Agenda - 04-02-2002 - 9a - Laserfiche WebLink

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i 3 NON-EMERGENCY AMBULANCE TRANSPORT REPORT Prepared by Nick Waters, Director of Emergency Management March 14, 2002 Orange County made the decision in early 1994 to stop providing Non-Emergency Ambulance Transportation and to allow private enterprise to perform the service. This decision was based in part on the misuse of the Emergency System and to delay the hiring of new staff positions needed to address the ever increasing call volume of Non-Emergency Transportation. The County Franchise Ordinance was then enacted, and applications for the service were received. Johnston Ambulance Service was awarded a Franchise to operate within Orange County on May 24th, 1994 and has provided the service consistently since. Non-Emergency Transports consist of routine calls to and from doctors' offices, hospitals, or clinics from nursing and rest homes, as well as private residences. Many calls for the service answers are elective calls, when the patient and/or family prefers an ambulance, even though medically it is not needed. Non-Emergency calls are those where response times have no negative effect on the patient outcome. County staff have been receiving an increased number of complaints over the past year, most of them concerning extended wait times to receive service. Staff worked with Johnston Ambulance on several occasions to correct this problem. Non-Emergency Transportation trips fall into one of two types - Scheduled or Short Notice. The trips that are scheduled in advance and are done by appointments take priority over the Short Notice Trips. The Short Notice Trips are put on the schedule at the nearest available time slot for the closest unit, which may be located as far away as in Wake County at the time of the request for service. Managed health care standards developed in recent years have a big impact on ambulance services by releasing patients early from the hospital when they require transportation. Unlike before, the convalescence was done before discharge from the hospital, so travel by family car was generally suitable. The number of people needing this type of service in Orange County, many referred by EMS, is increasing steadily. This situation has caused Johnston Ambulance to be nearly overwhelmed. Another company, AAA Transport of Durham, has applied for a franchise to do business in Orange County. The owner met with staff to present the application and discuss the company's ability to provide service to the citizens of Orange County. Staff feels the company can provide choice to the citizens, especially those with Short Term Notice needs who now experience long wait times. The Service Certification level of Basic Life Support is the same as for Johnston Ambulance Service. The fees for service between AAA and Johnston are comparable, with Base Rates of $225 for both companies. Johnston has a mileage charge of$5.00, while AAA is $5.00 per mile in-city and $7.50 per mile outside. Wait time for Johnston is charged at $45 per hour, with AAA at $60 per hour. Both have charges for oxygen and supplies. Johnston charges $25 for oxygen and supplies can be up to $50. AAA has $35 for oxygen and supplies at $35. AAA offers a flat rate for contracts of$185, for facilities for non-covered services under Medicaid. The Franchise Ordinance governing Non-Emergency Ambulance Transport needs to be updated to more accurately reflect changes in State regulations in recent years and to expand