| 7/17/2017 | 0 |
AMBULANCE SERVICE BOARD
| HELD IN COMMITTEE
Minutes note: Appearing:
Deputy Chief - EMS Division Steven Riegg
Asst City Atty. Patrick Mc Clain
James Baker - CEO Curtis Ambulance
Atty. Franklyn Gimbel - Bell Ambulance
Medacare (Paratech) - Rick Romansheck
Chief Riegg submitted a Private Ambulance Service Provider's turnback (unable to handle) report that covered 2016, 2017, 2015, and 2014; The current service agreement states that turnback calls for each private provider should be no more of 2% of the overall calls evry month. There have been some issues with Medacare and their increased number of turnbacks. The report for 2016 -2017 shows a consistent reduction in turn backs for Medacare; there has been a significant improvement for that company, especially since Paratech purchased Medacare in December 2016. Thereafter the report shows a significant decrease in the number of turn backs.
Mr. Romansheck said that Medacare is free standing, it is augmented financially by Paratech at this point and It is housed in some of the similar physical locations.
Ald. Witkowski said that based on the contract, turn back should be 2% or less, in looking at the report for the last three years, Bell ambulance does not exceed 2% at any time, Curtis ambulance appears to exceed 2%, consistently, Medacare ambulance exceed 2% consistently, and Paratech ambulance in 2014-2015 shows 2 months under 2% than for the next report goes below 2% for almost 12 months.
Chief Riegg said that ambulance service providers have until the 15th of every month to submit their turnback numbers for the previous month, per contract. He explains that a turnback is each of the private providers has their boundaries and when 911 dispatch receives a call it automatically goes to the primary private ambulance provider within those boundaries. Pursuant to the service agreement, if a private ambulance company cannot handle the call, they are required to contact dispatch within two minutes stating they are unable to handle the call. Dispatch will then give the call to the next provider in line. Depending on the private provider there is a mechanism where they have first, second and third back up.
In response to the numbers on the report, Atty. Gimbel said that Bell Ambulance has been on its toes in terms of its ability to respond to dispatches through the 911 system. Bell has a huge inventory of equipment and a larger group of employees that not only serviced the 911 dispatch but also a substantial part of the private community which requires BLS transports. Atty. Gimbel said that they have initiated conversations with the City Attorney's Office and Fire Department with the goal of having a new contract that will begin in 2018.
Based on the input from ambulance providers, boundaries are assigned based on the providers ability to provide expected services.
Other than staffing and equipment needs being met, Dr. Colella asked whether or not the contract allows for any changes depending on the changing needs within a given zone.
Atty. McClain said that this board does have the ability to make changes to the service area boundaries during the pendency of an existing contract. The agreement provides that the Fire Chief can recommend a change of the boundaries if there is a specific demonstrated deficiency. If this takes place, the Ambulance Service Board is empowered mid contract to recommend changes to the service boundaries.
Dr. Colella asked whether or not the contract will be brought to this board before is ratified.
Mr. Mc Clain said that the City Attorney's office with the help of the Fire Department and after consulting with providers will make recommendations of a proposed plan to this board. The board than, reviews the proposed contract and refers it to Public Safety and Health and finally the full Common Council for approval.
Mr. Mc Clain assured members that the City Attorney's office will have a draft ready for review by Ambulance Service Board in a timely manner.
Mr. Romansheck said that Paratech is been taking turnbacks from Medacare for many years; it has been a problem which is quite possibly related to the economics of the service area. There is a huge Title 19 population and the $150 reimbursement available under Title 19 is considerably less than the Medacare reimbursement of $350. ambulance service costs are an increasing problem in the geography where Medacare operates in.
Mr. Romansheck believes that providers have a good working relationship even though they are technically competitors.
Mr. Baker said that the current systems compared to that which existed in December 2007 is quite different. In December 2007 Curtis received 965 requests for service within their primary service zone and 4 backup requests from other providers; in December 2014 Curtis received 1450 request within their primary service zone and 89 requests for backups, a63% increase. Many of these requests did not justify an ambulance being sent. This has been the topic of discussion among providers. With the huge influx of battery patients there can be 100-150 battery patients a month; transporting 30-35% of these is unusual said Mr. Baker. While other providers have experienced a significant change, the two biggest changes have been a lack of discernable patterns. Normally what do is look at past demand levels in an attempt to adjust future staffing patterns. The system is designed that providers should not be penalized for turning back a call.
Mr. Baker also addressed the September 14 - August 15 turnbacks report, stating that it is inaccurate. He gave specific examples to the board in relation to the numbers reflected on the report provided by the Fire Department. The reality is that the software used combined the Curtis turnback calls and calls responded by Curtis from other providers. Staffing, road constructions and detours have also been part of the problem to provide service. Mr. Baker did state that given all of the challenges the system is working quite well.
Ald. Witkowski asked whether or not the present system causes any delay.
Chief Riegg responded that these calls are BLS calls (Basic Life Support); and that the safety issues are significantly less than with ALS (Advanced Life Support) calls.
| Pass | 6:0 |
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