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EMSA is a public trust authority of the City of Tulsa and City of Oklahoma City governments. It is the Authority's charged duty to ensure that the cities we serve receive the highest quality of emergency medical service at the best possible price. There are several entities that work together in the EMSA system, including:

• The Authority. EMSA, the Authority, provides independent business oversight and ensures compliance of a private ambulance service chosen to operate in the service area. The Authority does not provide ambulance service, but rather acts as an informed and impartial buyer of service for the cities it represents. The Authority also owns ambulances and other capital equipment used by the private contractor to provide service. EMSA also manages agreements, maintains patient records, bills and collects, purchases goods and services and manages the TotalCare ambulance subscription program and makes policy recommendations.

  Employees of the Authority report to and follow the direction of the 11-member EMSA Board of Trustees. Eight of the 11 trustees are appointed by the mayors of Tulsa and Oklahoma City.

• City of Oklahoma City and City of Tulsa. In addition to appointing individuals to serve on the EMSA Board of Trustees, the Cities must approve any changes to EMSA Trust Agreement, which governs EMSA operations.

• The medical director. An independent medical director provides medical oversight of the private ambulance company selected by the Authority and first responders (firefighters assisting in patient assessment and stabilization). The medical director conducts routine audits and testing of all medics practicing in the system, writes seamless protocols to ensure the continuity of care between first responders and transport medics, researches new treatment modalities and evaluates complaints.

  The medical director reports to the Medical Control Board, an organization composed of nine community physicians (eight of whom work in metropolitan hospital emergency departments) who serve voluntarily.

• The contracted provider. Since 1998, Paramedics Plus LLC has provided ambulance service for the Authority. Paramedics Plus is committed, by contract, to meet response times and other standards set forth by the Authority and the medical director.

  Paramedics Plus is a wholly-owned subsidiary of East Texas Medical Center (ETMC), based in Tyler, Texas. ETMC is a not-for-profit organization that operates the nation's second-largest rural EMS system with a service area spanning more than 17,000 square miles.