$248 million eyed for D.C. health care

[Candyman]

$248 million eyed for D.C. health care

http://washingtontimes.com/metro/20060926-111208-6227r.htm

[Pretty Ricky]

Why not give a million to communications so they can figure out the difference between a delta and an alpha call. This is just more waste of money by the city. 1 million for a study. Gimme a break!!!! Just build the hospital.

[Reel Fire]

They should take some of the money and work out a deal with Metro and have a sick call bus that runs around the city with a couple EMT's so they could pick up sick people twice a day. This would cut out half of the abuse for the ambulance.

[AL Deanii]

SOOOOOO maybe i won't start my tour with the same lady at 0445 hrs the finish my tour at 0415hrs next day with her......hmmm oh btw now the college campus students are calling for an ambo b/c they don't have cab fare.....LOVE THIS CITY

[Minimedic]

This is one of the worst plans for the city "poorest residents" I have ever heard. What in the hell will several ambulatory care centers accomplished spreaded throughout wards 6, 7, and 8. The only thing those centers will do is call 911 just as Kaiser and GW urgent care center currently do. What sickens me is how the city will not hold DOH accountable for making sure that every resident especially east of the river has health insurance, a pcp and a preventative health care 24 hour outreach service that educates residents about what 911 is for vs. going to see your doctor. Every resident in public housing, receiving TANF or some type of government assistance should have mandatory requirements including health insurance. The city should focus more on a "refusal policy" for 911. DCFEMS should not transport individuals for prescription refills, abd pain x2 or more years, headaches, hyperventilating, etc..

All universities should have their own EMS response and transport unit directly to their affiliated hospital, i.e., HU:HUH, GW:GWU, AU:Sibley, GT:GTH. Nursing homes seem to have magical escape routes for nearly killing or killing patients and DOH continues to ignore the city most vulnerable residents, the elderly. There are no mandatory reporting procedures in place for nursing home transport to hospitals. If there are, it is false information. Abuse 911! :mad:

The mayor stated that he is allocating money for new ambulances.What the F*&K! Another venue for wasting millions of dollars in EMS. The department has bought and wasted millions of dollars on used apparatus for EMS for the last 5 years and still we have broken down, fume invested, overheating, beatup, has been units that are an embarrassment for the nations capital. There are at least 5 different versions of ambulances right now out on the street. No one can tell one from the other old vs. used old? Yet Again, the city walks around with its eyes wide shut regarding the needs of EMS.


The Mayors Plan: "The new plan will devote $112 million for the construction of the "healthplex" and care centers; $10 million for cancer prevention; $10 million to help residents quit smoking; $10 million for chronic disease prevention; $6 million for a partnership between the National Institute for Medical Informatics and the D.C. Primary Care Association; $3 million to improve the city's ambulance system, with $2 million for the purchase of new ambulances; and $1 million for the D.C. Hospital Association to conduct a study of the city's urgent and emergent health care systems."

First, $10 million to help residents stop smoking, what? What is the statitics of residents in this city who have cancer related to smoking? the city is actually going to focus this much money on PR ads and paying ridiculous salaries to pass out pamphlets and make commercial ads..yeah, ok..

Second: $112 million for a healthplex, meaning what? the city need a level on trauma center equipped to handle all traumas including children with a helipad.

Third: $10 million for chronic disease prevention..that's all! I wonder what percentage of this money is going to someone fat salaries. The HIV/AIDS rate among young black women between the ages of 14 and 21 are worst than those in Africa.

Fourth: $6 million for a partnership that should exist for free. The National Institute for Medical Informatics should have been in place years ago. This just let DC residents know where the city stands regarding their health information. I do agree that all hospitals, clinics and physician offices should have a central database that should be accessible prior to treating a patient. What is the role of the The D.C. Primary Care Association? There are so many health clinics in this city and yet DC residents and these clinics still call 911 to go the nearest ER.

And last, 3 million to improve the city's ambulance system, with $2 million for the purchase of new ambulances; and $1 million for the D.C. Hospital Association to conduct a study of the city's urgent and emergent health care systems. What a waste...someone's getting paid some good money to tell us what we already know.

Common sense initatives for the 248 million:

1. Building a level 1 trauma center on the grounds of DC General hospital with several specialty research in-patient clinics located in the back of the hospital to focus on Diabetes, High Blood Pressure, HIV/AIDS, Alcoholism, Seizure, Obesity, cancer etc.

2. St. Elizabeth's Hospital should be rebuilt with an 24-hour medical care center equipped with x-rays, ct scans, blood lab, on-site ambulance.

3. The DC Jail should be moved (hint: Ward 2, 3, downtown or out of DC). The site for DC Jail could become the UDC Bachelor of Science College of Medicine and make the hospital a teaching university hospital like GW, Howard and Georgetown. This endeavor could lead to students east of the river possibly pursusing a medical career.

4. Build a state of the art EMS Headquarters equipped with medical and trauma set-ups to include a pool for teaching water rescue emergencies, etc.

5. Reorganize DC shelters and relocate those individuals to the appropriate places. Most of the individuals in shelters are alcoholics, drug abusers, mental patients, VA veterans and out-of-state individuals who come to DC for a free ride because of no accountablility procedures. These individuals abuse 911 the most. If the city is going to have shelters, then it should spreaded out throughout the entire city with medical clinics open 24 hours, accountablity procedures and temporary housing. It is pathetic to see how many MEN shelters are in this city.

6. Create outreach health technician positions that respond to calls at the request of 911 providers to assist with providing resources for transportation, health insurance benefits, selecting a health provider, etc.

7. Purchase mobile health clinics that go out to public housing complexes, elderly apartments and communities to conduct more health checkups.

8. Enforce JACHO rules and regulations on holding Ambulances in the ER for more than 30 mintues. There should be some type of fine imposed on hospitals.

EMS is basically drowning with a ball and chain around its neck with no life jacket coming no time soon, not even from the soon-to-be mayor. With the dire need of new technology, new leadership and managment, new medical practices and recruiting, settling pay and benefits issue..I cannot believe the council is going to approve the mayors spending of the tobacco settlement in this way. Again, the council and mayor either don't get it or get it and don't give a F*&K! Just as believing the Fire Chief about response times..clueless!

An ambulatory care center cannot treat traumas or follow a patients health record. Ambulatory care centers treat colds, fevers, headaches, etc. As soon as a patient walks in and complains of Chest pain, SOB, high fever, or the center is closed then the answer will be to call 911 to go to the nearest ER, going back to square one this does not solve the health care problems. The mayor has failed the residents east of the river with broken promises of a hospital. But guess what SE and NE residents: A baseball stadium will take care of your health needs!

[Pretty Ricky]

How about allocating money to the taxicab commision for patients who we know to be not needing an ambo but just a cab. Utilize either rapid units or PEC's to treat on the scene, and if it's determined that an ambo is not needed, then they can pass out cab vouchers to those people and send them on their way.

[2020]

How about allocating money to the taxicab commision for patients who we know to be not needing an ambo but just a cab. Utilize either rapid units or PEC's to treat on the scene, and if it's determined that an ambo is not needed, then they can pass out cab vouchers to those people and send them on their way.


This has been done, and successfully, in some smaller sized cities. It was a few years ago, but I read an article in a trade publication about a cost analysis being done in a medium sized city. I can't remember the city, or the details, but in the end, the analysis found it was much more cost effective to pass out flat rate cab vouchers for obviously "non-emergency" situations, then to have a medic unit or ambo on the road transporting to the ER. The hourly wage of the FD/EMS employees, the maint. & wear & tear on the rig, fuel cost, etc. we all factored in. The vouchers were only handed out after a complete evaluation was done, with documentation of course, and was determined that there was in fact no need for an emergency transport. The program turned out to be successful for the Fire/EMS Dept., and VERY successful for local cab companies.

I firmly believe that doing this would drastically reduce the b.s. runs, and general abuse of the system that occurrs on a daily (habitual) basis.

[Brooks]

I firmly believe that doing this would drastically reduce the b.s. runs, and general abuse of the system that occurrs on a daily (habitual) basis.

....Except that there are no cabs east of the River.

[2020]

....Except that there are no cabs east of the River.


Hmmm...I don't spend much time over there.

Maybe, w/ this system in place, the cab companies will find it lucrative over there.

[Pretty Ricky]

With that kind of money, I would start my own cab company. I could retire comfortably off the sharpshooters and b.s'ers that we run on the east side.

[Minimedic]

The cab voucher program sounds like a great idea, however, the city should be responsible and held accountable for the abuse of the 911 system. What I forsee is the regulars (shelters, dc village, homeless, etc) will become experts in using the cab voucher system and start selling the vouchers to individuals for money. A couple of suggestions:

1. DCFEMS could give out referral slips for transportation services, health insurance, obtaining PCP's and locating 24 hour pharmacies for non-emergencies. It's not like we don't act as social workers already.

2. DOH should have a 24-hour response vehicle that provide transportation services, how to sign-up for health insurance, getting prescriptions filled.

3. Each shelter should have a 24-hour medical clinic or pay for a on call RN to respond to their emergencies instead of calling 911.

4. There should be a RIGHT OF REFUSAL on the part of DCFEMS.

5. There should be a MOU between Metro access and DC Government that can be tracked via a computer tracking system for non-emergent transports.

6. DCFEMS could allocate positions call "Patient Care Reps" who would drive an SUV stocked with information for city services and respond to all non-emergency calls to clear them.

8. DCFEMS should be able to transport to other facilities besides ER's (Detox, St. Elizabeths, Shelters) in which the city should be billed for these services.

9. Shelters should have 24-hour reponse vehicles for the cold, hot, lice and just want to sleep patients.

10. DCFEMS to operate a Van, something like DC Rehab unit and give people a time frame for when the transport van will come around and pick them up. There will be 4 vans that operate in each part of the city. This van will collect information only for name, ss, dob, address, insurance info only and drop them as the front door of the ER's.

11. DC could use the money for a 24-hour, 365 day seizure clinic that just monitors seizure patients only.

12. It should be mandatory for DC police to transport Psych calls when cleared of blood sugar test by DCFEMS.

What amazes me is how we have all this focus on "did you violate protocols?", "did we follow protocols" and "Who is protocol trained?" when we treat and transport individuals whose chief complaint is 70% outside of the DCFEMS protocols.

[Pretty Ricky]

Lotta good suggestions......I think somewhere there should be some way of educating the public on the use of the 911 system as well as training dispatchers on screening calls more selectively. If I have to go on another Delta toothache, Alpha CPR, or Echo headache, I'm gonna go off on MPD stress.