Mayor Bowser Highlights Reforms at DC Fire & Emergency Medical Services, 2/22/17

>> MAYOR: GOOD MORNING,
EVERYBODY. GOOD TO SEE YOU. SO LET ME FIRST THANK YOU ALL FOR BEING HERE. WE HAVE SOME PROGRESS TO REPORT TO YOU AROUND OUR FIRE AND EMS
SERVICE, AND I AM VERY HAPPY TO BE JOINED BY OUR FIRE CHIEF,
CHIEF DEAN. GIVE CHIEF DEAN A BIG ROUND OF
APPLAUSE. [ APPLAUSE ] >> MAYOR: OUR MEDICAL DIRECTOR
FOR THE FIRE DEPARTMENT, DR. HOLMAN, CHIEF BAKER, CHIEF
FAUST, CHIEF MILLS, CHIEF DOUGLAS, CHIEF PEARSON AND OUR
FIREFIGHTERS AT THIS WONDERFUL FIRE HOUSE SO GIVE THEM ALL A
ROUND OF APPLAUSE. [ APPLAUSE ] >> MAYOR: WE ARE HERE TO
HIGHLIGHT THE INCREDIBLE PROGRESS THAT FEMS IS MAKING AND
HAS MADE OVER THE LAST TWO YEARS. AND I ALSO WANT TO TALK A LITTLE BIT ABOUT NEW LEGISLATION THAT I
WILL PRESENT THAT WILL PROTECT D.C. RESIDENTS. SO AS MAYOR I’VE HAD THE PRIVILEGE OF MEETING INCREDIBLE
PEOPLE FROM EVERY BACKGROUND AND EVERY NEIGHBORHOOD ACROSS THE
DISTRICT OF COLUMBIA. AND ONE PROMISE WE MADE IS TO
MAKE SURE THAT WE ATTRACTED GREAT LEADERSHIP FOR THE FIRE
AND EMERGENCY MEDICAL SERVICE HERE IN THE DISTRICT BUT ALSO TO
MAKE SURE THAT ALL OF THE FIREFIGHTERS AND MEDICAL
PROFESSIONALS HAVE THE TOOLS, TRAINING AND RESOURCES THAT THEY
NEED TO GET THE JOB DONE. SO WE CHOSE TO BE HERE TODAY AT
ENGINE 30 BECAUSE IT IS ONE OF THE BUSIEST IN THE ENTIRE CITY. THE MEN AND WOMEN WHO WORK HERE, THEY RUN INTO HARM’S WAY. THEY RESPOND TO EMERGENCIES, THEY MEET OUR RESIDENTS
SOMETIMES IN THE MOST DIFFICULT POSITIONS THAT THEY EXPERIENCE
IN THEIR LIVES, AND THEY PROVIDE PROFESSIONAL SERVICES. AND THEY RESPOND TO MORE THAN 500 D.C. RESIDENTS WHO CALL 911
FOR HELP EACH AND EVERY DAY. SO THAT IS WHY MY ADMINISTRATION
HAS BEEN SO FOCUSED ON MAKING SURE THAT CHIEF DEAN AND THE
WONDERFUL MEN AND WOMEN OF FIRE AND EMS HAVE THE RESOURCES THAT
THEY NEED. SO IN THE NEXT FEW WEEKS, I WILL
INTRODUCE A PIECE OF LEGISLATION AND WE CALL IT THE AFFORDABLE
EMERGENCY TRANSPORTATION AND PRE-HOSPITAL MEDICAL SERVICES
AMENDMENT ACT OF 2017. THIS LEGISLATION WILL HELP CLOSE
GAPS AND INSURANCE COVERAGE AND ENSURE THAT MORE DISTRICT
RESIDENTS HAVE ACCESS TO EMERGENCY MEDICAL CARE. IT REQUIRES INSURANCE COMPANIES TO COVER 100% OF THE COSTS
ASSOCIATED WITH EMERGENCY AMBULANCE AND PREHOSPITAL
SERVICES. THIS BILL IS JUST A PART OF OUR
LARGER EFFORT TO CONNECT MORE RESIDENTS TO AFFORDABLE AND
RELIABLE SERVICES THAT THEY EXPECT AND THAT THEY DESERVE. AND IT ROUTINELY — WHEN I FIRST TOOK OFFICE LET ME JUST SWITCH
GEARS A LITTLE BIT. THE CITY WAS STRUGGLING TO KEEP
UP WITH EMS CALL VOLUME AND WE ROUTINELY RAN OUT OF TRANSPORT
UNITS WHICH IS THE MOST CRITICAL PART OF OUR CRITICAL PATIENT
CARE. THESE WERE NOT GOOD DAYS FOR
FIRE AND EMS BUT WE WORKED CLOSELY WITH OUR LABOR UNIONS
AND WITH THE COUNCIL TO INVEST $12 MILLION IN FIRE AND EMS. THIS IS THE LARGEST SUCH INVESTMENT IN EMS IN THE CITY’S
RECENT HISTORY. AND NOW THE DEPARTMENT IS
STRONGER AND MORE RESILIENT THAN IT HAS BEEN IN MANY YEARS. TODAY WE HAVE MORE TRANSPORT UNITS, WE’VE ENHANCED TRAINING
OPPORTUNITIES FOR OUR FIRE AND EMS TEAMS. OUR FIRST RESPONSE AND TRANSPORT UNIT RESPONSE TIMES ARE BETTER
AND FASTER AND WE VASTLY IMPROVED THE CONDITION OF OUR
FLEET. WE HAVE MORE AMBULANCES, MORE
FIRE ENGINES AND MORE LADDER TRUCKS. IN THE LAST TWO YEARS, WE HAVE REFURBISHED 16 AMBULANCES AND
PUT THEM BACK ON THE STREET. THESE VEHICLES, COUPLED WITH OUR
BASIC LIFE SUPPORT UNITS MEAN THAT WE NOW HAVE 23 AMBULANCES
IN RESERVE. ADDITIONALLY, WE HAVE BEEN
AGGRESSIVE ABOUT ADDING MORE TALENT TO THE EMS FAMILY AND
JUST IN THE LAST TWO YEARS, WE HIRED 45 MORE FIREFIGHTER
PARAMEDICS AND WE ARE PLANNING TO NEARLY DOUBLE THAT NUMBER
WITH TWO MORE CLASSES FOR PARAMEDICS LATER THIS YEAR. WE’VE ALSO HIRED 48 FIREFIGHTER EMT’S AND 36 CADETS. THE VAST MAJORITY OF WHOM ARE D.C. RESIDENTS. UNFORTUNATELY OUR OUTSTANDING FIRE AND EMS TEAMS CAN’T BE
EVERYWHERE ALL OF THE TIME AND WE KNOW THAT MOST INCIDENTS
RELATED TO CARDIAC ARREST BECOME FATAL. IF SOMEONE ISN’T IMMEDIATELY THERE AND AVAILABLE TO PERFORM
CPR. THAT’S WHY WE LAUNCHED OUR HANDS
ON HEARTS CPR INITIATIVE AND OUR CLASSES ON THE BASICS OF
HANDS-ON CPR TO MORE WASHINGTONIANS THAN YOU CAN EVEN
IMAGINE. I AM PROUD THAT OUR EFFORTS ARE
MAKING A DIFFERENCE. THE OVERALL CPR PARTICIPATION
RATE FOR CARDIAC ARREST IN D.C. HAS INCREASED BY 20%. NONE OF THIS PROGRESS WOULD HAVE BEEN POSSIBLE WITHOUT THE
LEADERSHIP OF CHIEF DEAN SO I JUST WANT TO THANK THE CHIEF,
HIS ENTIRE LEADERSHIP TEAM AND OUR ENTIRE FIRE AND EMS FAMILY
FOR THEIR HARD WORK, THEIR COMMITMENT TO PROVIDING THE BEST
AVAILABLE SERVICES TO THE RESIDENTS OF WASHINGTON, D.C.
SO WITH THAT I WANT TO WELCOME CHIEF DEAN TO THE PODIUM TO
PROVIDE AN ADDITIONAL PROGRESS REPORT. >> GOOD MORNING TO MAYOR BOWSER AND OUR GUESTS ESPECIALLY OUR
DIRECTOR FROM THE OFFICE OF UNIFIED COMMAND, KARIMA HOLMES. ON BEHALF OF THE MEN AND WOMEN OF THE FIRE AND EMS DEPARTMENT
THANK YOU, MAYOR BOWSER. THE DEPARTMENT PROGRESS OVER THE
LAST TWO YEARS WOULD NOT HAVE BEEN POSSIBLE WITHOUT YOUR
LEADERSHIP. WE’VE MADE GREAT STRIDES BUT WE
EVEN HAVE MORE WORK TO DO. THERE NEEDS TO BE MORE ADVANCED
LIFE SUPPORT UNITS AVAILABLE SO FOR OUR MOST CRITICAL PATIENTS. OUR LEADERSHIP TEAM OVER THE LAST FEW MONTHS HAS LOOKED AT
THIS CHALLENGE AND WE HAVE CONCLUDED THAT WE NEED MORE
FIREFIGHTER PARAMEDICS. WITH ADDITIONAL FIREFIGHTER
PARAMEDICS THAT MAYOR BOWSER MENTIONED WE WILL BE CONVERTING
THREE OF OUR BASIC LIFE SUPPORT UNITS INTO MEDIC UNITS. WE PLAN TO MAKE THIS CHANGE ON MARCH 5TH. WORKING COLLABORATIVELY WITH LOCAL 36 WE ARE PLANNING A PILOT
TO PILOT A DIFFERENT STAFFING MODEL FOR THESE THREE UNITS
WHERE THE STATION HOUSES WILL BE RESPONSIBLE FOR STAFFING BOTH
THE MEDIC UNIT AND THE PARAMEDIC ENGINE COMPANY USING THEIR
ASSIGNED MEMBERS VERSUS THE WAY WE DID IT BEFORE WITH DETAILED
MEMBERS. WE’RE TRYING TO PILOT THIS TO
DETERMINE WHETHER SUCH A STAFFING MODEL WILL YIELD
EFFICIENCIES IN STAFFING, MANAGING SUPPLIES, MEDICATION
MONITORING, TRAINING, TEAMWORK AND OTHER AREAS. THE CHANGE IS ALSO CONSISTENT WITH ANOTHER PILOT WE DID WITH
LOCAL 3721 TO MOVE THEIR MEMBERS TO A 24-HOUR SHIFT SCHEDULED
LAST SUMMER. THIS CHANGE BECAME PERMANENT FOR
ALL LOCAL 3721 MEMBERS IN JANUARY. WE’RE EXCITED ABOUT HOW THE PILOT PROJECT IMPROVED OUR WORK
TOGETHER AS TEAMS AND THEIR BA — BATTALION AND EXPECT THIS
CHANGE TO REAP BENEFITS THROUGHOUT THE DEPARTMENT. WE CONTINUE TO LOOK FORWARD TO MAKE CHANGES IN THE WAY WE
OPERATE IN ORDER TO BETTER UTILIZE OUR EXISTING ADVANCED
LIFE SUPPORT RESOURCES. OUR GOAL IS OUR PARAMEDICS
SHOULD BE DOING ONLY PARAMEDIC WORK. OUR PROVIDERS ARE HIGHLY SKILLED BUT THEY ARE A LIMITED RESOURCE
AND WE NEED TO PRESERVE THEIR AVAILABILITY FOR OUR MOST
CRITICAL PATIENTS. WE HAVE BEEN MONITORING THIS
ISSUE FOR SEVERAL MONTHS AND HAVE SEEN A DECREASE IN THE
PERCENTAGE OF TIME THAT OUR ALS PROVIDERS ARE TRANSPORTING BASIC
LIFE SUPPORT PATIENTS WHICH IS ENCOURAGING. ANOTHER AREA OF INTEREST WE’VE BEEN MAKING EVERY EFFORT TO
TRANSFER OUR PATIENT CARE TIMES AT THE HOSPITAL. IT STARTS WITH MEMBERS UTILIZING AMR FOR NONCRITICAL PATIENTS. WHERE POSSIBLE, SO THEY ARE NOT AT THE HOSPITAL. ALSO, WE ESTABLISHED A GOAL OF 30 MINUTES FOR IN AND OUT OF THE
HOSPITAL FOR EACH ONE OF OUR AMBULANCES. WHILE THERE ARE SOME ASPECTS OF HOSPITAL TRANSFER CARE TIME GOES
OUT OF OUR CONTROL THERE IS ALSO ROOM FOR IMPROVEMENT. IN ALL CASES, WE HAVE THE OPPORTUNITY, WE ONLY — WE NOT
ONLY WANT TO MAKE OUR AMBULANCES AND MEDIC UNITS AVAILABLE, WE
ARE TRYING TO INCREASE THE TIME THAT THEY ARE AVAILABLE IN THE
LOCAL ALARM DISTRICT. IF WE ARE GOING TO BE ABLE TO DO
THAT EFFICIENTLY, PATIENT TRANSFER MUST BECOME IMPORTANT
TO EACH AND EVERY ONE OF OUR MEMBERS. WE HAVE SEEN A DROP IN OUR HOSPITAL TIMES. IT IS A MEAGER DROP TODAY IT IS THREE MINUTES BUT WE BELIEVE
WITH OUR MEMBERS WORKING CLOSELY WITH US THAT WE WILL CONTINUE TO
SEE THAT DROP UNTIL WE GET TO THE 30-MINUTE TIME LINE. ALL OF THESE EFFORTS COUPLED WITH THE ADDITION OF AMR HAVE
TRANSLATED INTO GREATER UNIT AVAILABILITY. WHICH HAS RESULTED IN IMPROVED RESPONSE TIMES, ADDITIONAL HOURS
WE ARE ABLE TO PROVIDE OUR MEMBERS WITH VALUABLE AND
NECESSARY TRAINING. REGARDING RESPONSE TIMES, WE
HAVE SEEN AN IMPROVEMENT OF 41 SECONDS IN OUR FIRST UNIT ON
SCENE. OUR AVERAGE RESPONSE — OUR
AVERAGE AMBULANCE RESPONSE TIME HAS IMPROVED FROM 8 MINUTES AND
7 SECONDS TO 6 MINUTES AND 30 SECONDS. THIS HAS PARTICULARLY BENEFITTED EAST OF THE RIVER WHO BEFORE AMR
FREQUENTLY HAD TO WAIT FOR AN AMBULANCE TO COME FROM THE
HOSPITAL NORTHWEST WHICH FOR CRITICAL PATIENTS RESULTED IN
RESPONSE TIMES THAT WERE TOO LONG. WE RESPONDED TO OVER 200,000 EMERGENCIES LAST YEAR AND I CAN
TELL YOU TO THE PERSON THE RESIDENTS AND VISITORS ARE THE
REASON THESE MEN AND WOMEN PUT THE UNIFORM ON EVERY DAY TO
WORK. WE HAVE IMPROVED THE TRAINING,
RESOURCES AND SUPPORTS TO ALL OF OUR EMPLOYEES TO ENSURE THAT WE
ARE PROVIDING THE BEST SERVICE AND CARE POSSIBLE WHILE ALSO
MAKING SURE THAT OUR MEMBERS MAKE IT HOME SAFELY TO THEIR
FAMILIES AND LOVED ONES AFTER EVERY SHIFT. A BIG PART OF THIS EFFORT IS DR. ROBERT HOLMAN. THE DEPARTMENT’S INTERIM MEDICAL DIRECTOR. HE HAS TAKEN ON SEVERAL PROJECTS AND INITIATIVES THAT WE BELIEVE
WILL CONTINUE TO MAKE US BETTER TOMORROW THAN WE ARE TODAY. LIKE THE IMMIGRATED HEALTHCARE COLLABORATIVE. DR. HOLMAN? >> THANK YOU. GOOD MORNING. I AM DR. ROBERT HOLMAN AND
BEFORE TURNING TO THE RELEASE OF OUR INTEGRATED HEALTHCARE
COLLABORATIVE REPORT I WOULD LIKE TO TALK A LITTLE BIT ABOUT
OUR NEW EMS TRAINING INITIATIVES. FIRST STARTING THIS SPRING, WE WILL BEGIN THE ENHANCED
PEDIATRIC EMERGENCY TRAINING IN PARTNERSHIP WITH CHILDREN’S
NATIONAL MEDICAL CENTER. THAT WILL INCLUDE EIGHT-HOUR
CLINICAL TRAINING FOR PARAMEDICS THAT FOCUS ON ACUTE EMERGENCY
ASTHMA TREATMENT AND PEDIATRIC TRIAGE. IN ADDITION, OUR NEW PARAMEDIC GRAND ROUNDS WILL INCLUDE
QUARTERLY FOUR-HOUR SYMPOSIA TO BE CONDUCTED BY LOCAL MEDICAL
SCHOOLS AND MEDICAL CENTERS. OUR FIRST SESSION STARTS MARCH
28TH. FOR OUR BLS PROVIDERS, OUR FOCUS
WILL BE ON [INAUDIBLE] AND CASE-BASED TRAINING WITH THE
ROLL OUT OF TWO-HOUR MODULES THAT WILL BE PRESENTED BY
COMPANY OFFICERS AT THE STATION LEVEL. THIS WILL LAUNCH IN THE NEXT TWO WEEKS. FINALLY, WE WILL CONTINUE OUR MODULAR APPROACH TO THE DELIVERY
OF REQUIRED, CONTINUING MEDICAL EDUCATION, CME, AS PART OF THE
NATIONAL REGISTRY AND THE D.C. DEPARTMENT OF HEALTH
RECERTIFICATION PROCESS. THIS IS A REVISED APPROACH THAT
WE STARTED IN EARLY 2016. INSTEAD OF THE TRADITIONAL
SINGLE CONTINUOUS 36-HOUR BLOCK THAT OCCURRED BIANNUALLY, OF CME
WE HAVE CREATED FOUR-HOUR BLOCKS FOR MODULES OF ROTATING TOPICAL
CONTENT THAT IS STRUCTURED TO MEET OUR RECERTIFICATION
REQUIREMENTS WHILE PROVIDING US THE FLEXIBILITY TO ADD ANY
OPERATIONAL OR QUALITY IMPROVEMENT-DRIVEN CONTENT. LEARNING IN FOUR-HOUR BLOCKS THROUGHOUT A TWO-YEAR PERIOD IS
GREATLY PREFERRED TO A CONTINUOUS SINGLE 36-HOUR BLOCK. I WOULD LIKE TO THANK OUR PARTNERS AT THE DEPARTMENT OF
HEALTH FOR SUPPORTING THIS EVOLUTION BECAUSE AS OUR STATE
EMS REGULATOR THEY HAVE HAD TO APPROVE THESE NEW APPROACH AND
THEY’VE BEEN VERY SUPPORTIVE IN GETTING US THERE. NOW, SWITCHING GEARS TO THE INTEGRATED HEALTHCARE
COLLABORATIVE. AS THE INTERIM MEDICAL DIRECTOR
FOR D.C. FIRE AND EMS, AND UNDER THE LEADERSHIP OF MAYOR BOWSER
AND CHIEF DEAN, I AM LOOKING FOR NEW PATHS FOR MORE APPROPRIATE
AVENUES OF CARE FOR THE CLOSE TO 200 PEOPLE, OUR LOW ACUITY
CALLERS WHO CALL 911 EACH DAY FOR NON-EMERGENT MEDICAL
REASONS. THESE LOW ACUITY CALLS ARE
NEITHER LIMB OR LIFE THREATENING AND THESE PATIENTS CAN BETTER BE
SERVED IN AN OUTPATIENT CARE SETTING. CURRENTLY, WASHINGTON D.C. HAS THE HIGHEST — THE 8TH HIGHEST
CALL VOLUME IN THE ENTIRE COUNTRY YET WE RANK AT THE 24TH
LARGEST CITY. AND 48% OF OUR 911 CALLS ARE
ASSESSED TO BE LOW ACUITY BY CALL TAKERS. WE HAVE KNOWN FOR A WHILE THAT SOMETHING HAS TO BE DONE BY THE
LARGE VOLUME OF OUR LOW ACUITY CALLERS BEYOND JUST INCREASING
THE NUMBER OF OUR EMERGENCY RESOURCES FOR THESE NONEMERGENT
CALLS. SO LAST APRIL, THE INTEGRATED
HEALTHCARE COLLABORATIVE OR THE IHC WAS LAUNCHED. TODAY WE ARE RELEASING THE IHC’S FINAL REPORT WHICH OUTLINES ITS
FINDINGS AND RECOMMENDATIONS AND WHICH WILL RESULT IN DELIVERING
BETTER MEDICINE FOR OUR MANY LOW ACUITY 911 CALLERS. THIS EFFORT COULD NEVER HAVE REACHED THE STAGE HAD IT NOT
BEEN FOR THE FULL SUPPORT OF MAYOR BOWSER AND THE INVOLVEMENT
OF MANY MEMBERS OF HER CABINET. OTHER STAKEHOLDERS, BOTH WITHIN
AND OUTSIDE CITY HALL, HAVE PLAYED VITAL ROLES BY DEVELOPING
FEASIBLE SOLUTIONS THAT WE HOPE WILL NOT ONLY EASE THE
DEPARTMENT’S OVERBURDENED EMS RESPONSE NETWORK BUT WILL ALSO
PROVIDE BETTER OUTCOMES FOR THOUSANDS OF DISTRICT RESIDENTS
AND PATIENTS. SO THANK YOU TO THE CITY’S THREE
MEDICAID MANAGED CARE ORGANIZATIONS. AMERIHEALTH, TRUSTED AND MEDSTAR FAMILY CHOICE. ALSO PROVIDING VALUABLE INFORMATION, INSIGHT AND
DIRECTION IN THIS ENDEAVOR ARE THE FOLLOWING. THE D.C. PRIMARY CARE ASSOCIATION, THE D.C. HOSPITAL
ASSOCIATION, THE DEPARTMENT OF HEALTH, THE DEPARTMENT OF
HEALTHCARE FINANCE, THE OFFICE OF UNIFIED COMMUNICATIONS, THE
OFFICE OF AGING, THE DEPARTMENT OF BEHAVIORAL HEALTH, THE
DEPARTMENT OF VEHICLES FOR HIRE, LOCAL 36, LOCAL 3721 AND EVEN
GEORGETOWN UNIVERSITY. YOU NOW HAVE A COPY OF THE
INTEGRATED HEALTHCARE COLLABORATIVE’S FINAL REPORT BUT
LET ME GO OVER A FEW HIGHLIGHTS. WE ARE RECOMMENDING THE
ESTABLISHMENT OF A NURSE TRIAGE LINE THAT WOULD BECOME PART OF
THE OFFICE OF UNIFIED COMMUNICATIONS 911 SYSTEM. [ APPLAUSE ] OUC CALL TAKERS ON THE RECEIVING
END OF THE INITIAL 911 CALL WOULD BE ABLE TO SCREEN THESE
CALLS AND CONNECT THESE LOWER ACUITY CALLERS TO A NURSE TRIAGE
FOR FURTHER ASSESSMENT. WITH THE GUIDANCE OF
WELL-ESTABLISHED PROTOCOLS AND USING HIS OR HER CLINICAL
TRAINING, THIS NURSE IS ABLE TO FURTHER ASSESS AND DIRECT A
CALLER TOWARDS NON-EMERGENCY DEPARTMENT RESOURCES. INCLUDING SELF CARE ADVICE OR NONEMERGENCY TRANSPORT TO
PRIMARY CARE CLINICS OR AN URGENT CARE CENTER. AND IN RARE CASES, THE NURSE MAY FLIP BACK THE CALL TO AN
EMERGENCY TRANSPORT TO AN EMERGENCY DEPARTMENT. IF MEDICAL CARE IS ADVISED, THEN THIS NURSE TRIAGE WILL SCHEDULE
THE APPOINTMENT AND ARRANGE A MEANS OF TRANSPORTATION FOR
SAME-DAY CARE. ONE OF THE IHC SUBCOMMITTEES
IDENTIFIED 16 CLINICS IN THE DISTRICT THAT ACCEPTED ALL
INSURANCES INCLUDING THOSE WITHOUT INSURANCE, HAD EXTENDED
EVENING AND WEEKEND HOURS AND PROVIDED ON-SITE BEHAVIORAL
HEALTH, CASE MANAGEMENT AND SOCIAL SERVICES. THE REAL GOAL BEHIND THE IHC IS TO HELP BUILD A LONG-TERM AND
BENEFICIAL MEDICAL RELATIONSHIP BETWEEN THESE PATIENTS AND THE
PRIMARY CARE PROVIDERS. THE IHC REALLY SERVES THREE
PURPOSES. IT SEEKS TO RESERVE THE
EMERGENCY TRANSPORT FOR THOSE WITH POTENTIALLY LIFE
THREATENING ILLNESSES. IT SERVES TO RELIEVE THE
DISTRICT’S EMERGENCY DEPARTMENTS FROM SOME OF THEIR OVERCROWDING,
AND MOST IMPORTANTLY IT SERVES TO DIRECT THESE NEEDY AND OFTEN
QUITE VULNERABLE PATIENTS TO SAME-DAY COMPREHENSIVE CARE. WE ARE REALLY EXCITED TO ANNOUNCE THE PROGRESS SO FAR. THANK YOU VERY MUCH. [ APPLAUSE ] >> MAYOR: SO WE’RE HAPPY TO
TAKE A FEW QUESTIONS. I’M GOING TO START WITH THE
PRESS FIRST, OKAY? I PROMISE I WILL GET TO YOU. ARE THERE ANY PRESS QUESTIONS? SPEAK NOW, SPEAK NOW. >> SO ON THE INSURANCE COMPONENT, CAN YOU EXPLAIN WHEN
YOU SAY YOU ARE GOING TO COLLECT MORE MONEY OR REQUIRE INSURANCE
COMPANIES TO PAY MORE FOR 911 SERVICES, WHAT DOES THAT MEAN? >> MAYOR: WE ARE ACTUALLY GOING TO REQUIRE THEM TO PAY FOR THE
COST OF AN AMBULANCE RIDE. CURRENTLY, THERE MAY BE A
BALANCE LEFT OVER FROM WHAT, YOU KNOW, WHAT IS BILLED FOR THE
AMBULANCE RIDE AND WHAT THE INSURANCE PAYS. AND RIGHT NOW THAT BALANCE IS BILLED TO A D.C. RESIDENT. SO WHAT WE ARE SAYING IS INSURANCE COMPANIES YOU MUST PAY
FOR THE COST OF THE RIDE. >> [INAUDIBLE]. >> THE MEDICAID IS NOT CHANGED. THIS IS FOR THE PRIVATE
INSURANCE COMPANIES SO THAT THEY ARE PAYING THE FULL COST VERSUS
US BILLING THE PATIENT PERSONALLY. >> SO CURRENTLY INSURANCE COMPANY JOE SMITH GOT
TRANSPORTED BY AMBULANCE, GOT A BILL, HIS INSURANCE COMPANY FOR
WHATEVER REASON ONLY PAID 75% OF THAT TRANSPORT, THE REST WOULD
FALL TO THE INDIVIDUAL? YOU ARE GOING TO REQUIRE THE
INSURANCE COMPANIES TO PICK UP 100% OF THE COST? >> CORRECT. >> SO ARE YOU CONCERNED WHAT
THAT MIGHT DO TO HEALTH CARE PREMIUMS? HOW DO YOU PROTECT RESIDENTS’ INSURANCE, PEOPLE WHO ARE BUYING
INSURANCE FROM SEEING THEIR PREMIUMS GO UP BECAUSE OF THIS
CHANGE? >> ACTUALLY THIS WAS ACTUALLY A
RECOMMENDATION THAT CAME FROM THE HEALTHCARE INSURANCE
COMMITTEE THAT WE ARE MOVING FORWARD. >> WHAT MAKES YOU THINK THEY WON’T RAISE INSURANCE RATES? >> I DON’T HAVE THE ANSWER FOR YOU ON THAT ONE, MARK. >> BUT OUR INSURANCE COMMISSIONER REVIEWS ANY RATE
INCREASES IN THE DISTRICT OF COLUMBIA TO MAKE SURE THEY ARE
FAIR AND REASONABLE, AND NOT HAVING SEEN THE SPECIFIC STUDIES
BUT THEY WILL BE LOOKING TO MAKE SURE THAT ANY RATE INCREASES ARE
ASSOCIATED WITH REAL COSTS. >> [INAUDIBLE]. ARE YOU GOING TO DO ANYTHING TO GO AFTER THOSE IN A MORE
AGGRESSIVE MANNER? MY UNDERSTANDING RIGHT NOW,
PEOPLE DON’T PAY IT. DOES IT GO OUT? >> THAT’S WHY WE WANT TO FOCUS ON THE INSURANCE PROVIDERS
PAYING FOR THE AMBULANCE RIDE. WE’RE A CITY WHERE WE HAVE
ALMOST 100% INSURANCE COVERAGE SO THERE IS REALLY NO REASON WHY
D.C. RESIDENTS SHOULD BE GETTING A BILL FOR AN AMBULANCE RIDE. [INAUDIBLE]. >> I DO NOT KNOW THAT NUMBER
EXACTLY. >> DO YOU KNOW HOW MUCH
ADDITIONAL REVENUE YOU EXPECT TO GENERATE FROM THE CITY? >> IT IS GOING THROUGH THE OFFICE OF CONTRACTING AND
PURCHASING RIGHT NOW. THEY HAVE NOT COME UP WITH A
NUMBER. >> SO ONE THING I THINK WE ARE
GOING TO RECOMMEND THAT THE ADDITIONAL FUNDS WILL BE
ISOLATED FOR AND REINVESTED IN EMS REFORM SO SOME OF THE THINGS
THAT WE’VE BEEN TALKING ABOUT, THOSE MONIES ARE GOING TO BE
COLLECTED IN ADDITIONAL EMS WORK. >> [INAUDIBLE]. >> MAYOR: I’M SORRY, ALL RIGHT,
I HAVE TO GO. WELL, NOT HAVE TO. I’M DELIGHTED TO GO TO SAM FORT. I DIDN’T SEE YOU, SAM, YOU’RE
RIGHT. YOU’RE SORRY. >> HOW LONG HAS IT BEEN, A YEAR SINCE YOU STARTED THIS AMS
PROGRAM, ABOUT A YEAR? >> THE THIRD-PARTY PROGRAM
STARTED MARCH 28TH? >> SO ABOUT A YEAR. SO AS WE DRIVE AROUND D.C. AND WE SEE THESE AMBULANCES DRIVING
AROUND WITH LIGHTS AND SIRENS, HAS IT MADE A DIFFERENCE AND CAN
YOU QUANTIFY THAT IN SOME WAYS? >> YES, WE CAN. WE ARE SEEING AN IMPROVEMENT IN UNIT AVAILABILITY. WE’RE SEEING AN IMPROVEMENT IN OUR RESPONSE TIMES AND WE ARE
SEEING AN IMPROVEMENT UP TO 33% INCREASE IN OUR TRAINING HOURS
AND THE AREAS THAT WE TALKED ABOUT IF WE WERE BRINGING THIS
ON BOARD. >> SO MAYBE IT IS JUST ME BUT I
DON’T RECALL HEARING A LOT OF THESE HORROR STORIES IN THE LAST
YEAR OR SO. IS THAT BECAUSE OF THESE
ADDITIONAL UNITS THAT ARE ON THE STREET? >> MAYOR: CAN YOU REPEAT THAT? >> ALONG WITH THE TRAINING WE’VE
DONE WITH THE PERSONNEL, THE AVAILABILITY OF UNITS AND
KEEPING UNITS IN THEIR FIRST RESPONSE DISTRICT HAS HAD AN
IMPACT ON OUR ABILITY TO PROVIDE A SERVICE TO THE COMMUNITY. >> YOU TALKED ABOUT RESPONSE TIMES HAVE IMPROVED. YOU SAID THEY HAVE GONE FROM 8 — 8 MINUTES DOWN TO 6; IS THAT
CORRECT? >> THAT WAS FOR TRANSPORT UNITS. OUR FIRST UNITS ON SCENE ARE GETTING THERE ABOUT 41 SECONDS
SOONER THE ENGINE AND LADDER TRUCKS THAT ARE IN THE
NEIGHBORHOODS. >> FINALLY FOR ME, WHAT DO I
BELIEVE THIS BOOK OR WHAT YOU ALL SAID? >> YOU FOR EXAMPLE SAID THERE WERE 200,000 EMERGENCIES LAST
YEAR. THIS BOOK SAYS 170,000. THE DOCTOR SAID THERE WAS 48 — THERE WAS A 48% INSTANCES WHERE
THE BASICALLY THE PEOPLE REALLY DIDN’T NEED EMERGENCY CARE AND
THIS BOOK SAYS 72. >> I THINK YOU ARE LOOKING AT
THE INTEGRATED HEALTHCARE COLLABORATIVE THAT LOOKED AT
MEDICAL ALARMS. WHEN I TALKED ABOUT THE OVER 200
I’M INCLUDING THE FIRE ALARMS AND ALL OF THE OTHER RESPONSES
WE GO ON AT THE SAME TIME. >> SO THIS IS FIRE AND EMS,
EVERYTHING? >> THAT’S EMS THAT YOU HAVE. WHAT I SPOKE ABOUT WAS FIRE AND EMS. >> OKAY. AND THE DOCTOR, THIS SAYS 72% OF
THE CASES ARE NOT REALLY EMERGENCIES. THAT’S WHAT IT SAYS IN HERE BUT YOU SAID 48. >> THANK YOU. SO WHAT I SAID IS THAT 48% OF
OUR 911 CALLERS ARE ASSESSED TO BE LOW ACUITY CALLERS AT THE
CALL TAKER LEVEL. WHEN OUR MEMBERS, WHO HAVE MUCH
MORE SKILL AND EXPERIENCE GET OUT TO THE FIELD AND THEY ASSESS
THE PATIENT IN THE FIELD, ABOUT 72% OF ALL CALLS ARE JUDGED OR
ASSESSED TO BE LOW ACUITY CALLERS. >> SO LET ME HELP A LITTLE BIT WITH THAT. SO WHAT WE ARE REALLY SAYING IS THIS, IS THAT WE BELIEVE THAT WE
HAVE BEEN OVERSENDING. 48% ARE BLS CALLS THAT MEANS 52%
ARE ALS AND THE REALITY IS REALLY ONLY 20% OF OUR CALLS
SHOULD BE ALS. SO THAT 72% GETS US CLOSER TO
THAT NUMBER SO THAT’S WHAT WE ARE REALLY SAYING IS BY USING A
NURSE TRIAGE THAT WILL ALLOW US TO ASSURE THAT WE ARE SENDING
THE APPROPRIATE RESOURCE TO THE APPROPRIATE TYPE CALL. >> MAYOR: LET ME JUST ADD, AND I ASKED THAT KARIMA HOLMES JOIN
US TODAY BECAUSE SHE IS THE DIRECTOR OF OUR OFFICE OF
UNIFIED COMMUNICATIONS AND DIRECTOR HOLMES AND CHIEF DEAN
AND HIS STAFF HAVE WORKED ALSO VERY CLOSELY TO MAKE SURE OUR
CALL TAKERS AND THE PROTOCOLS THAT THEY USE ARE ALSO HELPING
US LOWER OUR RESPONSE TIMES AND I’M VERY GRATEFUL FOR THE WORK
THAT THEY HAVE DONE. WE ALSO NOTICED THERE HADN’T
BEEN A NEW INVESTMENT IN CALL TAKERS IN ABOUT EIGHT YEARS AND
OVER THE LAST TWO YEARS WE HAVE BEEN ABLE TO ADD 30 ADDITIONAL
CALL TAKERS AND I’M ALSO GRATEFUL TO DIRECTOR HOLMES
BECAUSE SHE USED OUR L.E.A.P. PROGRAM WHICH IS FOCUSED ON
HIRING D.C. RESIDENTS TO FILL THOSE THINKS SO WE’VE BEEN ABLE
TO ADD MORE CALL TAKERS, PROVIDE MORE TRAINING TO THE CALL TAKERS
AND MORE TRAINING TO OUR EMS PROVIDERS BECAUSE OF THE SYSTEM
THAT CHIEF DEAN HAS PUT IN PLACE. WE WILL TAKE A FEW MORE QUESTIONS. YES, MISS RUCKER? >> FIRST I WANT TO SAY TO THE
MEN AND THE WOMEN OF THE FIRE DEPARTMENT AND COMMUNICATIONS
FOR SERVING US SO WELL. I KNOW THE CITY HAS GONE THROUGH
A LARGE NUMBER OF PEOPLE DURING THE MIDDLE OF THE DAY AND I WANT
TO THANK YOU ALL FOR YOUR HARD WORK. I HAVE THREE QUESTIONS. ONE, I WANT TO THANK YOU FOR
ADDING A NURSE TRIAGE. ONE RECOMMENDATION THAT I WOULD
HAVE. >> MAYOR: IT IS STILL IN THE
RECOMMENDATION PHASE. WE’RE DISCUSSING IT TODAY. >> ANOTHER RECOMMENDATION THAT WE HAVE NURSE PARAMEDICS OR
NURSE EVALUATORS. I DON’T KNOW IF YOU ALL STILL
HAVE THOSE BUT THAT MIGHT BE ANOTHER LEVEL OF SUPPORT THAT
YOU ALL HAVE. THE SECOND THING I WOULD LIKE TO
KNOW I SEE THE FACES BEHIND YOU AND I’M WONDERING HOW MANY ARE
DISTRICT RESIDENTS AND WHEN WE ARE GOING TO START USING THE
L.E.A.P. PROGRAM TO SERVICE EMS AND ALSO INTEGRATING IT WITH
MORE WOMEN. I KNOW YOU ALL HAVE A CADET
PROGRAM. I WAS AN EMT WITH THE FIRE
DEPARTMENT WHEN YOU LOOKED AT THAT SO I WOULD LIKE TO SEE THAT
LEVERAGED TO A BETTER LEVEL AND THEN THE THIRD QUESTION I HAVE
FOR EDUCATION I REALLY WANT TO SEE THE EDUCATION PIECE TAKEN TO
ANOTHER LEVEL. I’M NOT SAYING YOU CAN’T DO IT
BUT WHAT I KNOW IN THE PAST WHEN I WAS WITH THE FIRE DEPARTMENT
FROM 1990 TO 1994, THERE WAS A FIRE OR EMS CALL, FIREFIGHTERS
— [INAUDIBLE] THEY WERE GOING TO PUT THEIR FIRE OUT BECAUSE
THAT’S THEIR TRAINING AND THAT’S WHAT I NEED THEM TO DO AND I CAN
STILL TELL THE DIFFERENCE BETWEEN A MEDICAL WORKER AND AN
EMS CALL BY THE WAY THE TRUCK ROLLS UP. >> MAYOR: LET ME GET TO YOUR QUESTION I’M GOING TO ASK THE
CHIEF TO SPECIFICALLY TALK ABOUT OUR HIRING INITIATIVE AND THE
CADET PROGRAM AND HOW WE’VE RUN OUR RANKS. >> OKAY. THANK YOU. >> HOW ARE YOU DOING, MISS RUCKER? >> I’M FANTASTIC. >> SO WE HAVE GIVEN A TEST IN
JUNE OF ’15 AND WE’VE BEEN HIRING OFF OF THAT LIST AND 80%
OF THE PEOPLE WE’VE HIRED OR 90% OF THE PEOPLE WE’VE HIRED ARE
D.C. RESIDENTS. WE CONTINUE TO BRING BOTH MEN
AND WOMEN IN THROUGH OUR CADET PROGRAM AND WE ARE LET ME SEE IF
I REMEMBER THE NEXT QUESTION. >> [INAUDIBLE]. PARAMEDICS RIDING ON AN EMS VEHICLE. >> WE ARE DOING IT A DIFFERENT WAY AND WE ARE LOOKING TO USE
FIREFIGHTER PARAMEDICS TO BE ABLE TO CARRY THAT ALONG. WE BELIEVE THAT THE TRAINING, AS DR. HOLMAN HAS TALKED ABOUT THAT
WE ARE DOING AT THE UNIVERSITY WILL GIVE US THAT SAME LEVEL
WITH THE ASSISTANT MEDICAL DIRECTOR FOLLOWING AND MAKING
SURE THEY ARE GETTING THE COVERAGE THEY ARE GETTING. THE LAST THING YOU ASKED ABOUT WAS THE FACT THAT THEY WOULD
RATHER FIGHT A FIRE THAN — LET ME BE CLEAR THAT WE HAVE COME ON
AND WE’VE BEEN VERY CLEAR AND OUR MEMBERS HAVE EMBRACED THE
FACT THAT WE HAVE A MULTITUDE OF JOBS AND EACH JOB IS IMPORTANT
AND SO REGARDLESS OF WHETHER WE’RE GETTING ON THAT RIG AND
GOING TO SAVE SOMEBODY, MEDICAL OR FIRE, WE TAKE THEM BOTH
SERIOUSLY AND THAT IS — THAT WILL BE CONTINUING AND AS THE
YEARS GO ON I WOULD LOVE YOUR FEEDBACK TO SEE HOW WELL WE ARE
DOING. >> YOU ALL ARE DOING A GREAT JOB
BECAUSE YOU SAVE LIVES EVERY DAY. THE OTHER THING I WOULD LIKE TO ADD IS ONE OF THE 15 COMPONENTS
OF EMS IS EDUCATION. PEOPLE USED TO CALL THE 911
CENTER AND ASK FOR — [INAUDIBLE]. SO ONE OF THE THINGS WE NEED TO DO FOR THE PUBLIC IS TO FULFILL
THAT COMMITMENT TO EMS AND EDUCATE THE PUBLIC ON WHAT IS
APPROPRIATE TO CALL EMS FOR BECAUSE IF YOU HAVE A 72% RATE
THAT IS NOT THAT URGENT THAT’S A PROBLEM AND IT NEEDS TO BE
EDUCATION DONE ON THE LEVEL OF THE CITIZENS. >> WE AGREE WITH YOU AND IF YOU LOOK IN THAT PAMPHLET RIGHT
THERE THAT WE GAVE YOU YOU WILL SEE THAT PUBLIC EDUCATION IS ONE
OF THE COMPONENTS THAT THE IHC CAME UP WITH TO MAKE SURE WE
EDUCATE THE PUBLIC ON HOW TO AND WHEN TO USE 911 SO I AGREE WITH
YOU. >> [INAUDIBLE]. >> MAYOR: LAST QUESTION. >> DO YOU HAVE ANY CONCERNS —
[INAUDIBLE]. >> MAYOR: WE THINK THAT THERE
ARE A LOT OF PARTS OF OUR SYSTEM THAT ENCOURAGE PEOPLE TO CALL
FOR AN AMBULANCE WHEN THEY DON’T REALLY NEED ONE AND I HAVE TO
TELL YOU THAT I WOULD VENTURE TO GUESS THAT THAT COST PORTION IS
NOT A BIG DRIVER. ALL RIGHT. THANK YOU, EVERYBODY.

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