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HomeMy WebLinkAbout2015/11/02 - ADMIN - Minutes - City Council - Study Session (2) Jft St. Louis Park OFFICIAL MINUTES MINNESOTA CITY COUNCIL SPECIAL STUDY SESSION ST. LOUIS PARK, MINNESOTA NOVEMBER 2, 2015 The meeting convened at 8.21 p m Councilmembers present: Mayor Jeff Jacobs, Tim Brausen, Steve Hallfin, Gregg Lindberg, Anne Mavity, Susan Sanger(amved at 8:26 p.m.), and Jake Spano. Councilmembers absent: None. Staff present: City Manager (Mr. Harmening), Fire Chief (Mr. Koering), and Recording Secretary (Ms. Wirth). Guest: None 1. The Future of Emergency Medical Services (EMS) Mr. Harmening introduced the topic and stated the purpose of this discussion is to bring the Council up-to-date with Emergency Medical Services (EMS). Mr. Koenng presented the staff report, noting the Fire Department currently responds to approximately 4,000 medical calls a year without reimbursement and it is expected that demand will continue to grow. He reviewed that in 1969, the effectiveness of the EMS system was under attack because of its lack of effectiveness, and out of that process came a white paper detailing the changes needed. For many it was considered the birth of EMS. Then, in 1971, a popular television program raised EMS awareness and the idea of paramedics responding to homes and taking you to the hospital. Today, just as we did in 1971, when a 911 call is received, two paramedics respond, but an average of 75-80% of all Advanced Life Support (ALS) transports are not actually required. The law only allows reimbursement if the transport occurs to a hospital emergency room and because of the required response time, more paramedics are hired and ambulances purchased to meet the growing demand Councilmember Sanger amved at 8.26 p.m. Councilmember Hallfin asked if the ambulance does not get paid if the person is not transported. Mr. Koering answered in the affirmative and explained if services are rendered, then the person is transported. In Hennepin County, every 911 EMS call received has to start an ambulance. Mr Koenng presented statistics on the City's customer base, with 25% being 65 years of age or older with a strong base of private insurance, resulting in a high demand. In addition, as more senior and assisted living units are created, more EMS calls will be received. He noted since 1996, medical calls have doubled and according to State statistics, by 2030 the number of St. Louis Park senior residents will double. Mr. Koenng described the increasing frequency of overlapping calls that places additional demand on the system. Mr. Koenng stated future changes will include a focus on treatment in the home, a move away from transporting every patient to an emergency room, moving patients to appropriate care and transport back, connecting patients with resources (transportation options), giving more attention to preventative care, and reducing dependency on the system Study Session Minutes -2- November 2, 2015 Councilmember Sanger asked if it is being suggested the EMS will transport the patient back to their residence. Mr. Koering answered in the affirmative, noting 80% of all patients seen by a paramedic ambulance crew can be treated and stay at home. That would greatly lower the level of workload. Mr. Koenng explained the Center for Medicaid Services (CMS) and Accountable Care Organization (ACO) would manage care, assign payment/cost, and act as the insurance company (third party administrator that assures value-based purchasing). If the ACO indicates that the provider is not instituting value-based purchasing and meeting certain cnteria, there may not be full reimbursement. In addition, there would be penalties for no insurance, a tiered response, tnaged at the 911 Center, and fewer ALS transports. This will result in a controlled intake. Mr. Koering explained that throughout the entire process, it is about the patient's satisfaction scores on the service received. This may mean that for the City to be a player in the EMS world, it will have to also think about the patient's experience and be able to show metrics that they are impacting the customer in a positive way. This is important because Hennepin County (the current ALS) will only select providers that dnve their scores as well. Mr. Koering noted what drives response time is the idea you have to be there in 4.5 minutes but the reality is that you do not if the call is for minor issues (i.e., ankle pain, transport to a doctor's appointment). Councilmember Sanger asked how this addresses people who use the system for secondary gain and nursing homes that no longer have on-site nurses because it was more profitable to off load work to the EMS. She also asked how they can be incented to hire trained on-site staff to reduce the load on the EMS. Mr. Koering stated those who over use services will often times be directed towards more appropriate housing and to call for help in a less urgent way. He explained how firefighters work with the patient to find a better way to deliver services and teach them how to stay in their home. Mr. Koenng stated the Fire Department has to ask if their care makes a difference, is changing patient outcome, and sending the nght resources to the call. They will begin to chart those patient outcomes to show Hennepin County that the Fire Department is an effective partner He stated firefighters are the most trusted deliverer of EMS and there is the advantage of mutual aid Councilmember Hallfin asked about ambulance service that can respond in St. Louis Park Mr. Koenng explained that the City of Edina had a pnmary service area and they decided to maintain it However, St. Louis Park decided not to maintain their primary service area so it was taken up by Hennepin County. Mr. Koenng summarized his presentation and stated other providers and surrounding communities are discussing collaboration and how this can work. He noted the good news is that our firefighters can be trained to a higher level, if needed, and he continues to talk with our EMS provider about partnering concepts. Mr. Koering stated the purpose tonight is to provide this information and ask the Council to keep an open mind. He stated he will stay engaged in this conversation. Mayor Jacobs stated he did not realize the high number of calls received when emergency response is not actually required. Councilmember Mavity stated it reminds her of a Minnesota League of Cities speaker who described the challenge to our civic life when considering ourselves to be consumers instead of I Study Sesi ion Minutes -3- November 2, 2015 residents and neighbors. She stated it is a challenge when discu'ssing,theseiissues about customer satisfaction metncs and the-Cify needs to be careful in that shift,of thinking. Mr. Koering agreed . and stated1sthat'isa good point. Councilmember Sanger asked if the Fire Department will have to hire more medically trained staff and how-high volume,users who call for non-emergency reasons will'be addressed. Mr. Koering stated-today the EMS responds, works with the family, and at some point helps guide them towards social services to get family support for a different type of living situation. If they • do not_change, the,Fire Department is still an obligated responder. He explained that given the current demand and forecasted growth, additional'staffing will need to happen. The type of staff gomgTorward might look different-and not necessarily be firefighters. He,rioted'_the,good news is that'new-revenue streams will-offset some of those costs and create_sustainability. _ Mr. Koering thanked the Council for its support of the Park Nicollet Post Discharge Program and stated'the City-has well positioned itself-to take the next step'because of that"program. Communications/Meeting mCheck-In (Verbal) None. The meeting adjourned at 9:00 p.m: ' MelissaKennedy, City Clerk s Jeff' , ayor _ {