Item 4 - Report on Mobile Healthcare Services Option

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Executive Summary It is the conclusion of the Joint Elected Officials Ambulance Transport System (ATS) Task Force and the staff of Central Lane ATS provider agencies that no single solution to the Ambulance Transport Fund (ATF) problem is likely to totally resolve the challenge to re- balance the funds. Instead, a combination of solutions is recommended. The role of fee-based and insurance reimbursement systems such as Mobile Healthcare is to reduce overall expenses, maximize non-tax revenues, and reduce the reliance on taxes for balancing the ATF over the long term. The Task Force and staff agree that emergency ambulance transport has been and continues to be a core function and one of the highest priorities of local government. While every effort should continue to be made to maximize non-tax revenues and reduce expenses, particularly in the current economic climate, preservation of this essential public safety service must also be considered a priority for future tax support. Mobile Healthcare Services (MHS) are designed around the concept of taking health care to the patient, rather than simply taking the patient to a health care facility. Whenever safe to do so, patients are treated at the site of their illness or injury and released. Through a sophisticated communications system, all vital signs may be transmitted electronically to a medical control center along with video images of the patient, whenever needed. Essentially, it is using mobile telemedicine devices and processes to make house calls. Caregivers will either be nurses or paramedics with special additional training, responding on a non-emergency basis, in small one-person minivans known as Mobile Primary Care Units (MPCU). Recent studies have estimated that billions of dollars could be saved every year by more appropriately matching the type of care given with the type of care actually needed. Unnecessary EMS 9-1-1 calls and emergency department visits are eliminated. At the same time, routine non-emergency primary care is universally available 24 hours to all persons, resulting in better overall care at lower overall costs. Current capacity in the Central Lane ATS is adequate for actual emergencies but cannot sustain the continued increase in non-emergency calls. Medicare and Medicaid reimbursement for non-emergency calls is too low to add more ambulances as run volume increases. The solution is to carefully redirect non-emergencies to more appropriate and less costly resources. At the same time, MHS system design calls for increasing the reimbursement for emergency ambulance calls as a financial incentive for local health care providers to initiate more cost-effective MHS systems nationwide. This in turn helps to resolve ambulance funding shortages. The current EMS system, which consists of first response paramedic fire engines and emergency paramedic ambulances, is integrated with the MPCUs and non-emergency ambulances into a single multi-function MHS system. The 9-1-1 call-taking and EMS ·ª