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Local Governments and School Districts Blog

New Ways of Finding Revenue at the Fire Department

Authored by Ruder Ware Attorneys
Posted on February 3, 2015
Filed under Local Governments and School Districts

Very recently, a staff arbitrator from the Wisconsin Employment Relations Commission sided with the City of Green Bay (City) and dismissed a grievance filed by the Firefighter’s Union giving the City the go ahead to develop a program with a local hospital. Under the program, the City’s Fire Department would direct EMT/paramedics to do non-emergency follow-up visits with patients discharged from the hospital. In return, the hospital would pay the City per visit. 

Firefighters would be sent during the workday on appointments, subordinate to emergencies that arise, to review a patient’s medical needs, to do a safety check of the dwelling, and to complete an after visit summary. The impetus for the program came out of certain aspects of the Affordable Care Act (ACA) which denies reimbursement for the readmission of certain patients within 30 days of the hospital discharge. This aspect of the ACA caused a local hospital to look for ways to reduce the readmission rate of certain patients. Characteristics of such patients included individuals taking a lot of medications, those with multiple chronic diseases, and individuals who are isolated without much family support. Such individuals would not qualify for skilled nursing or home health care.

At the hearing, the union argued that the above program violated the terms of the collective bargaining agreement prohibiting the assignment of duties which are unrelated to firefighting. In finding for the City, the arbitrator stated the following:

“[These] visits are not home health care. Firefighters are not asked to provide patient care or treatment, unless an emergency arises during the course of their visit. Under [the program], the firefighter is assigned to report concerns that are medically related. The patients involved do not typically qualify for home health care. There is no basis for the delivery of patient care. Firefighter EMT’s have been identified for these calls, in part, because there is no medical justification or reimbursement for skilled home health care workers.

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I believe [the program] visits are related to fire prevention and to rescue with the meaning of [the collective bargaining agreement]. The safety check is designed to prevent fires and to eliminate trip hazards that might otherwise lead to injury and an emergency call. Similarly, the after visit summary is designed to preempt returns to the hospital…[The] visits also serve to preempt emergency EMT calls from individuals who need to be rescued.”

A review of your collective bargaining agreement with your Firefighter’s Union and a discussion with a local health care provider may yield both savings for the health care institutions and new revenue for the Fire Department. As seen in this case, this can all be done within the parameters of the labor agreement.