Dallas paramedics will soon make nonemergency house calls to frequent ambulance riders as Dallas Fire-Rescue reviews ways to respond to soaring ambulance demand.
"For a fact, we have some people who know the cafeteria menu at the hospital, and they'll call us to get a ride to the hospital just to get a good meal," Assistant Chief Norman Seals said.
On Monday, Seals briefed the Dallas City Council Public Safety Committee on plans for a Mobile Community Healthcare Program.
Dallas answered 193,820 emergency medical service calls in the past year, up 6.5 percent from the year before. The increase in demand has far outpaced Dallas population growth.
Among all patients, 54 percent are uninsured and 51 percent of bills are unpaid.
Seals said 253 of the most frequent ambulance users called at least once per month in the past year.
Starting in January, frequent riders will be the focus of the MCHP, with four paramedics in training for it now.
The City Council already included $645,000 for the program in the new city budget.
"We'll identify any needs they have and maybe hook them up with religious organizations, whatever avenue we can find to get help for this person," Seals said.
Committee members were pleased with MCHP.
"We need to reduce the number of frequent fliers who are using our ambulances in inappropriate ways, and this program is going to help us get there," Councilwoman Sandy Greyson said.
But Greyson and others were concerned MCHP could be used to reduce the number of ambulances on the street.
"I'm not looking at this as a way to come back and say we're going to take an ambulance out of service at all -- at all," Councilman Scott Griggs said. "I'd like to take that off the table right now."
DFR officials said cutting ambulances is not planned, but MCHP is one of several methods being considered to respond to growing EMS demand.
"We're better served all the way around to restructure what we have and reallocate what we have in order to grow the system," Seals said.
Dallas operates 40 ambulances with three more added in peak hours.
All of them are Advanced Life Support units with the latest cardiac care equipment and highly trained paramedics.
At least one paramedic firefighter also rides on all Dallas fire engines for basic life support.
Tiered response for emergency medical calls could help keep ALS ambulances available for the most critical cases.
Highly trained call-takers would determine which calls could be answered first by BLS fire engines instead of the current method of using engines as a backup when ambulances are in service.
Several committee members were concerned about possible errors sending the proper response based on information provided by callers.
"Sometimes that's difficult to determine, because the people that are making that assessment are nonmedical professionals, and they might not be able to describe it correctly," said Councilwoman Jennifer Staubach Gates, who is also a trained nurse.
DFR Chief Louie Bright promised to return to the Public Safety Committee in the near future with more information about tiered response before the change is implemented.
"There's still a lot of research, a lot of things that could take place in the future," he said. "We're not looking to reduce the number of units."
Editor's Note: The original article stated that city council had already included $465,000 for the program in the new city budget. They included $645,000 in the new budget.