Somebody call me a cabulance

Whidbey General Hospital is on the road to providing “cabulance” service for patients well enough to return home or transfer to a nursing home.

A cabulance is a van or small bus that can accommodate several wheelchairs or a reclining wheelchair. It isn’t equipped with life support systems or other high-tech medical equipment found in ambulances.

Medicare patients were able to ride from Whidbey General in an ambulance. But recently the federal agency has narrowed the definition of a “medically appropriate transfer,” said Scott Rhine, hospital CEO.

“Medicare says ‘no’ you can’t transfer these people in an ambulance,” Rhine told hospital commissioners Monday night.

This means Medicare won’t pay, so patients face an expensive ambulance ride as there’s no alternative transportation on Whidbey Island. And mainland services aren’t cheap because of the distances involved, Rhine said.

The commissioners voted Monday to pursue cabulance service and to try to have it established by Feb. 1, when the federal designation “Critical Access” goes into effect. It will bring higher payment to the hospital for treating Medicare patients.

Unknown yet is whether Medicare will pay for cabulance, so research is under way to keep fares affordable.

Doug Bishop, the hospital’s chief financial officer, did some cost estimates based on the hospital purchasing a 2004 Dodge Sprinter van, equipped with a hydraulic lift and five wheelchair stations.

The van would cost about $45,000 to purchase, plus about $50,000 per year to staff and operate.

Bishop estimates fares would run about $40 per trip to Coupeville, and $50 per trip to Oak Harbor.

But the numbers could change if a free vehicle is obtained.

Frank Jacobson, president of the hospital foundation, told the board it might be possible to obtain a used vehicle from Island Transit or win one of the grants Boeing awards each month to nonprofit organizations.

The board endorsed looking into both prospects to determine the chance of success in a timely manner.

Commissioner Dr. Paul Zaveruha voiced concern about patients who will be unable to pay the out-of-pocket expense regardless of the fare structure.

Bishop said he made allowances in the budget for some Medicaid eligible patients and about 2 percent in charity write-offs.

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