Ambulance services are overseen and regulated by the County; there are both private companies and public sector (911) services. The County ensures that the ambulance companies to provide services in most areas of the cities and county must adhere to uniform standards. Some fire departments handle their own transportation. When someone places a 911 call, the dispatcher contacts the ambulance company responsible for the zone in which the patient is located.

Ambulances are required to arrive at their destination no more than 8 minutes and 59 seconds from the time they are dispatched by 911. 

Ambulances go to the closest hospital best geared for the treatment being sought.  Not each hospital is created equal for emergency care.

Accident victims are taken to hospitals best suited to treat trauma. Other patients go to designated hospitals that treat stroke victims, heart attacks and children. Cases that don't fall into any of these four areas are taken to the closest hospital with a licensed emergency room.

The basic emergency ambulance transport is about $1,000 to $1,100. The cost is more like $1,200 to $1,300 for a transport that requires advanced life support. Included is the cost for paramedics and the ambulance ride itself. However, companies can charge extra for mileage, supplies and equipment.

Both Medicare and private insurance generally cover the cost of ambulance rides — as long as they are deemed medically necessary. Medicare pays 80% of an approved amount and patients pay the remaining 20%. Private health plans must cover emergency care, which includes ambulance transportation. But exactly how much is covered differs among policies.

County residents without insurance, county residents with insurance co-pays and county residents whose insurers refuse to pay for transport are not responsible for ambulance transport fees; their local tax dollars are considered payment toward the fee.

The law also prohibits the transportation of more than one patient in one ambulance vehicle, but again provides for exceptions. That section does not apply where a contract between the ambulance company and the County specifically provides otherwise or where a Fire Chief with territorial jurisdiction instructs otherwise. One example is where ambulances, in an emergency situation, are being used to evacuate stretcher-bound patients or those using wheelchairs.

Private ground ambulances are inspected annually by the County for compliance with safety and sanitation requirements of State statutes.