2002-07-15 Special Called Regular Meeting and Workshop Meeting

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t • i City of La Porte Emergency Medical Service Interoffice Memo To: Joseph Sease, Emergency Management Director Frorri Chris Osten, EMS Chief Date: 01/31/02 Re: Current EMS Transport Policy Recommendations It has recently been brought to my attention by my supervisory staff that in recent months the ability to obtain an alternate transport option (Private Ambulance Company) for emergent patients requesting to be transported to a hospital facility outside our approved facilities has become increasingly difficult. This impediment is due in part for several reasons, some of which I have listed below. 1. Default of Payment -Patients being transported by private ambulance companies at our request are simply not paying the bills that they receive from the private ambulance companies. These companies must make a profit to stay in business and unfortunately it is common knowledge that a large percentage of 911 calls for ambulance response do not end in any sort of payment due to a large portion of the patients being indigent. Inter-facility transports from hospital to hospital are considered to be guaranteed payments for privates ambulance companies due to payment and insurance verification being confirmed before the transport is received. Therefore, it is possible that in the near future we may not be able to secure any private ambulance companies to respond to La Porte for alternate transports to the Houston Medical Center. There are 80 private ambulance companies in the Houston area. They keep their fleets on the street to a minimum to keep payroll costs down. In addition, no doubt they would rather take a paying customer over an unknown (possibly non-paying customer) in La Porte. 2. Paramedic Staffing -There are fewer Paramedics graduating from colleges. The first services hit with this shortage are the private services. When we call for a private, increasingly we only get one Paramedic or at times, none at all. La Porte EMS prides itself on administering quality patient care and when a private ambulance company crew responds to La Porte to receive our patients there is no question in my mind that we are surrendering our patients to a sometimes lesser trained crew with an inferior set of patient care protocols and older less sophisticated medical equipment. 3. Statistics -Last year La Porte EMS called for a private ambulance company 67 times. The average response time for the private company in the year 2001 was just undertwenty-two minutes. The average on scene time for La Porte EMS was forty-seven minutes. This includes dispatching, making patient contact, accessing their needs, contacting the private ambulance company and waiting on their arrival. This in and of itself seems to me to be defeating the original goal of keeping our EMS units more available to our citizens when they are sitting on scene awaiting a private ambulance that may or may not materialize. 4. Delay in Appropriate Care - Many of our citizens have special needs and regiments of treatment started at other hospitals. Some examples are cancer patients receiving treatment from M.D. Anderson, Heart patients at St. Luke's and Memorial, and numerous pediatric problems that are treated at Texas Children's. When we transport these patients to a local hospital often, the local hospital will just arrange transport to the hospital of their (patient} choice resulting in an overall delay in appropriate patient care.