Wakulla outlines community paramedic pilot to reduce ambulance transports and ambulance hours

Wakulla County officials on Tuesday detailed a planned community paramedic program intended to reduce non-emergency ambulance transports and lower overall ambulance utilization.

Chief Lewis presented the county’s three-phase implementation plan, saying the program will use patient-centered mobile resources to treat some patients outside the emergency department and keep ambulances available for higher-acuity calls. “What that basically means is we’re using our current resources…to try to provide care for these patients that may not need to go to the ER,” Chief Lewis said.

Phase 1 focuses on establishing an EMS division to lead the program, completing a community needs assessment and setting measurable goals. Phase 2 includes staff selection, clinical competency evaluations and patient-selection criteria; Phase 3 is a full launch with expanded partnerships and ongoing evaluation.

Staff said the county has hired EMS Division Chief Randall Waltman to lead the effort. Waltman, who previously helped develop a similar program in Franklin County, has been meeting with regional stakeholders including the local HCA hospital and the Florida Department of Health to establish partnerships for follow-up care and potential reimbursement.

Chief Lewis said staff have already treated two or three patients through the pilot and cited one 911 call that did not result in a transport because the team treated the patient on scene. The chief said the county is tracking program metrics — including ambulance hours and utilization — to quantify cost savings and support reimbursement discussions with insurers and hospitals. “One of the metrics I’m going to be tracking is endless hours utilization…that would show a cost savings,” Chief Lewis said.

Staff estimated the program could reduce the large volume of low-acuity calls such as lift-assist or falls; Chief Lewis said the county receives “roughly 4 to 500” fall-related calls per year and that reducing those transports would free capacity for emergency responses. The presenters said the county is exploring funding from grants, insurance reimbursements and partnerships with hospitals; Medicare provides limited payment through a treat-and-no-transport code (referred to in the presentation as a “1099” code).

Commissioners asked whether the program would respond with a smaller non-ambulance vehicle; staff said the long-term plan is to dispatch a lesser vehicle for appropriate calls once the pilot’s operational details are finalized. No formal action or appropriation was taken at the meeting; the presentation was informational and staff said they will return with policies, protocols and any funding requests as needed.