Medical Transportation

Bureau of EMS Policy Statement
Policy Statement #99-08
Date10/10/99
SubjectRe: Medical Transportation
Supercedes/Updates

The purpose of this policy is to clarify the appropriate use of the various types of medical transportation available for non-emergency patient transports to, from, or between medical facilities. This policy refers to the patient care and operational aspects of ambulance and other forms of medical transportation, it does not address medical necessity for reimbursement by third party payers.

Many factors are involved when deciding on which type of medically related transportation is to be used for a specific patient. Included are patient condition at the time of transport, the specific level and type of care (ALS, BLS) or medical monitoring needed, personal preference, contracts and economics.

Ambulance service and patient care during transport are governed by Article 30 of the New York State Public Health Law. Patient care and or medical monitoring may only be provided by certified or licensed healthcare providers in an ambulance.

In the medical transportation industry there are ambulance, "ambulette"1; and livery forms of transportation. Each has an appropriate use. In each situation the patient's medical condition and the type and level of care required to treat the patient's condition must be the first consideration when deciding on which type of transportation to use for the transfer.

Policy

Transportation by ambulance is required if the patient requires medical care or medical monitoring as directed by a physician during the transport. Examples include, but are not limited to, administering oxygen to a patient who does not normally use it, assessment, maintaining IV's, cardiac (EKG) monitoring, or the periodic monitoring of pulse, respiration, blood pressure or other vital signs and documenting changes in a patient's condition. Medical care and/or patient monitoring can only be provided by a certified or licensed health care provider and can only be provided in an ambulance.

Ambulette or livery transportation is appropriate for patients who DO NOT need medical care or medical monitoring during the trip. Ambulette's may carry a patient's individually prescribed and provided oxygen (as if the patient is in a private vehicle). An ambulette service MAY NOT provide oxygen or oxygen delivery equipment and ambulette personnel MAY NOT monitor or deliver oxygen or adjust flow rates.

A service not licensed as an ambulance may not advertise the ability to provide medical care during transport. Services should exercise caution using medically trained staff on any vehicle that is not an ambulance. Such advertising and staffing only serves to confuse the public or health care institution regarding the actual levels of medical care and capabilities available.

Endnote:

1A.k.a.: Para-transit, wheelchair, invalid coach

Issued: John J. Clair, Associate Director - Operations

Authorized: Edward G. Wronski, Director