ce the costs of providing EMS and funding EMT activities have ranged from privatization to combining EMS operations with those of other public agencies, particularly fire departments. In Los Angeles and Orange County, public funds bare the major burden for such services, which are integrated with the Los Angels City Fire Department and/or offered by the county to unincorporated areas and dozens of contract cities (Fine, 1999). In this case, the county does not provide free emergency transport (i.e., ambulance) services, which are handled by private-sector carriers that charge fees to patients. As a result, says Fine (1999), the county budgets substantially less for such services than does the city of Los Angeles, which has experienced a 17 percent increase in calls for paramedic services over the last five years with corresponding budget increases.
Currently, quality standards for EMS units and EMTs vary widely across the country (Austin, 2000). Standards tend to be higher when these se
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