Ky. community paramedicine program seeing positive impact

Last year, the city spent nearly $500,000 to staff a 12th ambulance because of a steep increase in the number of people dialing 911

By Beth Musgrave
Lexington Herald-Leader

LEXINGTON, Ky. — The patient called 911 thiry times in a month.

The emergency?

He had fallen out of bed and needed a Lexington Fire Department ambulance crew’s help to get back into bed.

Thanks to a new community medicine program that launched this month, the Lexington Fire Department was able to connect the patient to services and eventually got the patient a lift device, said Lexington Fire Chief Kristin Chilton. “The person has been able to maintain their independence without calling 911.”

It’s been one of the early successes of a pilot program that dispatches paramedics but not ambulances to treat people who frequently call 911 but don’t necessarily need emergency medical care. A $252,201 federal grant plus $25,221 in city money was used to start the program.

At a press conference Wednesday, Lexington Mayor Jim Gray said the program will help the department shave costs and address critical needs of people who may need help but not an ambulance.

“If we dig a little deeper and treat the root problems, many patients would enjoy a new level of independence and a better quality of life,” Gray said. “At the same time, we hope this program will help us improve efficiency.”

Last year, the city had to spend nearly $500,000 to staff a 12th ambulance because of a steep increase in the number of people dialing 911. Calls have increased by about 7.5 percent each year for the last three years.

Of the 48,238 calls in 2017, nearly 9 percent were 266 people. Those people call for ambulances sometimes multiple times in a month or some can call multiple times in a day, fire officials said.

Abuse of ambulance services for non-emergencies has been a long-standing problem. In 2014, a Lexington Herald-Leader and WKYT investigation found in 2013, ambulance crews responded to 33,328 total calls, about 92 a day. Of that total, there were 11,829 unspecified “sick cases” and “injuries.” The fire department doesn't track how many of those calls are non-emergencies. But fire officials estimated in 2014 about 10 percent to 20 percent of the 11,829 sick calls didn’t require emergency help.

Some callers refuse to go to the hospital once they are checked out or medicated by EMTs.

And that’s a problem.

The city can’t charge an insurance provider or a patient if the patient isn’t taken to a hospital. According to data provided by the city in 2014, about 25 percent of all EMS runs are never billed.

Of the remaining runs, which are billed, a little less than 30 percent are collected, fire officials said Wednesday.

Lexington Firefighter Lt. Seth Lockard and Firefighter Patrick Branam, who staff the two-man program, have already started visiting many of the 266 people who call 911 frequently. Branam and Lockard have a stocked SUV. But it’s not just medical supplies — it’s knowledge of other community healthcare options they bring to patients. Branam and Lockard have spent a lot of time over the past several months getting to know the city’s social service and healthcare providers.

“There’s a lot of resources out there,” Lockard said. “But if I don’t know about them, other people don’t know about them either.”

Although not their sole responsibility, they will also work with heroin addicts and other overdose victims.

“(Branam) was already able to talk to one person into going to rehab,” Lockhard said.

They have even been able to help four-legged patients.

This winter, a homeless woman called several times to be taken to the hospital. She wasn’t sick. She needed a warm place to stay. She had a service dog who was not current on its vaccinations so she and the dog couldn’t stay in a homeless shelter. The community paramedicine program was able to find a veterinarian who donated the vaccines, Chilton said. She no longer calls 911.

The pilot program is scheduled to run until late 2018.

Copyright 2018 Lexington Herald-Leader

McClatchy-Tribune News Service

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