AMR Placer County Plans for the Future?

[digitaljim6]

They are certainly eligible for VHF business freqs. If they are on a business/industrial freq, their only eligibility is that they are engaged in a commercial activity 90.35(a)(1). They wouldn't get special consideration for being a public-safety related organization in that radio service. To get that, they are expected to apply in the public-safety radio services. That's why they're there. If they can get consent from the other co-channel and adjacent channel licensees, they can probably find something. Practically speaking, though, if you were another ambulance company, would you agree to accept interference from one of your competitors if you had the power to say NO? Likewise, if a for-profit ambulance company asked a city or county to accept interference from them would you expect the city or county to agree?

Anyone who has imminent safety-of-life traffic always gets priority 90.403(d). "Could I get the times on my last call?" does not qualify as "imminent safety-of-life" so only part of an ambulance company's traffic would be given priority over other users. This means that the ambulance company would have to wait for existing traffic to finish before they could initiate the majority of their transmissions. Not a great scenario. This would be like putting them on a single community repeater with ten other customers.

There are other operational restrictions, like: business/industrial transmissions cannot be retransmitted (console-patched, e.g.) on a public-safety channel unless it is an imminent safety-of-life situation. Certain business/industrial bands/frequencies may have restrictions or prohibitions on airborne use.

They still have to abide by the co-channel and adjacent channel distance separation requirements (beginning at 90.171). There are power, antenna height and operational area limits, too. For example, without additional justification, they could only get a 40km (25 mi) radius area for mobile operations in VHF. That means they couldn't legally talk to their units in Woodland from a base station on Highway 50 on the top of the hill near El Dorado Hills.

They might have better luck getting a channel by going narrowband (unless your company got the last channels that would work in the area). Then, they have to think about pagers, too, as it may be difficult to find a narrowband VHF pager manufacturer. Any don't forget that one-way signalling (paging) operation is secondary to two-way voice operation 90.233.

When you're in a metro area, the days of "there's always a public-safety channel available" have been gone for a while. That's one reason why parts of 700 MHz were reallocated to public-safety.

It may be a stupid question then, I am not that familiar with Part 90 but does it prevent a private ambulance company from using an I/B channel instead of a PW channel? It seems awfully counterproductive to not allow AMR in Sac County any channel, as opposed to giving them one they might be interfered on in the outlying areas, but at least they will have it. Some creative wording in the application might help this as well. "Applicant provides medical transport services"

Birken

 

[selgaran]

I assume in areas where AMR uses a single simplex VHF channel for dispatch, they have a mountaintop tone remote to extend coverage? Do the EMTs/medics carry VHF HTs in that case, or just Nextel?

In Yolo, it gets interesting. The 155.235 frequency is actually licensed to the County, they allow AMR to use it. Transmitter is located in Woodland, and does not cover out into the canyons on the western edge of the county, so when AMR responds out to those areas, they often request fire dispatch to relay their status back to their dispatch.

They do carry VHF portables, but it doesn't sound like they use them for much more than back-up "pagers" when they are out of the rig. You'll sometimes hear them request a test of the paging tones for their portable. They do have Nextels as well, and also alpha pagers.

The somewhat ironic thing, is that since most of the rigs appear to have 800 radios now for Davis and West Sac, as well as the VHF radios, Nextels, pagers, and an AVL system, and who knows what else, the AMR ambulances are probably more "in touch" than most of the public safety agencies in the county.

 

[Kirk]

I guess I'm somewhat spoiled, and have a clouded view of how EMS dispatching should be done, based on my single county experience. I worked for a private, for-profit ambulance company between 1988 and 1996, so I was familiar with the way things worked at least in San Luis Obispo County.

The ambulances were dispatched by the Sheriff's Dept, which was the county PSAP for non-incorporated areas. City PSAPs would call the SO when they needed an ambulance.

The county (which has its own radio communications shop & employees) operated and maintained a four-channel Medcom system on Meds 1-4. Meds 1 & 2 were multicast with voting receivers, each channel covering a different area. Meds 3 & 4 were voted, but with single transmit sites, and were used for medic/hospital communications. The system has since been changed to a single countywide dispatch channel w/GPS timebase simulcast on Med 1, and Med 2 was reallocated to medic/hospital use.

There were three ambulance providers in the county when I was involved in EMS. One was a healthcare district, and had their own VHF repeater. This system had a phone patch (these were the days when cellular coverage here was either non-existant or spotty), and also did Quick-Call paging for backup crews. Medcom could phone the system (reverse patch) and page backup units.

The largest provider had a UHF repeater on a high mountaintop, giving mobile coverage to about 90% of the county (handheld coverage about 50%). This was used as an ambulance-to-ambulance tac channel. Intrafacility transfers were all handled through Medcom.

The provider I worked for was small, and had a small coverage area. We had a simplex VHF 155MHz channel, and used it similarly to the UHF repeater used by the larger company. We had a single FB at our single station, with a decent antenna on a tower.

All of the providers had both VHF and UHF radios in their ambulances, VHF having fire channels, CALCORD and company nets as appropriate.

Today, some things have changed, but not much. The provider I worked for is gone, and the larger provider swallowed up their service area. Dispatching is now all on Med 1, and coverage is very good. Crews carry UHF portables and commercial alphapagers. Alpha pagers get run numbers and times, but the bulk of the dispatch happens on Med 1. Cellular phones are used for confidential information as needed.

The weak link in our system is that when units are in quarters, they go off-air and are available by telephone. In the event of a cable cut or other telco outage, there's no way to reach a unit in quarters unless they happen to have a scanner or HT turned on. I've always thought this was crazy, but it fell on deaf ears when I was in the business, and it hasn't changed. The simple solution is to go to quick call paging, and have crews keep their HTs in alert mode while at their stations, but nobody seems interested.

It seems to me that the best way to handle this is to have government channels in each area to handle dispatching, rather than requiring the private provider to get his own channel(s). As ambulance contracts come and go, an old provider really has no incentive to give up their frequencies when they lose a county contract, and a new provider will have minimal time to coordinate new frequencies prior to their go-live date.

If the private provider is to provide their own dispatching, then they can use the frequencies licensed by the county. If they want a private channel, then it's up to them to coordinate, or use Nextel or some other service.

Monterey county recently changed providers (AMR was ousted in favor of Westmed), and it appears as though AMR has retained their UHF channels in the county, despite the fact that they have no operations there. Westmed hasn't licensed anything, and is using the county UHF system and Nextel. Seems fine to me.

I'm a proponent of private provider ambulance services, but worry a bit that the number crunchers making the decisions arn't familiar enough with radio to know what's best. Commercial providers often lack backup power, redundancy and coverage in fringe areas. Many also don't know what "preventative maintenance" is.

Nextel, cellular and other LMR systems work most of the time, and I think it's easy to justify the lower costs. But as I recall trying to call my wife after a 6.0 earthquake here a few years ago, I found that cellular and landlines were quickly overwhelmed and unavailable (I've since managed to convince her to get her ham license). And this was a pretty minor quake with no power outages or downed lines.

The concept of Med channels was a good one, and while perhaps there arn't quite enough channels to enable the system to work everywhere, I think it would benefit the state greatly to get all of the ambulances operating on the same band. In a disaster situation, ambulances from varying parts of the state often lack any common radio channels (excepting maybe CALCORD), crippling them pretty severely when operating in other response areas.

Just my opinion, of course.

 

[digitaljim6]

Unless the provider only handles government agency calls, they need some communications method to support their private calls. There is a TON of business in non-code-3 ambulance services. Transports to/from MRI, dialysis, one hospital to another, non-emergency home-to-hospital, are usually done without notifying any government agency.

There are plenty of UHF Med Net channels. The original 8 became 16 and then 32 after the 12.5 and 6.25 splits were added. The 2 dispatch channels became 4 and then 8. Units are required to be capable of operating on the 8, 16 or 32 channels depending on when they were first licensed. See the table and footnotes in section 90.20.

I would have a problem with a for-profit company using a government funded resource for their own use (unrelated to any contract) unless they are paying the government for it. Radio sharing unrelated to the government's activities may even violate Part 90 if the ambulance company does not meet eligibility requirements for the government channel they would be using. "Shared use of radio stations" requires that the unlicensed user be otherwise eligible for a license on the frequencies that they use - see 90.179(a). If the channel assignment is restricted to a governmental entity or to a non-ambulance function (like firefighting), an ambulance company would not be eligible and could not use it for their own use.

Radios aren't the only place the bean counters make me nervous. There is a constant drive to increase revenues and decrease expenses. The lowest bidder may not always provide the best service for the dollar.

To keep perspective, I remember that private ambulance companies are businesses. They are often not noble organizations with a true calling although some of their employees are like that. If you are in doubt about the business aspect of emergency medical services, here is a description of AMR's ownership from one of their recent (1-13-2005) FCC filings:

"Upon consummation of the Transaction, 100% of the stock of AMR will be held by AMR HoldCo. Inc., which in turn will be 100%-owned by Emergency Medical Services L.P. The general partner of Emergency Medical Services L.P. is Emergency Medical Services Corporation. Emergency Medical Services Corporation is 99.9% owned by Onex Partners L.P. The general partner and manager of Onex Partners L.P. is Onex Corporation, a publicly-traded company. Mr. Gerald W. Schwartz, the Chariman, President and CEO of Onex Corporation, is the controlling shareholder of Onex Corporation and is a Canadian Citizen."

Gee, maybe it should be CMR - Canadian Medical Response!

 

[Kirk]

I'm not waving the AMR flag, but I'm not going to bash them publically. There are some fine folks that work for that company, doing their best to provide quality patient care. On the same note, there are many advocates for public ambulance services (fire service based) that have less than angelic motives.

The trend, at least in the counties around me, is that non-emergency transportation is handled by the contract holder. I don't know what the leagality is, but around here there are no other providers. The non-emergency transportation business tends to be more profitable than 911 response, and as such my county grants an exclusive contract for ambulance service to a single provider per area. When I was in the business, the nursing homes, hospitals, etc all had the phone number of Medcom, and transports were coordinated through them, on the Med channels. The same units used for emergency response were used for routine transfers, so Medcom needed to know who was in service and for what.

I'm not advocating putting non-emergency transport units on the government channel, although it'd sure be nice if they had the capability to operate there in an emergency in areas where the two types of units are distinct and separate.

As for there being plenty of Med channels available, I'm not hearing any narrowband Med use around here, so there are effectively ten channels available for wideband users. Roll in the fact that the county to the South of me dispatches on Med 10, the one to the North dispatches on Med 10, and the one to the East dispatches on Med 9, SLO Co had to use something else for dispatch (hence, Med 1).

I'll admit, though, it's nice to talk to someone else that seems to understand all of this. Back in my EMS days, when I talked Med channel usage with my co-workers, I often got the deer-in-the-headlights look.

 

[Kirk]

Hrm, wonder who makes the towers that hold the AMR antennas? Could it be ROHN?

http://www.onex.com/index.taf?pid=64&_UserReference=AE3AA8335A78D5EF4491C1E4

 

[digitaljim6]

I agree with your statements about motives. There are good and bad on both sides. It seems that, for the most part, the crews themselves are dedicated, no matter what their bosses are like.

Does the exclusive county contract prevent other companies from doing business there or does it only prevent them from getting agency calls? There are lots of private (citizens, hospitals, doctor's offices, labs, etc) sources of ambulance calls even if they are code 1 or code 2 only.

My Med Net experience started up on the north coast in the late 70's when regional EMS agencies and federal funding were all the rage. That was also back when federally compliant rigs had to be orange and white. It cost a ton of money for an 8-channel UHF mobile in those days (Programmable radio? What's that?). Remember the orange APCORs?

 

[digitaljim6]

You would think so. It would be interesting to do an inventory and see. After all, many Motorola radio models had RCA integrated circuits in them during the 70's and 80's. RCA still made two-way stuff then. Makes one wonder who was invited to whose backyard barbeques in the summer.

I hope they have better luck with tower climbers than the Deter Tower Company in Iowa did:

http://www.radioiowa.com/gestalt/go...-435E-B89277D88236AE68&dbtranslator=local.cfm

Hrm, wonder who makes the towers that hold the AMR antennas? Could it be ROHN?

http://www.onex.com/index.taf?pid=64&_UserReference=AE3AA8335A78D5EF4491C1E4

 

[Kirk]

Does the exclusive county contract prevent other companies from doing business there or does it only prevent them from getting agency calls? There are lots of private (citizens, hospitals, doctor's offices, labs, etc) sources of ambulance calls even if they are code 1 or code 2 only.

I'm pretty familiar with the Code 1 and Code 2 calls, as I've probably run hundreds (maybe thousands?) of them. If we got a call to our ambulance station on the business line for a transport, we'd call Medcom and give them the details before going in service. And yes, it prevents other companies from doing business:

6.60.020 County ambulance service provider agreement.
No individual, partnership, corporation or other entity shall operate, conduct, advertise or otherwise be engaged in the business or service of the transportation of patients upon the street, or any public way or place within the county, unless the county, through the board of supervisors, has executed a written county ambulance service provider agreement with the individual, partnership, corporation, or other entity. An ambulance operated by an agency of the United States or by the state shall not be required to have such an agreement.
(1) The county ambulance service provider agreements with private providers shall provide for some method of ensuring that in the event the provider ceases to perform the agreement for any reason (including insolvency, bankruptcy, voluntary or involuntary dissolution of the business) the ambulances and operating equipment used by the provider in carrying out the agreement will be available for use by the county, or another private provider operating under agreement with the county, free of any legal encumbrances. The provisions may take the form of county ownership with lease-back arrangements or some other method, as recommended by the ambulance performance/operations committee.
(2) The agreements shall address other areas of operation and performance, including, but not limited to, coverage requirements, minimum response time standards, staffing and certification requirements, review of financial and other records, data collection and reporting requirements, system interaction and rates.
(3) The agreements will be developed by the ambulance operations/performance review committee before submission to the board of supervisors for approval on behalf of the county.
(4) During the term of any agreement, proponents of any additional provider service in any of the assigned ambulance service areas shall have the burden of demonstrating that the public health, safety and welfare require the additional service. (Ord. 2629 § 1 (part), 1993)

My Med Net experience started up on the north coast in the late 70's when regional EMS agencies and federal funding were all the rage. That was also back when federally compliant rigs had to be orange and white. It cost a ton of money for an 8-channel UHF mobile in those days (Programmable radio? What's that?). Remember the orange APCORs?

The ambulances I worked out of initially had GE Mastr II 8 channel mobiles. And the orange APCORs? I have one in my garage. Does this mean I'm old?

 

[digitaljim6]

I wonder if they chase out-of-town rigs out of the county when they come in with a long-distance transfer.

No, you're not old...unless you remember watching Johnny and Roy in the pilot movie in January of 1972!

 

[N5FDL]

Yes, there is/was a Yolo Passport

In May, I saw an AMR Passport talkie and it had a Yolo talkgroup. Not use if it was ever used as I didn't get a chance to listen.

 

[n6766j]

well, i could be wrong. i am simply a scanner freq. i have no inside information. for all i know they could be using nextels to dispatch and i just don't know it. but from the conversations i've had with paramedics, it sounds like they just listen to fire.

They (AMR) uses NexTel for a lot of stuff so it is quite probable they are dispatching with it in this area. Having spent 15 years with AMR, nothing surprises me...that's why I left!