 In the USA private ambulance companies provide 911 emergency services in large cities as well as most rural areas by contracting with local governments.In areas that the local County or City provide their own 911 service, private companies provide discharges and transfers from hospitals and to/from other health related facilities and homes.In most areas private companies are part of the local government Emergency Disaster plan, and are relied upon heavily for the overall EMS response, treatment and recovery.