Alameda paramedicine pilot set to launch

Alameda paramedicine pilot set to launch

Michele Ellson
Alameda Community Paramedicine Pilot

Firefighter-paramedics Stephen Lucero, Michael DeWindt, David Wills, Armando Baldizan and Patrick Corder will be providing some additional services starting in June. Photo courtesy of the Alameda Fire Department.

Paramedics with the Alameda Fire Department will soon be able to do more than ferry patients to the hospital and provide care on the trip there: They’ll also provide assistance to chronically ill patients after their hospital stay is over to make sure they are getting the care they need to avoid a return trip.

Alameda is one of more than a dozen California agencies participating in a statewide community paramedicine pilot that could pave the way to expand paramedics’ services beyond what state law now permits them to do in an effort to improve care, reduce costs and take pressure off overcrowded emergency rooms.

“We’re helping people understand what resources are out there, and how to access them,” said Patrick Corder, one of five Alameda firefighter-paramedics trained to participate in the pilot program. “We’re really excited about it.”

The pilot is set to launch in June.

Alamedans with one of a half-dozen chronic diseases who are hospitalized at Alameda Hospital or others in the Alameda Health System will be eligible for 30 days’ worth of post-hospital care from the specially trained paramedics, who will check to make sure patients suffering from congestive heart failure, pneumonia, diabetes or a handful of other chronic illnesses are taking their medications and performing other tasks required to remain healthy.

The paramedics will also work with frequent 911 callers who use emergency rooms as their primary mode of care with more appropriate services, a move that could reduce costs and what Corder said are now lengthy waits for beds in overcrowded emergency rooms.

“We had a crew wait for more than two hours a few weeks ago to get a patient off a gurney and into a bed,” he said.

Other agencies engaged in the pilot will deliver different services, including hospice support and follow-up treatment of tuberculosis.

The data gathered from the pilot will be used to determine whether the state Legislature should change state law to more permanently permit paramedics to provide such programs.

State law currently only permits paramedics to deliver patients who call 911 to a hospital emergency room, and they can only provide emergency care to patients until hospital staffers take over. But an aging population and a decline in the number of doctors available to serve them have prompted health care agencies to look at ways to improve care.

One other motivator: The Affordable Care Act, which docks Medicare payments to hospitals that have an excessive number of patient readmissions within 30 days of discharge.

A July 2013 report on the viability of community paramedicine programs prepared at the behest of the California HealthCare Foundation and the California Emergency Medical Services Authority determined that community paramedicine offered “a potentially promising solution” for addressing gaps in health care in the state. Its authors recommended that the state initiate a pilot to gather more information.

The report’s authors found that other paramedicine programs already in place reduced emergency room visits, hospital stays and costs. A program put in place by a private ambulance company in Fort Worth, Texas in an effort to reduce emergency room visits for frequent 911 callers was able to cut hospital admissions for 23 patients with congestive heart failure nearly in half, saving $16,000 per patient.

They found substantial support for the idea of community paramedicine, though some of the people they interviewed expressed concerns about whether the new programs would overwhelm the existing system’s capacity and paramedics’ skills and also, where the money to fund the programs would come from.

Local nurses’ unions recently voiced objections to the pilot, with spokespeople from two nurses’ unions questioning whether paramedics have the skills to provide such care.

Paramedics participating in the program received special training designed by the University at California, Los Angeles Center for Prehospital Care.

The pilot was approved for one year, with the possibility of an extension for a second year. Training began in January, and the pilot is expected to conclude in 2017.

Alameda County is allocating $1.25 million in Measure A health care taxes and ambulance provider fines to fund pilot efforts in Alameda and Hayward. The city will hire temporary firefighters to backfill for those who are piloting the program.

Related: Alameda to join paramedicine pilot