ems license number on the side of the ambulance

[Guest guest]

I know this is kind of late in the game since this was discussed awhile

back, but does anyone know where I can find the info for the rule of

putting the license number on the side of the ambulance. How big do

the numbers have to be, where should they be placed, color, all that

good stuff. EMS rule number would be great.

Thank you all

[Guest guest]

157.11 (d)

(7) All EMS vehicles shall have the name of the provider and a current

department issued EMS provider license number prominently displayed on both

sides of the vehicle in at least 2 inch lettering. The license number should

have the letters TX prior to the license number. This requirement does not

apply to fixed wing aircraft.

This applies only to ambulances.

________________________________________

From: texasems-l [texasems-l ] On Behalf Of

rescue_25 [rescue_25@...]

Sent: Thursday, November 13, 2008 12:08 AM

To: texasems-l

Subject: ems license number on the side of the ambulance

I know this is kind of late in the game since this was discussed awhile

back, but does anyone know where I can find the info for the rule of

putting the license number on the side of the ambulance. How big do

the numbers have to be, where should they be placed, color, all that

good stuff. EMS rule number would be great.

Thank you all

[Guest guest]

What's the big deal, fer cryin out loud? We put them on our ambulances in

Shackelford County at least three years ago when I was there. It took about 3

minutes to do it, and it didn't cost much at all.

You can buy stencils and a can of paint and do the same thing. Gimme a

break, heah! <g>

GG

>

> All the rule states is 2 " letters prominantly displayed on both sides of the

> truck.? I understand several agencies are going to approach GETAC about

> getting this section of the new rule postponed until GETAC can re-visit it.?

DSHS

> is already not going to enforce until January 1, so you might hold off until

> after GETAC...

>

> Dudley

>

> BTW, it is Rule 157.11, Section (d) Paragraph (7)

>

> ems license number on the side of the ambulance

>

> I know this is kind of late in the game since this was discussed awhile

> back, but does anyone know where I can find the info for the rule of

> putting the license number on the side of the ambulance. How big do

> the numbers have to be, where should they be placed, color, all that

> good stuff. EMS rule number would be great.

>

> Thank you all

>

>

>

[Guest guest]

All the rule states is 2 " letters prominantly displayed on both sides of the

truck.? I understand several agencies are going to approach GETAC about getting

this section of the new rule postponed until GETAC can re-visit it.? DSHS is

already not going to enforce until January 1, so you might hold off until after

GETAC...

Dudley

BTW, it is Rule 157.11, Section (d) Paragraph (7)

ems license number on the side of the ambulance

I know this is kind of late in the game since this was discussed awhile

back, but does anyone know where I can find the info for the rule of

putting the license number on the side of the ambulance. How big do

the numbers have to be, where should they be placed, color, all that

good stuff. EMS rule number would be great.

Thank you all

[Guest guest]

Gene,

To me the issue is not the provider number itself but rather I don't think this

will fix the problem they want to fix. The only way to stop these rogue

operators is through enforcement and harsh punishment. Until the Legislature

allocates enough money to the folks at DSHS to do the job correctly I don't care

what you put on the side of the truck nothing is going to change. I hope when

the Legislature goes back to Austin the folks that are peeved about this rule

will work with us to get more money for DSHS so they can crush the operators

that are tainting our industry.

Sent via BlackBerry by AT & T

ems license number on the side of the ambulance

>

> I know this is kind of late in the game since this was discussed awhile

> back, but does anyone know where I can find the info for the rule of

> putting the license number on the side of the ambulance. How big do

> the numbers have to be, where should they be placed, color, all that

> good stuff. EMS rule number would be great.

>

> Thank you all

>

>

>

[Guest guest]

I'll agree it's an easy fix.

Now the negative is it really will not stop any wrong doing. Shady

services just like shady contractors can make sure a little mud hides

part of the numbers. Or worse they can put on other services numbers

so public reports a problem by number and the wrong service gets in

trouble. Not hard to get some magnetic strips and place numbers then

every few days switch. Yes there is the slight chance that a DSHS

rep will be at the hospital and catch the discrepancy.

Renny

>

> What's the big deal, fer cryin out loud? We put them on our

ambulances in

> Shackelford County at least three years ago when I was there. It

took about 3

> minutes to do it, and it didn't cost much at all.

>

> You can buy stencils and a can of paint and do the same thing.

Gimme a

> break, heah! <g>

>

> GG

>

>

>

> >

> > All the rule states is 2 " letters prominantly displayed on both

sides of the

> > truck.? I understand several agencies are going to approach GETAC

about

> > getting this section of the new rule postponed until GETAC can re-

visit it.? DSHS

> > is already not going to enforce until January 1, so you might

hold off until

> > after GETAC...

> >

> > Dudley

> >

> > BTW, it is Rule 157.11, Section (d) Paragraph (7)

> >

> > ems license number on the side of the

ambulance

> >

> > I know this is kind of late in the game since this was discussed

awhile

> > back, but does anyone know where I can find the info for the rule

of

> > putting the license number on the side of the ambulance. How big

do

> > the numbers have to be, where should they be placed, color, all

that

> > good stuff. EMS rule number would be great.

> >

> > Thank you all

> >

> >

> >

[Guest guest]

I respect the opposition some providers have but we do not plan to postpone

the enforcement of this part of the rule. Beginning January 1, 2009 the

provider number will be required on the ambulance.

Maxie

**************Get the Moviefone Toolbar. Showtimes, theaters, movie news &

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t

p://toolbar.aol.com/moviefone/download.html?ncid=emlcntusdown00000001)

[Guest guest]

On Friday, November 14, 2008 06:09, spiband@... said:

>

> I hope when the

> Legislature goes back to Austin the folks that are peeved about this rule will

> work with us to get more money for DSHS so they can crush the operators that

are

> tainting our industry.

Or even better, perhaps DSHS could get out of the horizontal taxi business

altogether and give it to the Railroad Commission, so they can focus on actual

EMS providers exclusively. The last thing I want to give the DSHS more money

for is to get further sidetracked from our real mission. Leave transfer service

regulation to local authorities, just like taxis.

Rob

[Guest guest]

I couldn't agree more. But fat chance of that with the economy the way it

is, sales tax receipts lagging, and so forth.

GG

>

> Gene,

>

> To me the issue is not the provider number itself but rather I don't think

> this will fix the problem they want to fix. The only way to stop these rogue

> operators is through enforcement and harsh punishment. Until the Legislature

> allocates enough money to the folks at DSHS to do the job correctly I don't

> care what you put on the side of the truck nothing is going to change. I hope

> when the Legislature goes back to Austin the folks that are peeved about this

> rule will work with us to get more money for DSHS so they can crush the

> operators that are tainting our industry.

> Sent via BlackBerry by AT & T

>

> ems license number on the side of the ambulance

> >

> > I know this is kind of late in the game since this was discussed awhile

> > back, but does anyone know where I can find the info for the rule of

> > putting the license number on the side of the ambulance. How big do

> > the numbers have to be, where should they be placed, color, all that

> > good stuff. EMS rule number would be great.

> >

> > Thank you all

> >

> >

> >

[Guest guest]

Believe me, Rob, you don't want the RRC to take over transfer ambulances or

gurney cars. Here in AZ, they are not considered to be ambulances and they

are not governed by DHS. They are under the Corporation Commission, and

believe me, all the CC cares about is that they pay the annual fee.

Friend of mine was carried by one of them from home to hospice on his last

day on earth. It was 110 degrees outside, and the air conditioning in the van

was not working. The crew were dressed in dirty clothes, not uniforms, and

they smelled. He was on oxygen, but they didn't have any, so we had to load

up his tank and take it with him. They almost pulled one of his IVs out and

would have if I hadn't stopped them.

The ride to the hospice was stifling hot. He died an hour after he got

there.

I went to our regional DSH office to complain and that's when I found out

that they have nothing to do with regulating " gurney cars. " I went to the CC

and complained, and they wouldn't even take a complaint. I wrote a letter to

the President of the stretcher van service and never received a reply.

Then I found out that Tucson Medical Center, the hospital that owns the

hospice, was the one that scheduled a stretcher van rather than an ambulance,

because they were paying for it. Despicable! It's the hospitals that are

promoting this.

No, Rob, you do NOT want the RRC to take over gurney cars.

GG

>

> On Friday, November 14, 2008 06:09, spiband@... said:

> >

> > I hope when the

> > Legislature goes back to Austin the folks that are peeved about this rule

> will

> > work with us to get more money for DSHS so they can crush the operators

> that are

> > tainting our industry.

>

> Or even better, perhaps DSHS could get out of the horizontal taxi business

> altogether and give it to the Railroad Commission, so they can focus on actual

> EMS providers exclusively. The last thing I want to give the DSHS more money

> for is to get further sidetracked from our real mission. Leave transfer

> service regulation to local authorities, just like taxis.

>

> Rob

>

>

**************

Get the Moviefone Toolbar. Showtimes, theaters, movie news & amp;

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t

p://toolbar.aol.com/moviefone/download.html?ncid=emlcntusdown00000001)

[Guest guest]

They will have Blackhawk helicopters stationed in all metropolitan areas.

Upon notification of a " hit " on a rogue ambulance, the Blackhawk will take it

out. Simple.

GG

>

> So if I am driving down the road after the inception of the rule and see a

> HFD, DFR, A/TC, or SAFD unit without a number I can call my local Dishes EMS

> constabulary, then they will ????????

>

> -MH

> ____________ ________ ________ _

> From: texasems-l@yahoogrotexasem [texasems-l@yahoogrotexasem] On Behalf Of

> Bishop, Maxie [maxie.bishop@...]

> Sent: Friday, November 14, 2008 4:38 PM

> To: texasems-l@yahoogrotexasem

> Subject: RE: Re: ems license number on the side of the

> ambulance

>

> There have been several comments concerning the provider number being placed

> on the sides of the EMS vehicles. Here is the language in 157.11 that

> applies, please note the font size or color is not specified in rule so that

will

> be left to the provider in order for the provider to keep with their color

> scheme.

>

> All EMS vehicles shall have the name of the provider and a current

> department issued EMS provider license number prominently displayed on both

sides of

> the vehicle in at least 2 inch lettering. The license number should have the

> letters TX prior to the license number. This requirement does not apply to

> fixed wing aircraft.

>

> EMS vehicles are defined as:

>

> (36) Emergency medical services vehicle-

>

> (A) basic life support vehicle;

>

> ( advanced life support vehicle;

>

> © mobile intensive care unit (MICU);

>

> (D) MICU rotor wing and MICU fixed wing air medical vehicles; or

>

> (E) specialized emergency medical service vehicle.

>

> This rule does not apply to aircraft nor does it apply to any vehicle that

> is not defined as an EMS vehicle. It is my understanding the EMS committee has

> 157.11 on their agenda, but it not the intent of the department to postpone

> the enforcement of this rule which will begin January 1, 2009.

>

> Maxie Bishop, RN, LP, State EMS Director

> EMS and Trauma Services

> maxie.bishop@...<mailto:maxie.mailto:maxie.mailto:mama>

>

>

> ____________ ________ ________ _

>

> From: texasems-l@yahoogrotexasem<mailto:texasems-mailto:texasems-mai> on

> behalf of spenair

> Sent: Fri 11/14/2008 9:13 AM

> To: texasems-l@yahoogrotexasem<mailto:texasems-mailto:texasems-mai>

> Subject: Re: ems license number on the side of the ambulance

>

> I'll agree it's an easy fix.

>

> Now the negative is it really will not stop any wrong doing. Shady

> services just like shady contractors can make sure a little mud hides

> part of the numbers. Or worse they can put on other services numbers

> so public reports a problem by number and the wrong service gets in

> trouble. Not hard to get some magnetic strips and place numbers then

> every few days switch. Yes there is the slight chance that a DSHS

> rep will be at the hospital and catch the discrepancy.

>

> Renny

>

> --- In texasems-l@yahoogrotexasem<mailto:texasems-mailto:texasems-mai> <

> mailto:texasems-mailto:texasems-mai> , wegandy1938@ , wegandy

> >

> > What's the big deal, fer cryin out loud? We put them on our

> ambulances in

> > Shackelford County at least three years ago when I was there. It

> took about 3

> > minutes to do it, and it didn't cost much at all.

> >

> > You can buy stencils and a can of paint and do the same thing.

> Gimme a

> > break, heah! <g>

> >

> > GG

> > In a message dated 11/13/08 10:43:50 PM, THEDUDMAN@.. In a mes

> >

> >

> > >

> > > All the rule states is 2 " letters prominantly displayed on both

> sides of the

> > > truck.? I understand several agencies are going to approach GETAC

> about

> > > getting this section of the new rule postponed until GETAC can re-

> visit it.? DSHS

> > > is already not going to enforce until January 1, so you might

> hold off until

> > > after GETAC...

> > >

> > > Dudley

> > >

> > > BTW, it is Rule 157.11, Section (d) Paragraph (7)

> > >

> > > ems license number on the side of the

> ambulance

> > >

> > > I know this is kind of late in the game since this was discussed

> awhile

> > > back, but does anyone know where I can find the info for the rule

> of

> > > putting the license number on the side of the ambulance. How big

> do

> > > the numbers have to be, where should they be placed, color, all

> that

> > > good stuff. EMS rule number would be great.

> > >

> > > Thank you all

> > >

> > >

> > >

[Guest guest]

There have been several comments concerning the provider number being placed on

the sides of the EMS vehicles. Here is the language in 157.11 that applies,

please note the font size or color is not specified in rule so that will be left

to the provider in order for the provider to keep with their color scheme.

All EMS vehicles shall have the name of the provider and a current department

issued EMS provider license number prominently displayed on both sides of the

vehicle in at least 2 inch lettering. The license number should have the letters

TX prior to the license number. This requirement does not apply to fixed wing

aircraft.

EMS vehicles are defined as:

(36) Emergency medical services vehicle-

(A) basic life support vehicle;

( advanced life support vehicle;

© mobile intensive care unit (MICU);

(D) MICU rotor wing and MICU fixed wing air medical vehicles; or

(E) specialized emergency medical service vehicle.

This rule does not apply to aircraft nor does it apply to any vehicle that is

not defined as an EMS vehicle. It is my understanding the EMS committee has

157.11 on their agenda, but it not the intent of the department to postpone the

enforcement of this rule which will begin January 1, 2009.

Maxie Bishop, RN, LP, State EMS Director

EMS and Trauma Services

maxie.bishop@...

________________________________

From: texasems-l on behalf of spenair

Sent: Fri 11/14/2008 9:13 AM

To: texasems-l

Subject: Re: ems license number on the side of the ambulance

I'll agree it's an easy fix.

Now the negative is it really will not stop any wrong doing. Shady

services just like shady contractors can make sure a little mud hides

part of the numbers. Or worse they can put on other services numbers

so public reports a problem by number and the wrong service gets in

trouble. Not hard to get some magnetic strips and place numbers then

every few days switch. Yes there is the slight chance that a DSHS

rep will be at the hospital and catch the discrepancy.

Renny

>

> What's the big deal, fer cryin out loud? We put them on our

ambulances in

> Shackelford County at least three years ago when I was there. It

took about 3

> minutes to do it, and it didn't cost much at all.

>

> You can buy stencils and a can of paint and do the same thing.

Gimme a

> break, heah! <g>

>

> GG

>

>

>

> >

> > All the rule states is 2 " letters prominantly displayed on both

sides of the

> > truck.? I understand several agencies are going to approach GETAC

about

> > getting this section of the new rule postponed until GETAC can re-

visit it.? DSHS

> > is already not going to enforce until January 1, so you might

hold off until

> > after GETAC...

> >

> > Dudley

> >

> > BTW, it is Rule 157.11, Section (d) Paragraph (7)

> >

> > ems license number on the side of the

ambulance

> >

> > I know this is kind of late in the game since this was discussed

awhile

> > back, but does anyone know where I can find the info for the rule

of

> > putting the license number on the side of the ambulance. How big

do

> > the numbers have to be, where should they be placed, color, all

that

> > good stuff. EMS rule number would be great.

> >

> > Thank you all

> >

> >

> >

[Guest guest]

Renny,

I have to agree with you, those that don't want to follow the rules will find

away around it. Since the numbers are 2 " in reality that can be the same color

as your trucks so they are not seen by the public, but if they are on each side

somewhere, they are within the rule. Now, those that want to play by the rules

will make sure they are seen.

Those that I have talked with have not complained about putting them on, other

than it looks like a pest control or HVAC truck, and the fact that it was done

under the table by the state.

Wayne

Subject: Re: ems license number on the side of the ambulance

To: texasems-l

Date: Friday, November 14, 2008, 9:13 AM

I'll agree it's an easy fix.

Now the negative is it really will not stop any wrong doing. Shady

services just like shady contractors can make sure a little mud hides

part of the numbers. Or worse they can put on other services numbers

so public reports a problem by number and the wrong service gets in

trouble. Not hard to get some magnetic strips and place numbers then

every few days switch. Yes there is the slight chance that a DSHS

rep will be at the hospital and catch the discrepancy.

Renny

>

> What's the big deal, fer cryin out loud? We put them on our

ambulances in

> Shackelford County at least three years ago when I was there. It

took about 3

> minutes to do it, and it didn't cost much at all.

>

> You can buy stencils and a can of paint and do the same thing.

Gimme a

> break, heah! <g>

>

> GG

> In a message dated 11/13/08 10:43:50 PM, THEDUDMAN@.. . writes:

>

>

> >

> > All the rule states is 2 " letters prominantly displayed on both

sides of the

> > truck.? I understand several agencies are going to approach GETAC

about

> > getting this section of the new rule postponed until GETAC can re-

visit it.? DSHS

> > is already not going to enforce until January 1, so you might

hold off until

> > after GETAC...

> >

> > Dudley

> >

> > BTW, it is Rule 157.11, Section (d) Paragraph (7)

> >

> > ems license number on the side of the

ambulance

> >

> > I know this is kind of late in the game since this was discussed

awhile

> > back, but does anyone know where I can find the info for the rule

of

> > putting the license number on the side of the ambulance. How big

do

> > the numbers have to be, where should they be placed, color, all

that

> > good stuff. EMS rule number would be great.

> >

> > Thank you all

> >

> >

> >

[Guest guest]

So if I am driving down the road after the inception of the rule and see a HFD,

DFR, A/TC, or SAFD unit without a number I can call my local Dishes EMS

constabulary, then they will ????????

-MH

________________________________

From: texasems-l [texasems-l ] On Behalf Of

Bishop, Maxie [maxie.bishop@...]

Sent: Friday, November 14, 2008 4:38 PM

To: texasems-l

Subject: RE: Re: ems license number on the side of the ambulance

There have been several comments concerning the provider number being placed on

the sides of the EMS vehicles. Here is the language in 157.11 that applies,

please note the font size or color is not specified in rule so that will be left

to the provider in order for the provider to keep with their color scheme.

All EMS vehicles shall have the name of the provider and a current department

issued EMS provider license number prominently displayed on both sides of the

vehicle in at least 2 inch lettering. The license number should have the letters

TX prior to the license number. This requirement does not apply to fixed wing

aircraft.

EMS vehicles are defined as:

(36) Emergency medical services vehicle-

(A) basic life support vehicle;

( advanced life support vehicle;

© mobile intensive care unit (MICU);

(D) MICU rotor wing and MICU fixed wing air medical vehicles; or

(E) specialized emergency medical service vehicle.

This rule does not apply to aircraft nor does it apply to any vehicle that is

not defined as an EMS vehicle. It is my understanding the EMS committee has

157.11 on their agenda, but it not the intent of the department to postpone the

enforcement of this rule which will begin January 1, 2009.

Maxie Bishop, RN, LP, State EMS Director

EMS and Trauma Services

maxie.bishop@...<mailto:maxie.bishop%40dshs.state.tx.us>

________________________________

From: texasems-l <mailto:texasems-l%40yahoogroups.com> on behalf

of spenair

Sent: Fri 11/14/2008 9:13 AM

To: texasems-l <mailto:texasems-l%40yahoogroups.com>

Subject: Re: ems license number on the side of the ambulance

I'll agree it's an easy fix.

Now the negative is it really will not stop any wrong doing. Shady

services just like shady contractors can make sure a little mud hides

part of the numbers. Or worse they can put on other services numbers

so public reports a problem by number and the wrong service gets in

trouble. Not hard to get some magnetic strips and place numbers then

every few days switch. Yes there is the slight chance that a DSHS

rep will be at the hospital and catch the discrepancy.

Renny

>

> What's the big deal, fer cryin out loud? We put them on our

ambulances in

> Shackelford County at least three years ago when I was there. It

took about 3

> minutes to do it, and it didn't cost much at all.

>

> You can buy stencils and a can of paint and do the same thing.

Gimme a

> break, heah! <g>

>

> GG

>

>

>

> >

> > All the rule states is 2 " letters prominantly displayed on both

sides of the

> > truck.? I understand several agencies are going to approach GETAC

about

> > getting this section of the new rule postponed until GETAC can re-

visit it.? DSHS

> > is already not going to enforce until January 1, so you might

hold off until

> > after GETAC...

> >

> > Dudley

> >

> > BTW, it is Rule 157.11, Section (d) Paragraph (7)

> >

> > ems license number on the side of the

ambulance

> >

> > I know this is kind of late in the game since this was discussed

awhile

> > back, but does anyone know where I can find the info for the rule

of

> > putting the license number on the side of the ambulance. How big

do

> > the numbers have to be, where should they be placed, color, all

that

> > good stuff. EMS rule number would be great.

> >

> > Thank you all

> >

> >

> >

[Guest guest]

I was sitting in the room a few weeks ago when a DSHS person came to inspect our

ambulances. He said we would have to put the number on the box, and it should be

in 2 " numbers, but he said there was nothing telling us where other than it had

to be plainly visible and on both sides. He said they were recommending it be on

the front fenders, but we could put it where ever.

But what he stressed more than anything was not the number on the truck. He

wanted us to understand that the new rule was going to require us to maintain

temperature control for our drugs and fluids. Something else new is that all

ambulances have to have epi-pens for treating anaphylaxis, and even ECA's have

to be trained to do it. We already do that, so no problem, and we carry out drug

bag into the station when we're not running, but we're going to have to find a

way to keep the fluids at room temperature. Carrying them in and out might be

too much.

So, not putting the number on the box, or making it the same color as the box

would probably draw fire from a DSHS swat team, but from what he was saying, we

would get in a lot more trouble if we didn't maintain temperature control for

our drugs.

--

[Guest guest]

Okay,? allow me to step in here...(sorry about the length...but go the

distance...its worth it?

First, a couple of years ago, GETAC appointed a diverse group of people to

examine the current regulatory structure of EMS and Trauma in Texas and make

some recommendations for future changes.? One of the LARGE issues that came out

of the work of this group was that across this great, vast state of ours, there

is a lot of differences and discrepancies in the way that DSHS enforces and

regulates by the rules.? DSHS hires the best people they can, don't get me

wrong...but unfortunately they pay pauper's wages and as a result you often get

a wide variety of folks for this horribly low pay.? This leads to a great deal

of problems.? Some reported to this Task Force included someone taking over a

service after a bad administrator left, called DSHS for help on verifying rules

and was told " I am going to be coming out there in two weeks, you better have

all this fixed or there will be serious trouble " ...yet in another part of the

state, the program specialist replies " lets set up an appointment next week and

we can talk through these issues and get them resolved " .? In other areas of the

state, one person in the regional DSHS office agrees a solution will solve the

problem being discussed then another person dings them at a surprise inspection

6 weeks later (same DSHS regional office) because they don't like the solution

that was agreed upon.? This Task Force made a recommendation that EMS and Trauma

be brought back under a single department in DSHS, similar to the way the old

Bureau worked prior to the last re-organization and some other things to help

solve many of these issues.

Next, how is DSHS going to prove that you have kept your medications and fluids

at a " constant " temperature.? The 157.11 rule states that every agency has to

have a plan to do this (has been in there since pre-2001)...and unless I am

mistaken, it has not changed.? Still, we get wrong messages being sent to EMS

providers and now we are going to have ambulances delaying their responses

because they have to re-load the units (or spend a bunch of money on on-board AC

unit retro-fits) before they can roll out...or like my agency used to

do...accidentally respond to a call with all the drugs still back at the

station...This drug and fluid thing has driven me crazy for years...can anyone

tell us how much heat (or cold) for how long actually can cause issues?? Also,

have you ever done a temperature study to see exactly how hot or cold the back

of your ambulance gets (inside the drug box)?? We did, and even on the hottest

of hot days in South Texas August we only?reached an air temperature of 92

degrees.? The other thing...why doesn't the heat and cold of the UPS truck do

damage?? Why is it just the heat and cold in the back of the ambulance?

Now, on to my point on the EMS License Numbers on the side of the truck.? Way

back when Terry Bavousett was still the EMS Director for Texas, rule 157.11 came

up before GETAC for its 3 year review.? The EMS Subcommittee started reviewing

and updating this rule.? This was a really busy and hectic time for GETAC and

TDH because the re-org was hitting the ground and there was a lot of other

political things going on.? Besides 157.11, there were several other rules up

for review including the certification rule, education provider rule, first

responder rule and the air medical (157.12 and 157.13).? The Air Med providers

were forming into a task force and starting to review their own rules, and there

were a lot of issues surrounding this as well.?

TDH came into these meetings with some things they wanted to see done.? First

draft they wanted to have the Official Company name (the owners) on the side of

the truck as well as the name they were operating under in 6 " letters.? There

was a problem (and what do you know there still is) with people operating under

a name (say ABC Ambulance) and then when they got in trouble with CMS or TDH,

they would re-label the trucks with XYZ Ambulance and get back to operating.?

Limited staff and resources made it very difficult to keep up with these

losers.? So, myself and a few others suggested that for some people you would

not be able to get all of this information on the side of a Type II ambulance

(van).? Can you imagine " TWO GREAT GUYS MAKING MONEY, INC dba DUDLEY AND GENE'S

AMBULANCE SERVICE " in 6 " letters on the side of a van?? We suggested, because of

this, that we try and come up with a different way to accomplish the same goal.?

TDH stated they would review this and bring back some suggestions.?

Then, 3 months later, when the rule came back, I believe this change was in

there that the EMS Provider number had to be " prominently " displayed on both

sides of the truck with a TX in front of it.? Unfortunately (and this is a

horrible excuse but it is the truth) the EMS Committee probably never discussed

this again because with all the changes and the unknown new process for moving

rules forward to be approved, and the pressure to get all these big rules

through and done as quickly as possible...we addressed some other big topics but

never visited this...sending it to GETAC for approval.? It then took it 4 or

more years to finally get approved as a new rule and we were all surprised when

we were told of this change.?

I do agree with Gene, it is not a big deal, its stupid and it is easy to

fix...BUT...it is the principal of the thing. Here are my points:? How many

police and fire vehicles have their TCLEOSE or TCFP license numbers on side of

them?? What difference will this make?? Who is going to see it...compared to the

10 " letters (like our units have) displaying the agency name?? The EMS Provider

number does not tell you what unit you had a problem with...just the agency.? If

you want to know the specific unit, you have to find the OTHER 2 " numbers

prominently displayed on the front and back of the unit (called a license

plate).? What definition of " prominently displayed " will be used?? Gene, don't

know where you put yours, I have seen them on the front lower corner of the box,

by the belt line, on the fender, on the door, above the rear wheels...and then

color...so I put BLACK letters on my navy blue truck...to me that is

prominent...don't see our DSHS folks allowing that one to slide.? Do they have

to be reflective?? Not very prominent at night...of course we never have issues

at night so I guess it is only important during the day during DSHS office

hours.?

My largest aggravation is this:? I think this looks, feels and tastes horrible

from a profession stand-point.? We have such a problem in our industry that we

are grasping at stupid straws in an attempt to solve our problems.? You don't

see these numbers displayed on police cars, firetrucks, hospitals, doctor office

doors, or anywhere else there are enforcement issues.? Lastly, this is going to

make rule-breakers out of the agencies who attempt to do the right thing.? You

see, probably 75% (totally made up but feels good) of EMS Providers in Texas are

attempting to do it right.? It is just in the larger municipal areas where the

problems are?way out of control.? In all these areas you have agencies (like

those who post on here) who attempt to do the right thing.? They cooperate and

assist DSHS, they self-report problems, they do their best to follow the rules,

they get upset when they get dinged during surprise inspections, and this is one

more regulatory hurdle ALL of us good guys will work to clear...despite

differences of opinion of the DSHS enforcement people, despite the extra work,

and despite the aggravation.?

AND, it is these same good guys who will get dinged on this new regulation when

their crew washes?2 or 3 letters?off in 18 months (because they didn't have the

funds to get them done like their lettering so they used 2 " sticky numbers from

walmart)?and then gets a call and runs into DSHS people at the ED...or upon the

hiring of a new program specialist in their region, gets dinged because they are

not prominently displayed and has to spend 4 or 5 hours over the next couple of

days explaining to all the new staff that the old DSHS people who are now off in

jobs making living wages, felt it was okay but the new group doesn't...leading

eventually (because us good guys don't like to rock the boat for the poor DSHS

people who are over-worked and under-paid) to us having to take the numbers we

have had on the trucks for 2 years off and putting brand new numbers on that are

off-standing colors and reflective for $120 from our local graphics shop thereby

making more work for the guys who are doing this correctly...MEANWHILE...Two

Great Guys Making Money are still throwing our parents and grand-parents into

the back of crappy trucks not equipped to do their jobs with people who

shouldn't even be in this business let alone caring for our loved-ones sitting

next to them toting them from one facility to another violating every Medicare

and Medicaid rule out there, just not to the level that gets attention, and

dodging DSHS issue after DSHS because they don't and won't spend the money to do

the job right...but gosh-durn-it...they have a 2 " TX number prominently

displayed on the side of their meat wagons...

I will repeat, I agree with Gene...this is petty and minor...BUT ENOUGH IS

ENOUGH....where do we draw the line in the sand?? What little minor thing comes

next?? If this had any chance of improving the state of affairs?for EMS in

Texas, I would be trumpeting it?from the highest point in the land...but it

doesn't.?

So, want some fun?? Come to the GETAC EMS Committee meeting in Ft. Worth next

Sunday at 1300.? This item is on the agenda, and it is a great opportunity for

stakeholders to voice their concerns and non-concerns to DSHS regarding this

issue (or any other).

It promises to be fun and exciting!!!

Dudley

RE: Re: ems license number on the side of the ambulance

I was sitting in the room a few weeks ago when a DSHS person came to inspect our

ambulances. He said we would have to put the number on the box, and it should be

in 2 " numbers, but he said there was nothing telling us where other than it had

to be plainly visible and on both sides. He said they were recommending it be on

the front fenders, but we could put it where ever.

But what he stressed more than anything was not the number on the truck. He

wanted us to understand that the new rule was going to require us to maintain

temperature control for our drugs and fluids. Something else new is that all

ambulances have to have epi-pens for treating anaphylaxis, and even ECA's have

to be trained to do it. We already do that, so no problem, and we carry out drug

bag into the station when we're not running, but we're going to have to find a

way to keep the fluids at room temperature. Carrying them in and out might be

too much.

So, not putting the number on the box, or making it the same color as the box

would probably draw fire from a DSHS swat team, but from what he was saying, we

would get in a lot more trouble if we didn't maintain temperature control for

our drugs.

--

[Guest guest]

Sent from my iPhone

Kimberley Cunningham, BS

kimberleyrc@...

> Okay,? allow me to step in here...(sorry about the length...but go

> the distance...its worth it?

>

> First, a couple of years ago, GETAC appointed a diverse group of

> people to examine the current regulatory structure of EMS and Trauma

> in Texas and make some recommendations for future changes.? One of

> the LARGE issues that came out of the work of this group was that

> across this great, vast state of ours, there is a lot of differences

> and discrepancies in the way that DSHS enforces and regulates by the

> rules.? DSHS hires the best people they can, don't get me

> wrong...but unfortunately they pay pauper's wages and as a result

> you often get a wide variety of folks for this horribly low pay.?

> This leads to a great deal of problems.? Some reported to this Task

> Force included someone taking over a service after a bad

> administrator left, called DSHS for help on verifying rules and was

> told " I am going to be coming out there in two weeks, you better

> have all this fixed or there will be serious trouble " ...yet in

> another part of the state, the program specialist replies " lets set

> up an appointment next week and we can talk through these issues and

> get them resolved " .? In other areas of the state, one person in the

> regional DSHS office agrees a solution will solve the problem being

> discussed then another person dings them at a surprise inspection 6

> weeks later (same DSHS regional office) because they don't like the

> solution that was agreed upon.? This Task Force made a

> recommendation that EMS and Trauma be brought back under a single

> department in DSHS, similar to the way the old Bureau worked prior

> to the last re-organization and some other things to help solve many

> of these issues.

>

> Next, how is DSHS going to prove that you have kept your medications

> and fluids at a " constant " temperature.? The 157.11 rule states that

> every agency has to have a plan to do this (has been in there since

> pre-2001)...and unless I am mistaken, it has not changed.? Still, we

> get wrong messages being sent to EMS providers and now we are going

> to have ambulances delaying their responses because they have to re-

> load the units (or spend a bunch of money on on-board AC unit retro-

> fits) before they can roll out...or like my agency used to

> do...accidentally respond to a call with all the drugs still back at

> the station...This drug and fluid thing has driven me crazy for

> years...can anyone tell us how much heat (or cold) for how long

> actually can cause issues?? Also, have you ever done a temperature

> study to see exactly how hot or cold the back of your ambulance gets

> (inside the drug box)?? We did, and even on the hottest of hot days

> in South Texas August we only?reached an air temperature of 92

> degrees.? The other thing...why doesn't the heat and cold of the UPS

> truck do damage?? Why is it just the heat and cold in the back of

> the ambulance?

>

> Now, on to my point on the EMS License Numbers on the side of the

> truck.? Way back when Terry Bavousett was still the EMS Director for

> Texas, rule 157.11 came up before GETAC for its 3 year review.? The

> EMS Subcommittee started reviewing and updating this rule.? This was

> a really busy and hectic time for GETAC and TDH because the re-org

> was hitting the ground and there was a lot of other political things

> going on.? Besides 157.11, there were several other rules up for

> review including the certification rule, education provider rule,

> first responder rule and the air medical (157.12 and 157.13).? The

> Air Med providers were forming into a task force and starting to

> review their own rules, and there were a lot of issues surrounding

> this as well.?

>

> TDH came into these meetings with some things they wanted to see

> done.? First draft they wanted to have the Official Company name

> (the owners) on the side of the truck as well as the name they were

> operating under in 6 " letters.? There was a problem (and what do you

> know there still is) with people operating under a name (say ABC

> Ambulance) and then when they got in trouble with CMS or TDH, they

> would re-label the trucks with XYZ Ambulance and get back to

> operating.? Limited staff and resources made it very difficult to

> keep up with these losers.? So, myself and a few others suggested

> that for some people you would not be able to get all of this

> information on the side of a Type II ambulance (van).? Can you

> imagine " TWO GREAT GUYS MAKING MONEY, INC dba DUDLEY AND GENE'S

> AMBULANCE SERVICE " in 6 " letters on the side of a van?? We

> suggested, because of this, that we try and come up with a different

> way to accomplish the same goal.? TDH stated they would review this

> and bring back some suggestions.?

>

> Then, 3 months later, when the rule came back, I believe this change

> was in there that the EMS Provider number had to be " prominently "

> displayed on both sides of the truck with a TX in front of it.?

> Unfortunately (and this is a horrible excuse but it is the truth)

> the EMS Committee probably never discussed this again because with

> all the changes and the unknown new process for moving rules forward

> to be approved, and the pressure to get all these big rules through

> and done as quickly as possible...we addressed some other big topics

> but never visited this...sending it to GETAC for approval.? It then

> took it 4 or more years to finally get approved as a new rule and we

> were all surprised when we were told of this change.?

>

> I do agree with Gene, it is not a big deal, its stupid and it is

> easy to fix...BUT...it is the principal of the thing. Here are my

> points:? How many police and fire vehicles have their TCLEOSE or

> TCFP license numbers on side of them?? What difference will this

> make?? Who is going to see it...compared to the 10 " letters (like

> our units have) displaying the agency name?? The EMS Provider number

> does not tell you what unit you had a problem with...just the

> agency.? If you want to know the specific unit, you have to find the

> OTHER 2 " numbers prominently displayed on the front and back of the

> unit (called a license plate).? What definition of " prominently

> displayed " will be used?? Gene, don't know where you put yours, I

> have seen them on the front lower corner of the box, by the belt

> line, on the fender, on the door, above the rear wheels...and then

> color...so I put BLACK letters on my navy blue truck...to me that is

> prominent...don't see our DSHS folks allowing that one to slide.? Do

> they have to be reflective?? Not very prominent at night...of course

> we never have issues at night so I guess it is only important during

> the day during DSHS office hours.?

>

> My largest aggravation is this:? I think this looks, feels and

> tastes horrible from a profession stand-point.? We have such a

> problem in our industry that we are grasping at stupid straws in an

> attempt to solve our problems.? You don't see these numbers

> displayed on police cars, firetrucks, hospitals, doctor office

> doors, or anywhere else there are enforcement issues.? Lastly, this

> is going to make rule-breakers out of the agencies who attempt to do

> the right thing.? You see, probably 75% (totally made up but feels

> good) of EMS Providers in Texas are attempting to do it right.? It

> is just in the larger municipal areas where the problems are?way out

> of control.? In all these areas you have agencies (like those who

> post on here) who attempt to do the right thing.? They cooperate and

> assist DSHS, they self-report problems, they do their best to follow

> the rules, they get upset when they get dinged during surprise

> inspections, and this is one more regulatory hurdle ALL of us good

> guys will work to clear...despite differences of opinion of the DSHS

> enforcement people, despite the extra work, and despite the

> aggravation.?

>

> AND, it is these same good guys who will get dinged on this new

> regulation when their crew washes?2 or 3 letters?off in 18 months

> (because they didn't have the funds to get them done like their

> lettering so they used 2 " sticky numbers from walmart)?and then gets

> a call and runs into DSHS people at the ED...or upon the hiring of a

> new program specialist in their region, gets dinged because they are

> not prominently displayed and has to spend 4 or 5 hours over the

> next couple of days explaining to all the new staff that the old

> DSHS people who are now off in jobs making living wages, felt it was

> okay but the new group doesn't...leading eventually (because us good

> guys don't like to rock the boat for the poor DSHS people who are

> over-worked and under-paid) to us having to take the numbers we have

> had on the trucks for 2 years off and putting brand new numbers on

> that are off-standing colors and reflective for $120 from our local

> graphics shop thereby making more work for the guys who are doing

> this correctly...MEANWHILE...Two Great Guys Making Money are still

> throwing our parents and grand-parents into the back of crappy

> trucks not equipped to do their jobs with people who shouldn't even

> be in this business let alone caring for our loved-ones sitting next

> to them toting them from one facility to another violating every

> Medicare and Medicaid rule out there, just not to the level that

> gets attention, and dodging DSHS issue after DSHS because they don't

> and won't spend the money to do the job right...but gosh-durn-

> it...they have a 2 " TX number prominently displayed on the side of

> their meat wagons...

>

> I will repeat, I agree with Gene...this is petty and minor...BUT

> ENOUGH IS ENOUGH....where do we draw the line in the sand?? What

> little minor thing comes next?? If this had any chance of improving

> the state of affairs?for EMS in Texas, I would be trumpeting it?from

> the highest point in the land...but it doesn't.?

>

> So, want some fun?? Come to the GETAC EMS Committee meeting in Ft.

> Worth next Sunday at 1300.? This item is on the agenda, and it is a

> great opportunity for stakeholders to voice their concerns and non-

> concerns to DSHS regarding this issue (or any other).

>

> It promises to be fun and exciting!!!

>

> Dudley

>

> RE: Re: ems license number on the side of the

> ambulance

>

> I was sitting in the room a few weeks ago when a DSHS person came to

> inspect our ambulances. He said we would have to put the number on

> the box, and it should be in 2 " numbers, but he said there was

> nothing telling us where other than it had to be plainly visible and

> on both sides. He said they were recommending it be on the front

> fenders, but we could put it where ever.

>

> But what he stressed more than anything was not the number on the

> truck. He wanted us to understand that the new rule was going to

> require us to maintain temperature control for our drugs and fluids.

> Something else new is that all ambulances have to have epi-pens for

> treating anaphylaxis, and even ECA's have to be trained to do it. We

> already do that, so no problem, and we carry out drug bag into the

> station when we're not running, but we're going to have to find a

> way to keep the fluids at room temperature. Carrying them in and out

> might be too much.

>

> So, not putting the number on the box, or making it the same color

> as the box would probably draw fire from a DSHS swat team, but from

> what he was saying, we would get in a lot more trouble if we didn't

> maintain temperature control for our drugs.

>

> --

>

>