Spokane routing non-emergency medical calls away from ambulances, ERs

Larz Cale was lining up housing, a job and future studies at Spokane Community College when he contracted the flu, then pneumonia, last month.

The 25-year-old had just sold his car and attempted to quarantine himself at the Union Gospel Mission, where he was staying while waiting for SNAP to help him find an apartment. So he called 9-1-1 for help.

“I couldn’t do anything. It hurt to move, it hurt to breathe,” Cale said.

Paramedics arrived and told Cale he needed care, but his symptoms didn’t raise to the level of an emergency. He elected, like dozens of other people in the city, to get a ride from a non-emergency driver to an urgent care clinic, an initiative the city hopes will save money and free up Spokane Fire Department personnel for more urgent calls.

Brian Schaeffer, interim chief of the fire department, said the program allows fire officials and health care providers to match patients with the services they need, without heaping on additional expenses.

“We take them to where they want to go, and we take them in a vehicle that’s a right-size approach,” Schaeffer said.

The program, called “Ride to Care,” is coordinated by SNAP in conjunction with 13 other health care providers, insurance companies, philanthropic organizations and others. MedStar Transportation provides seven drivers that can pick up patients after they’ve been evaluated by a paramedic and take them to one of two participating urgent care centers: Providence Urgent Care at 5th Ave. and Division Street, and Spokane Urgent Care operated by CHAS Health on Lidgerwood Street.

Schaeffer said the service will only be offered after a paramedic has evaluated a patient.

“We still put our hands on patients, we still get a thorough understanding of the results of those diagnostic tests that we’re doing, and we make an educated decision,” Schaeffer said. “We want to be that safeguard.”

Funding partners have ensured the program will continue for nine months, and SNAP is working to extend services for a full year, said Julie Honekamp, SNAP’s chief executive officer. The organization is working to craft regulations that would allow billing insurance companies or Medicaid for the service, which would ensure its survival beyond the pilot program.

“It’d be great if we could move to a fee-for-service model, but that’s something that we’ll be exploring,” said Julie Honekamp, SNAP’s chief executive officer.

The City of Spokane contributed $46,000 in funding through its Community, Housing and Human Services Department, in addition to the time city-employed fire personnel are evaluating patients. According to SNAP, an additional $105,000 is needed through donations in order to keep the Ride to Care program going through the end of the year.

Medicaid is reimbursing the expenses of some of the rides through Special Mobility Services, a vendor headquartered in Spokane, said Lucy Lepinski, chief operating officer for SNAP.

Mayor David Condon said at a news conference held at the downtown fire station Monday to announce the program that the service is one the city owes to its most vulnerable residents.

“One of the top issues that people bring up, is to live in a safe community,” Condon said. “A part of that is, obviously, when you call for help, you get it.”

Providing alternative methods for patients with non-emergency health issues to reach health care providers, rather than ambulances and emergency rooms, was one of several recommendations made by a task force Condon convened in 2013 and led by former City Councilman Steve Salvatori.

The Ride to Care program has served 45 patients so far, SNAP officials said Monday.

Cale said his driver not only took him to three appointments, but also took him to several different pharmacies before his Medicaid assistance was verified and he received his prescriptions.

“That right there, that was what helped me,” Cale said. “That was the deciding factor.”