Ambulance law differences
December 31st, 2006 by 
Alica
blog 12/31
How does Brandon’s new ambulance ordinance compare to Minnehaha County’s, which now governs Brandon’s surface ambulance services?
In most sections, the county ordinance goes into more detail than the city’s. The city ordinance states that all services licensed by the city must be licensed first by Minnehaha County, or must provide documentation that they meet all the requirements of the county ordinance as well as the “different or additional provisions” of the city ordinance.
An example of “different provisions” would be the amount of insurance required. The city requires less. An example of “additional provisions” would be that the city requires disaster training and the county does not.
But it is unclear what is or is not required when the city ordinance does not address topics that are in the county ordinance. For example, the county requires that records be kept of all calls. The city makes no mention of call records. Does that mean the city ordinance defaults to the county ordinance on that point, or would the city’s omission of a record-keeping section be considered one of the “different provisions?”
It’s your duty to be informed, and to let your city councilmen know how you feel about the city’s emergency services. The complete Brandon ordinance can be found on this blog.
Ordinance MC31-02, for licensing surface ambulance service in Minnehaha County, can be found online at www.minnehahacounty.org/ordinance/licensing_ambulance/MC31-021.pdf. (CLICK ON LINK BELOW)
Here is a more in-depth analysis of the differences.
Licenses required: Both are the same except the county makes provisions for licenses issued by municipalities or private contracts.
License term: County is four years. City is one year.
Quality assurance/oversight: The county may contract for quality assurance review, with six areas of review specified. The city will have a Safety Committee but doesn’t specify any areas of review. Neither states qualifications for persons who do the quality assurance or oversight.
Vehicle specifications: The county requires vehicles to meet state standards. The city requires vehicles to meet Sioux Falls Regional Emergency Medical Services Authority standards.
Response: The county requires acknowledgement within 60 seconds of a request and ambulance en route within 10 minutes. The city lists no response requirements.
Staffing: The county calls for compliance with state standards. The city requires at least one EMT (driver) and one emergency medical technician-paramedic.
Medical director/control: The county requires a doctor with staff privileges with at least one acute-care hospital in the county. The city requires a doctor but does not require hospital staff privileges.
Insurance: Both call for $1 million in insurance for employee professional liability coverage per incident. The county further requires $500,000 property damage per incident, $500,000 personal injury for one person per incident and $1 million personal injury in the cumulative per incident, plus an umbrella policy of $1 million per incident. The city requires an annual aggregate (total) of no less than $2 million.
Equipment: The county requires equipment to meet state standards. The city requires equipment to meet REMSA standards and sets guidelines for equipment inspections annually.
Licensing: The county, in a section of the ordinance, outlines what information must be included in the license application, with 15 items listed. The city lists required information on various topics in sections relating to that topic.
Geographical boundaries: The county issues licenses for specific geographical areas with a priority to not overlap boundaries. Any service wanting a license for an area already covered by another service must show that a need exists for more than one ambulance and that a second service will not affect the ability of the first to do its job. The city allows for more than one service.
Safety and sanitary standards: The county lists 10. The city lists none.
Record keeping: The county requires records to be kept of all calls. All records must be kept for at least five years and must be available to the county for quality assurance purposes. The city lists no record keeping requirements.
Confidentiality: The county provides for confidentiality of records. The city lists no confidentiality requirements.
Disaster training and response: The county lists no disaster training or response requirements. The city requires services to take disaster training. The city allows for licensed services other than the contracted service to respond to calls in emergencies such as bad weather (tornado or blizzard).
Suspension, revocation: The county requires a hearing to determine if a license should be revoked. The city requires a hearing only if the license holder requests one.
Enforcement: The county states that any ambulance that conducts service without a license is guilty of a class 2 misdemeanor. The city lists no noncompliance consequences.
www.minnehahacounty.org/ordinance/licensing_ambulance/MC31-021.pdf
Posted in Ambulance | 
January 3rd, 2007 at 10:30 pm
Where to start? There is so much information or lack thereof on this issue that it’s virtually impossible for the general public with little or no medical background to make heads or tails of this ordinance. Here are my questions.
1. Should our city council even be writing a new ambulance ordinance? are they qualified to do so? With no medical background, how do they know what to include or omit?
2. I have a huge problem with the medical director part of the ordinance. They are not going to require that the physician have hospital priviledges? Are you kidding me??? Why in the world not? That is STANDARD PRACTICE. Who is this going to benefit, a future service that doesn’t have medical director with priviledges?, surely not future Brandon patients. Would you choose a family doctor for your children that doesn’t have priviledges at a Sioux Falls hospital?
3. We are going to put our safety committee in charge of overseeing an ambulance service? Does anyone on that committee have emergency medical experience? NO they don’t. We are putting them at risk having them make decisions they know nothing about. Will they be doing the run reviews and QA reviews? If they do run reports, will the medical terminology mean anything to them, how about the proper dose of epinephrine, or how many joules to use for a cardiac shock?
4. No safety and sanitary stipulations? Who’s making sure patients are not cross contaminted?
5. No record keeping of calls? Why? If you can’t produce call information, what happens if we get sued?
6. No confidentiality requirements? Does our city council realize that HIPPA laws are federally mandated? Bad things can happen if there is a HIPPA violation. On the other end….if I become an ambulance patient my medical record is not protected???? No thanks.
7. As stated by Councilman Karber (and also the ordinance) we shall hire a medical director to oversee. That to me is paying for something we already get for FREE. How much is this going to cost?
8. If we’re going to hire someone at I’m sure a premium price, why not just have our own ambulance service?? Use that money to hire an emergency medical manager/paramedic. There are many, many communities that can transfer their own patients to Sioux Falls. We have a terrific volunteer service, let’s let them do the job they obviously love.
9. Our volunteer service is one of the best and has many state certified EMT’s. EMT-B’s are qualified in life saving techniques with over 110 hours of training. They respond in approximately 5 minutes, and stabilize the patient for transfer by Rural Metro. Brandon is never short of volunteers like some other communities. If we’re so willing to throw money into this new ordinance, why not throw the money into our existing first responder service..I’m sure they’re are expensive items they would love to have.
10. What will happen to our existing volunteer service if we let another ambulance service into Brandon?
11. What is broke about our present system? How many documented deaths are attributed to slow response time? WE ALREADY HAVE VOLUNTEER FIRST RESPONDERS, many who are EMT’S.
12. Is this possibly overkill and overspending just like the issue of the median for Holly boulevard that the people said no to? The difference is we’re dealing with a life and death issue. People of Brandon, speak up and be heard, we’ve been given a second chance to educate ourselves, thanks to the watchful eye of a brandon resident. This ordinance was going into effect without us knowing the details. Why is that? We didn’t ask. Obviously if you don’t ask, you’re not told.