Stressing that no changes whatsoever would be made to emergency 911 ambulance calls, Assistant to the City Manager Aaron Baker introduced a review of non-emergency inter-facility transports made by Mesquite Fire and Rescue Department personnel to the Mesquite City Council at its meeting on Tuesday, Feb. 13.
The review, conducted by an outside agency, Hobbs, Ong and Associates, examined IFT operations between medical facilities in Mesquite and those in St. George, Utah, and Las Vegas. “The city is reviewing the operation of the EMS/IFT component as a continuation of its desire to provide the best services possible in the most effective and cost-efficient manner,” the report said.
According to the report, “approximately 60 percent of the IFTS are made from Mesa View Regional Hospital to St. George destinations with the remainder generally to Las Vegas area destinations.”
The report examined the costs of the transports showing that a five-hour transfer staffed with full-time personnel costs approximately $1,854 while that same transfer using part-time staff costs $1,072 thereby saving the city $782.
The costs of a four-hour transfer using full-time staff costs approximately $1,306 while part-time staff making the same transfer costs approximately $680, saving $626.
Most IFTs have been using full-time staff and using overtime-paid regular staff to cover in the firehouses. The report suggested that reserve firefighters could be utilized for IFTs rather that using on-duty firefighters as a way to reduce costs. “The city has shown that the Mesquite Fire and Rescue department paid a total of $72,439 in overtime during FY2016-17 for all unscheduled overtime including that paid due to callbacks made in the course of an IFT,” the report said.
The report showed the severe disconnect between what it costs the city for each transfer versus the amount of insurance reimbursements. Medicare pays approximately $182 to $591 for a single transfer with Medicare paying approximately $141 to $496 per transfer. “The reimbursements from Medicare and Medicaid seldom, if ever, cover the cost of the transfer,” the report said.
Currently, the city only collects about $1 million a year in IFT reimbursements. After taking into account the internally generated fees, the net funding gap has ranged from $2.2 million to a budgeted gap of $4.9 million in FY 2017-18, according to the report.
The report made several recommendations on a short-term, 6-month schedule that included using reserve firefighters for IFTs prior to using on-duty firefighters, reviewing ambulance fees to determine if administrative paperwork can be reduced, and implementing an incident reporting system that will capture more data that can be used for analysis.
On a long-term, 12-month basis, the report recommended a taskforce charged with examining ways to reduce costs and increase reimbursements. The taskforce would be comprised primarily of city officials and representatives from affected medical facilities in Mesquite, St. George and Las Vegas.
Other long-term goals recommended by the report include issuing Request for Proposals to assess private sector interest in providing IFTs, re-evaluating the one-size-fits-all model for ambulances and fire apparatus, and considering a ballot question to provide additional property tax increment to support emergency medical services.