About us

The Ambulance District Association of Missouri (ADAM) is a consortium of leaders from ambulance districts all over the state.

What is an ambulance district?

Ambulance Districts in Missouri are known as Political Subdivisions of the State. We are authorized by the Comprehensive Emergency Medical Services Act of 1971 in Chapter 190 of the Missouri regs. Ambulance districts are subject to inspection by the State of Missouri DHHS for licensure, otherwise we report only to the elected Board of Directors. Ambulance districts are standalone entities and are not affiliated with any county commissions or county governments.

Where are all the ambulance districts located?

Generally, once you move out of the larger populated areas like Kansas City and St. Louis, which are covered predominantly by fire departments, you will find ambulance districts.

To see an interactive Google Earth map of all the ambulance districts in Missouri click the map below. Note, you may need to download Google Earth to get the full experience.

How are ambulance districts financially supported

When an ambulance transports someone they are allowed to bill Medicare, Medicaid, private insurance, or direct to the patient. Generally, this is not enough to cover the high costs of readiness, so ambulance districts are also supported by a sales tax or a property tax.

What is the cost of readiness?

When you call 911 your expectation is an emergent response from a paramedic. There are personnel on standby who are well-trained and well equipped to respond. For that to happen a sophisticated infrastructure must exist before the 911 call. For an ambulance you need at least 2 personnel who have met the state requirements for licensure. They need a competitive annual salary and benefit package. They need training specific to that agency to function and a continuing education program to maintain their licensure. They need a fully stocked, well-equipped, well-maintained, fueled, and insured ambulance. There needs to be a radio system to communicate with them, and a modern, fully staffed communications center to receive and dispatch calls. As they care for the patient, they need protocols which are mandated by the state and maintained by a paid physician medical director. When the patient is delivered to the hospital the event must be recorded on an electronic patient care report (EPCR) software program that is HIPAA compliant, and a military grade laptop which will send encrypted data to the billers. This will require qualified billers who are certified in coding medical calls. The support staff for a typical ambulance district will consist of human resources, finance, supervisors, logistics, fleet management, operations personnel, and finally a chief. All of these personnel will need a competitive salary and benefit package too. All of this needs to exist before the call comes in and that’s why we call it the cost of readiness.