AURORA | Bad doctor jokes are nothing new to Brian Good.
Chief engineer with Aurora Fire Rescue, Good had city officials rolling with a saw bones-centered one-liner at a recent public meeting.
“Stand aside doctor, we’re paramedics,” Good said to a roomful of cops, firefighters, city staffers and politicos at the May 22 meeting of the city council’s public safety committee.
That’s a line Good, who’s now based out of Aurora Fire headquarters at the Aurora Municipal Center, had to use on numerous occasions when he was stationed as an engineer at north Aurora’s Fire Station Two. Good and his fellow firefighters would often travel to the nearby Anschutz Medical Campus — sometimes several times a day — on routine medical calls, often transporting mildly ill or injured patients from doctor’s offices to the emergency room at UCHealth just a couple blocks away.
“It’s weird to take a usually fairly stable patient away from a doctor or a cardiologist or a surgeon,” said Vance Maune, another engineer stationed in the city’s Hoffman Heights neighborhood. “We’ve had people with cardiac problems taken from a cardiologist.”
Since 2015, Aurora firefighters — many of whom are also trained paramedics — have responded to the local medical campus more than 1,400 times, according to public records. That equates to approximately 300 calls a year to the myriad hospitals, group homes, rehab facilities and resource centers housed within the healthcare complex in north Aurora. In the first half of this year alone, first responders have already hurried to the area 250 times, responding to everything from animal bites to heart attacks. Of the responses made this year, 229 calls resulted in a patient being transported. The majority of conveyed patients were taken to UCHealth’s Anschutz Inpatient Pavillion at 12605 E. 16th Ave.
The calls come from a smattering of addresses around the campus, including UChealth, the new Veteran’s Affairs hospital, and Children’s Hospital Colorado, among several others. Through June 6 of this year, more than half of all calls to the campus have been to the Day Resource Center, which provides a slew of homeless services in a building that used to serve as a gym for the Aurora Police Department. The facility opened in 2017 after Aurora City Council members appropriated nearly $1 million of marijuana tax revenues to finance the project.
The greater campus is one of the top 10 addresses firefighters travel to on a regular basis, according to Sherri-Jo Stowell, spokeswoman for Aurora Fire. Those frequent trips, which often involve a short ambulance ride, have caused an undue strain on department resources, according to city officials.
“There are some concerns there about an appropriate allocation of resources,” said Jason Batchelor, deputy city manager.
Currently, an ambulance is dispatched along with Aurora Firefighters to every medical call that comes through the 911 dispatch system, Batchelor said. As fire vehicles cannot transport citizens for medical treatment, many calls end with patients being taken from the scene in an ambulance — even if the journey is just a few hundred feet across Anschutz. Of the some 1,400 people on the campus who have been contacted by authorities following a medical call in the past four and a half years, only 121 patients were not transported to a local hospital. Many of those calls don’t require a full crew of firefighters and an ambulance full of medical personnel, according to Batchelor.
“We don’t want to use a sledge hammer to take out a fly,” he said.
To combat those unnecessary responses, Aurora Fire Chief Fernando Gray has been in talks with representatives at UCHealth to devise a new system that wouldn’t trigger the 911 dispatch protocols for certain medical calls based out of the campus.
“They’re basically looking at ways not to call us,” Gray said.
Previously supposed to be unveiled this summer, the on-campus transport program is currently on hold due to staff turnover, according to UCHealth spokeswoman Jessica Berry.
“The proposal is still being worked out,” Berry wrote in an email.
In the meantime, the short trips around Asnchutz will continue to incur huge costs for patients, according to Maune with Aurora Fire.
“We take people downstairs, out to the ambulance, and drive them to the other side of the building — literally,” he said. “And then that patient incurs a huge expense from that.”
The current cost to receive basic life support services aboard an ambulance in Aurora is $1,560, according to David Patterson, CEO of Falck Rocky Mountain. Originally based in Denmark, Falck became the city’s sole ambulance provider following a competitive bid process in 2015.
Patterson said Falck also bills patients $24 per mile, and can charge slightly more for advanced life support procedures administered during a ride, such as intubation and manual defibrillation.
But the majority of the city’s ambulance riders receive only basic life support, and nearly half of all 911 patients treated in Aurora ambulances are on Medicaid, meaning they face no out-of-pocket expenses for services provided in an ambulance, according to Patterson. Patients on Medicare are also covered for everything but their co-pay.
Still, a 2017 report published by Kaiser Health News found ambulance rides across the country often cost several thousand dollars, and those costs can be unexpectedly thrust upon patients who wind up being treated by out-of-network providers.
Falck responds to some 40,000 calls across the city every year, according to Julian Dewberry, manager of business development with Falck.
Dewberry said he wasn’t aware of any conversations aimed at reducing the number of ambulances and fire vehicles sent to the Anschutz campus, but that Falck would be “open” to such discussions.
Barring the implementation of a new transportation paradigm to address calls coming out of Anschutz, first responders will continue to make regular treks to the medical complex as they are duty-bound to do, Batchelor said.
“Our guys are going to respond when they’re called,” Batchelor said. “It’s just a little absurd that you’re in a premier medical facility west of the Mississippi and (you’re) calling 911 for a transport.”
He said the practice speaks to larger concerns regarding abuse of the emergency medical system.
“Folks for any number of reasons are not accessing routine, regular healthcare and they’re using the emergency healthcare system for things that would be best seen outside of that system,” Batchelor said. “Aurora is not alone in that. I think all major cities are dealing with that, and it’s a challenge.”
He pointed to a program in Washington D.C. that utilizes Uber to transport people to local hospitals without incurring eye-popping ambulance bills.
“An ambulance is a very, very expensive means to solving what could be a simple transport issue,” Batchelor said.
Aurora does not currently have any plans to implement a similar program. Still, Gray has started a new program in an effort to curb frequent users of the emergency system. He recently assigned a lieutenant to oversee the new “para-medicine program,” which provides resources and advice to frequent flyers.
Stowell said the program helped a local woman install an electric lift in her home after she began calling 911 every day to ask emergency personnel help her get up the stairs. Batchelor said firefighters also helped counsel a diabetic man who was calling 911 most days due to low blood sugar caused by an ill-advised routine of not eating before exercising.
“It’s essentially trying to do some follow-up and intervention outside of one of those acute responses,” he said.