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What we can learn from the Alameda, Calif., EMS transition

Editor's note: EMS services in Alameda County changed hands recently from AMR to Paramedics Plus. The transition occurred after the parties worked through several legal hurdles, and when it came time to finally hand over the reins, everything went smoothly. Art Hsieh believes there are some lessons here for EMS systems around the country.

California EMS is as disparate as it is in any other state in the U.S.

In the San Francisco Bay Area, the majority of the service is provided by commercial EMS providers and fire departments. Many of the providers have been in place for 20 years or more.

In my home county, however, there has been significant upheaval in the system in the past 18 months, culminating in the transition from one private transport provider to another that occurred Halloween night.

While there have been ongoing issues and lawsuits about the bidding and award process, when it came time to shift, the transition appeared to go smoothly. Employees who worked for the incumbent provider moved over to the new provider's units at the appointed time. Many people I know worked long and hard, on both sides of the operational fence, to ensure that coverage would not be reduced during the transfer.

It's a nice change to see how we can cooperate to make things work well.

I look forward to seeing how the new system develops under new requirements and financial structure. Money continues to be tight in the current economy, and there isn't a penny to spare in the provision of emergency care to the community.

At the same time, an organization, public or private, has to remain solvent in order to provide service. Both demands will need to be balanced in a thoughtful, realistic manner. Like the situation in Pinellas County, Fla., success will require creative the efforts of many smart, motivated individuals to create the best way to deliver EMS services to its communities.

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