City Tries to Cut Down on Unnecessary Ambulance Calls

By Petula Dvorak
Washington Post Staff Writer
Saturday, March 29, 2008

The ambulances come screaming down city streets, rushing on calls to burst boils, clip hangnails and check on smelly body parts. At the cost of $700 a visit.

Meanwhile, the District's ambulances are unavailable to help in real 911 emergencies, a problem the city's Fire and Emergency Medical Services Department is trying to fix with a new program it rolled out this week called Street Calls.

Thirty people accounted for 2,400 emergency transports last year, said Michael D. Williams, the department's chief medical officer. That's a good chunk of the 78,000 ambulance trips his teams made in that same period, he said.

The program to try to change the lopsided statistic was announced by Mayor Adrian M. Fenty (D) in his State of the District speech this month and was introduced this week.

Medical workers will get into vans and visit the top 20 offenders who habitually call 911 in instances of "misuse" and try to work with them to gently curb the inappropriate calls that send ambulances racing around town, department spokesman Alan Etter said.

"There are individuals on this list who call 911 if they have a hangnail. Literally. That has happened," he said. "We have known for a very long time that the system is abused."

Paramedics will visit the people periodically to see whether they have health issues they can bring to nonemergency centers. They will take careful notes and log them into a database that will be linked with other social services agencies, Williams said.

The No. 1 offender on the list was taken to the hospital 243 times last year. No. 2 got 198 trips, and No. 3 went 119 times. The lowest number on the list was a man who went 27 times. "That's still twice a month," Williams said.

Because some of the people are transported every other day, the paramedics know them and their problems well. They will refer them to social service programs and suggest that they seek help for the life issues that often spark their medical problems, he said.

"Some of these people are known alcoholics. If we can refer them to detox and if they no longer drink, they may find a job, find a home, and that's 200 times a year we don't have to pick them up," he said.

Street Calls is an outgrowth of the EMS task force that was formed after a string of missteps was revealed in the city's response to the homicide of New York Times reporter David Rosenbaum in his Northwest Washington neighborhood two years ago.

Rosenbaum, 63, was fatally bludgeoned in a street robbery in January 2006. Rosenbaum's son and daughter filed a lawsuit against the city after a report by the D.C. inspector general's office cited an "unacceptable chain of failure" by firefighters, paramedics, police officers and hospital personnel in treating Rosenbaum.

The family reached a settlement with the city, forgoing a financial award in return for the District's promise to overhaul its emergency medical response system. The Street Calls program is part of that overhaul.

"The idea is not to discourage people from calling 911. You have to call 911 when you have a true emergency," Etter said. "But there are ways we can help these people without giving them a $700 ambulance ride."

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