Fire district to introduce new home care program

The Point Roberts fire district is getting ready to implement a community paramedic program sometime in April, fire chief Christopher Carleton told commissioners at their regular board meeting on March 14. The program would offer a level of non-emergency home medical care, education and referral services for residents.

The program is authorized by RCW 35.21.930, the Community Assistance Referral and Education Services Act (CARES). The law was passed to address problems caused by high volumes of low-acuity or non-emergency 911 calls experienced by local municipalities. Many of these calls typically ended with a ride to the local ER.

CARES programs allow providers to offer non-emergency medical and educational assistance and referral to primary and other service providers. In Snohomish County, 911 calls were reduced by 60 percent and ER visits by 50 percent following the establishment of their CARES program. Similar programs have been established nation-wide; the first program began in 2011 in Mesa, Arizona. The federal government subsequently provided the city with a $12 million Innovation Award to expand the program. It subsequently added nurse practitioners to its personnel mix as did other cities such as Anaheim, Los Angeles, Denver and Riverdale, Georgia, among others.

In Washington state, the program requires fire districts to annually “measure any reduction of repeated use of the 911 system and any reduction in avoidable emergency room trips attributable to the implementation of the program.”

That won’t be an issue in Point Roberts, it seems. In eight months in 2017, the fire district had a total of 77 EMS responses, 36 of which required no transports.

In response to questions from the All Point Bulletin, Carleton replied, “Our most pressing issue does not lie in chronic “high users” of the 911 system. Many of the fire and medical issues we face are more connected to our unique status as U.S. exclave. We are looking for ways to help ease that difficulty and improve the healthcare status of our community in an easily accessible and imminently affordable fashion.”

Carleton provided a recent example of a resident who had required daily antibiotic infusions that could have been provided through a home visit program; instead, the resident spent a month in an expensive nursing facility. He added, “The Community Paramedic program can ensure that home care can be an effective option and help patients understand and comply with their provider’s home care instructions.  We also hope to assist patients recently discharged from hospital stays to adjust to their conditions, carry out effective home care, and reduce the need for additional hospital admissions.”

A prime component of the program will be fire commissioner Virginia Lester, a nurse practitioner who ran the Point Roberts Clinic for many years. Carleton is also seeking approval to bring on Deb Shields, an Advance EMT, as a physician’s assistant.

Addressing fellow commissioners, Lester told them, “I just want to underline that we don’t want to replace anything that has to do with the clinic; this is an extension of services to help people who don’t have access.”

Carleton echoed Lester, adding, “There’s no replication, no competition, [the program will] provide more services to the Point Roberts community.”