Hello Neighbors,
I am looking forward to the discussion on the future of Sebastopol’s Fire Services and point out the Matrix, and the previous Sebastopol Fire Department (summer 2022) report lacks any discussion of Emergency Medical Service (EMS) reimbursement measures. I am a public health professional and a homeowner and put together some current information on EMS cost recovery and fall prevention to explore as funding for fire services is discussed. Several of the fire districts in our area are partially funded by reimbursement measures, I urge the city decisionmakers to explore EMS reimbursement measures.
Specifically I recommend a deeper analysis of fire services financing through; 1) billing for EMS/medical calls covered by insurances
2) EMS charge to nonresidents
3) target fall prevention to reduce EMS calls
Emergency Medical Services (EMS) Cost Reimbursement and Targeting Fall Prevention 60% of Sebastopol fire responses are categorized as “medical” Medical includes life threatening emergencies such as accidents, heart attack, stroke, difficulty breathing/shortness of breath. Nationally 17% of 911 calls from people 65 and older involve falls in the home, EMS assists with lifting an individual as well as determining whether the person has sustained potential injuries. Once some falls, a recurrence is likely and potentially preventable. “Nearly 50% of lift-assist calls result in a second lift-assist call within two weeks”National Council on Aging.
Older adults significantly benefit from fall prevention exercises “Firefighters and emergency medical technicians (EMTs) can play an important role in engaging and educating older adults on services available in the community before and after a fall.” National Council on Aging People who have called EMS because of a fall, can be referred to a fall prevention service. ■ Fall prevention classes held at Senior Center
■ 10 Second Balance Test - a self test station could easily be implemented in areas targeting older adults, such as in front of markets, hardware store etc. Can You Pass the 10-Second Balance Test?
First Responder Fees
An increasing number of fire departments/ districts have a cost recovery fee for service to be able to fund their services. Per state regulation, no profit can be made, any First Responder fee is limited to the actual cost of the service. Most insurances cover first responder costs, most agencies have an appeal/waiver system for those without insurance coverage. MediCare and MediCAL cover EMS services, in most models EMS bills the patient, not the insurer.
EMS agencies have implemented charges for:
○ Non-residents which are not paying parcel taxes for that area/city (Rancho Adobe) ○ Calls that do not require transport (national average 21% of calls) ○ Fee for every call (Sonoma County Fire District)
○ 2nd or 3rd responses to non-life threatening call (repeated lift assist) 1 Action points
- Explore EMS fee reimbursement models and successes from regional fire districts - How many non-residents are billed for EMS? Which EMS services are billed? Lessons learned? - Estimate feasibility and financial benefit for City of Sebastopol - Look at potential partners for targeted community fall prevention activities (such as students in EMS, Nursing programs, high school students)
- Explore simple no cost interventions to prevent repeat falls after EMS response (such as a follow up phone call to assure patient/family knows about fall prevention and lift assist resources) Thank you for considering my points.
Michelle Kelly
[email protected]
Additional information
Press Democrat - When a fire agency responds to an emergency call, you might see a fee https://www.pressdemocrat.com/article/news/when-a-fire-agency-responds-to-an-emergency-call-you-mightsee-a-fee/ Sonoma County Fire Department Charges First Responder Fee https://www.sonomacountyfd.org/
First Responder Fees are cost recovery to support increasing EMS cost for advanced EMS services by first responders, not covered by property taxes. They are permitted under Section 13916 of the California Health & Safety Code. https://www.sonomacountyfd.org/files/c77a59247/Ordinance+2020-02+EMS+Fees.pdf Models targeting fall prevention to decrease fire department/EMS calls Partnering with Fire and Emergency Medical Services to Prevent Falls https://ncoa.org/article/partnering-with-fire-and-emergency-medical-services-to-prevent-falls Helping Yourself After a Fall
https://www.southmetro.org/659/5416/Helping-Yourself-After-a-Fall?activeLiveTab=widgets What do you do after the lift assist?
https://www.firerescue1.com/community-risk-reduction/articles/what-do-you-do-after-the-lift-assist-f4loGPxO nq0Rvofq/#:~:text=Lifting%20the%20patient%20off%20the,more%20significant%20and%20lasting%20impact.
Other models of cost recovery- similar to Sonoma County Fire District Burbank Fire Department to charge $100 for medical calls not requiring ambulance transport https://www.firerescue1.com/fire-chief/articles/fire-department-to-charge-100-for-medical-calls-not-requiring -transport-u0mPaasyUMINgofr/
Charges $100 for its response to emergency medical calls that don’t include transporting someone to the hospital, which officials said is a way to recover personnel costs. It's part of a cost-recovery effort; residents can avoid all out-of-pocket EMS expenses by enrolling in a membership program for $48 a year. 2 3