This just pisses me off.

[Arctickat]

Thanks KS, I appreciate the info for clarity. You're in a similar situation as I. We have a community that is on the border between my ALS service and a BLS service. Typically the BLS service responds, but the community has requested that my ALS service respond instead. It's been in the courts for months. Now that I have a fair understanding of your situation I go back to my original post. Who is to blame? The System.

[nypamedic43]

I don't know about Kansas but in NY we have what they call Certificates of Need. They are issued by the state to ambulance companies and they define the territories that they cover. The company that I work for in Chemung County hold the CON for the whole county and for the northwest corner of Bradford County in PA and the northeast corner of Tioga County in PA. We contract out the eastern most part of our county to Greater Valley because they are much closer to those communities than we are. Because of this both companies have to be dual state certified.

Arctickat, I'm not sure the reasoning behind the community in between the BLS units and your ALS units, being in court for ALS coverage. Could you explain? because I really am interested

As for 10 codes, they did go the way of the dodo with NIMS. Everyone is supposed to use clear text...I realize that some places don't. I slip every once in a while and use them, even after all this time. Our system works like this, Chemung County 911 receives an emergency call. The dispatcher calls our dispatcher and then our dispatcher dispatches the closest ambulance to the call. Our dispatch frequency is 154.505...so we use 5 codes internally, mostly because the scanner land. For example...5-18 is a DOA, 5-4 is in service, 5-7 is cancelled or refusal of treatment/transport. But we only use those codes on our own frequency, we use clear text on the county channels.

Now, as to the OP. I understand where you are coming from, given the dispatch information. However, with that being said, a person has the right to call any ambulance service in the area that they so choose. Just as they have the right to refuse treatment from anyone else, regardless of whether or not they are the closer unit. With multiple companies in the immediate (50 mile radius)area it becomes confusing and the lines blur a bit. They probably called the other service because they have had a good experience or experiences with that company,not just because they are out of the same town as the hospital the family wants the patient to go to. Hospice can get really tricky. IF the patient is going for something that is out of the scope of their being on hospice, they actually go OFF hospice for that ER visit and any subsequent stay in the hospital. When they get discharged from the hospital, they have to reapply to hospice. Sounds kinda tedius huh....

[Arctickat]

Arctickat, I'm not sure the reasoning behind the community in between the BLS units and your ALS units, being in court for ALS coverage. Could you explain? because I really am interested

It's still in the courts, once all the legal crap is exhausted I'll fill you in. what it boils down to is legal jurisdiction and who actually has the right to decide.

[mikeymedic1984]

Sorry if I am echoeing something that someone else already posted, but this was probably more of a billing situation, than a territory situation. Once you enter a hospice program, hospice is responsible for most bills, Medicare will not cover ambulance transportation of a hospice patient (except for the original transport from hospital to hospice/home -- and they typically deny that claim at first because they see the admission to hospice date as the same date). So it is likely that the hospice representative called the service that they contract with to do the transport. The private service I work with part-time has several contracts with hospice agencies, and it is not uncommon for us to go into someone elses 911 zone and handle the transport.

[Bieber]

I don't know about Kansas but in NY we have what they call Certificates of Need. They are issued by the state to ambulance companies and they define the territories that they cover. The company that I work for in Chemung County hold the CON for the whole county and for the northwest corner of Bradford County in PA and the northeast corner of Tioga County in PA. We contract out the eastern most part of our county to Greater Valley because they are much closer to those communities than we are. Because of this both companies have to be dual state certified.

There's actually not a lot of private EMS in Kansas, surprisingly. EMS here is usually county-based, third-service, although there's some municipal-based EMS services, a handful of fire-based services, and Med-Act (though I think they're a trust?) in Johnson county (Olathe) and AMR (but I think they're just in Topeka). I know the counties to the north and south of mine are a little odd in that there's no one county service but a munch of small little municipal services, although even we have like, two municipal services in our county as well for some of the small little towns way out there in the boonies. My service doesn't usually end up interacting much with other services unless we're providing ALS intercept for one of the small volunteer BLS services.

Edited October 10, 2012 by Bieber

[RuralKSEMS]

There's actually not a lot of private EMS in Kansas, surprisingly. EMS here is usually county-based, third-service, although there's some municipal-based EMS services, a handful of fire-based services, and Med-Act (though I think they're a trust?) in Johnson county (Olathe) and AMR (but I think they're just in Topeka). I know the counties to the north and south of mine are a little odd in that there's no one county service but a munch of small little municipal services, although even we have like, two municipal services in our county as well for some of the small little towns way out there in the boonies. My service doesn't usually end up interacting much with other services unless we're providing ALS intercept for one of the small volunteer BLS services.

We've got two services in the county. One is covering a small part of the county including a largish (by rural standards) town. The other (mine) covers the rest of the county and most of the other small towns in it. In our service we have two paramedics, 5 nurses, 14 AEMTs, and I'm not sure how many EMTs. We also have several EMR/FR groups. My service is actually privately owned but gets a subsidy from the county so I'm not sure how you would term it. The people that own my particular service also run services in three other counties.

I know AMR is in Topeka. They use to have MedAct (I think) in Kansas City. I'm not sure who runs in Whichita. Most of the services I know of are country run.

[Bieber]

Johnson county is still Med-act and Wichita is served by a county-based third service.

[RuralKSEMS]

Got ya. I'm in a county that's just below Nebraska and about 75ish miles from St.Joe so you know how rural that area is.