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Service Targets 911 Callers; Residents with non-emergency issues redirected

WASHINGTON, D.C. -- D.C. fire officials are answering the call for those who dial 911 the most.

Fire and Emergency Medical Services Chief Medical Officer Michael D. Williams said the department has made steady progress in redirecting residents who frequently call 911 for non-emergency health problems.

Dr. Williams said this week he expects the 8-week-old Street Calls program to have a "ripple effect" that will save tax dollars once it is established, though early gains have been small.

"As a taxpayer you pay for Medicaid with taxes, so later down the road we're hoping to save you money," Dr. Williams said.

Under the Street Calls program EMS workers visit the homes or recent whereabouts of the 30 most frequent 911 callers over the past 15 months. These represent a substantial percentage of city ambulance calls. They are either treated or given health assessments on the spot while others are referred to more advanced services such as dialysis, housing assistance or mental health services.

Dr. Williams said reaching the top callers is critical because they are the most likely to die within a year of becoming frequent callers.

Of the top 30 callers over the period, two are dead and three are presumed dead. A dozen others have not ridden in city ambulances in the past two months and EMS workers haven't been able to contact them.

Paramedics found the remaining callers and referred them to various services.

For example, one diabetic man used to call 911 when he was out of blood sugar test strips. The Street Calls team brought him test trips and connected him to an organization that refills them for free.

Four homeless clients were referred to housing and mental health services.

The top callers are typically discharged from the hospitals to which they are taken immediately, and they ride an ambulance about seven times a month on average. The trips cost $268 plus $6.06 per mile driven, fees that are covered indirectly by taxpayers though Medicaid or D.C. Healthcare Alliance.

Eight of those callers were taken at least once to a hospital last month, but five were not thanks to the Street Calls program, Dr. Williams said.

Those five represent about 35 fewer transport calls and more than $9,300 in savings on ambulance trips.

Ben Young, a spokesman for D.C. Council member David A. Catania, at large independent, said Mr. Catania supports the plan because it frees tax dollars to help the uninsured or under insured.

"The overarching problem is the lack of health care [for those who can't afford it]," Mr. Young said. "But this is seeking to address that."

Street Calls was initially scheduled to target the top 20 callers who account for about 10 percent of the city's 127,000 annual calls for emergency service.

Dr. Williams said the department quickly moved through those 20, expanded to the top 30 and is now targeting the top 50.

The program is part of a $3.6 million initiative to improve emergency services, though a recent cut to the department's budget has threatened several EMS programs and halted the expansion of Street Calls.

Currently one team of two paramedics and an emergency medical technician seek out and visit the frequent callers. Fire officials would like to field two teams.

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