Questions/Answers

Two decades ago, Thailand was recognized internationally as a model of health management for providing its people with good medical care and emergency medical services as a basic human right. However, according to a more recent study by the National Research Counsel of Thailand, the most vulnerable individuals are unable to access emergency medical services, which points to social inequality. At present the EMS system (the 1669 hotline) has two primary users: accident victims and patients in emergency situations. Consequently, due to agency legal restrictions and penalties for overreaching, individuals in non-life-threatening situations and those with non-emergency requests lack access to needed services. Meeting this obvious gap in services, the Kalasin Municipality stepped up to the challenge and established the (phone access) 1132 non-emergency services system to serve all and especially those most vulnerable. This service programs works through a participatory work process with transparency and accountability. Consideration one: program objective The object of the Kalasin ES Program is threefold: • to bridge social inequality by offering medical services to all • to increase effectiveness of medical care • to offer services where a governmental policy gap exists

Attaining the Thai government’s goals of Sustainable Development amid navigating governmental policy constrains, the Kalasin Services Program is designed to follow the law by developing a participatory process through a network of stakeholders. This network consists of responding to people’s needs as its central operation and people receiving fast, efficient, professional, and timely services, with medical services meeting the highest of standards. The network system fosters a sense of belonging among the City’s citizens, who can easily access transparent and verifiable information from such sources as Facebook, Line, Traffy Fondue, and www.kalasin-mu.go.th.

There are three goals pertaining to non-emergency patient transfer service systems per the Sustainable Development Agenda: •comprising goal 10.3 aims to reduce inequality by eliminating policies, procedures, and practices that prevent stakeholder participation. At the center is listening to patient needs and establishing a non-emergency delivery service system in accordance with standards of emergency medical services, available equally to all. •goal 16.7 looks to ensuring a positive communication network among all levels of responsibility to aid in their decision making, and to promote access to information among the public, government agencies, and the Kalasin Municipality. •goal 17.17 encourages cooperation among the public and private/civil sectors with use of the governmental communications system, allowing all levels to actively share and interact creatively. With a focus on participation, this initiative helps create transparency from the agency while increasing reliable and convenient access to services to the public. Such interactive cooperation encourages those at all levels to utilize their unique experiences, talents, and strengths.

•The social dimension translates to human development. A persistent volunteer service creates a sense of belonging and is the key partner in driving sustainable development. Furthermore, it reduces the burden on family members; it limits inequality in accessing services for all people; it helps create peace and harmony without leaving anyone behind. •The economic dimension seeks to ease the burden on the poor, who otherwise would incur expenses in transporting family to medical facilities. •The organizational dimension provides consistency of operations and adherence to laws and medical standards among all sectors, public, private, and civil.

Poverty and other forms of inequality are huge social problems; however, if governmental agencies create equal access to public services, inequality is greatly reduced. Utilizing the concept of leaving no one behind builds communities and creates a supportive society where, as in the case of the Kalasin Emergency Services Program, people are free to live happier, healthier, and more productive lives.

Open and free access to services requires non-discrimination on the basis of sex, gender, gender identity, religion, etc. Everyone who requests help receives help, without exception.

Taking guidance from the Ministry of Public Health and with consideration for the multitude of medical conditions, EMS personnel are trained to assess individual needs, such as special transport, psychiatric patients, and general care patients.

There are two components of operations, normal operations and resolution of operational concerns. Normal operations • Innovation: the problem facing local agencies was simply put—no money, no trained personnel, no time, no knowledge, no vehicles, and no equipment to assist with transporting patients. This situation was unacceptable to the Kalasin Municipal administration who created a memorandum of agreement among public, private, and volunteer organizations. With a provincial coordinator as head, the network was developed and sustained, as outlined in the manual “Referral Services in Non-Emergency Condition/Infectious Waste Management/Risk Management Manual.” • planning: on-going discussions of operational guidelines, resource utilization, maintaining a working communications model, and assessing satisfaction of services keeps the program timely and vital. For ease in communications and practices, services divide patients into three groups: (1) general services, (2) services for those with special mobility issues, and (3) providing psychiatric group services • Procedures: (1) receive information, take history of symptoms, discern former place of treatment, and place new information in patient database, (2) arrange equipment and coordinate personnel, and (3) transportation of patients to medical facilities and return to on-call status • Analysis and Evaluation: 31% of general patients had access to separate service; 1.63% of patients required special mobility; 10% were in need of psychiatric services; no additional injuries or deaths resulted from delivery of services.

Resolution of Operational Concerns • operational problems exist during incidents of urgent care which are resolved by communications with the command center. • when problems arise with the 1132 hotline, a redundant system has been developed using digital technology on the easily accessible government platform—simple to use, able to interact between service providers and service recipients; and allows inspection of each step of work such as online communication, location pinning, and service requests. • periodic case conferences seek to find solutions to problems and provide training in radio communications and enhance interactions between operators.

Kalasin Municipality sees tremendous benefit in the concept of “kind community,” which is a community that helps, supports, and is ever-persistent with potential. Volunteering, networking, and fundraising have emerged as hallmarks of the non-emergency transport model. After consulting with a nearby providence whose non-emergency services was not available on an equal basis to all citizens, the Kalasin Municipality adopted a system of service response to all in need.Kalasin Municipality led digital technology to increase efficiency by keeping community leaders, volunteers, health providers and the general community informed: hotline 1132, LINE application, Traffly Foundue, FaceBook and the municipal website.

The results of the study visit the Nonthaburi Municipality and Bueng Yitho Municipality, Thailand, found that a van that crashed, provided a non-emergency transport service to deliver the patient to a doctor or to do physical therapy. Vehicle staff trained in service from the Ministry of Public Health. However, the service fee of the private shuttle is high, but the poor or middle-income people cannot use the service. Kalasin Municipality has adopted the concept of non-emergency transportation service to organize a system that meets the needs of the people together with cooperation partners.

Kalasin Municipality led Digital technology has been used to increase the capacity of the patient transport network in non-emergency conditions as follows: 1) Increase the potential of informing information from community leaders, volunteers, public health, general public through easy-to-use municipal platforms. For example, Hotline 1132, Application LINE, Traffly Foudue, Facebook, Fan Page, Resuscitation, Kalasin Municipality 2) Enhance the work potential of officers by using radio communication, reducing the risk of false communication, direct line, Command Center, Resuscitation Center, LINE Application Resuscitation Kalasin Municipality open chat 1132 forwarding with love and Super Talk 4G for communication risks.

At present, knowledge is transferred informally by providing interested parties in both emergency and non-emergency situations by studying the recovery operations. Living-Rescue Kalasin Municipality to apply the knowledge gained in accordance with the local context, such as 1) Lampang Municipality. 2) Thung Song Municipality, Nakhon Si Thammarat Province. 3) Nong Waeng Subdistrict Administrative Organization, Roi Et Province 4) Ban Phai Municipality Khon Kaen Province, Thailand.

Potential for transferring non-emergency patient delivery services is a product of the challenge in solving the problem of government policy gaps with a simple format. Rather, it requires a commitment to heart-to-heart operations and fulfilling needs through patient-centric approaches, a management model, the involvement of network partners, and is a key local mission with authority in Providing public services empowers workloads using easy-to-access technology on municipal platforms, so the potential for localization can be achieved within the constraints of local contextual policies.

Municipalities both short-term and long-term, such as improving facilities, medical supplies, and the private sector development budget, supporting personnel with rescue vehicles / fuel, and maintenance costs. At present, there are 10 rescue vehicles / motor lance, 8 medical service networks and 5 Private Rescue Rescuers.

Responding to the needs of the people at the center by working together between the public and private sectors, creating a sustainable financial dimension, government budget by using the annual municipal development budget and raising money from the sector. People support car repair money, fuel and other money that the government cannot support, as well as the organizational dimension where the public and private sectors act to balance power, that is, if an agency fails to operate, the other will encourage. Warn is a check to enhance collaboration.

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1.Local Administrative Organizations should submit the application and relevant documents to the National Institute of Development Administration (NIDA), which is assigned as to carry out the assessment, for the first-round assessment via email in pursuit of Government's policies on digit government development vision. 2.Assessment and evaluation criteria for innovations of the Local Administrative Organization with Good Governance Award 2020 include: 2.1 Innovation responds to local community's problems 2.2 Target beneficiary the comparison between the received budget and the earned benefits 2.3 Innovation's worthiness 2.4 Integration of all sectors 2.5 Sustainability of the innovation

The “1132 Referral system for patients requiring special transfers” has been assessed using five categories as follows: 1) Responding to local public problems (Fair) 2) Impact on beneficiary groups (Good) 3) Project innovativeness (Good) 4) Quality of public participation(Excellent) 5) Project sustainability (Excellent) The overall is very good.

The 1132 Referral System for patient requiring special transfers was initiated in 2016 by Kalasin Municipality. This innovative was classified in the Public Service innovation which focus on the transition from the old public administration to the new public service management which covers all citizen in the area of authority of the Kalasin Municipality. The hotline 1132 aims at solving a common issue of Kalasin people in reaching the hotlines 1669 which is Emergency Ambulance Hotline in Thailand. In 2020, the Office of the Permanent Secretary of the Prime Minister, Thailand, has appointed the National Institute of Development Administration (NIDA) to perform an assessment of local administrative organizations for the Annual Good Governance Award for Local Administrative Organizations. This award has been established since 2002 to encourage local government authorities in Thailand to improve their governance mechanisms and public service provision, as well as to recognize innovative practices that lead to sustainable social and environmental solutions.

Please describe how the initiative is inscribed in the relevant institutional landscape (for example, how it was situated with respect to relevant government agencies, and how the institutional relationships with those have been operating). (200 words maximum) The work represents a special working style that solves the problem of policy constraints by organizing an organizational structure that responds to the needs of the service recipients and applies technology to increase operational flexibility, consisting of the Kalasin Municipality as a principle organization. The public services under the Act Decentralization, procurement, establishment of the coordination center, recruitment of personnel and government budget, and support organizations are divided into 3 parts: 1) Screening vulnerable people is responsible for screening vulnerable people with information. Quantity / Quality Provide details and coordinates for assistance to the Coordination Center, including Public Health Volunteers, Civil Defense Volunteers 2) Academic Support, is responsible for receiving information and analyzing medical assistance and requesting assistance from command centers such as Kalasin Hospital, Public Health Service Center 3) Support personnel with knowledge, resuscitation-rescuers skills, are responsible for providing assistance in delivering patients with medical standards, such as trained civilian defense volunteers. Volunteer resuscitation by motor vehicle (Motor lance) 4) Funding support organization is responsible for providing resources for work operations such as budget for the purchase of medical equipment.

The 2030 Agenda for Sustainable Development puts emphasis on collaboration, engagement, coordination, partnerships, and inclusion. Please describe which stakeholders were engaged in designing, implementing and evaluating the initiativeand how this engagement took place. (200 words maximum) The development of a sustainable service system must be able to meet the needs of the people, which requires the work of all stakeholders. Expectations of clients and operational stakeholders showed that the vast majority of patients expected to receive timely and safe service. Expected relatives were assisted in the referral system. The public health volunteers expect to help people access public health services and have a good quality of life. The hospital expects a comprehensive and timely patient transfer system with impressive services from Expectations There is a meeting of the recruiting group, a working style that is perfect, has freedom of work, Kalasin Municipality is a feast, supports the operation, uses an efficient bottom-up management system. A The service of non-emergency patients must be comprehensive, equitable and safe in accordance with the emergency medical standard.

Demonstrate the ability to resolve government policy constraints through a participatory process through volunteer processes with determination get benefits, there is a special form of transport that does not violate policy. Patients and relatives were satisfied, delivered on time according to medical standards, no injuries and death occurred while working and increases the accessibility of medical care. This should be promoted in the government policy revision to meet the needs of people in the non-emergency patient transfer. And expand the results to local government to provide services for receiving patients from home, delivering to nursing homes, and taking back home.