Many Memphians turn to 911’s ambulances for non-emergency medical care. Once an ambulance is dispatched, the caller can refuse transport or go to the emergency room.
“Oftentimes, we’re not truly helping a person by taking them to the ER when they could be better served at a behavioral health center, a doctors office, or somewhere else,” said Kevin Spratlin, manager of the Memphis Fire Department’s Healthcare Navigators Program.
The Memphis Fire Department is the largest emergency medical services or EMS provider in the state of Tennessee. It runs more than 30 ambulances daily and staffs paramedics on its fire trucks.
Susan Dalton, program manager for Innovate Memphis, said about one in five calls to EMS are for non-emergencies. Among them are repeat callers and super users—people who call 911 for non-emergencies multiple times a month.
“People are in need of medical transportation and their first action is to call 911,” said Dalton.
The caller isn’t the only one who’s ill served by a non-emergency call to 911. Those calls use services—dispatchers, paramedics, ambulances, ER workers—needed for true emergencies.
In March 2019, the fire department partnered with Innovate Memphis and the Memphis Crisis Center on a solution to one of the biggest issues contributing to those calls—limited access to reliable transportation. 901RideChoice is a free referral service that connects those in need of rides with service providers who can get them where they need to go.
“Everyone needs to remember that getting people connected with the resources is often dependent upon physically moving them to the resource," said Spratlin. "The transportation piece is incredibly important. I can’t emphasize that enough.”
In addition to connecting calls with ride providers, the team provides information and connections to resources related to disability, senior needs, housing, and now COVID-19.
Spratlin’s department fields 911 EMS calls that dispatchers can safely say are non-emergent.
He said there are two main issues that contribute to over-utilization of emergency services. The first is barriers to primary care like inadequate insurance and limited access to transportation. An ER has to treat an individual regardless of insurance status and an ambulance has to provide the ride. For some people, it's their only healthcare option.
The second is mental and behavioral health issues coupled with substance abuse.
Holly McCaskill with Memphis Crisis Center coordinates the 901RideChoice call center and said they have responded to over 2,400 calls in the program's first year.
The program partners also hope that by helping people access transportation for regular preventative care and medical treatments, they can also reduce the number of legitimate emergencies in the future.
“If we can get folks to their doctor’s offices when they need to go, maybe we
can keep them healthy and prevent an emergency down the line,” McCaskill said.
The majority of 901RideChoice calls come from elders and people with disabilities living in low-income, underserved communities.
“A lot of elderly and disabled individuals want to gain their independence back and part of that independence is having access to transportation,” said McCaskill.
Catching a Ride
901RideChoice partners with MATAplus and private companies to provide rides. The referral to the provider is free, but the individual pays for any provider fees associated with the ride.
In the future, the partners hope to secure funding to subsidize those fees.
“A lot of the callers simply cannot afford the fee,” said Courtney McNeal, community outreach specialist for Innovate Memphis.
That's especially true of seniors and those living with disabilities who are likely to be lower-income and living on a fixed income.
For some individuals, insurance covers transportation costs to routine medical services, but many people are not aware of how to access this benefit. McCaskill and the team at the call center help to educate callers on those benefits.
“There is a mismatch between the insurance companies, the ride providers, and the people that need to utilize the services,” said Dalton.
In addition to medical calls, 901RideChoice also fields calls for rides to buy food, pay an MLGW bill, go to the Social Security Office, or any other day-to-day needs. The partners said the goods and services people need may or may not exist in their own neighborhood, but regardless, they’re unable to access it without transportation.
"The 901Ride program strives to improve the lives of those in vulnerable populations. This includes the elderly, disabled individuals, and those living in poverty," said McCaskill.
the Right Response
901RideChoice is one component of a larger effort to reduce non-emergency calls to 911 and redirect non-emergency callers to resources other than ambulance transport to an ER.
The Healthcare Navigator Program has various initiatives designed to connect people with the most appropriate resource and best serve their needs. Its team refers to this as “the right response.”
“We always show up, we always provide care, and we know that people trust us in the community,” said Spratlin. “Our job is to take the trust that people have in us and get them to the appropriate resource.”
One HNP initiative is the Crisis Assessment and Response to Emergencies or CARE project. The fire department partners with the Memphis Police Department and Alliance Healthcare Services for callers experience a mental health or substance abuse crisis.
“Instead of sending an ambulance to someone with a behavioral health complaint, we will send this care team and they navigate that person to the appropriate behavioral health resource," said Spratlin.
Another initiative is the Rapid Assessment Decision and Redirect or RADAR program. RADAR replaces the ambulance ride to the ER with regular sedans that include a physician, nurse practitioner, or physicians assistance on board with paramedics to answer non-emergency 911 calls. They can offer basic care on the spot or help the patient get to another provider.
The Healthcare Navigator Program also has nurses embedded at the 911 dispatch center who can triage a callers' needs by phone and connect them with resources in the community if they don't have need for immediate assistance.
Get more information and contact 901RideChoice at their website here or by calling 901-743-3901.