St. Marys Ambulance Service has been in operation since 1965. From humble beginnings this service has grown to be one of the cutting edges in the state. From the most highly trained employees statewide to equipment that is technologically advanced, St. Marys Ambulance has been able to provide our community with a service that rival or surpasses most urban Emergency Medical Services.
In February of 1993, the St. Marys Ambulance Service was approved to become an ALS service, meaning that we could provide Advanced Life Support to the citizens of the community. This allowed our Paramedics to administer life saving medications, intubations, and cardiac monitoring in the field. In 1999 all of our medics were certified as Critical Care Paramedic, an across the board training level unknown in the state of Pennsylvania.
In the past 10 years our service has acquired advanced life saving equipment such as the LifePak 12. This machine can detect abnormal heart rhythms, administer cardiac defibrillation and with the additional CO2 detector,We can endotracheally detect carbon dioxide in the lungs. We have upgraded our radio equipment to better communicate with each other and nearby agencies. We have added cellular capabilities to our vehicles for further communication. We have recently acquired portable ventilators to use on long distance emergency transports. In addition we have currently acquired power assisted cots that will reduce back injuries for our employees.
In the past ten years, St. Marys Ambulance Service has seen major expansion including the construction of a new station. This new station was constructed to accommodate the expansion of the service in regards to vehicle housing, office space, crew quarters and in house training.
One of the greatest assets of the expansion has been the in house training facility. This facility has allowed our employees to acquire the training needed to keep them abreast of current treatments and procedures. It has also facilitated the training for our Paramedics to become certified as Critical Care Paramedics. Our service was the first in the state to achieve this exemplary level of training. In addition, we regularly offer CPR,EMT, and EMT Paramedic classes through the American Heart Association and Butler County Community College to the public with instructors that are trained and certified right here at our station.
Our service maintains a strong commitment to our community. We are common but our comforting sight at most outdoor school activities including football and soccer games, Stallion football, and wrestling and cheerleading tournaments. We routinely donate our efforts to civic occasions like the hometown Festival, St. Marys Airport Drag Races, various health fairs and the Lee Foster Memorial Runs. We are a familiar presence to our youth offering CPR classes in the schools in addition to career days, city park programs and station tours. Our employees commonly hold one on one CPR classes for the local medical and industrial facility employees.
Our service has always prided itself on its employees achievements and abilities. We could not have gotten this far without the direction of our Manager Robert Sorg. His compassionate and forward thinking attitude has been our primary asset. he has taken this service from a small town Ambulance Service to a vital Pre Hospital Emergency Care Service that is second to none in the area.
All of those engaged in providing health services should constantly review and make a critical analysis of their activities. Health problems and health services change, but the fact remains,health is everyone's business.
The mission of St. Marys Area Ambulance Service is to become and to progress as an integral member of the medical community of the St. Marys Area.
The Service will strive to provide the best possible emergency and non-emergency health care and transportation of the sick and injured residents of the City of St. Marys and surrounding area by providing quality equipment and facilities to render these services.
Efforts will continue to be made to provide a work environment which encourages the developement, education and growth of it's professional staff. We strive to provide access to Advanced Life Support (ALS) and Basic Life Support (BLS) health care services through our programs or through coordination of programs with other health care providers.
St. Marys Area Ambulance Service, as a not-for-profit corporation, will further this effort through responsible stewardship of the community's human and financial resources.
Elk Regional Health Center
Dubois Regional Medical Center
Butler County Community College
Kane Community Hospital
American Heart Association
Pennsylvania Dept. of Health
Pennsylvania State Police
Physicians Desk Reference
American Red Cross
"I hereby apply for a subscription to St. Marys Area Ambulance Service,Inc. (SMAAS) and agree to the following terms and conditions:
SMAAS, upon receipt of a properly completed subscription application and the appropriate fees as indicated on the subscription application, entitles the holder to medically necessary EMERGENCY AMBULANCE SERVICE . THE SUBSCRIBER IS ENTITLED TO UNLIMITED USE OF St. Marys Area Ambulance emergency services within the City of St. Marys, based upon availability of available resources, at no further"out of pocket" expenses to the subscriber. The subscription is effective, upon receipt and acceptance of my subscription and the assignment, expires annually on April 30th.
The FAMILY PLAN includes husband, wife, and unmarried children living at home under 18 years of age. Full time college students up to 24 years of age are included in the Family Membership.
The INDIVIDUAL MEMBERSHIP covers the individual named on the membership card only.This membership is effective upon receipt by the St. Marys Area Ambulance Service, and expires annually on April 30, following receipt.
This subscription also includes access tp pre-scheduled NON-EMERGENCY AMBULANCE SERVICE which is determined to be medically necessary by the St. Marys Area Ambulance Service Management. Non-emergency service is subject to availability, staffing, scheduling, and equipment constraints. This is an additional service, but not a contractual obligation between St. Marys Area Ambulance and the subscriber. Emergencies always have priority. 24 hour notice and Physician authorization may be required for these non-emergency services.
The subscriber will be responsible for all charges associated with non-emergency ambulance services which are provided in good faith but is later determined that the charges are not covered by the subscriber's insurance for any reason.
Subscribers are also responsible to provide full cooperation with St. Marys Ambulance's designated billing representatives in their effort to collect any and all reimbursements associated with the provision of emergency medical services, non-emergency ambulance services or alternate medical transportation services. Subscribers are also required to remit to st. Marys Ambulance Service any and all reimbursement immediately upon receipt from any source including commercial or government agencies or any other third party insurance carrier or program for services provided under the terms and conditions off the subscription program. St. Marys Area Ambulance reserves the right to initiate legal action against the subscriber to recover any and all reimbursement received by the Subscriber related to the provision of subscription related services. Any and all costs, fees and intereste associated with the lega action necessary to recoversaid reimbursement will also be the responsibility of the subscriber assessed.
Subscribers will be offered discounted rates for use of alternative medical transportation including wheelchair van services for medical transports. Wheelchair van service is subject to availability, staffing levels, scheduling, and equipment constraints. A minimum of 24 hour notice must be given for a request for wheelchair van service. This membership will provide wheelchair transportation within the City of St. Marys at a rate of $5.00 per trip. A $1.00 per mile charge will be added to any transport outside the City of st. Marys.
Soley the staff of st. Marys Area Ambulance Service or its Medical Director will make dispatching and transportating decisions regarding the acceptance of the request for pre-scheduled non-emergency related ambulance and medical wheelchair van transportation services.SMAAS's acceptance of insurance assignment for pre-scheduled ambulance service may be contingent upon the determination of my insurance that use of the ambulance was medically necessary.
A valid subscription provides supplemental financial protection for an amount, which is calculated as the DIFFERENCE BETWEEN ALLOWABLE CHARGES BY THE SUBSCRIBER'S INSURANCE PROGRAM, AND THE GROSS BILLED for medically necessary emergency or non-emergency ambulance services. This protection is also extended to subscribers who utilize St. Marys Ambulance services under the terms and conditions outlined, and have no applicable or billable coverage for medical transportation.
Subscription coverage applies only to persons who accept all terms of this agreement. This subscription is non-refundable and non-transferable.
As part of the consideration for this subscription agreement, I hereby assign to SMAAS all my rights and benefits under my hospitalization and any other applicable medical insurance or other benefits or insurance policies for service rendered to me by St. Marys Area Ambulance Service,Inc.
I authorize and direct my insurer(s) and medical benefits provider (s) to pay directly to SMAAS all sums owed for each service rendered to me. When services are rendered: I will notify my insurance as required, and provide insurance numbers and authorization needed by SMAAS to bill my insurance. SMAAS will send my bills directly to my insurer or other medical benefitsprovider. I agree to forward to St. Marys Area Ambulance Service any payments I receive for services rendered to me by or for SMAAS under this subscription agreement"
NOTE: This is not an insurance contract. This is not a solicitation to persons receiving medical assistance benefits.
St, Marys Area Ambulance Service (SMAAS) is required by law to maintain the privacy of certain confidential health care information, know as Protected Health Information or PHI, and to provide you with a notice of our legal duties and privacy practices with respect to your PHI. St. Marys area Ambulance is also required to abide by the terms of the version of this notice currently in effect.
Uses and Disclosures of PHI:
SMAAS may use PHI for the purposes of treatment, payment, and health care operations, in most cases without your written permission. Examples of our use of your PHI.
This includes such things as obtaining verbal and written information about your medical condition and treatment from you as well as others, such as doctors and nurses who give orders to allow us to provide treatment to you. We may give your PHI to other health care providers involved in your treatment, and may transfer your PHI via radio or telephone to the hospital or dispatch center.
This includes any activities we must undertake in order to get reimbursed for the services we provide to you, including such things as submitting bills to insurance companies, making medical necessity determinations and collecting outstanding accounts.
For health care operations:
This includes quality assurance activities, licensing, and training programs to ensure that our personnel meet our standards of care and follow established policies and procedures, as well as certain other management functions.
Reminders for scheduled Transports and Information on Other Services:
We may also contact you to provide you with a reminder of any scheduled appointments for non-emergency ambulance and medical transportation, or to provider information about other services we provide.
Use and Disclosure of PHI Without Your Authorization:
SMAAS is permitted to use PHI without your written authorization, or opportunity to object, in certain situations, and unless prohibited by a more stringent state law, including:
· For the treatment, payment or health care operations activities of another health care provider who treats you.
· For health care and legal compliance activities.
· To a family member, other relative, or close personal friend or other individual involved in your care if we obtain your verbal agreement to do so or if we give you an opportunity to object to such a disclosure and you do not raise an objection, and in certain other circumstances where we are unable to obtain your agreement and believe the disclosure is in your best interests.
· To public health authority in certain situations as required by law (such as to report abuse, neglect or domestic violence).
· For health oversight activities including audits or government investigations, inspections, disciplinary proceedings, and other administrative or judicial actions undertaken by the government (or their contractors) by law to oversee the healthcare system.
· For military, national defense and security and other special government functions.
· To avert a serious threat to health and safety of a person or the public at large.
· For workers compensation purposes, and in compliance with workers compensation laws.
· To coroners, medical examiners, and funeral directors for identifying a deceased person, determining cause of death, or carrying on their duties as authorized by law.
. If you are an organ donor, we may release health information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ donation and transplantation.
· For research projects, but this will be subject to strict oversight and approvals.
· We may also use or disclose health information about you in a way that does not personally identify you or reveal who you are.
Any other use or disclosure of PHI, other than those listed above will only be made with your written authorization at any time, in writing, except to the extent that we have already used or disclosed medical information in reliance on that authorization.
As a patient, you have a number of rights with respect to your PHI, including: · The right to access, copy or inspect and copy most of the medical information about you that we maintain. We will normally provide you with access to this information within 30 days of request. We may also charge you a reasonable fee for you to copy any medical information that you have the right to access. In limited circumstances, we may deny you access to your medical information, and you may appeal certain types of denials. We have available forms to request access to you PHI and we will provide a written response if we deny you access and let you know your appeal rights. You also have the right to receive confidential communications of your PHI. If you wish to inspect and copy your medical information, you should contact our privacy officer.
The Right to amend your PHI.
You have the right to ask us to amend written medical information that we may have about you. We will generally amend your information within 60 days of your request and will notify you when we have amended the information. We are permitted by law to deny your request to amend your medical information only in certain circumstances, like when we believe the information you have asked us to amend the medical information that we have about you, you should contact our privacy officer.
The Right to request accounting:
You may request an accounting from us of certain disclosures of your medical information that we have made in the six years prior to the date of your request. We are not required to give you an accounting of information we have used or disclosed for purposes of treatment, payment or health care operations, or when we share your health information with our business associates, like our billing company or a medical facility from/to which we have transported you. We are also not required to give you an accounting of our uses of protected health information for which you have already given us written authorization. If you wish to request an accounting, contact our privacy officer.
The right to request that we restrict the uses and disclosures of your PHI. You have the right to request that we restrict how we use and disclose your medical information that we have about you. SMAAS is not required to agree to any restrictions you request, but any restrictions agreed to by St. Marys Area Ambulance in writing are binding on St. Marys Area Ambulance.
Internet, Electronic mail, and the Right to obtain Copy of Paper Notice on Request. If we maintain a web site, we will prominently post a copy of this notice on our web site.
If you allow us, we will forward you this Notice by electronic mail instead of on paper and you may always request a paper copy of the notice.
Revisions to the Notice:
St. Marys Area Ambulance reserves the right to change the terms of this notice at any time, and the changes will be effective immediately and will apply to all protected health information that we maintain. Any material changes to the notice will be promptly posted in our facilities and posted to our web site, if we maintain one. You can get a copy of the latest version of this notice by contacting our privacy officer.
Your Legal Rights and Complaints:
You also have the right to complain to us, or to the Secretary of the United States Department of Health and Human Services if you believe your privacy rights have been violated. You will not be retaliated against in any way for filing a complaint with us or to the government. Should you have any questions, comments or complaints you may direct all inquiries to our privacy officer.
Privacy Officer Contact Information:
Robert Sorg, Privacy Officer
St. Marys Area Ambulance Service, Inc.
773 Johnsonburg Road
St. Marys, PA. 15857
Effective date of the Notice: April 14.2003
S.M.A.A.S. Membership Subscription Application
Board Members,Paramedics & EMT's