one officer covering multiple towns, wasn't there a town that disbanded their local PD, contracted with someone else, and were unhappy with the results? and anyone who works in the rural areas knows you usually don't have quick responses.
You get what you pay for. If it's important to the local populace, they'll figure it out.
 

Tigger

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Good point. Yet the most common plan to bring paid EMS stated in this thread can be summed up as "pay for it or we'll take our ball and not play". So far @akflightmedic is the only one to propose any type of actual solution.
Well, perhaps that's what is needed. No one is going to pay for something that they get for free currently. Nearly one knows what the difference between EMTs and paramedics are. The populace sees a volunteer BLS ambulance in a station, they assume they have an ambulance service.

I don't have much issue with volunteer first response in rural areas. Use it to augment a paramedic ambulance/fly car that covers many many miles. It's not perfect, but there are limitations to living in super rural areas.

My issue lies with municipalities that do have the tax revenue to support paid EMS just like their law enforcement but chooses not to. I suppose if that service gets out quickly on most every call like an adequately staffed career agency would then there is less issue (though it be nice if there were paramedics not willing to work for free since it devalues the education) I have less issue with that.
 
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