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  1. #1
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    Private ambulance companies running code

    In Illinois, private ambos can run lights and sirens only in "bona fide emergencies."

    I live in an area where there are MORE than enough FD ambulances to go around. So actual emergencies usually go through 9-1-1, and are handled by the FD. Sometimes, if the patient wants to go to a specific hospital, the FD will call a private ambulance for them. But if it's an emergency, the FD will transport to the nearest hospital every time.

    So why do I see private ambulances flying Code-3 everywhere?? I've thought about stopping them to see if they're actually responding to/from an emergency, but I'm not going to be "that kind of cop" (and boy would I be red if it WAS an emergency!).

    Has anyone had any dealings with private ambulance companies? Ever do a traffic stop on one? Ever see an accident caused by one?

    What are your thoughts?
    "Well I'd lock him up for what we know he did, and then throw in a few extra years for what he probably did." ~Hank Hill

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  2. #2
    The Po-po

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    If it's an ambulance, and it's running code and I see them coming up to an intersection that I'm waiting at, I wil clear the intersection for them! No freakin way am I gonna delay an ambulance to an emergency! If you have a genuine concern, call the city agency non emergency number that you're in and see what they're headed too!
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  3. #3
    Whats In Your Wallet?
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    Many private ambulance companies are contracted out by cities to respond to 911 calls. Others deal with people who are criticaly ill, and some require quick transport to hospitals for treatment.

    There are actually a few reasons as to why they run code in IL.

    And no, not in every case do the FD respond to an emergency call. If you get 2 calls in, one a level one trauma, and another possibly a level 2, they might send the FD to the level 1 and the private to the level 2....... both of which require running code 3.
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  4. #4
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    My thought is why do I care if an ambulance is running code or not?! It aint my responsibility to check to see if someone inside the bus is really having a "bona fide emergency." Besides, I don't like the idea of a wrongful death suit filed against me!
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  5. #5
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    I understand what Ten-32 is talking about, see it all the time in the city, and no privates are contracted out for city 911 runs. Talked to one of our guys that worked as an EMT and another guy that works for a private company and they are told to run code for EVERYTHING, even a routine transport, because they can squeeze more runs in on a shift, which means more $$$ to bill Public Aid. Have your dispatch call the private's dispatch and inquire why they are running like that. If it's an emergency in a burb with FD ambulances, find out why they (FD) aren't responding to that "emergency."

    A year or so ago, I responded on a "Fire calling a 10-1 (Emergency assist)" at a nursing home, only to get there and find out it was called by a private ambulance crew that needed a hand lifting a transport patient. They both should have been locked up.

    Aside from a few south burbs that contract out privates for their municipalities, there's no need for all those code ambulance runs all over the city. One ever clips me, I'll get their radio tapes frozen and they will pay dearly.

  6. #6
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    My jurisdiction is one private ambulance company. They're contracted by the city and work with our fire dept, no big deal, they're good people. Situation here sounds far different than there.

  7. #7
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    Omega and TexasNarc, I've never stopped an ambulance, and I never would! The problem is I can't call the "city agency," because any joe-citizen can call a private ambulance to transport him for a hang nail, and that ambulance could go code-3, and we would have no way to know that it really wasn't an emergency, until the ambo gets in a crash and kills someone.

    MCSD, I understand what you're saying, but it doesn't apply around here. And while there might be multiple "reasons" to run code, the law is clear that they cannot activate their emergency lights except "when responding to an emergency call for and while actually conveying the sick or injured"
    Obviously, I'm not referring to a private ambulance that has been contracted by a municipality, and I'm not referring to transporting the critically ill, as both of those would qualify as emergencies.

    As a side note, in my area, private ambulance companies are not contracted by municipalities, as municipalites use the MABAS mutual aid system when they need additional ambulances.

    I was referring to ChiTownDet's experiences... and I was really asking not because they run code, but because they are frequently very irresponsible when doing so. I've seen one run with only a siren and no lights, flying through red lights and such. That time I did call their dispatch, but who knows what gets done with that?

    I don't have a problem with ambulances running code... I only have a problem with the private companies who I frequently see doing it very dangerously.
    Last edited by Ten-32; 03-30-2008 at 03:58 AM. Reason: speling
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  8. #8
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    ........................
    Last edited by Huey County; 08-05-2009 at 02:26 AM.
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  9. #9
    Brav989
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    Heh. Round my way there are only private ambulances. There are FF/Paramedics, but they ride on fire engines.

  10. #10
    Bitter Gun Owner
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    Quote Originally Posted by Huey County View Post
    Some of the M.A.B.A.S. cards do in fact include the use of private ambulances. Most the time around the forth of fifth Box Alarm Level.
    Yep, but not in the areas where I've observed these problems. Besides, if there was a fifth alarm ambulance box, I'd know about it.
    "Well I'd lock him up for what we know he did, and then throw in a few extra years for what he probably did." ~Hank Hill

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  11. #11
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    I've wondered about this for years. In my town there are two nursing homes across from the fire station. On medical emergencies, the fire department medics are dispatched there. Other times, I see private ambulances pull up there after running lights and siren. We dispatch for the fire department and on those occasions, the fire department medics are available but not summoned by the nursing homes.

    My Mom was in a nursing home for a few months last year. One day she had a scheduled visit to her doctor's office. My Dad said a private ambulance showed up at the nursing home for her after running lights and siren.

    I guess I'm just curious about why this exists. It seems that there are some paramedic types that post on this forum. I would find their input interesting to read.

  12. #12
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    Ems

    I used to work for a paid Ambulance Service for seven years before getting hired at a PD earlier this year. Hopefully I can shed some light.

    Most people call 911 for their emergencies, but most nursing homes, doctors offices, etc call the direct line to the Ambulance service because it saves time and they don't get the first response engine from the 911 system.

    Trust me when I say some of these calls that come in direct are the most serious calls that we used to go on. When the 911 calls came from nursing homes it was usually because family members were there at the time and were the ones that called 911, rather than the staff of the nursing home.

    Our private agency was contracted to do all EMS for the county I worked in so we went on everything no matter what. All calls for us were emergency medical dispatched by the operator who took the call (either 911 or our company dispatcher) and given a priority (ALS or BLS and HOT or COLD). The ultimate discretion was up to the crew themselves but for the most part unless the call sounded like it was mishandled (a lot of strokes came under non emergency responses through the old protocols) we would listen to the dispatchers priority.

    Most private agencies are VERY strict with their emergency response priorities due to liability so I have a hard time believing that their bosses would be telling them to step up to code if it wasn't really necessary. If you ever have a question, call the companies central dispatcher and ask where that unit is going. Go there, and talk to the crew when things calm down. If you want to do it without seeming like your trying to get them in trouble just offer them a quick hand or whatever and see for yourself what they are responding to.

    Again, we were left with the ultimate discretion to decide to run code or not, and that is based on the information given at time of dispatch, NOT what you find when you get there, so I am not sure what you would do if your personal opinion was it wasn't a real "emergency" when you got there anyway.

    My humble, usless opinion: If they are being safe, smile wave. If they are driving recklessly then write down the plate or ambulance number and call the company and have it handled that way.

    EDIT: I see what you said now about them driving recklessly. Meet them at the scene and give them a stern warning about driving safely and call the company telling them you did so. If you see that guy doing it again, well... at least in NY the laws stipulate you have to drive with due regard... I imagine your state has the same. If you have to as a last resort i'd say take enforcement action at the hospital after the call was over.
    Last edited by PTLovesMe81; 03-30-2008 at 09:05 AM. Reason: I read more info about your post.

  13. #13
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    I have worked for a couple private ambulance companies as an EMT before becoming a Deputy Sheriff and I guess technically I'm still on a roster as being part-time for one. At times it seems like your running code to something stupid, but other times they are true medical calls or emergency transports.

    The first place I worked for would transport for a few of the local fire departments. They would respond to the 911 call with the local fire departments and take people to what they call "Hospital of choice" that was out of the fire departments area. The company would also responds to "Hot" calls for some reason and this is beyond me to the reason why, but to nursing homes on a code. I responded more than once working for this company to a code. The thing that got me each time we responded to these kinds of calls you were always across town and there were at least 6 PAID fire stations with ambulances between you and the call. The nursing homes should had been calling 911, but they didn't, they called a private ambulance.

    This company was all about making the money though and there were many times you would question the response level, but it was there company policy. It was up to the owner of the company who is not even a First Responder on whether or not they traveled at emergency response or not. The only way other than with a supervisor's approval that you could travel at an emergency level would be if you determined the patient was going down hill.

    The second company in which I'm on the part-time roster for primarily transports critical patients from hospital to hospital that the helicopter will not take. Normally they do long distance transports that's just too far out of the area for fire departments, I mean like 2 and 6 hour or longer transports. The only time they expedite is when the patient gets bad or when the patient is already bad.

    Normally this company had there transports for the day predetermined before the day, but they also helped out the more Raul fire departments out in the sticks(I mean Raul I mean over an hour one way to a hospital). This company employees a lot of off duty LEO's as drivers.
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  14. #14
    Bitter Gun Owner
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    Thanks for all the replies. I realize now that maybe I should have posted in the Illinois forum; sorry...

    To reiterate, I have NO problem with ambulances running emergency when there is an emergency. It's just that I work in an area that uses full-time, paid, municipal paramedics and ambulances, dispatched via 9-1-1. If there's an emergency, why would people call a private?

    Hearing from PTLovesMe and NebraskaDeputy did shed a little light, maybe. But I'll tell ya... if I was a patient, or the family of a patient, in a nursing home that calls a private ambulance for medical emergencies, when there's 8 fire stations in a 10 mile radius, I'd be freakin' p*ssed!!!!!!!!
    "Well I'd lock him up for what we know he did, and then throw in a few extra years for what he probably did." ~Hank Hill

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  15. #15
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    The ambulance is part of the police department in my agency. Civilian EMT's, but the budget is part of the PD. They run lights and sirens to freaking everything. Don't know about where you are but a lot of people think the ambulance is their personal taxi to the ER cause they have a belly ache or a head ache. Thank god we usually have 2-3 rigs running at a time.

  16. #16
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    I'm currently a paramedic for a private service and also a dispatcher for the same service. We provide all 911 ALS (paramedic level) EMS for the area as well as all interfacility transfers.

    All 911 calls go to the city or county PSAP and are transfered to our Emergency Medical Dispatchers if it's a call for a medical emergency. The call is prioritized and all pre-arrival instructions are provided by our dispatcher. An ambulance is sent and the appropriate municipal first responders are notified and sent.

    Any emergent response is based on protocols and not "to get there faster to make more money."

    There are numerous reasons an ambulance may be running hot and you as a police officer wouldn't know why. But believe me, I couldn't imagine in any decent size municipality the cops would have enough time to even care.

    1) The ambulance could be in one municipality (at the hospital, enroute back from the hospital, posted there for status, etc) and dispatched to a call in another. We frequently run hot across city lines responding to a call. The cops not in the jurisdiction where the call is located won't know about it.

    2.) As previously stated most medical facilities call private services directly. We literally have 100's of nursing homes, doctor's offices, outpatient facilities, urgent care centers, etc that call us directly for service. Their call is run through the dispatch protocols just like a 911 call to determine response priorities and are frequently a Med 1 (hot.)

    3.) Many large employers, factories, etc have a medical response team who also frequently call EMS directly.

    For both #2 and #3 we sometimes notify the municipal first responders but most of the time don't. Again, this is based on protocol for that specific facility. If the already have a doctor on scene or a medical team on scene there is no need to send fire as first responders. So again, 10's of 1000's of calls in our area will have an ambulance running hot and the cops would have no idea of the call. Again, they'd be too busy to even care.

    4) We run 1000's of inter-facility transfers. Many of these are emergent and require a hot response. Municipalities don't know and definitely don't care to know about these. Examples are too numerous to list. Many hospitals are specializing in certain areas, ie OB, heart, trauma, burns units, etc. A patient may present to hospital 1 which no longer treats significant cardiac disease. This patient requires transport to Hospital 2 for an active heart attack. These transports can often be hot as well.

    I used to work in Dayton, OH where 911 medical service is provided by the fire department. There was also several private services in the area. These services covered all the nursing homes, urgent cares, doctor's offices, etc and had protocols in place for emergent responses to these locations. The fire department never knew, or cared, where these ambulanced responded to.

    Hope that helps.

  17. #17
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    In Alabama, most ambulance service is provided by private firms. Quite often, they recieve a subsidy from the city/county which they serve. In my personal experience, their running emergency has never been a problem.

  18. #18
    Molon Labe
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    MOST of the bamulance companies out here in LA are private.......The paramedics ride in their own little red truck or on the main rig....

    LA City is one of a few of the large agencies out here that have their own ambulances......
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  19. #19
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    Something you may realize is that private ambulances are part of the ground support for air medical services. Not all hospitals have a helipad right at the hospital, so for inter-facility transfers of critical patients, the flight crew is ferried to the patient lights and sirens, the patient is picked up from the referring hospital and transported back to the aircraft lights and sirens. Additionally, since helicopters can only fly in near perfect weather critical inter-facility transfers can only be handled on the ground and this is always handled by a private ambulance company or the air medical service's ground team (which some of you would also call a private ambulance company). Not all hospitals are created equal ... a community hospital has very few resources and will often need to transfer critical patients to large university or state run medical centers. Hospitals do not call 911 when they have an emergency ... they call their contracted vendor for that service.

    Lastly, private ambulance companies work standby details for large events. Any emergency that happens at the event (concerts, parades, sporting events, etc) that ambulance crew handles just like a regular 911 ambulance.

  20. #20
    Ten Six
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    Quote Originally Posted by ChiTownDet View Post
    I understand what Ten-32 is talking about, see it all the time in the city, and no privates are contracted out for city 911 runs. Talked to one of our guys that worked as an EMT and another guy that works for a private company and they are told to run code for EVERYTHING, even a routine transport, because they can squeeze more runs in on a shift, which means more $$$ to bill Public Aid. Have your dispatch call the private's dispatch and inquire why they are running like that. If it's an emergency in a burb with FD ambulances, find out why they (FD) aren't responding to that "emergency."

    A year or so ago, I responded on a "Fire calling a 10-1 (Emergency assist)" at a nursing home, only to get there and find out it was called by a private ambulance crew that needed a hand lifting a transport patient. They both should have been locked up.

    Aside from a few south burbs that contract out privates for their municipalities, there's no need for all those code ambulance runs all over the city. One ever clips me, I'll get their radio tapes frozen and they will pay dearly.
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  21. #21
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    In my county we have private and fire that run. I know that if I am hurt and I need help I don't care who it is. I know (medix) our private group is a class act, and they know what they are doing. I would even go as far as to say that I would rather have them there than some of the FD members. So do they not let other states private ambulance run code?

  22. #22
    vvincelli
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    Problem we have here is that whenever EMT is dispatched they ALWAYS go code to the scene. Even if WE are the requesting Agency and tell them there is no visible or perceived injury, just want an ambulance / EMT to check them out, no rush, priority 3, we will get a firetruck, an ambulance, and a paramedic - all going full-bore code to the scene. Never fails. We've tried to work this out and their line is "it's our policy". Why we always get all three when we only need the one? "it's our policy". Actually, it's so all three providers get in on the billing (even if patient refuses). That, and the fact that now the narrow city street is basically an emergency vehicle staging ground (for no good reason) - Ugh.

    Second problem we have is that they will not take our word for ANYTHING. If they are initially dispatched, expect them in all their glory. All their rigs, ambulance, medics, whatever. We try so HARD in certain situations cause it takes a simple matter and turns it into a disaster. MVA with unknown injuries? Everyone goes (understandable). We arrive on scene immediately and there are absolutely NO injuries, roadway is already a little tight? "Please cancel Fire and the Medics. No injuries. Bad spot. Please cancel them.". Forget it. You're getting all of them. Fire / Rescue / Ambulance / Paramedic. Better get ready to shut down the road for this little bumper-to-bumper minor accident, cause they will NEVER cancel.

    Very, very aggravating.

    Job security is one thing, but when you're taking a tough situation and making it drastically worse - Ugh.

    - V

  23. #23
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    Here in Nevada, we get private ambulances as well as fire dept. ambulances responding to EVERY call, as the fire department will not transport, unless there isnt a private ambulance available. I personally know when I was injured they had a private ambulance transport me with life threatening injuries.

    The problem here is I've recently seen a couple private ambulances running with sirens on, but no lights, which I thought was VERY strange.

  24. #24
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    Quote Originally Posted by DCPSDcop View Post
    Something you may realize is that private ambulances are part of the ground support for air medical services. Not all hospitals have a helipad right at the hospital, so for inter-facility transfers of critical patients, the flight crew is ferried to the patient lights and sirens, the patient is picked up from the referring hospital and transported back to the aircraft lights and sirens. Additionally, since helicopters can only fly in near perfect weather critical inter-facility transfers can only be handled on the ground and this is always handled by a private ambulance company or the air medical service's ground team (which some of you would also call a private ambulance company). Not all hospitals are created equal ... a community hospital has very few resources and will often need to transfer critical patients to large university or state run medical centers. Hospitals do not call 911 when they have an emergency ... they call their contracted vendor for that service.

    Lastly, private ambulance companies work standby details for large events. Any emergency that happens at the event (concerts, parades, sporting events, etc) that ambulance crew handles just like a regular 911 ambulance.
    This is very true. When I was injured (broken femur, broken collarbone, brain bleeding), they took me to the nearest hospital, which wasnt a trauma center. The hospital looked at everything and decided i needed to go to a level 1 trauma center, and transferred me in an ambulance there.

  25. #25
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    I feel your pain

    Quote Originally Posted by vvincelli View Post
    Problem we have here is that whenever EMT is dispatched they ALWAYS go code to the scene. Even if WE are the requesting Agency and tell them there is no visible or perceived injury, just want an ambulance / EMT to check them out, no rush, priority 3, we will get a firetruck, an ambulance, and a paramedic - all going full-bore code to the scene. Never fails. We've tried to work this out and their line is "it's our policy". Why we always get all three when we only need the one? "it's our policy". Actually, it's so all three providers get in on the billing (even if patient refuses). That, and the fact that now the narrow city street is basically an emergency vehicle staging ground (for no good reason) - Ugh.

    Second problem we have is that they will not take our word for ANYTHING. If they are initially dispatched, expect them in all their glory. All their rigs, ambulance, medics, whatever. We try so HARD in certain situations cause it takes a simple matter and turns it into a disaster. MVA with unknown injuries? Everyone goes (understandable). We arrive on scene immediately and there are absolutely NO injuries, roadway is already a little tight? "Please cancel Fire and the Medics. No injuries. Bad spot. Please cancel them.". Forget it. You're getting all of them. Fire / Rescue / Ambulance / Paramedic. Better get ready to shut down the road for this little bumper-to-bumper minor accident, cause they will NEVER cancel.

    Very, very aggravating.

    Job security is one thing, but when you're taking a tough situation and making it drastically worse - Ugh.

    - V


    I totally feel your pain on this one. HOWEVER, something you may not realize is something one of my supervisors once put so eloquently: "The EMS system is like a tube of toothpaste, once it comes out its IMPOSSIBLE to get back in." In New York State there is a reason for this. By state protocols there is the following:

    Paramedics can be cancelled by EMT's already on scene after they have assessed the patient and determined no EMS is needed. EMT's can also cancel all responders (Paramedics, EMT's and CFR's). CFR's can only cancel EMT's and Paramedics if there are NO injuries perceived or complained off what-so-ever. If we were ever to cancel prior to someone "medically trained" getting there and something were to happen our certifications would be on the line, and we would be open to a huge civil liability.

    In reality most of the time, EMS gets there and asks the same question "are you okay?" and the patient says yes, and then we can leave. According to New York State, we are not allowed to be cancelled by Police, Fire, or any other type of service unless they have medically trained personnel on the scene.

    As far as slowing it down and knocking down to non-emergency, I would imagine thats a local protocol, but I always downgraded when fire or pd was on scene advising me to.

    Do I agree with this system? Not totally, I think its a waste of resources many a times, but its the system we have in NYS.
    Last edited by PTLovesMe81; 03-30-2008 at 06:45 PM. Reason: Brain Hurts

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