Posted to alt.med.ems and fireradio@yahoogroups.com on 18 July 2001
Funny thing just happened - I searched the Yahoo.com News service for 911 and I went to a spy cam page. How odd. Peter S
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The Arlington MA FD operates a BLS ambulance staffed by 2 FF/EMTs who are supported by a ALS unit from Armstong Ambulance Inc that is staffed by 2 paramedics. Arlington is a residential suburb of Boston housing 42,000 folks in 5 square miles. Here is some selected text from the ALS / BLS agreement.
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Interim Agreement Between The Town of Arlington (Massachusetts) and Armstrong Ambulance Service Inc
This interim agreement is made between the Town of Arlington called, "TOWN", and Armstrong Ambulance Service Inc., called, "ARMSTRONG" for the purposes of outlining temporary provisions of emergency Advanced Life Support (ALS) services to the Town of Arlington.
Whereas; The Town of Arlington wishes to continue receiving Advanced Life Support services as presently provided by ARMSTRONG to augment its Basic Life Support ambulance service and,
Whereas; Armstrong Ambulance Service has been providing these services to the Towns of Arlington, Belmont, Bedford, Burlington, Lexington, North Reading, Reading, Watertown, Wilmington, Winchester, and Woburn, utilizing a two tiered response system under the oversight and leadership of the North Suburban Emergency medical Consortium (NSEMC) and the South Middlesex Emergency Medical Consortium (SMEMC) and,
Whereas; Ongoing financial losses and changes in the Medicare reimbursement system have necessitated the parties to renogotiate the terms and conditions of their previous agreement and,
Whereas; Both parties wish to continue in this relationship of providing and receiving emergency ALS services in the pre-hospital care environment for the protection and benefit of its residents and visitors within its boundaries,
Now Therefore; The parties agree to the terms and conditions as noted:
TO BE CONTINUED
1. Service Provisions
1.1 ARMSTRONG shall provide the Town of Arlington with 24-hour, 7 days per week, regional based emergency ALS services subject to the provisions agreed upon by the North Suburban Emergency Medical Consortium.
1.2 The ALS service shall be provided by ARMSTRONG utilizing non-transporting vehicles.
1.3 The TOWN shall provide the ambulance transport when ALS intervention is needed and the patient shall be transported to the closest most appropriate medical facility, based upon Point of Entry guidelines, utilizing patient preference where ever possible and as directed by the ARMSTRONG Paramedic staff or the medical control physician.
1.4 ARMSTRONG reserves the option to dispatch the closest available ALS unit to any request made by the TOWN. In the event a transporting unit is the closest unit and is subsequently dispatched, it is understood by both parties that this vehicle will not transport the patient unless specifically requested by the Fire department Officer in charge at the scene.
1.5 ARMSTRONG shall provide the TOWN with the appropriate radio communications hardware for the primary use in communicating with the ARMSTRONG Communications Center. ARMSTRONG shall provide and maintain this equipment at no cost to the TOWN. In the event of a radio system failure, the TOWN shall utilize its own phone system as a temporary measure to communicate with the ARMSTRONG Communications Center.
1.6 The TOWN 911 communications or dispatch center personnel shall request an ARMSTRONG Paramedic response for every request persuant to the NSEMC dispatch criteria guidelines. Requests shall be made immediately following the dispatching of the TOWN ambulance to insure the immediate response of ALS personnel. In no way does this preclude the EMS personnel from requesting a response from another ALS provider if it is clear that the other agency would have a shorter ETA.
1.7 Both parties agree to maintain their vehicles at all times in conformance to all local, state, and federal laws or regulatory provisions as set forth by the agency charged with its oversight.
TO BE CONTINUED - Same Bat Channel - Same Bat Station!
2. Billing, Collection and Payment Provisions
In lieu of a direct subsidy to ARMSTRONG for providing 24-hour Paramedic services, the parties agree that all payments received for ambulance tranpsports whereby the TOWN provides the BLS and ARMSTRONG provides the ALS shall be paid to ARMSTRONG and shall constitute full payment to ARMSTRONG for providing 24-hour paramedic service to the TOWN.
The TOWN shall not be liable for any additional costs incurred by ARMSTRONG and ARMSTRONG shall not be liable for any additional costs incurred by the TOWN pursuant to the provisions outlined in this agreement.
2.1 Billing procedures for ALS patient transports covered by Medicare Insurance
The TOWN will perform the billing and collections for all patients transported who are covered under the Medicare insurance program. The TOWN will also perform all third party or balance billing for these individuals.
Following remittance from Medicare, in accordance with their guidelines, the TOWN shall make a reasonable effort to collect the 20% balance due. The TOWN or its billing agent shall bill the patient or secondary insurance according to industry billing practices in an effort to collect payment. ARMSTRONG shall have the option of requesting further collection procedures after reviewing outstanding accounts with the TOWN.
2.2 Billing procedures for ALS patient transports covered by other Insurance or no insurance
ARMSTRONG would have the expressed right to bill the patients and or their insurance provider and collect full payment for all services rendered pursuant to this agreement.
4. Terms & Termination
The provisions of this agreement shall become effective on February 1, 2001 and shall terminate on June 30, 2001. Armstrong shall not provide ALS services to any community noted beyond the termination date unless reflective in a subsequent agreement between Armstrong and the Community.
9. Authorization
[signed by Town Manager on 3-2-01]
[not signed by Armstrong Ambulance]
[I picked up this document from the Town Manager's Office on 10 July 2001 - so technically I guess it had already expired - I have no idea if a new agreement is in effect yet]
[The Annual Town Meeting passed a Article in Spring 2001 setting up a Enterprise Account to deal with these ALS costs]
One other interesting item - "Armstrong shall maintain at all times during this agreement, statutory Workers Compensation insurance coverage for its employees as well as automobile liability and property coverage in minimum amounts of $1,000,000. Further, Armstrong shall maintain professional / general liability coverage in minimum amounts of $1,000,000 / $3,000,000."