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Frequently Asked Questions


Emergency Medical Service (EMS) is a complex issue in the Charlottesville/Albemarle community. In 2007 the Charlottesville City Council approved monies for an initiative to enhance the community's existing volunteer service to provide seamless service, enhance ambulance capacity, and improve response times.  A committee was convened to explore the most effective use of these funds to ensure that those goals were met.  The Committee included members from the Charlottesville Albemarle Rescue Squad (CARS), the Charlottesville Fire Department (CFD), the Albemarle Fire Department, the University, and the business community and citizenry. A staffed CFD ambulance will strengthen the regional EMS system to proactively address today’s EMS service needs by filling critical gaps and plan for projected increased EMS system demands for this region.

The information that follows is offered to assist in answering questions that may come up with this complex community challenge.

The information that follows is offered to assist in answering questions that may come up with this complex community challenge.

PRESS HERE for a copy of the final report from the Committee 

About the Existing EMS System
The Emergency Medical System for Charlottesville, Albemarle and the University of Virginia is achieved through a seamless process and involves the Charlottesville Albemarle Rescue Squad (CARS), the Western Albemarle Rescue Squad (WARS), the Scottsville Rescue Squad (SRS), the Albemarle County Fire Rescue Department (ACFR), the Charlottesville Fire Department (CFD) and sometimes the University of Virginia.

When a 911 emergency call is made for assistance, the caller does not request a specific agency. The EMS system initiates the necessary resources such as the closest EMS responding agency (usually a fire engine) and the closest EMS transport agency (usually one of the volunteer rescue squads).

A response to a citizen’s home in the City may involve a combination of responders such as a City of Charlottesville fire engine with Emergency Medical Technicians (EMTs)/medics, CARS (which may be a mix of CARS medics and/or Albemarle County paid medics). All of which is transparent from the person in need.

The Biggest Challenge for Our Area is improving Ambulance Capacity
The 2007 Matrix Study first identified that there is a gap in the number of ambulances needed to cover the City and urban area for Albemarle County.

  • The Matrix study indicated that 3.5 staffed ambulances are needed during the peak period*.
  • CARS maintains 3 staffed ambulances (with the assistance of 2 Albemarle County paid medics)
  • CARS Chief Dayton Haugh, ACFR Chief Dan Eggleston and City Fire Chief Charles Werner validated the Matrix Study recommendation that an additional staffed ambulance would be beneficial during peak times*.

*“Peak Time Period” is defined as Monday through Friday from 8 a.m. to 8 p.m.

Is this new effort a duplication of the EMS that CARS provides?
No, CFD has been an EMS agency for nearly 20 years and now approximately 50% of City incidents are EMS in nature. CFD has also been designated as an EMS transport agency since 2005 although it has not utilized ambulances. CFD has had a long history working with CARS. CFD often provided drivers and/or ambulance attendants when CARS was short staffed in a way transparent to the public.

The proposed CFD ambulance staffing initiative addresses two gaps (ambulance capacity and medics) that have been acknowledged by the EMS Committee. This initiative is not a duplication of services. The gap was acknowledged by both the Matrix study and the EMS Committee. The proposed CFD ambulance staffing initiative addresses two gaps (ambulance capacity and medics) that have been acknowledged by the EMS Committee by placing more ambulances in the whole system to respond to more calls in a timely fashion. This is not a duplication of services.

Does Albemarle County have paid medics?
The County provides two paid medics at CARS Monday through Friday to supplement CARS daily staffing from 6 a.m. to 6 p.m.  If the County moves its medics from CARS to serve another area of the County more in need; it will likely result in one less ambulance available in the City.

The Albemarle County Fire Rescue Department has purchased and staffs a 24 hour ambulance at the Charlottesville-Albemarle Airport (future Hollymead Station). The Earlysville and the 29 North corridor was one of CARS primary response areas which is now being primarily served by the County (paid Fire Rescue medics).

Why wasn't CARS involved in the City’s budget request?
To date, CARS has not made any funding requests of the City and they have not acknowledged that they are experiencing any problems, financial or otherwise to City staff.

Why not just give money to CARS to solve the response problem?
CARS continues to conduct successful fundraising campaigns and continues to exceed their annual goals of giving. The primary gap continues to be staffing (having skilled and trained volunteer medics) and ambulance capacity (having enough ambulances in the system with medics that can respond immediately to the increasing volume of calls).

Why not put City medics at CARS?
Similar to the multiple fire stations (having fire stations strategically spread out so they can get to fires quicker), it is better to distribute the ambulances geographically to provide the best possible response times by reducing response travel distances. It is not recommended to cluster all resources at one location. The proposed location of a City staffed ambulance in the Fontaine Avenue area will also allow for a quicker response times to the Fry’s Spring area which currently has some of the longest City response times for fire and EMS.

Why not establish a CARS satellite location at one of the City fire stations?
This would not solve the problem of insufficiently staffed ambulances. CARS considered this as an option at their Berkmar sub-station but could not consistently maintain the daily staffing.

Is the City fire department trying to take over CARS?
The City is not taking over CARS. The proposed CFD staffed ambulance crew will be an augmentation of resources for the EMS system and implemented exactly the same way that the County has done with its Hollymead staffed paid medic ambulance.

The intent of the City staffed ambulance is to fill the ambulance and medic gaps.

What about medics who are trained with advanced life support skills?
One problem identified and unanimously supported by the EMS Committee was the need for more medics in the system. Medics are in high demand and in short supply.

The City staffed ambulance initiative will provide a staffed ambulance and will add medic response capabilities from each City fire station by staffing firefighter/medics on the fire engines. The new City medic ambulance will also be utilized to train/precept both local and regional medics as CFD will invite other local and regional EMS agencies to send personnel for training and precepting.

The positions that will be staffing the City’s ambulance will also be Firefighter/Medics which allow them to enter hazardous environments and make the necessary rescues when needed.

What is this about ambulance billing or revenue recovery?

NOTE: No one will be denied service regardless of ability to pay.
The concept of Revenue Recovery (ambulance billing) was first suggested at the County’s October 2006 Board of Supervisors meeting.

Almost every city in Virginia and most of the surrounding localities are utilizing ambulance billing to offset EMS costs. The revenue recovery model projects significant revenue which could be used to defer costs away from tax revenue.

1. Revenue recovery (ambulance billing) will only be applied to those that have insurance.

2. Billing does not adversely affect insurance premiums.

3. Most health insurance plans already include ambulance fee coverage as part of their premium whether the service is used or not.

4. The ambulance fee becomes a user fee that only affects 5% of the population rather than a tax that is applied to everyone.

5. Results in a better funding model for Volunteer agencies.