Proposal for the alternative transport for ambulatory non emergent patients by local EMS and Fire Administrations
I propose an alternative transport of a specific population of Federal and State DSHS dependents. I have communicated (phone and email) with representatives of Washington State DSHS and Local Para Transit and both were receptive to this concept. Municipal Para Transit fulfills a critical role as they will have to be available and willing to respond to the location of Fire/EMS crews. Once on scene, they will provide transport to non-emergent patients that cannot provide their own transportation or individuals that have mobility issues and require the assistance provided by ADA equipped vehicles (wheelchair access). For transport costs to be reimbursed by DSHS, patients must be delivered to a 24 hour urgent care clinic. To be considered for alternate transport, patients can be screened that meet certain criteria after initial Fire/EMS evaluation.
Two that stand out are;
1. Individuals that are ambulatory and do not have a need to be seen at the Emergency Room (prescription refill, cold symptoms, bandage removal etc.).
2. Abusers of the 911 system that are seen multiple times a week without a diagnosis of illness (typically a mental or behavioral health issue). There will be others in the system that qualify for alternate transport and this will be a huge cost savings to DSHS. The representatives of Washington State DSHS have stated that there is currently a program that is funded for transport of DSHS dependent families to Seattle Children’s hospital. The program pays a transport company $35.00 each way and the representative said that would work for my proposal as well. Also, it was discussed that whichever Fire/EMS agency that participates in this program will receive a “kickback” on a portion of the savings realized by the alternative transport and the 24 hour urgent care clinic vs. the private ambulance and ER visit. I am unsure of what could be agreed upon but the individual I discussed this possibility with seemed unaffected by the suggestion.
Currently, the hold-up is finding an agency that fits the demographics to participate in the pilot program and meeting the transportation needs of enough individuals to make this cost effective; At least ten individuals under the management of DSHS a day that fit the parameters for alternative transport. My best guess is an agency that uses private ambulance for at least twenty BLS transports a day and has a high client ratio of DSHS dependents. This would possibly provide the needed number of transports via Para Transit and be an income of at least $700.00 a day. The municipality already has the expense of the Para Transit bus and Fire/EMS is already providing evaluation and arranging transport to this target group
