I think he is talking about having BLS and ALS patient types for calls, all fire engines would be able to treat BLS but not transport (so assume its like a lift assist, a BLS run but likely will end up with a refusal and thus doesnt always need an ambulance). ALS patients would need an ALS ambulance or some sort of engine with ALS providers.
Honestly, and this is a personal thing, I really dont like the inclusion of EMS transporting fire engines, in the game acting as both a firetruck and a transporting ALS unit, it gets in the way with a ton of shit, especially when there are patients at a call that requires lots of enignes, it ends up getting in the way when i go through my transport requests and accidentally send that engine to the hospital and thus require another engine from somewhere else, or I would need to consciously choose not to send it, and then just get another ALS unit to the scene which by that point I could have just sent 1 ALS unit and 1 engine rather than the ALS transporting engine. It eats up assets instead of freeing them like squads and quints (attempt) to do.
If it were up to me, and the way I read this chain, all engines should be able to treat BLS without an ambulance, and ALS transporting engines should be changed to just ALS treatment but no transport (in essence, treat the patient fully and then have it come in as a transport request, even better, have it tell you beforehand that transport will be needed. Example is cardiac arrest, an ALS engine could start working on them, get them prepped for the ambulance, and when the ambulance gets there they just stick the guy in the back and cook it all the way to the hospital).
I kinda went off on another tangent of a topic but let me know if I got that wrong, and what people think about that.