Monday, November 02, 2009

Part IV: Ambulance Service

And now with our fourth installment -- Emergency medical services.

Part IV: Ambulatory Service Issues:

As cities and counties are uniquely positioned, and asked, to provide for the general health, safety, and welfare of their communities, the ability to regulate emergency transportation within their jurisdictions is a key cornerstone to the provision of public safety and health. Local governments throughout the state have worked closely with private providers to assist in this effort, and in many circumstances, rely heavily on the private sector to help with these services.

The current licensing and regulation framework, where the state applies universal licensing provisions for private and public providers, but allows for local regulation of some practices has positioned Utah as one of the best managed states in the nation in its provision of emergency transportation.

For the past several years, a private provider has complained that the current process of state licensure is anticompetitive and has asked for law changes that would allow for direct negotiations between emergency transportation operators and hospitals with little or no city or county oversight. Cities and counties have continued to express concern with these proposals due to the potential that such negotiations could undermine the ability of single providers to remain profitable within a given geographic area. With current licensure requirements that require ubiquitous service within a given geographic area, it is imperative to ensure that the license holder is self-sustaining. In addition, cities and counties have increasingly begun to assist in providing such services as the public provider. Those public provider contracts are obtained either through direct negotiations with the current private provider or through the awarding of a contract to the public provider by way of an RFP process.

While we currently do not anticipate legislation this year, we do wish to continue to educate the legislature on this matter to ensure a complete understanding of our position, which includes the following key components:

  1. Cities and Counties are charged with the maintenance of general health and safety, and emergency transportation is a key component to the provision of public safety and health.

  2. Ensuring the viability of a single provider, within a geographic area, is imperative to ensure adequate public safety service and response.

  3. Cities and counties should be able to regulate certain aspects of the operation of emergency transportation within their communities to maintain general health and safety.

  4. Cities and counties should be able to provide emergency transportation services if a private provider is not capable or willing to provide adequate service.

  5. Competition should not occur at the hospital level, but should occur at the licensure level, where geographic service areas are considered in their entirety and universal service and coverage are contemplated as a part of a larger service component.

  6. Allow Cities and counties to designate a single dispatch system such as VECC for all ambulance service requests. Such a system eliminates confusion for the public, provides a single medical protocol and consistent dispatching of ambulance service to meet the correct medical and transport needs of the public.

We look forward to working with the legislature in the coming years on this important public safety issue, and appreciate the support we have received to maintain our high standard of public safety response and service.