Riverside starts "community paramedic" program to cut calls and increase levels of care
RIVERSIDE, Ohio (WKEF/WRGT) - It's the one number that when you call, you're positive you'll get an answer: 911.
But, how many calls are really life or death?
Paula Balcom could probably tell you. Like many paramedics nationwide, she sees a handful of the same patients for the same reasons. Deemed "frequent flyers," they pick up the phone for just about anything. However, people who are used to calling 911 are now getting a call back.
"Many times they are surprised," said Balcom, a firefighter/paramedic with the Riverside Fire Department.
Her job no longer finishes with her run. Balcom has started following up with recent patients from behind her desk.
"They can let us know if they're feeling better, and then at that point, we can figure out what else we can do for them," Balcom told DOX 45's Shavon Anderson.
It's an opportunity to tell them about other agencies and places where they can get the help they need, without calling dispatchers. She's what some call a "community paramedic." It's a new title under a new program started in October, after Riverside Fire Chief Dan Stitzel realized his department needed a change.
"Years ago, it was just about putting out fires," Stitzel said.
That's not the case today. To put it in perspective, Riverside residents made 4,287 calls to the fire department in 2015. Of those, 628 were for fires, according to an annual report.
"9-1-1 is pretty simple, everybody knows it," said Stitzel. "It's kind a crutch for people to call, when they don't know who to call."
Community paramedicine, also called 'Mobile Integrated Healthcare,' isn't a new concept. Departments nationwide have been switching to the model for years. Here in Ohio, the service only became legal in 2015, when the state started allowing EMTs, AEMTs and paramedics to perform in non-emergency situations.
Records show annual calls in Riverside are up by nearly 1,000 since 2010. The increase lead to an idea, with help from the non-profit clinic Reach Out Montgomery County.
"We decided to look at the EMS runs, and the data," said Executive Director Sharon Sherlock.
Along with Miami Valley medical students, they did a study on how people use the city's emergency services.
"We weren't even sure if they were calling EMS because they felt is was imperative, or they were thinking, 'I have no other way to get care,'" said Daniel Mohan, a 2nd year student at the Boonshoft School of Medicine.
The group found a pattern.
"40 to 50 percent were maybe what people might be considering unnecessary runs," said Sherlock.
The reason? A lot of people simply need a ride to a medical facility.
"It's just really hard to get around the city, especially as they're getting older," Mohan added.
Whether it's a call for lift assistance out of a bed or chair, for medication or other issues, Balcom acts similarly to a medical middle man. A few days a week, she teams up with Reach Out nurse Tammi Whalen to visit patients at home. Then, she points them to the clinic or similar agency.
"Community paramedic is connecting people with resources in the area," Whalen said. "That's not something that the paramedics have traditionally been trained in. They know where the hospitals are. The other things? It's always a little different."
The outcome? People get high-quality, consistent care. However, the program highlights a broken system.
Judy Evans is a pharmacist at Reach Out. She told FOX 45 it's usually the elderly and low-income that end up slipping through the cracks. They keep going to the hospital because when they're discharged, many can't afford medicine or medical equipment. Their symptoms keep coming back.
"I don't know about you, but I like to live," Evans told FOX 45's Shavon Anderson. "So do people who don't have insurance, and don't have doctors."
Evans sometimes fills as many as 100 prescriptions per day, with referrals and walk-ins. She often asks patients how they've been getting by.
"I have people tell me things like, 'I buy my insulin on the street,'" she said.
Though Evans can't say much, the answers are heartbreaking. Sometimes, she voices concern about safety.
"People are borrowing friends, family members' medicine," Evans said. "Some people say, 'You know, I just go through the trash, and hope maybe I can find something.'"
With Riverside's program in place, the ultimate goal is to cut non-emergency runs. Freeing up medics is especially important, since the department provides mutual aid to at least eight nearby agencies.
The shift also has another added benefit: saving money. In the city, ambulance prices fall into three ties. Transportation with Basic Life Support is priced at $666.25, according to Stitzel. Advanced Life Support can run patients $894.30, with the higher price billed at around $1,145.42.
Most cities rely on reimbursement from insurance companies, Medicare and Medicaid.
Money aside, the job is an extension of the already hard work done by our first responders. It's also glimpse into the future of healthcare.
"It's special," Balcom said. "Just simply, if someone tells you that you made a big difference in their life."
Right now, Riverside's model is funded through an EPA grant. The grant specifies that only patients with respiratory issues can qualify for the non-emergency home checks, including calls for equipment repairs/defects, radon testing, smoke detectors and air quality. Eventually, they'll expand to everyone.
"The more funding we have, I think the bigger impact we can have in the community and regionally," said Stitzel.
You don't have to contact the fire department if you need help from the Reach Out Clinic. Call them at (937) 258-2000.