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.
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