Joint Services Agreement

on Ambulance Service Study

• Passed by the City of Lake Charles and the Police Jury in 2001
• Purpose:

To collaborate in the study of alternative means of providing emergency response and the development of a parishwide ambulance ordinance

Overview

• Review of the current ambulance service system in Calcasieu Parish
• Flaws of the current system
• Ambulance service options considered
• Unresolved issues

The Current System:

How Does It Work?

• E-911 establishes Emergency Service Number (ESN)zones
• The process:

-          Call comes in to E-911, who gathers information

-          E-911 dispatches ambulance provider

Ø       Where ESN zone has one provider, that provider is called

Ø       Where ESN zone has multiple providers, calls are rotated between providers

Flaws of the Current System:

• Places fairness to providers above the care and treatment of patients
• No response time standards
• Providers are not obligated to serve low population areas

Any new ordinance should include:

• Scrapping the rotation system used for ambulance calls              
• Operational requirements  

-          Personnel, equipment, vehicles

• Performance standards

-         Response times, medical treatment protocols

Possible Ambulance Response Areas

ZONE

MILEAGE

RESPONSE TIME

POPULATION

%

Urban

0 to 4 miles

0 to 8 minutes

140,239

76.4%

Suburban

4 to 7 miles

8 to 12 minutes

33,627

18.3%

Rural

Beyond 7 miles

Beyond 12 minutes

9,711

5.3%

Any new ordinance should include:

• Provisions for air ambulance service                        
• E-911 designated as sole dispatch agency for emergency ambulance needs
• Enforcement authority  

-          Inspections for operational requirements

-          Adherence to performance standards

Options Considered

Option 1:  Competitvely Selected Provider (CSP) –

For Emergency and Non-Emergency Ambulance Service

Option 2:  Competitively Selected Provider (CSP) –

For Emergency Ambulance Service ONLY

Option 3:  Publicly Provided Emergency Ambulance Service         

Option 4:  *Multiple Provider System

Options 1

CSP For Emergency & Non-Emergency Service

• Request for Proposal (RFP) process
• Committee appointed to review proposals
• One provider would serve LC, unincorporated areas of parish, and any other municipalities choosing to participate

• Features

-          Response time standards and quality standards are established and enforced

-          Penalties applied for non-performance

-          Rates are for emergency and non-emergency services

Option 2

CSP For Emergency Service Only

• Request for Proposal (RFP) process, but for emergency service only
• Public $ subsidy required             
• Features (same as Option 1
• Non-Emergency Ambulance Service

-          Retail competition

-          Operational requirements are enforced

-          Rates are not regulated

Option 3

Public Entity Establishes EMS Service

• Would necessitate acquisition of facilities, equipment, personnel, etc.
• Employed successfully in other areas of the country
• Tax will almost certainly be required
• “Retail” competition for non-emergency ambulance service
• Callers may tend to misuse service because it’s “free”

Option 4          

Multiple Provider System

• Method needed for ambulance call allocation (Automated Vehicle Locator system is an option.  Minimum cost of $200,000.)
• Must ensure all areas have adequate coverage    
• West Cal-Cam EMS remains the provider for Wards 4 and 7 (Sulphur, Westlake, and Vinton areas)
• Rates regulated for emergency service but not non-emergency service
• Existing Lake Charles ordinance could serve as the basis for a joint ordinance, with selected modifications

Unresolved Issues

• Air ambulance requirements (Option 4
• Coverage for low population areas (Option 4)  
• Structure for enforcement
• Extent of enforcement