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Home > Topics > EMS Management

Ohio county leaders balk at referring 911 callers to social service agencies

County commissioners worry that it could interfere with EMS workers’ medical duties or intimidate elderly people into not calling 911 in a real emergency

By Dean Narciso
The Columbus Dispatch

DELAWARE COUNTY, Ohio — When paramedics respond to a call from an elderly person, they sometimes find someone who is confused or uncomfortable but not with a medical emergency.

“The complaint may be a headache or toothache or back pain,” said Delaware County EMS Chief Mike Schuiling. “While it may not be an emergency, the caller believes it to be an emergency. Sometimes, they just need groceries.”

Delaware County EMS wants to train its workers to refer such people to mental-health agencies, social workers or nursing homes. But county commissioners worry that that could interfere with EMS workers’ medical duties or intimidate elderly people into not calling 911 in a real emergency.

“They might quit calling because they might have heard of someone who called 911 and ended up in a nursing home,” Commissioner Ken O’Brien said at a recent meeting.

The proposed partnership between EMS and the county’s Council for Older Adults would assign a council staff member to a patient during certain non-emergency 911 ambulance runs to provide them with options, said Bob Horrocks, the council’s executive director. The staff member would be assigned to an EMS station where people who didn’t need medical transport would be taken with their permission.

One goal is to get help for people who call 911 frequently but don’t have medical emergencies.

“We’re not in the business of putting people in nursing homes,” Horrocks said. “We’re there to provide advice and options and services.”

O’Brien conceded that the program likely would help people. But he also worries that patients’ private medical information could be illegally shared with non-EMS workers, resulting in a lawsuit. Even one inadvertent breach of private medical records could pose big problems, he said.

Schuiling said Genoa Township and the city of Delaware each have begun similar programs in the past year with no problems. And Upper Arlington’s StayUA program is considered a model.

Columbus paramedics offer patients nonmedical help by referring them to Columbus Public Health, said Firefighter Brian Evans, who works with EMS quality control.

Schuiling said he was surprised by the commissioners’ decision to pull the item from the agenda for future consideration.

“I expected it to pass with no issues,” he said.

So did Cindy Farson, the director of the Central Ohio Area Agency on Aging, which oversees an eight-county region, including Delaware.

“I don’t think it’s that overwhelming of a concern,” she said of the commissioner’s issue with medical records. “Your chances of (paramedics) calling adult protective services for cases of severe neglect aren’t any less.”

The program would be funded for a year through grants from the Council for Older Adults and would then find other funding, said Schuiling, who plans to bring the proposal back.


McClatchy-Tribune News Service
©2014 The Columbus Dispatch (Columbus, Ohio)

The comments below are member-generated and do not necessarily reflect the opinions of or its staff. If you cannot see comments, try disabling privacy and ad blocking plugins in your browser. All comments must comply with our Member Commenting Policy.
Patrick Gomer Roberson Patrick Gomer Roberson Tuesday, August 19, 2014 8:08:16 AM As a 25 year EMT/paramedic, I can see problems arising from this situation. I have personally seen medics and nurses who were burned out and no longer having compassion never lay a hand on the patient whose care was entrusted to them. Vital signs were made up out of thin air and the problem totally missed and the patient would have died if not for adequate pt assessment by providers. Two cases where I personally took care of patients with vague symptoms, a fall with a hurt thumb walked to ER, Checked in and found third degree heart block after a heart attack, a chronic back pain, called dispatch to cancel EMS, didn't hear the cancel and arrived on scene to obtain a refusal of care and transport. Found profound brady cardia. transported pt to hospital and they survived. In either case if I had not of preformed adequate vital sign assessment both patients would have died.
Michael Charles Michael Charles Tuesday, August 19, 2014 6:08:02 PM Yes Patrick. That's why you don't staff THOSE burn out medics and nurses in this program. You staff it with appropriately trained and motivated individuals. This isn't intended for every medic on every ambulance. You site two incidents in 25 years where two life threats were ALMOST missed, but were not. I can site you 60,000 non-life threats incidents in one of my 29 years that both the patient and EMS and the ER would have benefited from had this proposed program been in place. As a 29 year paramedic I can see solutions and better outcomes arising from this program. We have implemented a version of this program here. No bad outcomes found. The status quo of everybody who calls 911 gets transported to an ED by ambulance as the only and best remedy for caller's issue is breaking and bankrupting our emergency healthcare delivery systems. The status quo needs to be challenged. I applaud and appreciate Delaware County EMS and the Council on Aging for making that effort.

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