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Billings council directs staff to pursue nurse navigation trial after Global Medical Response briefing
Summary
After a detailed presentation by Global Medical Response, the council directed staff to begin formal contract work on a nurse navigation program that would give dispatchers a nurse‑triage option for low‑acuity 911 calls; key issues to be clarified include liability, local AMR funding, reporting and community education.
Billings City Council on June 15 heard a detailed briefing from Global Medical Response (GMR) on a nurse navigation service that routes low‑acuity 911 calls to trained nurses for triage, referral to clinics, telehealth, or alternative transport, rather than automatic ALS ambulance dispatch.
Steve Moffett, GMR’s business development manager, told the council the model gives dispatchers an option to transfer eligible low‑acuity calls to a nurse who can act as a “safety net” for missed high‑acuity cases, ask more questions and route callers to self‑care, telehealth, urgent care or BLS transport. Moffett cited retrospective ESO data and GMR’s operational results, saying that nationwide roughly 93% of the calls they screen do not require life‑saving intervention and that only about 3% return to the 911 system for a higher‑priority response after nurse screening.
Moffett described a phased implementation (foundation → expansion → maturity) with a 90–120 day implementation window once contractual and medical‑director approvals are in place. He said the navigation service is no cost to patients for the triage; when ride shares are used to reach clinics or the ED, GMR covers those rides; ambulance and clinic fees would remain as today. GMR stated its national centers staff nurses licensed in the caller’s state and maintain follow‑up and quality monitoring dashboards.
Council members asked detailed operational and legal questions: how behavioral health crises are triaged (nurse navigation excludes patients in current crisis and returns them to PSAP triage), transfer and return rates, potential rural limitations, IT/CAD integration, and who bears program costs. Moffett said local AMR would underwrite program operation in Billings and that indemnity and liability terms would be negotiated in the contract. Fire Chief Hopple said the department would work to ensure robust protocols and emphasized safety: “I want to guarantee you as a fire chief that I don't take this lightly.”
After discussion, councilmembers signaled support for directing staff to continue negotiations and to bring a proposed agreement, liability terms and reporting requirements back to council for approval. Staff said they will work with the medical director, hospitals and AMR and return a contract and implementation plan for council action.
