Definitions to curb ‘frequent flyers’

In the health care world they are called “frequent flyers” — people who inappropriately use ambulance services and hospital emergency department resources by calling on them often, many times when they may not be needed.

Sponsored by Rep. Tara Mack (R-Apple Valley), HF262 would create a new statewide “community paramedic” definition that would aim to curb the problem that advocates say is burdening precious ambulatory and hospital emergency department resources across the state, especially in smaller communities.

Approved March 8 by the Health and Human Services Finance Committee, the bill now goes to the House floor. A companion, SF119, sponsored by Sen. Julie Rosen (R-Fairmont), awaits action by the full Senate.

Brought forward by the Minnesota Ambulance Association, HF262 would allow experienced paramedics in communities across the state to undergo 120 additional hours of training to become certified by the Emergency Medical Services Regulatory Board as “community paramedics.”

The bill would require the human services commissioner in consultation with representatives of emergency medical service providers, physicians and local public health agencies to determine specified services and payment rates for community paramedics. Under the bill, paramedics could perform “chronic disease monitoring and treatment; minor medical procedures intended to prevent avoidable ambulance transportation or avoidable hospital emergency department use; provision of patient information and care referral options for meeting physical and mental health care needs.” Such procedures would be covered by Medical Assistance.

Rep. Erin Murphy (DFL-St. Paul) successfully amended the bill to modify the language to include the consultation of a public health nurse. The Minnesota Nurses Association opposed the bill’s original language because “it was a threat to the practice of nursing and a risk to patient safety.”

O.J. Doyle, a retired paramedic and legislative consultant to the ambulance association, said the bill mirrors a pilot program recently conducted in Fort Worth, Texas that put so called “frequent flyers” into a planned care program and, as a result, saved local ambulatory services and hospital emergency departments $564,000.