Department of Public Health - Office of Emergency Medical Services/Ambulance Inspections

This is a Massachusetts State Auditor report on selected activities of the Department of Public Health's Office of Emergency Medical Services, especially ambulance inspections and contract oversight during fiscal years 1997 and 1998.

“The scope of our audit included an examination of OEMS activities during fiscal years 1997 and 1998.”

Auditors wanted to see whether OEMS was running its programs effectively, meeting its goals, and properly overseeing ambulance licensing and contracted services.

“Our overall objective was to determine whether OEMS’s program objectives were being met and expected results were being achieved in the most efficient and effective manner.”

Ambulances carry patients in emergencies, so weak inspections and follow-up can affect public safety and public confidence.

“Emergency services, which provide vital life-saving treatment and transport, must have the total confidence of the public.”

If you or someone you love needs an ambulance, this report matters because some vehicles with serious problems were still being used before inspectors found them.

“It should be noted that, up to the point of inspection, these vehicles were in operation and transporting patients.”

The auditor concluded that the inspection program needed more support, better follow-up, and real enforcement when ambulance services failed to fix problems.

“However, without adequate internal support from DPH, the Ambulance Inspection Program is in danger of becoming meaningless and ineffective.”

The auditor recommended more staffing, verification that ambulance companies correct violations, and penalties such as fines or suspensions when they do not.

“In addition, OEMS should ensure that ambulance service providers that fail inspections implement their corrective action plans and should fine or suspend those providers that do not do so, in accordance with 105 CMR 170.710.”

The findings were broad: in the auditor's test, most ambulance services reviewed were not inspected before their licenses expired, and some were still operating with expired licenses.

“Specifically, we noted that 191, or 74%, of the 259 tested ambulance services were not inspected prior to the expiration of their license and that 68, or 26%, were inspected on a timely basis.”

BLS means Basic Life Support ambulance service, and ALS means Advanced Life Support ambulance service; the report says ALS services needed annual license reviews and BLS services needed reviews every two years.

“A license shall remain in effect for a period of 12 to 24 months, at the discretion of the Department.”