Crain’s Detroit Business — Ambulance services can transfer patients only to or from a community in which they are licensed. Those licensed service providers are also usually required to maintain dedicated ambulances in a given community around the clock for 911 calls, said Kolby Miller, CEO of Medstar.

Rural communities may not need another truck for 911 service, or the demand doesn’t make it worth it for a company like Medstar, but the transfer demand is there.

“We get called not infrequently to go a long way away, sometimes north of the bridge,” Miller said. “The local provider isn’t available or won’t do it, so we’re asked. But the medical control authority is going to ask me if am going to be providing 911 service. If they approve me for one truck, then I have an obligation for the 911 calls and can’t leave for any long-distance transfers. Some of the system’s design is set up by the providers in the system to protect the market they want to protect. So unless I can be present all the time, I can’t service those transfers. This is a structural problem, not a staffing problem.”

For instance, Medstar isn’t licensed in Grand Rapids or Saginaw, so therefore cannot perform a patient transfer between those two communities even if it has capacity and the need exists.

Last year, War Memorial was unable to secure enough patient transports and petitioned the Michigan Bureau of Emergency Medical Services to allow for a downstate ambulance service to perform transfers.

The state authorized one Medstar ambulance to provide transfer service from War Memorial for a few weeks.

But other systems aren’t as lucky and are resorting to drastic measures, Jahn and Madden said. 


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