Ambulance Service in the Greater Boston area is divided into "public" and "private" components. The "public" component primarily involves emergency response to urgent situations (motor vehicle crashes, falls, heart attacks, strokes, bleeding, shootings, stabbings, etc) that occur in public and private locations (on streets and in homes and offices).
The "public" ambulance service is funded primarily by the cities and towns. Access is obtained by dialing 911 or the 7 digit telephone number for the local police or fire departments. Dispatch and coordination is conducted primarily on the police and fire department radio channels.
"Private" ambulance service is provided by private for-profit companies / businesses. Access is obtained by dialing the 7 digit telephone numbers for the various companies. ALS and BLS service is available. Emergency and nonemergency service is available. (Emergency service involves high speed response with flashing lights and sirens.) "Private" service may be used when the patient seeks to go to a distant specialty hospital, or does not wish to have public employees entering his home. The patient is required to pay all costs (which usually are covered by health insurance policies). HMOs are also attempting to transport more of their patients via private ambulances. All nonemergency transfers of patients to and from nursing homes is done by private ambulances. Most emergency transfers from hospitals (or nursing homes) to hospitals is done by private ambulances.
Most ALS units are operated by private companies (except in the City of Boston). Most of the ALS units are capable of carrying patients. NSP ALS units and South Shore Hospital ALS units are not capable of transporting patients - they use small trucks to carry 2 paramedics each.
When the NSP units go enroute to a hospital, 1 paramedic will stay in the ambulance with the patient, and the other paramedic will drive the ALS truck behind the ambulance to the hospital. The paramedic in the ALS truck may talk to the MD in the hospital while enroute to the hospital - and relay any orders to his partner via portable radio.
February 2001 - Both the Lynn and Cambridge Fire Departments are hiring or training employees to provide paramedic service. In addition, the Arlington Fire Chief was quoted in the Arlington newspaper as expressing an interest in having the Arlington FD provide ALS.
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"Public"
A mixture of systems are used. It is common for the local FD to supply a BLS ambulance which is augmented by a private or hospital nontransporting ALS unit. In other cases, private ALS and BLS transporting units are operated under contract to the municipality. [I am not sure how the financing works on those contracts]
February 2001 - New Medicare rules are taking effect and it is causing changes in the billing policies on EMS incidents. In Arlington, historically the ALS provider has billed Medicare about $360 for each ALS transport. $120 of that sum is given to the local city or town that provided the transport vehicle. The new Medicare regulations state that the ALS provider cannot bill for transportation costs if that did not provide a transporting vehicle.
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Town or City - First Response (FR) - Transport (TR) - ALS Provider
Arlington - FR : FD + PD - TR : FD Rescue 1 - ALS : NSP
Belmont - FR : FD - TR : FD Rescue 1 - ALS : NSP
Boston - FR : FD + PD - TR : City EMS - ALS : City EMS
Braintree - FR : FD + ?PD - TR : Fallon - ALS : Fallon
Brookline - FR : PD + FD - TR : Fallon BLS + ALS - ALS : Fallon
Cambridge - FR : FD - TR : FD Rescue 1 + 2 + Pro ALS - ALS : Pro
Chelsea - FR : FD - TR : Cataldo Amb + Cataldo ALS
Dedham - FR : FD - TR : Fallon - ALS : Fallon
Everett - FR : FD - TR : Cataldo Amb + Cataldo ALS - ALS : Cataldo
Lynn - FR : FD - TR : FD Sqd 1,2,3 + Action ALS - ALS : Action + North Shore
Malden - FR : FD - TR : Cataldo BLS + ALS - ALS : Cataldo
Medford - FR : FD + PD - TR : Amstrong A1 is ALS
Melrose - FR : FD - TR : FD Rescue 1 - ALS : Action
Milton - FR : FD + ?PD - TR : Fallon - ALS : Fallon
Needham - FR : PD + FD - TR : Rescue 1 + 2 - ALS : Natick Hospital ALS
Newton - FR : PD + FD - TR : AMR Medic 1,2 + Rescue 1 - ALS : AMR Medic 1,2 (backup ALS from Medic 4 which is a Waltham AMR ALS unit usually)
Quincy - FR : FD + PD - TR : Fallon - ALS : Fallon
Reading - FR : FD + ?PD - TR : FD - ALS : NSP (1 or 2)
Revere - FR : FD - TR : Cataldo A1 (BLS) - ALS : Cataldo
Saugus - FR : FD - TR : Cataldo A1 - ALS : Cataldo
Somerville - FR : FD + PD - TR : Cataldo ALS + BLS - ALS : Cataldo
Stoneham - FR : FD + ?PD - TR : Action - ALS : Action
Wakefield - FR : FD + ?PD - TR : Action - ALS : Action
Waltham - FR : FD + PD - TR : AMR Medic 1 (BLS) + AMR Rescue 1 (BLS) - ALS : AMR - (Feb 2001 - some BLS + ALS backup from Armstrong - also BLS backup from Weston FD + Watertown FD + Lexington FD + ?Belmont FD)
Watertown - FR : FD + PD - TR : FD Rescue 1 - ALS : NSP(4) - (commonly, Belmont FD R1 provides BLS backup)
Wellesley - FR : FD - TR : AMR Rescue 1 (ALS)
Weymouth - FR : FD + ?PD - TR : Fallon - ALS : Fallon + South Shore P1
Winchester - FR : FD + PD - TR : FD - ALS : NSP (1 or 3)
Winthrop - FR : FD + ?PD - TR : Cataldo - ALS : Cataldo
Woburn - FR : FD + ?PD - TR : FD - ALS : NSP (1)
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Radio Info
Radio usage varies from place to place. The easiest way to explain it is to just make a list. So here goes. (In general, if the local FD operates a ambulance, they will have a mobile radio and 1 or 2 portable radios to use on the FD radio channels.)
Typically, when a private ambulance company provides 911 services to a city or town, they will use the radio IDs of "Ambulance 1", "Ambulance 2", "Ambulance 3", etc. (Amb 2 + Amb 3 are typically units coming in on coverage when Amb 1 is busy)
Arlington - NSPs have mobile radio to access FD freq
Belmont - NSPs have mobile radio to access FD freq
Boston - City ambulances operate on 462.975R + 462.95R + 460.55R - each crewmember has a portable radio - no other agencies use these freqs
Braintree - 2 or 3 Fallon ambs have portables to access FD freq
Brookline - 1 or 2 Fallon ambs has portable to access FD freq
Burlington - NSP have mobile radio to access FD freq
Cambridge - Professional Paramedics have a portable on City 800TRS - possibly Professional BLS units do also - they use the radios to talk to Cambridge City Hospital and FD first responders
Chelsea - duty Cataldo unit has portable on FD freq and is dispatched on 154.325R by the fire dispatcher
Dedham - Fallon units have mobile radio on 153.95 - dispatched by FD dispatcher
Everett - no Cataldo units use the FD radio freq
Lexington - NSP have mobile radio on FD freq
Lynn - ALS unit has radio on FD freq
Malden - 1 Cataldo unit has portable on FD freq - FD dispatches the Cataldo unit via the FD freq
Massport - covered by Boston EMS who use their City freqs
Medford - Armstrong A1 has radio on Medford FD freq and is dispatched by the FD dispatcher - backup Armstrong units may or may not have radios on 153.89
Melrose - ?Action Amb has radio on FD freq and is dispatched by the FD dispatcher
Milton - Fallon units operate on ?PD freq
Needham - P1 from Natick Hospital has mobile radio on Needham Fd radio freq
Newton - AMR units have radios on Newton PD freq - Newton PD dispatchs AMR units on the PD freq
Quincy - Fallon units are dispatched on the PD radio channel by the PD dispatcher
Reading - NSP units have mobile on FD freq
Revere - Cataldo A1 has radio on 154.175R and is dispatched by the Revere FD dispatcher
Saugus - ?Cataldo A1 has radio on Saugus FD radio freq and is dispatched by the Saugus FD dispatcher
Somerville - Cataldo units operate on Cataldo radio freqs - FD units upgrade to ALS (request Cataldo ALS) by ordering the FD dispatcher to call the Cataldo dispatcher via telephone
Stoneham - Action Ambulance units operate on Action freqs (453.125R)
Wakefield - Action Ambulance units operate on Action freqs
Waltham - AMR units operate on FD Channel 1 and Channel 5 - AMR units are dispatched by the FD dispatcher via FD Channel 1 (154.40)
Watertown - NSP units have mobile radio on FD radio freq
Wellesley - AMR unit has portable radio on FD radio freq - AMR unit is dispatched by FD dispatcher
Weston - Emerson ALS 1 has mobile radio on Weston FD radio freq (154.16R)
Weymouth - Fallon units have portable radios on FD radio freq (154.235R) - FD dispatcher controls AMR units
Winchester - NSP units have mobile radio on Fd freq (483.6875R)
Winthrop - Cataldo units use Cataldo freqs
Woburn - NSP units have mobile radio on FD radio freq
Private ambulance units and hospital ALS units that are operating on FD radio freqs are controlled by the FD dispatcher.
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Backup
Arlington frequently gets BLS backup from Armstrong Ambulance - sometimes by Winchester FD - never from Lexington FD - rarely from Belmont FD
Boston City EMS gets backup from private ambulances - much less frequent nowadays than in the past - Boston EMS units rarely travel outside of the city
Brookline gets backup BLS units from Fallon, never from the City of Boston
Burlington gets BLS backup from Woburn FD + Bedford FD + Lexington FD
Cambridge gets BLS backup from Professional Ambulance - ALS backup comes from Cataldo Ambulance of Somerville - never get help from Boston
Lexington gets BLS backup from rescue 2 which is staffed by a HQ Engine or Ladder crew as needed
Medford gets backup BLS units from Armstrong Ambulance Company
Needham gets BLS backup from their own Rescue 2 (which is probably staffed by the crew of Eng1 or Engine 3 as needed)
Quincy - never get aid from the Boston City EMS
Stoneham - get BLS backup from ?Reading FD rarely - ALS backup has been received from NSP1 out of Burlington
Somerville gets backup BLS from Professional in Cambridge and Armstrong out of Medford - backup ALS comes from Professional in Cambridge - never get aid from Boston
Winchester - get BLS backup from Woburn FD Rescue or Arlington FD R1
Woburn - get BLS backup from crossmanned R2 or from Winchester FD or Burlington FD
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Last Updated - 30 Sept 2000 - 15 Oct 00 (radio info) - 12Feb2001 - added backups - changed ?FDs to ?PDs (typos) - added some Medicare billing info