1. A New Identity in Rural Missouri AN EMERGENCY MEDICAL SERVICES APPROACH TO NON-EMERGENCY TRANSPORTATION JAMES A. MCGEE, JR. RN ADMINISTRATOR, SOUTH HOWELL COUNTY AMBULANCE WEST PLAINS, MO

2. Today’s Discussion  Background Information  Is there a role for EMS in Non-Emergency transportation?  Traditional Role of EMS  New Landscape of EMS  South Howell County Ambulance Approach  Silos of non-emergency transportation

3. Disclaimer I do not endorse, nor am I remunerated by any company/corporation, for any product which is mentioned.

4. My Background  Emergency Services and Emergency Dept.  Ground and flight EMS 1983 - 1994  Emergency room nursing 1994 - 2004  Managing South Howell County Ambulance District since 2004

5. South Howell County Ambulance  500 square mile “District” serving 27,000 people  Five departments  Clinical Operations  Communication  Medical Transport  Education  Fleet  Business/Administration

6.  Is There a Role for EMS in Transporting “Passengers”?

7. Traditional Role of EMS  911 based or other seven digit number for emergency calls  “Emergency” response and “patient” oriented  What was once affordable is becoming increasingly unaffordable... $$

8. Changing Landscape of EMS  Driven by costs outpacing fee for service revenues  Moving toward a community health model offering several services  Traditional EMS  Community Paramedics  Non-Emergency Transport  Reduces transport load of EMS  Has a preventative aspect

9. The South Howell Approach  Began MT Operations in May 2010  Why?  24 EMS transports per month  Cost to begin and operate less than adding EMS staff

10. MT by the numbers  Began with two vans, one full-time driver and hand full of part time drivers  Steady climb in numbers  Currently have three vans two ambulatory/WC/Stretcher and one ambulatory/wheelchair  Adding fourth in January/February 2016  Four full-time drivers and four part-time drivers  Operate 24/7/365

11. Transport Breakout

12. Stand-a-lone Silo’s in transportation  Private  Public  EMS  Hybrid

13. Cooperative Silos Collective resources to meet transportation needs The more we pull the less efficient the system is A less efficient system is more costly to all EMS can be a positive player

14. Considerations EMS in Missouri has 24/7/365 operations We tend to have staffed dispatching services We have burdensome costs related to non- emergencies Those costs can be effectively managed by non-emergency transportation SNF takebacks? Dialysis Explore all options...

15. What points can I Clarify Sub-titled: how else can I confuse you...