Goal: Divert unneeded trips to the hospital
By Philip Haldiman
Diverting unnecessary visits from the hospital is a great way to save money and provide the best possible emergency medical care to those who need it the most, and ultimately save more lives.
Peoria is about to launch its second community paramedicine pilot program that aims to do just that, thanks to a $175,000 grant from United Health Care.
The program will include the cities of Surprise and Goodyear, with Peoria designated as the primary applicant and administrator.
The three cities will work collaboratively to provide staffing for the paramedicine unit, which will respond to and serve all three cities while in service, and will share the costs of staffing through the grant.
The one-year period pilot starts in October.
Peoria Fire-Medical Department Chief Bobby Ruiz said the program will focus on those who use the hospital the most and those who might need resources before they become the highest users of the system.
Mr. Ruiz said 70% of patients who go to the hospital end up back in the hospital within 30 days.
“The program’s goal is to reduce recidivism of frequent users, and to find alternative resources for some of our customers who don’t need to go to the hospital, but need to go maybe to an urgent care or a doctor.”
Under the program, a community paramedicine unit will operate three days a week, eight hours per day, and will respond to pre-scheduled appointments.
The grant funds will include training costs for 12 paramedics, medical direction fees, continuing education costs, data analysis and a mobile computer terminal.
Emergency Medical Service Chief Jim Bratcher said paramedics are often times in the home of a patient and they realize there are additional needs but they are there on an emergent basis and aren’t able render all services needed.
He said the program allows paramedics to go back in a more controlled environment, delve into the resources the patient may need and try to connect that patient with those resources in the community.
Non-emergency visits can last as long as two hours, he said.
“We are basically the hub in the spoke of the wheel that reaches out to all the community resources such as hospice, primary care physician, transportation and meal resources. All those social determinates of health that the individual may not have access to or may not know exist,” Mr. Bratcher said.
This isn’t Peoria’s first community paramedicine pilot program
A previous one-year program concluded in 2017 and was successful in bringing down participants’ ER visits — 758 patients were contacted during the program and 74 of those were frequent users of the 911 system for health care needs. At completion of the program, visits decreased from 447 to 54, according to city officials.
The pilot program was made possible through a $150,000 grant from the Vitalyst Health Foundation to the consortium of five fire-medical departments in Peoria, Goodyear, Avondale, Surprise and Sun City.
Mr. Bratcher said the program garnered encouraging results and has given residents resources to help meet their health care needs and not rely on the 911 system,
But the program moved to part-time and then to one-day a week due to dwindling funds.
He said the new program is similar but will additionally look at sustainability costs and continue to look for sustainable funding resources for the program in the future.
The source of the sustainment funding and long-range plans have not been determined yet, but one of the performance metrics at the conclusion of the grant will be to present options for ongoing sustainability, Mr. Bratcher said.
“We will look at real-time costs, not only from the grant perspective but from the administrative side so that we can identify and actually monetize what it costs to provide this service long-term,” he said. “What are the potential savings in the health care system, and most importantly, what benefits does it bring to the community in terms of overall health and the health of the individuals we serve?”
Also unique to this program, the paramedicne vehicle will respond when requested to incidents from the 911 system.
This will take the delay out of the system as much as possible, Mr. Bratcher said.
“The vehicle will be able to be dispatched if our paramedics are out in the field on an emergent call, realize a need, and if they are available will be able to respond directly to the scene,” he said.
Using city resources
Community Assistance Manager Carin Imig said her department will continue to act as a conduit between Peoria residents and local as well as regional nonprofits serving many very specific needs such as housing issues, which may contribute to the overall well-being of an individual. This includes noticing the air conditioning or heating in the house is inoperable. In this case, the community assistance division is responsible for the operations of an emergency home repair program which addresses life and safety concerns.
In addition, this time, she said the connection will remain strong and symbiotic, but slightly enhanced thanks to the recently opened Community Assistance Resource Center, 8335 W. Jefferson St.
There is a strong synergy between city departments and paramedicine and the variety of programs offered to some of the city’s most vulnerable residents, Ms. Imig said.
“We can now refer the paramedicine clients expanded opportunities to connect to important and related services through partnerships we have with nonprofit agencies now located in the new Community Assistance Resource Center,” she said.
Mayor Cathy Carlat is a strong proponent of the paramedicine program, a reflection of the city’s proposed general plan which will be on the ballot next year.
“This program aims to build a healthier community,” she said. “By proactively reaching out to those in need, we are able to provide the support our residents need to live their best lives; and I’m thrilled to see this program once again offered to our community.”
Philip Haldiman can be reached at 623-876-3697, firstname.lastname@example.org, or on Twitter @philiphaldiman.