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Concerns about ambulance service addressed

Reprinted from: The Richmond News Leader, July 7, 1990

By Paul Bradley

 Changes in the city's emergency medical service system not only have prompted two volunteer rescue squads to announce plans to pull out of Richmond, they also have raised numerous questions among residents.

Officials say elderly citizens especially want assurances that an ambulance will start rolling once the 911 emergency number is dialed.

To answer those questions, the city has hired a public relations consultant and held meetings with groups who ask for them. Last week, for example, several city officials met with a group of senior citizens concerned about the changes.

What follows are some frequently asked questions with answers provided by Richmond Ambulance Service Inc.

Q: What is Richmond ASI?

A: Richmond Ambulance Service Inc. is a non-profit corporation created last February after the financial collapse of the city's private ambulance contractor. It provides and coordinates ambulance service in Richmond.

Q: Is the corporation replacing the city's volunteer rescue squads?

A: No, While the Forest View and Lakeside volunteer rescue squads have decided to withdraw from the city, the West End and Tuckahoe squads remain in Richmond. They will continue to offer free ambulance service.

Q: Who decides whether a rescue squad or a Richmond ASI Ambulance responds to a call?

A: Dispatchers send the closes available unit, regardless of whether it is paid or volunteer. The volunteer squads serve specific geographic areas, while the city ambulances serve the bulk of the city.

Q: Do the squads have to meet the same standards as Richmond ASI?

A: In the past, the city contractor and the rescue squads operated under different medical directors and standards of care. Under the new system, all ambulances will meet standards established by a medical control board. One such standard calls for advanced life support to be the minimum level of care in Richmond within six months. Most rescue squad members are qualified to provide only basic life support and would need more training to reach advanced life support status.

Q: Why is the new system supposed to work better?

A: Having a unified system means the same level of service will be provided to all parts of the city. An unstructured system can lead to inconsistent levels of care, dependent mostly upon where in the city an ambulance is needed.

Q: How much does ambulance service from Richmond ASI cost?

A: The average charge for call will be $295. Emergency calls will cost more - $320 plus mileage. Non-emergency calls – such as when a patient is transported from a hospital to a nursing home – will cost slightly less. City officials say the fees are in line with cities of comparable size.

Q: What happens if an ambulance responds, and the caller decides he or she not longer wants the ambulance?

A: The caller would be charged only if medical treatment is given.

Q: Why does it cost do much?

A: To keep proberty taxes down, the city is trying to recover the cost of providing ambulance serivce. Richmond now provides $1.4 million in tax subsidies for ambulance service every year. It paid another $3.2 million for 20 new ambulances and other equipment. It is estimated ambulance service would cost $6 million yearly if no fees were charged. The fees also reflect rising health-care costs and efforts to ensure ambulances are available around the clock.

Q: Will insurance and Medicare pay for ambulance services?

A: Most insurance policies will cover medically necessary ambulance services but may not cover all expenses. Richmond ASI has started an ambulance subscription program that will take care of uncovered costs.

Q: How does the subscription program work?

A: For an annual fee of $49, the program covers all out-of-pocket expenses for a family for medically necessary ambulance services in Richmond, or to the surrounding counties. All residents of the city are eligible for the program, whether they have insurance or not?

Q: Will I get service even if I can't pay?

A: Yes. Ambulance service will be provided regardless of the ability to pay.

Q: Are more changes coming?

A: Later this year, city firefighters will respond to emergencies as "first responders" and will begin a basic level of care before ambulances arrive. A "first responder" component is considered an important part of an emergency medical system. Henrico and Chesterfield counties have "first responder" system.

Q: How can Richmond ASI be prevented form falling as did its predecessor?

A: The ambulance system is based on a highly structured system designed to prevent it from failing. The city owns the ambulances and rigid performance standards are set in the contract. For example, a $10-per-minute fine is assessed on each call wherein the contractor does not meet the established response time.

Q: How can someone register a complaint?

A: By calling Richmond Ambulances Service Inc. at 355-9300.

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