Central Valley in California. Like I said, I really have no idea, though. I was hoping someone else knew more.
I think it may depend on the area you are in. For example, I'm in South Florida (what every other person outside of South Florida calls Miami... idiots). Here, in Miami Dade County, we have a county fire department, along with city departments for the various cities in the county. Not all cities have a fire department. Some of them are covered by the county. In any case, the firefighters are also the ones that serve as paramedics (they have to get certified by the county to be considered paramedics). If you get into a bad accident, a fire rescue unit shows up. You may get a fire truck, which has 4-6 firefighters in it. They are all trained in basic life support (BLS). You may have a couple that are trained in advanced life support (ALS). Depending on the number of ALS members, that unit might get ALS classification. The other trucks, the ones that people call ambulances, are all ALS units, and pretty much everyone in it is ALS certified. I think it's a four man unit, and at least three have to be ALS certified. There are also private ambulance companies. They are not affiliated with any hospitals, and they are usually only BLS certified.
So let's say you faint at home. The closest unit will always be dispatched to you. It may be a BLS classified unit. Depending on what the person that calls 911 says, you may get a second unit to show up, possibly a rescue unit. They will show up and check you out. Let's say they find that you are having a heart attack. The rescue unit, if it's there, will transport you. If there is no rescue unit, one gets dispatched to you. They show up, and hey transport you.
Now lets say that you faint at home, and the fie department shows up, and they determine that you are fine, and they don't need to transport you. What they usually do is tell you that they didn't find anything that requires immediate attention, and you can go to the hospital if you'd like, but they aren't going to transport you. They give you the options of having someone you know take you, or they can call for an ambulance. The ambulance is from a private company, and they are basically an overpriced taxi with the option of turning on emergency lights and running red lights for and additional $500.00+. The thing is, the ambulance at least has the equipment to monitor you while you are on the way to the hospital. At least a basic monitoring.
Funny enough, or not funny at all, if you do have something happen to you while on the way to the hospital in an ambulance, and it's a BLS ambulance, the ambulance will pull over and call fire rescue. They will do their best to stabilize you until the rescue unit shows up and moves you to their unit for transport. At that point, you get charged by both the county and the private ambulance company for the transport.
In most cases, the ALS units are county/city units. Private companies only have BLS units, for the most part. There is one are in the city of Miami, that has no city rescue unit (ALS), and because of politics, and the fees generated for services, they don't allow the county to service that area. They ended up contracting a private company to provide them with a private ambulance unit, which is owned by the private company, but is actually manned by city firefighters, except for the driver, I think. If I'm not mistaken, the driver is an employee of the ambulance company.
I get that, but I don't like it. If they think I'm hurt worse, then tell me that and make me take the ambulance. If they're just afraid of it, hitting me with a (totally unreasonable) $2,800 bill isn't my preference.
Well that's the thing, you may be asymptomatic. They just aren't sure if you do have something that is wrong with you. If you don't like that they tell you to go and bill you $2,800 when they are not sure if you are hurt or not, imagine how you would feel when they tell you that you definitely have to go, bill you $2,800 and it turns out there was nothing wrong with you.
