Indiana’s Long Term Care Ombudsman weighs in on new Westfield ordinance for non-emergency 911 calls at residential care facilities

WESTFIELD, Ind — Starting this fall, residential care facilities in one Indiana city could start paying a price for repeatedly calling 911 for non-emergency help. Westfield city leaders say their new ordinance is about protecting resources that have been strained by 911 call volume.

The City believes it is the first — but won’t be the last — in Indiana to start charging a fee for non-emergent calls coming from residential care facilities — a problem Westfield Fire Chief Rob Gaylor said has been growing along with the city itself.

“Population has almost doubled in the last five years,” Gaylor said. “We’re going to see another almost 50% increase in population by 2030. So, yeah, the run volume is going to continue to rise.”

Gaylor added that facilities will often call on behalf of older residents who’ve fallen but aren’t injured, or need to be taken to routine follow-ups with a doctor — things Gaylor believes the facility should be able to manage without straining city resources.

“Now, if they’re sick — obviously, if people are sick — call 911, we’ll take care of sick people,” Gaylor said. “But by and large, that is not always the case.”

Halfway into the year, the fire department has responded to over 1,600 EMS runs. Nearly a third of calls, the department reported, came from residential care facilities. Of those, a third were deemed “non-emergent,” leading to overlapping calls and crews running to a residential care facility at least once daily.

Council members unanimously agreed Monday to charge those businesses $500 for their first, second and third offenses. Each subsequent offense earns the business a $1,000 fee. In Monday’s council meeting, Westfield Mayor Scott Willis said there are several businesses in the city he believes call 911 for lift assistance as a way to, ostensibly, shirk liability.

“They would rather us take on the liability of lifting that person off the ground than their own facility,” Mayor Willis said during Monday’s meeting. “And that’s unacceptable.”

State Long-Term Care Ombudsman Lynn Clough said via email, in part, facilities may err on the side of caution to avoid liability. Other reasons for high non-emergent call numbers are: “Many facilities are understaffed or lack proper training and protocols for handling non-injury situations, like falls without injury or mild symptoms. EMS can become a default option. Sometimes, residents insist on transport ‘just to be safe,’ even when the situation doesn’t rise to an emergency level.”

The LTC Ombudsman’s role is to advocate for residents of long-term care facilities like nursing homes and licensed assisted living facilities, handling problems related to residents’ rights, safety and wellbeing in those facilities across the state. As such, Clough worries about the potential consequences of Westfield’s ordinance.

Clough believes the ordinance could discourage people from calling 911 for real emergencies because they fear they will be penalized. Clough also indicated that assisted living facilities could pass the cost of fines the new rule will generate along to their residents.

Clough supports the city’s efforts to reduce unnecessary EMS strains but wants to emphasize the importance of also avoiding posing unintentional risk to older adults. She urged facilities and city leaders to ensure staffing numbers, training, resident rights and appropriate safeguards are part of the implementation.

“I understand the strain on emergency services, but policies like this must be carefully balanced to protect residents’ safety and rights,” Clough said. “I’m concerned this ordinance may discourage facilities from calling 911 even when it’s truly needed, or worse — lead to the death of a resident, as well as added costs and potential discharges for residents who can’t afford to pay. No one should have to weigh their safety against a fee.”

Chief Gaylor said the rule won’t be enforced until October, ensuring the city has ample time to thoroughly educate facilities on the ordinance and how to avoid fees. The goal is compliance, and making sure EMS services are always available for true emergencies.”

“911 is for emergencies and that’s the part that I can’t stress enough,” Gaylor said.