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UNHS Patient Transport offers easy access to medical services - Medically Speaking, Volume Two, Number Eleven, 5/7/15

Utah Navajo Health System, Inc. has received much- deserved accolades for its tremendous EMS program, but the UNHS Non-Emergency Patient Transport Service is another program that provides a vitally important resource for Native American patients.

The Non-Emergency Patient Transport Service began with only two employees and four vehicles, making twelve transports each week, according to Patient Transport/EMS Director Dustin Coggeshell. Today, the program has nearly thirty-five transport drivers, two dispatchers and two employees who handle the Patient Transport billing. The program has several vehicles, including two high-top stretcher vans that can be used for wheelchair transport, as well as a pair mini-vans for wheelchair transport. The program averages 450 patient transport encounters each month, taking patients to their appointments at local clinics and throughout Utah and the Four Corners area. Transport drivers take patients as far away as St. George, Salt Lake City and Draper, Utah, Phoenix, Arizona and Denver, Colorado. They also transport patients to nearby locations like Farmington and Shiprock, New Mexico, Durango and Cortez, Colorado, Tuba City and Kayenta, Arizona, and Blanding.

"We started out not knowing where we were going with this program," Coggeshell explained. "It was a contract we had with the State of Utah Department of Health to provide non-emergency transport under a tribal contract. The program has grown and has been recognized at the Navajo Nation Tribal level by the Health and Human Services Committee. They are really impressed with the service we provide for the Navajo people."

Coggeshell said the UNHS Patient Transport program has made several presentations to the Navajo Nation Tribal Council's Health and Human Services Committee. It was recognized in 2012, when Navajo Nation Tribal Delegate Charles Damon II said he was impressed with a contract UNHS negotiated with the Utah State Medicaid Office. The contract allowed UNHS to provide non-emergency patient transportation with Medicaid reimbursement. Damon said the contract allowed UNHS to transport its patients to cancer centers, nursing facilities, dialysis centers and other facilities outside the Utah Strip.

Patient Transport Assistant Heather Brown said many of the patients who use the program are dialysis patients. Twenty-three dialysis patients are taken to dialysis centers at Blue Mountain Hospital in Blanding, and in Kayenta, Tuba City, Cortez, Shiprock and Farmington. These patients are transported three times each week and represent a large portion of the monthly transports. Brown said Native American patients who live within the UNHS service area (the Utah Navajo Strip or San Juan County), have traditional Medicaid coverage and meet certain eligibility criteria can qualify for the Non-Emergency Patient Transport service. Patients can request this service by contacting a UNHS eligibility worker at the Montezuma Creek Community Health Center to see if they meet eligibility criteria.

Patients who qualify are asked to give 72-hours notice to the Patient Transport dispatchers in Montezuma Creek and Monument Valley, who schedule the transport services. Patient trans- port services are available at all four UNHS Community Health Centers, in Blanding, Monument Valley, Montezuma Creek and Navajo Mountain. For those who qualify, Medicaid will pay for the transport costs, which include, mileage, gas, and in the case of a long distance transport, hotel stays for the patient only. The patient only needs to provide money for their meals during the transport.

Coggeshell said many dialysis patients are actually on the list for kidney replacement. If a kidney becomes available Patient Transport will make last minute arrangements to get those patients transported to Denver for a kidney transplant.

"We've had three or four so far. All in Denver," Coggeshell explained. "We work with these dialysis patients for so long, three days a week, you really get to know them and their family. You get to know where they're at health-wise and then you see this huge change like in an hour when they say, 'hey, we've got a kidney for you'. That's a huge difference and I know some of our drivers get emotional about it. You get really attached to the patients and they're just like family and friends when you run with them so long.

"You think patient transport is just driving patients to their appointments," Coggeshell continued. "It's actually providing patients with access to healthcare, especially in a rural area where it might be hard for people to get to their appointments or much needed life-saving services like dialysis."

Another great aspect of the Patient Transport service is stretcher transport and wheelchair vans that provide inter-facility transport. This is an alternative to an ambulance, Coggeshell said. It's a stretcher van with one EMT and one driver, and its set up with stretchers.

"We work closely with bigger healthcare facilities like San Juan Regional Medical Center or University of Utah and we do discharges for them," Coggeshell continued. "Stretcher vans are used if the patient doesn't need an ambulance or any type of treatment in transport, and only very minor monitoring, but still needs to lay on their back and can't be in sitting position. We will send a van to Salt Lake City to pick up a patient and transport them to the nursing home in Blanding. In rare cases these patients go straight home."

The Patient Transport Service recently purchased a slightly used, Ford custom stretcher van, with a high top. Coggeshell said the van is basically brand new. It can transport up to two wheelchair patients and hold three additional people. All the Patient Transport stretcher and wheelchair vans are built around safety and are ADA compliant.

Training is another important aspect for Patient Transport employees. All employees are trained in proper techniques for lifting and moving stretchers, lifting and moving patients to avoid injuries, and wheelchair setups so patients are properly fastened when transported. This training is ongoing. Drivers are required to demonstrate, quarterly or annually, that they know how to handle the equipment. Drivers are required to sign off on this training, in front of the managing staff for Patient Transport, before they are sent out on the road.

Coggeshell said he's also proud the UNHS Patient Transport program has been recognized at the state level. The State of Utah was so impressed with how UNHS created the program, they used it as part of the statewide standardization for other tribal transport services, he explained.

"So when a lot of policies and procedures were being developed at the State Medicaid Office, we worked closely with them. They used a lot of our operational methods in their statewide standardization for tribal transport services for other tribes," Coggeshell said.

He also noted that the Patient Transport program is the only UNHS operation that does its own billing. Heather Brown and Kathleen Sam are responsible for all the Patient Transport billing, while billing for all other departments goes through the main billing office for UNHS.

Coggeshell and his staff have created a patient transport program that serves UNHS patients in a variety of ways, helping make access to medical services more convenient. Patient Transport is the perfect compliment to the EMS program. Although it hasn't received the publicity of EMS, it has been recognized as one of the outstanding patient transport programs in Utah and on the Navajo Nation. For more information about the UNHS Patient Transport Service or to schedule transportation

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