District to offer homecare visits

Hospital commissioner Candace Harper, l., fire commissioner Virginia Lester and fire chief Christopher Carleton listen to hospital commissioner Robin Nault. Photo by Pat Grubb

The Point Roberts fire department is poised to expand their services with a community paramedic program.

“The idea of our program is to go out into the community to those people who would like us to do home visits,” chief Christopher Carleton told hospital district commissioners at their January 4 meeting. Department paramedics and advanced emergency medical technicians would get an overview of a patient’s medical condition and concerns, review their medications and work with their primary care provider.

“If they don’t have [a provider ]our hope is to work with them to be part of the medical system and either become patients at the clinic or connect with some kind of primary care provider either in Canada or south of the border.”

The program is modeled on many in the state that operate under 2015 legislation allowing pre-hospital medical providers to serve patients in non-emergent situations. A primary goal for community paramedic programs is connecting with people who use 911 as their main avenue to receive medical care and get them connected to the wider medical care system. The new Point Roberts program has been approved by Whatcom County medical program director Marvin Wayne.

Fire district commissioner and licensed nurse practitioner Virginia Lester will be working with Carleton to expand the level of service the program can provide. “She can do things beyond what I might be able to do in a paramedic capacity,” he said, including writing prescriptions while patients transition to a primary care provider.

Services provided through the program would be free of charge.

Lester emphasized that the program was not intended to replace the services provided by the Point Roberts clinic and she has no intention of using it as a launchpad for her own practice. “I have no interest in taking these patients on as clients,” she said in a later interview. “The clinic does not make house calls. There is a void here and we are filling it.”

Carleton said the program could potentially bring clients to the clinic, rather than take them away.

‘We want to be partners in any avenue we can,” Carleton said. He added they would also be working with Circle of Care, the local group working with seniors. “We can get them involved if someone needs help to stay in their home and social support the county and state programs are not able to come to Point Roberts to provide.”

One focus would be on community members recently discharged from the hospital who might need to be checked or have a dressing changed, Lester said. Another would be connecting with those who don’t seek medical care until too late.

“I think there are people who are shut-ins and tend to stay shut in until they’re really bad and we get a 911 call,” she said. “We can reduce hospital readmittance and reduce the number of people who use 911 and emergency as their primary care provider,” Carleton said, adding they could transport patients to the clinic for services if a lack of transportation was the barrier to them getting medical services.

Along with the clinic and Circle of Care the program would be another avenue to connect people with a wide variety of social programs, and advocate to get them served in their community.

“We would do our best to get them involved in some way,” Carleton said. “My expectation is those agencies should provide what they provide in the rest of the county and come here to Point Roberts. Some do. It’s a matter of reminding people that Point Roberts is part of Whatcom County and we deserve the same access to services as anyone else.”

“I think this is great,” said hospital district commissioner Robin Nault. “There’s a need out there.” She said there had been discussions in the past about providing in-home services in conjunction with the fire department that had not moved forward because Unity Care, the company contracted to run the clinic, had not allowed nurse practitioner Natalié Davidson, whom they employ, to work outside the clinic.

“There has been a bit of a disconnect between the fire department and the clinic and I appreciate you guys coming in. I would love to see this mesh with the clinic,” she added.

Carleton said they were working on outreach and guidelines for the program. He said if there were less than 50 people interested in the service he, working with Lester and other emergency medical personnel in the district, could handle the program without operational changes.

“If we get 500, we’ll need to make some adjustments.”