Following National EMS Week, it’s important to recognize how we can continue to support the dedicated teams providing lifesaving care every day to Michigan patients and communities.
In my role as director of health policy initiatives at the MHA, it’s a priority to identify the challenges facing our EMS workforce so we can bridge solutions with our member hospitals. We continue to be engaged with the state’s EMS Coordination Committee (EMSCC) with extensive discussions around the barriers that have a direct impact on our EMS workforce, hospitals and patients. I’ve outlined a few of these challenges below, along with how teams are responding.
Challenge: EMS teams are limited in where they transport patients for care. Because hospital emergency departments (EDs) are a common and reimbursable destination for the ambulance provider, it leads to a growing number of behavioral health patients presenting to hospital EDs rather than a specialty behavioral health facility.
Response: While hospitals are equipped to stabilize and triage patients, the ED is not the most appropriate care setting for an individual in need of mental or behavioral healthcare. Given the establishment of Crisis Stabilization Units (CSUs) in Michigan, which are designed to provide 24/7 care for emergent behavioral health needs, the MHA wants to ensure that EMS providers are reimbursed for the transport of patients to this care setting. We are working to add CSUs as an approved destination for patient drop-off to ensure timely and appropriate services can be rendered to patients experiencing a behavioral health emergency.
Challenge: Responding to physical and behavioral health emergencies are especially challenging for EMS and ambulatory agencies due to continued staffing shortages.
Response: The MHA is working to identify alternative, appropriate and reimbursable mechanisms to transport patients with behavioral health needs who do not require the medical interventions provided in an ambulance. We also launched an ongoing public awareness campaign to expand interest in healthcare careers in Michigan, targeting messages to high school and college students as well as working professionals.
Challenge: Regulation and reimbursement mechanisms vary between EMS and hospitals, which can lead to conflict when challenges occur on either side.
Response: The MHA convened a group of executive leaders from behavioral health hospitals and EMS services to share some of the challenges each side experiences interacting with the other. One immediate action item from this discussion was the recognition that not all behavioral health hospitals have the same protocols for accepting new admissions, which can be a challenge for EMS providers. In response to this, the MHA deployed a survey that is currently in the field to identify how each hospital accepts patients, what mode of transportation is authorized and whether their admission status (voluntary/involuntary) plays a role. This information will help the MHA and the EMSCC better understand and identify opportunities to standardize the process and ensure a more seamless handoff between EMS and behavioral health hospitals.
The role EMS plays in our world cannot be understated – the MHA is heavily engaged in responding to concerns raised by this group and aligning priorities to continue offering support and collaborating on solutions. We must work together to overcome these challenges.
Members with questions may contact the MHA advocacy team.