Out of area transport

[JetMedic]

I’m a medic in Los Angeles County. I presently work for a private IFT company. I was assigned to a transport that picked up and then dropped off at facilities that were both outside of my county.
I know I can pick up patients in county and take anywhere outside of county. I also know that some provisions were made that allows me to pick up patients out of county to bring them in. But operating totally outside of county? How legal is that?

 

[CCCSD]

Consult your company policy which should address this.
Does your company operate within a compact between Counties?

 

[Jn1232th]

Out of county you work under same protocols. Picking up from another county to bring into yours is kind of a grey area. Now if your totally running calls of out of your county and your not accredited in said county or your company isn’t ( and it’s not mutual 911 aid) then that’s kind of weird area.
But I’m just going off my experience as a medic in L.A county few years back

 

[JetMedic]

Consult your company policy which should address this.
Does your company operate within a compact between Counties?

I’m not trusting what my company says for several reasons. First, when I first posed the question they were very quick to answer “Yes! Totally legal. Now run the call.” Secondly, when pressed for proof all they could give was anecdotal evidence “I’ve done it before.” And lastly, after several days of asking I have yet to see any regulatory proof that supports their claims. I’m thinking that if it actually existed they would have thrown it my face already (something they’ve done in the past on numerous occasions).
I’ve contacted the county EMS authority and I’m awaiting their response.

 

[CCCSD]

So if you don’t trust your company’s policy manual, which should reflect current LEMSA policies, then start looking for a new job.

 

[Tigger]

I’m pleased that Colorado is moving to state licensure. Doesn’t seem necessary to restrict licensed ambulances from transporting patients to appropriate destinations. Also would be nice to get one sticker, instead of the four counties some services in my area must get because of the geography.

 

[JetMedic]

So if you don’t trust your company’s policy manual, which should reflect current LEMSA policies, then start looking for a new job.

Already in process. Just about done with A&P school and will be starting a whole new career. The company is experiencing an exodus due to the shady nature of their business practices. Especially when they don’t readily produce the sort of policies you speak of.
That said, do you always trust that private, for profit companies never bend the rules and exploit their employees?

 

[JetMedic]

I’m pleased that Colorado is moving to state licensure. Doesn’t seem necessary to restrict licensed ambulances from transporting patients to appropriate destinations. Also would be nice to get one sticker, instead of the four counties some services in my area must get because of the geography.

That would definitely simplify things and alleviate this sort of confusion. I don’t see CA eliminating county accreditations anytime soon, tho.

 

[JetMedic]

Out of county you work under same protocols. Picking up from another county to bring into yours is kind of a grey area. Now if your totally running calls of out of your county and your not accredited in said county or your company isn’t ( and it’s not mutual 911 aid) then that’s kind of weird area.
But I’m just going off my experience as a medic in L.A county few years back

There are definitive policies that allow for picking up out of county to bring back into LA County, as well as provision for mutual aid requests and disaster responses. No gray areas there. But I’m not finding anything (so far) that has addressed transports that do not involve my accredited county at all. I’ve contacted County FHS & EMSA for clarification. Just awaiting their response. Thought I would tap the community for input while I wait.

 

[CCCSD]

Already in process. Just about done with A&P school and will be starting a whole new career. The company is experiencing an exodus due to the shady nature of their business practices. Especially when they don’t readily produce the sort of policies you speak of.
That said, do you always trust that private, for profit companies never bend the rules and exploit their employees?

No. I’m mature and experienced enough to know what I’m doing.

 

[JetMedic]

No. I’m mature and experienced enough to know what I’m doing.

Then you ought to know better. We work in a field where our actions are evidence based. That’s why we have things like treatment protocols and medical direction. And that the word of a manager of a for profit company isn’t necessarily gospel. Because I’m mature and experienced enough to know who to trust and when.
But I really appreciate the input. It was helpful.

 

[CCCSD]

Then you ought to know better. We work in a field where our actions are evidence based. That’s why we have things like treatment protocols and medical direction. And that the word of a manager of a for profit company isn’t necessarily gospel. Because I’m mature and experienced enough to know who to trust and when.
But I really appreciate the input. It was helpful.

So read your protocols like I said originally, then read your company guidelines.
It’s really simple.

 

[JetMedic]

So read your protocols like I said originally, then read your company guidelines.
It’s really simple.

Normally, I would agree with you. But County treatment protocols do not cover IFT transport boundaries. And neither do company policies or guidelines. They are written under the assumption that transports are carried out within the county. Plus, when asked, my managers have not been eager to provide me with any information as to their policies concerning out of county conduct. Hence my suspicions over their trustworthiness.
Please do not think I would be tapping an online forum if I hadn’t already looked into the matter and came up empty. I’m not exactly new to this game. But this is a new and unique issue I’ve never had to deal with in over two decades.
As before, thanks for your input.

 

[Jim37F]

My two cents, which really are only worth that $0.02 since it's been close to 7 years si cents I've worked in Los Angeles County.... but I remember LA and OC being relatively unique/"special" in that they were really some of the only County/LEMSAs that required an additional local Co cert on top of State EMT Certification to work in. San Bernardino, Riverside, Ventura, Kern Counties never did.

So sounds like you're more worried over whether or not your Company is licensed as an Ambulance company in whichever (Ventura, Riverside, San Bernardino?) County... which is something you should be able to look up yourself fairly easy.

Otherwise if you're that concerned over the integrity of your management, that you find yourself unable to accept at face value your supervisor telling you they are properly licensed foe that pickup.... then it's simple. Start applying to different Ambulance companies.

 

[mgr22]

Normally, I would agree with you. But County treatment protocols do not cover IFT transport boundaries. And neither do company policies or guidelines. They are written under the assumption that transports are carried out within the county. Plus, when asked, my managers have not been eager to provide me with any information as to their policies concerning out of county conduct. Hence my suspicions over their trustworthiness.
Please do not think I would be tapping an online forum if I hadn’t already looked into the matter and came up empty. I’m not exactly new to this game. But this is a new and unique issue I’ve never had to deal with in over two decades.
As before, thanks for your input.

You mentioned at least twice that you aren't sure your agency is trustworthy, and asked for advice. Two experienced people have suggested that you consider other employment. Sounds like good advice to me. You don't have to take it, but why debate it?

 

[johnrsemt]

Glad I work in states that have statewide protocols

 

[johnrsemt]

Think about doing 75% of your runs from State A, and transporting 98% to State B.
That is my PT job, we cover both sides of a state line; 40 miles west into the state we are based in, and 56 miles east into the state that we transport mostly to

 

[JetMedic]

You mentioned at least twice that you aren't sure your agency is trustworthy, and asked for advice. Two experienced people have suggested that you consider other employment. Sounds like good advice to me. You don't have to take it, but why debate it?

For one I’m already on track for retiring from EMS in a few months, and starting a new career in a different industry. So I’m way ahead of that advice.
But I’m investigating this subject not to debate anyone, but because I just want the facts. This isn’t so much a “should I stay or should I go” endeavor. I’m going, regardless. But since I have little to lose I’m asking on behalf of those who do. The younger medics who “don’t want to make waves”.
I looked at the company policies. They are consistent with LA County regs. But stop when it comes to operating outside of county. If that could jeopardize a license for someone with more to lose than me, I feel we should have an answer either way.
As far as trust, I left AMR because I caught them lying about their own policies, which I was able to prove with their own SOP. And I also caught my present manager in a few minor (personal, non-company related) lies. So yeah, I have trust issues. And y’all are right. Time to leave. And I am. This “discussion” is just a last resort source for information. No disrespect, but this is the lowest common denominator.

 

[JetMedic]

My two cents, which really are only worth that $0.02 since it's been close to 7 years si cents I've worked in Los Angeles County.... but I remember LA and OC being relatively unique/"special" in that they were really some of the only County/LEMSAs that required an additional local Co cert on top of State EMT Certification to work in. San Bernardino, Riverside, Ventura, Kern Counties never did.

So sounds like you're more worried over whether or not your Company is licensed as an Ambulance company in whichever (Ventura, Riverside, San Bernardino?) County... which is something you should be able to look up yourself fairly easy.

Otherwise if you're that concerned over the integrity of your management, that you find yourself unable to accept at face value your supervisor telling you they are properly licensed foe that pickup.... then it's simple. Start applying to different Ambulance companies.

Already set to leave in a few months. Between AMR and PRN, I decided years ago that this was no longer the job it once was. But if not for the schools closing for the pandemic I’d be finished with A&P school & gone already. But I stuck around because it is a paycheck.
That said, I admit I have trust issues with my manager. I’ve already caught him in a few minor lies. So when I asked him to back up his claim and he hasn’t…well, like I said. I’m leaving. I just wanted to see if someone could point me to a source I hadn’t considered. Shame a few just took the opportunity to point fingers instead.

 

[JetMedic]

Consult your company policy which should address this.
Does your company operate within a compact between Counties?

I think we got off on the wrong foot here and the discussion spiraled. Please allow me start over.
Thank you. I have looked through my company’s policies and SOP. Aside from generally stating that they will operate within the confines of state and county regulations it didn’t address the specific issue at hand. I have also looked through the county rules and came up empty as well. I am awaiting further word from our DHS and EMSA. I just started this thread as a separate alternative for info, hoping maybe someone could share an avenue I haven’t yet considered.