Increasing Efficiency for LAFD Transport Services
Posted by Councilmember Englander on March 21, 2016 at 2:24 PM
This Wednesday, I submitted a motion to the City Council requesting the Los Angeles Fire Department (LAFD) report back on the feasibility of implementing a fee for non-Advanced Life Support (ALS) responses to skilled nursing facilities, similar to the fee charged by the City of Santa Monica. Additionally, I have asked that the report include issues related to responses at skilled nursing facilities specific to the LAFD, and identify any aspects of the Santa Monica model that may not work in the City of Los Angeles.
Often, LAFD firefighter paramedics are called on to respond to nonemergency or Basic Life Support (BLS) calls at skilled nursing facilities, which employ staff that should be able to deal with these types of calls without needing LAFD assistance. Responding to these calls can take an ambulance out of service for a significant amount of time, resulting in a reduced number of ambulances available to respond to serious emergencies. This is especially true when a non-emergency BLS call results in a patient transport.
Other cities in the region face similar issues with these types of responses, and some have found innovative ways to address them. The City of Santa Monica charges a cost-recovery fee for non-ALS calls to skilled nursing facilities and for most BLS transports initiated at these facilities. This fee is charged to the facility and not to the patient, and serves three purposes: first, it allows the City to recover the costs of providing non-ALS services to these facilities; second, it discourages skilled nursing facilities from calling paramedics for non-ALS services; and third, it reduces the number of BLS transports from these facilities. Santa Monica indicates that its fee has been successful, as skilled nursing facilities often find it more cost effective to deal with non-emergency and BLS transport in-house, as opposed to city resources. Santa Monica does not charge this fee for ALS calls to skilled nursing facilities, or for BLS calls initiated by medical transport providers.
Emergency medical response makes up the bulk of LAFD calls, and that percentage continues to grow. It is imperative that the City find ways to provide these important services in a cost effective and responsible manner, and ensure that firefighters are not spending an inordinate amount of time dealing with non-emergency calls, especially when other resources are available and able to handle these issues. A cost recovery fee for non-ALS services to skilled nursing facilities may enable the Department to recover costs associated with these calls while simultaneously discouraging them when they are not needed.
-Mitchell Englander, Chair of Public Safety Committee